391555 (ELEC)PERMIT NO. DEPARTMENT OF BUILDING & SAFETY DST
3 C C 5 COUNTY OF RIVERSIDE FIELD j
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
$
UNITS
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POWER OUTLET
Parcel No.
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ROOF DRAINS
GAR. SQ. FT. @
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Pl. Ck. Fee f
CAR P. SQ. FT. @
Lot Size
DRAINAGE PIPING
WALL SQ. FT. @
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+
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DRINKING FOUNTAIN
Electrical Fee Dbl Is I�
Zone Restriction
URINAL
SQ. FT. @
SMI Fee f
Plumbing Fee
Dbl $
ESTIMATED CONSTRUCTION VALUATION $
Bond Amt.
f
Plan No.
WATER PIPING
NOTE: Not to be used as property tax valuation
SWIM POOL, PVT
FLOOR DRAIN
MECHANICAL FEES
SWIM POOL, COMM
f
WATER SOFTENER
VENT SYSTEM FAN EVAP. COOL HOOD
SIGN
Supplimental Permit Numbers
WASHER (AUTO)(DISH)
APPLIANCE DRYER
Registr. Fee f
Mileage Fee f
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
Reinsp. Fee
f
LAUNDRY TRAY
AIR HANDLING UNIT CFM
IDLE METER
Tel.
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
Total Fees
WATER CLOSET
COMPRESSOR HP
POLE,TEMP/PERM
City
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
Received by
Trees required ...
SHOWER
BOILER B.T.U.
SQ. FT. @ c
BATH TUB
SQ. FT. @ c
Sewage System
WATER HEATER
SQ. FT. RESID @1'/.c
/%
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SEWAGE DISPOSAL
Zip
SQ. FT. GAR @ s/. c
HOUSE SEWER
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL.
TOTAL FEES
MOB.HM.FEE
MICRO FEE
MECH. FEE PL. CK. FEE
CONST. FEE
E. FEE
SMI FEE __[______FEE
PLUMB. FEE
PERMIT NO.
1391555-1
Job Address02 � � t�.J
Space
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Valuation
Date
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Pl. Ck. Fee f
Set Backs
Lot Size
Construction Fee Dbl f
Legal Description
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L. M! V
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Electrical Fee Dbl Is I�
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Group
Type
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Plumbing Fee
Dbl $
Bond Amt.
f
Plan No.
Ian Checker
Final Dot n e r
Unit
Sp. Insp. Fee $
Demol. Fee
f
Const. Lender
Branch
Supplimental Permit Numbers
Registr. Fee f
Mileage Fee f
Address City Zip
Witness Fee $
Reinsp. Fee
f
Owner/Agent
Tel.
Zip
Total Fees
f
Address J /' 7 +1,�
4 "C.�
City
Zip
M.O. N.C. Cash Chet r
Received by
Trees required ...
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License#
Sewage System
Address
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IIIf Sewer District
Form 284-208 (Rev.8�8) P 5
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF WORK
FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
I HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE WITH
THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA.
1 HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE SO IN
ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA.
verified by
NO.
OPERATION DATE
INSPECTOR
NO.
OPERATION
DATE INSPP:TOR
BUILDING APPROVALS
MECHANICAL APPROVALS
1
Set Back
33
Ventilation System
J
2
Ftgs 8 Frms
34
Plenums 8 Ducts
2A
Slab Grade
35
Furnace Comport.
3
Steel
36 Inlets
8 Outlets
4
Grout Blocks
37
Combustion Air
5
Bond Beams
38
Compressor
6
Roof Deck
39
Appl. Clearance
7
Framing
40
Fire Damper
8
Vents
41
Smoke Detection Device
9
Garage Fire Wall
42
Commercial Hood
10
Fireplace P. L. E]
43
Final
10A
Fireplace T.O.
P'
_
ADDITIONAL INFORMATION
~
SEWAGE SYSTEM SIZE & LOCATION
11 Exterior Lath
12 Internal Lath
12A Drywall
13 Finish Grade
INSULATION Thick R
Value
7A Walls (Batts)
12B Ceiling (Batts)
12C Ceiling (Blown)
14 Final
PLUMBING APPROVALS
15 Ground Plumb
16 Water Piping
17 Rough Plumb
18 Vents
19 Sewage Disposal
20 Sewer
21 Water Heater
22 Water Softener
23 Water Service
24 Gas Test
zs
Final
Tank Pit L.Line
REAR OF PROPERTY LINE
ELECTRICAL APPROVALS
PSL
P/
26 Power Pole
27 Conduit
28 Service Entrance
29 Wiring
29A Grounding Wire
298 Bonding
30 Fixtures
31 Service
32 Final
STREET NAME
NOTICE: THIS IS NOT A BUILDING PERMIT DISTRICT
APPLICATION TO CONSTRUCT Permit No
DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF RIVERSIDE
In
199 9/74 CANARY—FILE, PINK—APPLICANT
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Owner hitect Contractor
Addre Address Address — -
Ciry,,�����
Phone Phone
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I (we) the undersigned, hereby certify and acknowledge that I (we) have read the application and agree that if Curb and Gutter, and
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Paving, and/or Dedication of right of way is required by the County of Riverside, the Riverside County Department of Building and Safety
3
shall not make a Final Inspection until said requirements have been met. I am also aware that no work is to be done within the County R/W
O
without an encroachment permit.
NOW, therefore, it is agreed that I (we) will not -occupy said property and will ,not cause said property to be occupied until .I ,(we) have
complied with .all .laws of the County of Riverside and the State of California .governing said property.
DATE SIGNATURE OF OWNER AND/OR AGENT ---
Approval by Signature from the Following Departments Listed Below
Must Be Obtained Prior to the Issuing of a Construction Piermit.
1 SPACE NO.
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JOB ADDRESS ,_ — SINGLE FAMILY DUPLEX
LEGAL DESCRIPTION e
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OF PROPERTY
APARTMENTS AGRIC.
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— COMMERCIAL [ INDUSTRIAL ❑
COMMUNITY
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ALTERATIONS LJ
NO. OF SUBMITTED PLANS ____ USE OF PERMIT �"7'tr
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CASE NO.
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NO. OF PA KING SPACES REQUIRED NO. OF BUILDINGS NOW EXIST G -.-
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ZONE�ETBAC'KS: FRONT SIDE REAR
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GRADING PERMIT REQUIRED? YES `j NO ❑ LOT SIZE
SETBACK ORDINANCE # __— OF FEET REQUIRED ON STREET
DATE 3- SIGNATURE OF LAND USE OFFICIA
F
DEDICATION REQUIRED: YES ❑ NO ❑ NO. OF FEET___ t
CURB AND GUTTER REQUIRED: YES ❑ NO ❑ STREET
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IL
CAN CURB AND GUTTER FEASIBLY BE INSTALLED? YES ElNO ❑
HAS AN ACCEPTABLE APPLICATION BEEN MADE FOR ENCROACHMENT PERMIT FOR DRIVEWAY AND'; STREET
CIMPROVEMENT?
YES ❑ NO F1
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DATE _ SIGNATURE OF ROAD DEPT. OFFICIAL
Z
SWIMMING POOLS PUBLIC r
WSEWAGE
DISPOSAL
FOOD ,ESTABLISHMENT
= G
WATER -POLLUTION REMARKS
�n FLOOD CONTROL
W AIR POLLUTION
_ DIV OF HWY J
o a — YOUR PROPERT•Yf Y BE SUBJE TO
o FLOOD. RIVERSIDE COUNTY ASSUMES
NO RESPONSIBILITY IN EVENT OF FLOOD.
199 9/74 CANARY—FILE, PINK—APPLICANT
PERMIT NO.
391555
DEPARTMENT OF BUILDING & SAFETY FIELD OFFICE Dsr
COUNTY OF RIVERSIDE
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
Job AddressSpace
- `'� -
NO. PLUMBING FEES -71
IST FL.
2ND. FL.
POR.
GAR.
CAR P.
WALL
ESTIMATED CONSTRUCTION
SQ. FT. @ $
UNITS
4 ,q ��!
Valuation
$
SQ. FT. @
YARD SPKLR SYSTEM
MOBILEHOME SVC.
SQ. FT. @
BAR SINK
POWER OUTLET
SQ. FT. @
ROOF DRAINS
SQ. FT. @
DRAINAGE PIPING
SQ. FT. @
DRINKING FOUNTAIN
SQ. FT. @
URINAL
VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
SWIM POOL, PVT
PI. Ck. Fee y
FLOOR DRAIN
MECHANICAL FEES
SWIM POOL, COMM
Construction Fee Dbl E
WATER SOFTENER
VENT SYSTEM FAN EVAP. COOL HOOD
SIGN
5
WASHER (AUTO)(DISH)
APPLIANCE DRYER
Zone Restrict' ,
'~
Group
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
Plumbing Fee
Dbl $
LAUNDRY TRAY
AIR HANDLING UNIT CFM
IDLE METER
Final Da�te
/ — ! %
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
Sp. Insp. Fee E
WATER CLOSET
COMPRESSOR HP
POLE, TEMP/PERM
Branch
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
00SHOWER
Mileage Fee $
BOILER B.T.U.
SQ. FT. @ c
Reinsp. Fee
BATH TUB
Owner/Agent
SQ. FT. @ c
Tel.
WATER HEATER
Zip
SQ. FT. RESID @11hc
Total Fees
SEWAGE DISPOSAL
AddressCity
i
SQ. FT. GAR @ 1% c
HOUSE SEWER
M.O. N.C. ash Check
Received byantra
Trees required
GAS PIPING
PERMIT FEE
PERMIT FEE
4ELSE
/
PERMIT FEE
DBL.
TOTWE
MOB. HM. FEE
MICRO Fq
MECH. FEE PL. CK. FEE
I CONST. FEE
SMI FEE
FEE PLUMB. FEE
PERMIT NO.
3 915 5 5
Job AddressSpace
- `'� -
Zip
Owne
Com unity
4 ,q ��!
Valuation
$
Date
w T �
Dist.
I(
Off.
.—
fk.C.
MH.Permit Fee $
Micro Film Fee
Cop E
Use of Permit Ae f t/� //
!J S� / i >� t� -y-
v
Parcel No.
rO
Use/Case No.
Ck. By
Mech. Fee Dbl 5_
PI. Ck. Fee y
Set Backs
Lot Size
Construction Fee Dbl E
legal Description
k-4 , %
.
A
1.� L V r,t
F
5
S R
Electrical Fee Dbl $
Zone Restrict' ,
'~
Group
Type
SMI Fee $
Plumbing Fee
Dbl $
Bond Amt.
$
Plan No.
Ian Checker
Final Da�te
/ — ! %
Pr
o
Inspector1
f
Unit
Sp. Insp. Fee E
Demol. Fee
is
Const. Lender
Branch
Supplimental
Permit Numbers
Registr. Fee $
Mileage Fee $
Address City Zip
Witness Fee $
Reinsp. Fee
y
Owner/Agent
Tel.
Zip
Total Fees
s
AddressCity
i
Zip
M.O. N.C. ash Check
Received byantra
Trees required
for
T &.
`
�
Tel.
/
License#
iewage System
Address
ll
City Zip
[,� �. x
T LL P
Sewer District
'AlForm 284-208 (Rev.8/78) P 5
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF WORK verified by:
FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
I HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE WITH
THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA.
I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE SO IN
ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA.