369010 (MECH)BUILDING PERMIT - —
PERMIT NO. DEPARTMENT OF BUILDING & SAFETY FIELD Dsr
369010 COUNTY OF RIVERSIDE /M
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
Owner
3690101
UNITS
IST FL. SQ. FT. @
Community
f:Y' /moi —1
2ND. FL. SQ. FT. @
Date
1 l/.r' —'//- 77 ---
Dist.
YARD SPKLR SYSTEM
F.C.C.
MOBILEHOME SVC.
BAR SINK
POR. SQ. FT. @
Micro Film Fee
Cop $
GAR. SQ. FT. @
Parcel No.
'� �o -r�
POWER OUTLET
ROOF DRAINS
CAR P. SQ. FT. @
PI. Ck. Fee s
DRAINAGE PIPING
WALL SQ. FT. @
Lot Size
Construction Fee Dbl $
DRINKING FOUNTAIN
Legal Description F
r
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/ `✓ L� �'Y/ !
S S R
Electrical Fee Dbl s
URINAL
SQ. FT. @
Group '1`k
Type -
..
ESTIMATED CONSTRUCTION VALUATION $
SMI Fee
s
WATER PIPING
NOTE: Not to be used as property tax valuation
SWIM POOL, PVT
FLOOR DRAIN
MECHANICAL FEES
Dbl $
SWIM POOL, COMM
WATER SOFTENER
VENT SYSTEM FAN EVAP. COOL HOOD
Plan Checker
-
SIGN
WASHER (AUTO)(DISH)
APPLIANCE DRYER
Demol. Fee
$
GARBAGE, DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
Supplimental Permit Numbers
Regisir. Fee $
LAUNDRY TRAY
AIR HANDLING UNIT CFM
IDLE METER
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
Reinsp. Fee
TEMP USE PERMIT SVC
WATER CLOSET
COMPRESSOR HP
1,00POLE,TEMP/PERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
$
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
M. 0. N.C. Cash Check
SQ. FT. @ c
BATH TUB
Contractor fit✓ ` 'Y / t tai
') U �'�'�
�
SQ. FT. @ c
WATER HEATER
SQ. FT. RESID @1'/.c
SEWAGE DISPOSAL
SQ. FT. GAR @ '/. c
HOUSE SEWER
Sewoge System
GAS PIPING
PERMIT FEE
f U
PERMIT FEE
PERMIT FEE
DBL.
TOTAL FEES
610
MOB. MOB. HM. FEE
MICRO FEE
MECH. FEE
f� U
PL. CK, FEE
CONST. FEE ELECT. FEE
SMI FEE --F
FEE PLUMB. FEE
I HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE WITH
THE LAWS OF RIVERSIDE COUNTY AND, THE SThTE OF CALIFORNIA.
PERMIT NO.
Job Address - Space
Zi
T.
Owner
3690101
..,,�✓-
Community
f:Y' /moi —1
Valuation
E
Date
1 l/.r' —'//- 77 ---
Dist.
Off. '
F.C.C.
' MH Permit Fee S
Micro Film Fee
Cop $
Use of Permit
(',Qr/�. '' t r�a'�
Parcel No.
'� �o -r�
Use/Case No..
Ck. By
.-�.:
Mech. Fee Dbl
PI. Ck. Fee s
Set Bocks
Lot Size
Construction Fee Dbl $
Legal Description F
r
�) -y-� /rf 1�C1 y
/ `✓ L� �'Y/ !
S S R
Electrical Fee Dbl s
one Restrictions
"e —/
Group '1`k
Type -
..
SMI Fee
s
f�,v Cl,� / ✓` rr+ i
Plumbing Fee
Dbl $
Bond Amt.
$
Plan No.
Plan Checker
-
Final Dat �� spa r Unit
(/
Sp. Insp. Fee $
Demol. Fee
$
Const. Lender Branch
Supplimental Permit Numbers
Regisir. Fee $
Mileage Fee s
Address City Zip
Witness Fee 5
Reinsp. Fee
$
Owner/Agent
Tel. Zip
Total Fees
$
f
Address
City Zip
M. 0. N.C. Cash Check
.Received by ��
�'j
Contractor fit✓ ` 'Y / t tai
') U �'�'�
�
Tel.
LicenseY
Trees required
Sewoge System
AddressCit
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/�'-/
/fir
/Y/'��j' ! Zip
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THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CE TION OF WORK verified by:
FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
T LL
P
Sewer District
I HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE WITH
THE LAWS OF RIVERSIDE COUNTY AND, THE SThTE 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.
Form 284-208 (Rev.8/78)
NO.
OPERATION DATE
INSPECT -.`,R-
-NO.
OPERATION
DATE INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
1
Set Back
33
Ventilation System
2
Ftgs & Frms
34 Plenums & Ducts
2A
Slob Grade
35 Furnace Comport.
3
Steel
36 Inlets & 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.
43 Final
JOA
Fireplace T.O. ❑
No
ADDITIONAL INFORMATION
SEWAGE SYSTEM SIZE & LOCATION
11 Exterior Lath
12 Internal Lath
12A Drywall
13 Finish Grade
INSULATION Thick R
Value
7A Walls (Botts)
12B Ceiling (Botts)
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
25
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
29B - Bonding
30 Fixtures
31 Service ._
32 Final
STREET NAME
NOTICE: THIS IS NOT A BUILDING PERMIT
APPLICATION TO CONSTRUCT
DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF RIVERSIDE
DISTRICT
Permit No
284 199A 9/74 CANARY—FILE, PINK—APPLICANT
LV a C
Owner Architect— —" _ Contractor _
Address 9'12B 1_CwtjAddress___ Add res (._LL_CAk1"_1ft�L__1?K
city �- s11(�12�_ city-----
Phone "— Phone _ Phone —7 45
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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 wilt 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 List?.e
Must Be Obtained Prior to the Issuing of a Construction Permit.
I SPACE NO.
USE OF STRUCTURE
JOB ADDRESS O SINGLE FAMILY DUPLEX
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LEG L DESCRIPTION OF PROPERTY
--�� -- APARTMENT E:] AGRIC.
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— -=L COMMERCIAL INDUSTRIAL
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COMMUNITY --- , ALTERATIONS [�
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NO. OF SUBMITTED PLANS _ USE OF ERMIT I
L
CASE NO.
-
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NO. OF PARKING SPACES REQUIRED "— NO. OF BUILDINGS NOW EXISTING —
o
ZONE; \ SETBACKS: FRONT SIDE REAR
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m
GRADING PERMIT REQUIRED? YES ❑ NO ❑ LOT SIZE
SETBACK ORDINANCE ## OF FEET REQUIRED ON EET
DATE _155� % _�SIGNATURE OF LAND USE OFFICIAL
(
DEDICATION REQUIRED: YES ❑ NO ❑ NO. OF FEET_—
W
CURB AND GUTTER REQUIRED: YES ❑ NO ❑ —STREET
i
f-
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CAN CURB AND GUTTER FEASIBLY BE INSTALLED? YES ❑ NO ❑
W
HAS AN ACCEPTABLE APPLICATION BEEN MADE FOR ENCROACHMENT PERMIT FOR DRIVEWAY AND STREET
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IMPROVEMENT? YES ❑ NO ❑
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DATE _ SIGNATURE OF ROAD DEPT. OFFICIAI
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SWIMMING POOLS PUBLIC
a
SEWAGE DISPOSAL
FOOD ESTAB.LiISHMENT
= O
WATER POLLUTION — REMARKS
FLOOD CONTROL—
z AIR POLLUTION
_ DIV OF HWY
c a — YOUR PROPERTY MAY BE SUBJECT TO
o
c FLOOD. RIVERSIDE COUNTY ASSUMES
NO RESPONSIBILITY IN EVENT OF FLOOD.
284 199A 9/74 CANARY—FILE, PINK—APPLICANT
BUILDING PERMIT
PERMIT NO.
369010
DEPARTMENT OF BUILDING & SAFETY
COUNTY OF RIVERSIDE
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES NI
IST FL.
2ND. FL.
FOR.
GAR.
CAR P.
SQ. FT. @ $
SQ. FT. @
SQ. FT. @
Community
/ A,/ Y
UNITS
MOBILEHOME SVC.
SQ. FT. @
SQ. FT. @
POWER OUTLET
WALL SQ. FT. @
SQ. FT. @
ESTIMATED CONSTRUCTION VALUATION $
F.C.C.
MH. Permit Fee E
NOTE: Not to be used as property tax valuation
Useof Permit 1/l ..sem'
/ F /fJ /, !� /(, 0� I
SWIM POOL, PVT
MECHANICAL FEES
Ck. By
SWIM POOL, COMM
VENT SYSTEM FAN EVAP. COOL HOOD
Set Backs
SIGN
APPLIANCE DRYER
Legal Description F
S 5 R
FURNACE UNIT WALL FLOOR SUSPENDED
one Restrictions
ie
Group +c.w
AIR HANDLING UNIT CFM
SMI Fee E7.'.
IDLE METER
ABSORPTION SYSTEM B.T.U.
Pion No.
TEMP USE PERMIT SVC
COMPRESSOR HP
Unit
POLE,TEMP/PERM
HEATING SYSTEM FORCED GRAVITY
Const. Lender Branch
AMPERES SERV ENT
BOILER B.T.U.
Mileage Fee $
SQ. FT. @ c
Witness Fee $
Reinsp. Fee 1 $
SQ. FT. @ C
Tel. Zip
SQ. FT. RESID @1'/.c
Address
City Zip
SQ. FT. GAR @ 3% c
Received by
Controcto,;K�
T!!/ '42�,� r /"�' %� +
Tel.
PERMIT FEE
1:00
PERMIT FEE
DBL.
TOTAL FEES�
MOB. HM. FEE
MICRO FEE
MECH. FIEF!
PL. CK. FEE
I CONST. FEE ELECT. FEE
PERMIT NO.Job
69010..�
369010
Address - Space
r (�-N
Zip
Owner
Community
/ A,/ Y
Valuation
$
Date,,.
4) // 7
Dist.
//
Off.
F.C.C.
MH. Permit Fee E
Micro Film Fee Cop E
Useof Permit 1/l ..sem'
/ F /fJ /, !� /(, 0� I
Parcel Noo.. %� �%% �,/�
�,� I —1 3 '" 4'1
Use/Case No.
Ck. By
Mech. Fee Dbl $ !/
PI. Ck. Fee E
Set Backs
Lot Size
Construction Fee Dbl $
Legal Description F
S 5 R
Electrical Fee Dbl E
one Restrictions
ie
Group +c.w
Type
SMI Fee E7.'.
Plumbing Fee Dbl $
Bond Amt.
E
Pion No.
Plan Checker
Fina Inspe r
Unit
Sp. Insp. FeeS
Demol. Fee $
Const. Lender Branch
Supplimental Permit Numbers
Registr. Fee $
Mileage Fee $
Address City Zip
Witness Fee $
Reinsp. Fee 1 $
Owner/Agent
Tel. Zip
Total Fees E
Address
City Zip
M. 0. N.C.0 Cash El Check
Received by
Controcto,;K�
T!!/ '42�,� r /"�' %� +
Tel.
License#
Trees required
Sewage System
AddressCiy
1 .:�� _
t Zip
T LL P THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESS4TION OF WORK verified by:
`Sewer District FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
I HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE ItNCCORDANCE WITH
(DSTHE LAWS OF RIVERSIDE COUNTY ARID THE STATE OF CALIFORNIA.
I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE SO IN
CCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA.
Form 284-208 (Rev.8/78) @s ,