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353816, 366915 (SFD)PERMIT_NO: DEPARTMENT OF.' BUILDING S SAFETY FIELD 3 5J O CdUNTY` OF RIVERSIDE J 81 4 .1. L ail y M ..j._ZCQNW5TR. CTION' J s. Spoe :� NO. ;- • ELECTRICAL FEES ` NO. I PLUMBING'FEES 33816NO. i ' SQ. FT @ $ �.y.. UNITS 1.. IST FC. SQ. FT �4�.. �-i ty F -ARQ SFKLR SYSTEAA a, . ` 2N6. FL: R MOB ILEHOME;SVC. BAR SINK Use of Permit SQ. FT Us ( s Y . POWER OUTLET ROOF DRAINS _ Mach. Fee? Dbl, E Md GAR/t., ' SQ. FT 4 ' _ { .. DRAINAGE' PIPING . 1NXLL SQ. FT. ®. Construct n Fee D61 E LagoLDaxriphon - ft' '- rl�j i +•�. ir3'' `f 0-2 DRINKING FOUNTAIN Zone,I ie�•o .. qqi SQ. FT 1!r%F � i Type - - , 'URINAL- 'r/ESTIMATED CONSTRUCTION VALUATION; WATER.PIPING.._, 4 •Bond Amt Lir NOTE: Not to be used as property.tax valuofion. ; '.f `SWIM POOL, PVT FLOOR'pRAIN' ` naor S l/ MECHANICAL'FEES 3 : ': • SWIM POOL,'COMM, - WATER SOFTENER E: NT''SISTEM FAN. EVAP. COOL, .., HOOD ..},_ - �''-: ' "� SIGN -- '- ,WASHER`,(AUTO)(DISH)' APPLIANCE t DRYER Lender r -" - +' - - GARBAGEDiSPOSAL. , Mileagla'Tee ' E FURNACE.. UNIT WALL FLOORfSMSPENDED.-}�;ta•l+r ��•.�r y 1 tl 'ONORY TRAY.'' Owner/Agent AIR HANDLING UNIT s t, „" CFM rrt ,'-; IDLE•�METER ._ :; ;KITCHEN SINK City ,/? ZIp :„"?' �'�F'�i s°�1,. a ..'.x•` rf sit. ABSORPTION'SYSTEM' B'T'U TEMP;USE PERMIT SVC` WATER CLOSET Contract' ` - _ r ,r,;' COMPRESSOR >' HP; ,, c t.. i " C Llcensel POLEJEMP%PERM LAVATORY' SewugeSystemr HEATINOSYSTEM FORCER , GRAVITY ° ? ~ Kt l r AMPERES SERV'ENT 1 SHOWER ' BOILER, I B.T.U. SQ. FT: �1 .. c 41:r BATH TUB' SQ. FT WATER•HEATER' �_ r. Q.. FT; RESI%a SEWgGE'DISPOSAL- ,SQ. FT. GAR;@ 'i'..t- 'HOUSE SEWER - 1 T GAS PIPING PERMIT FEE j�^ PERNUT`FEE. ";PERMIT FEE' DBL..' j -J- Fji' MOB HM FEE. 'f•- ' ' MICRO FEE * �f -y, �n .•�_. MECH FEE •7 CONST FEE • . ELECT. FEE 1: SMI* FEE FEE PLUMB. FSE" ' .' :� o. is rei► - +i. ;>�y .. .� �! •r'. PER '' J s. Spoe :� - Z �"' /,(•1r% �� 33816NO. tIV aluation Sit/. F.CC . MH.Permi�i Fee _ ! ' fv Micro.Filr�Fee Cop Efw Use of Permit Igo Us ( s F - Mach. Fee? Dbl, E Md ,L-•`✓ 'a,y!�'"'�,•.. 'tki .Lott. - F �5'' -• j 5 •' ., �PI.,Ck.fe E `vfe Construct n Fee D61 E LagoLDaxriphon - ft' '- rl�j i +•�. ir3'' `f 0-2 y '_' Electriml pee - Dbl E� Zone,I ie�•o .. Gr Type SMI Fee [yr PlumbingnFee DbIE�,. _ 4 •Bond Amt Lir i •' naor S -Unit Sp. ImpylFee E E: _ ••��ranch n j,.," - Demol."'Fee''It E'Ccnst Lender r -" - +' - Sup/,,�II 1 Permit Numbers 1 ((� - - ,r. Registr.LLFee i � E" Mileagla'Tee ' E 'Address ,'' : City zip .Reiri4p, Fse _ E - Owner/Agent Tel Zip, �.Tgtal Fees. f 9ddrebs= - - �`• - r 1,',,' 'Sr g},;•r.L s -v t'ML rx City ,/? ZIp :„"?' �'�F'�i s°�1,. a ..'.x•` rf sit. 1. I Contract' ` - _ r ,r,;' Tel - il;+ - - "_ �' Llcensel iRecelr rb • ,f - 4 Y i S. JOrt ,Trees jequired q,' - • SewugeSystemr Address III' f City 1 :i`' :Zip. itLL P IS PERMIT SHALL'BECOME'VOID IFWOk IS NOT COMMENCED WITHIN 120 CVS..CESSATION OF WORK verified F R 120 DAYS ;SHALL,ALSO CAUSE PERMIT TO BECOME VOID.' y I HEREBYAGREE THAT ALL WORK IN CONNECTION`WITH THIS PERMIT WILL BE NE IN ACCORDANCE'WITH / _THEIAWS OF RIVERSIDECOUNTY;AND-THE STATE OF CALIFORNIA. i 1 HEREBY CERTIFY THAT THE INDIVIDUAL„WHO. PREPARED THE PLANS AND SPECIFICATI©NS HAS DONE SO IN r +( ev:BY78) ACCORDXNCE WITH SE' C '554UbF THE9BUSINESS AND PRC7FESSIONS�`Oi1E O fiHE STATE OF',CALIFOkNCA: NO. OPERATION DATE INSPECTOR NO. OPERATION DATE INSPECTOR BUOLD9MG.APPROVALS MECO-0AMUCAL APPROVALS 1 Set Back 33 Ventilation System 2 Figs 8 Frms 34 Plenums & Ducts 2A Slab 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 10A Fireplace T.O. E QO ADUTDONAIL IMPORMAT9OM g ' SEWAGE SYSTEM SUZE LOCAU60 M 11 Exterior Lath i 12 Internal Lath 12A Drywall 13 Finish Grade INSULATION Thick R Value 7A Walls (Batts) 12B Ceiling (Botts) 12C Ceiling (Blown) 14 Final PLUMBIM0 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 P/L MEAN OF PROPERTY LINE ELECTRICAL APPROVALS P/ 26 Power Pole 27 Conduit 28 Service Entrance 29 Wiring 29A Grounding Wire 29B Bonding 30 Fixtures 31 Service 32 Final STREET NAME PERMIT NO. ,366915.1'..* Mach Fee PERMIT NO. DEPARTMENT'OF.BUILDING &SAFETY':... FIELD ? `DST Electrical Fee 3669 15 SMI Fee COUNTY OF AIVERSIDE'. r` Plumbing Fee. Db! s -Sp. Insp. Fee 7 CONSTRUCTION ESTIMATE $ NO. ELECTRICAL FEES; NO. PLUMBING r rs ' '2 :7Z V `t ���d ��� UNITS f is IST FL. SQ. FT. a Total Fees �i $ 2ND. FL. SQ. FT, N.C.171 Cash Received by - YARD SPKLR-SYSTEM ' FOR. .5 �, G_a / MOBILEHOME SVC, . ,v _BAR SINK. ^ Ci GAR., ,SQ. FT. Q 4,%0 Q+� POWER:OUTLET ROOF DRAINS I ' CAR P. SO. FT-.'@. 1, ,- . • ,r DRAINAGE PIP,ING., «- WALL S 'SQ. FT.. ® 2 ' DRINKING FOUNTAIN' ISQ. FT - URINAL ESTIMATED CONSTRUCTION VALUATION $' - WATER'P,IPING _ 2G�j NOTE: Not to be used as property tax .valuation SWIM POOL, PVT FLOOR DRAIN,. MECHANICAL FEES SWIM POOL; COMM WATER,SOFTENER _ VENT SYSTEM FAN EVAP. COOL 'HOOD SIGN WASHER (AUTO*SH) L APPLIANCE' DRYERGARBAGE DISPOSAL _Ala FURNACE UNIT WALL FLOOR SUSPENDED LALINDRY'TRAY AIR HANDLING UNIT CFM IDLE METER : ,, :1fITCHEM1IiSINK'i ABSORPTION SYSTEM B:VU. TEMPUSE PERMIT SVG• _ 4eWATER CLOSET COMPRESSOR HP?t7 POLE,TEMPLPERM - LAVATORY ., j{j^' 7D HEATING SYSTEM_ FORCED GRAVITY w �A D AMPERES'SERV ,ENT fy? C ; SHOWER "' . •• ' '- �' f1V' BOILER B.T.U. SQ: FT:.: Co3 c. .• BATH TUB SQ. FTS C�°..;. c' ; ;.WAT!R'HEATER : 4116j 5,SQ. F.T. REND (gT l t/�',C0 . -`'"+e C� SEYVAGE' DISPOSAL HOUSE SEWER GAS PIPINGE)d/S L'liri PERMIT FEE Q PERMIT FEE °. (j 0 ,'PERMIT FEE I DBL. TOTAL FEES IMOB.HM.FEE' MIC FEE ; MECH. FEE' C FE 'CONST -.FEE ELECT.4EE'?,-. 1 --� EE FEE1 PLUMS FEE PERMIT NO. ,366915.1'..* Mach Fee Dbl S PI Ck.,Fee odS Construction. Fee. Dbl $ Electrical Fee DbI E SMI Fee t Plumbing Fee. Db! s -Sp. Insp. Fee $ ,Demo!. Fee $ ''Registr...Fee f ;,Mileage Fee. 3 :r Witness Fee f Reinsp. Fee $ Total Fees �i $ A.O..Ll N.C.171 Cash Received by - Trees required Sewage•system - U. {� lazo Foim:284208(Rev:8/78j Check Job Address // ,io cpce ;:Zip Alow..,tij'J t1ii ry F �i r t cyG rti corn,unity/ - Valuation - ` t tom, Data -"Dist Off.. F.C.C. Aj Use of Permit - ,r.Parcel No. Use/Case,No. / •�' r' �� I� 4 /} LV % �� / ! �'-' �• s � - - ' :lot Size _. Legal Description Set,Baclis - S .. f, R • - .7-.� / - - ZoneAesiri Tions'' Group' _ Type Bond Amt._ Plan No. _ - Plan'Ch -kerfinal Date Inspector. a, - nit. Const. Lender 'Branch4qp�11.,P._6,nilt Number's• Address, City Zip2. /.11; 01 A a �,�` `.r.{. ✓' rr _ 'Tel. - ,,• �. Address City ` -✓ V /� � �x �'• - M1.,: i+' y, +n._ V r%CC''!•.'1 yw- ':�'.u'Y'w .r Contractor - - '' 'Tel •"` °'`' 'r .' .Llcense# _Address City - Zip - P THIS PERMIT SHALCBECOME;VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS.. CESSATION OF WORK verified by:q. FOR 1120 DAYS SHALL ALSO U PERMIT'TO BECOME VOID. I HEREBY AGREE T '444 l 10N WITH THIS PERMIT WILL BE DONE' IN ACCORDANCE WITH THE LAWS OF RIVERSI D THE STATE OF CALIFORNIA. I.HEREBY'CERTIFY THAT TIRE INDIVIDdAL-WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE SO IN A RDANCE WITH'SECTION 5541 OPTHE BLtS KSS AND PROFESSIONS, CODE OF THE STATE OF.'CALIFORNIA. I NO. OPERATION DATE INSPECTOR NO. OPERATION DATE ,tiNSPECTOR BUOLDIMG APPROVALS AR[ECHAMICAL APPROVAU I Set Back :"0 1 9 �� 33 Ventilation System 2 2A figs 8 Frms Slab Grade Z 34 Plenums 8 Ducts z_ 35 Furnace Comporl. 3 Steel 36 Inlets=8 Outlets 4 Grout Blocks 37 Combustion Air _,ejG.pp�% 5 Bond Beams 38 Compressor z -f-c- d0 6 Roof Deck ,Z 39 Appl. Clearance 7 Framing U'� .- :9 40 Fire Damper B Vents 41 Smoke Detection Device�� 9 Garage Fire Wall 42 Commercial Hood /Ar/a 10 Fireplace P. L. E] 43 Final Z� �lyJp�l IDA Fireplace T. 0. OP'N A®®ITIOMAL ONFORARATIOkI NO. - SEWAGE SYSTEAR SIZE � LOCATIOM 11 Exterior Loth 12 Internal Loth 12A Drywall 1 13 Finish Grade INSULATION Thick R Value 7A Walls (Batts) 12B Ceiling (Batts) A0��. 12C Ceiling (Blown) 14 Final 15 Ground Plumb 1,` 16 Water Piping 17 Rough Plumb 18 Vents )9 Sewage Disposal 20 Sewer 21 Water Heater '�-. — ��/`j► 22 Water Softener 23 Water Service 24 Gas Test %-Z -80 25 Final Fin z.. _ y� � 7 Tank Pit I-Aine REAR OF PROPERTY (LINE (ELECTRICAL APPROVAU • P/L /' P/ S 26 Power Pole 27 Conduit 28 Service Entrance 1 29 Wiring /�.Z(��%9 QCi 29A Grounding Wire 298 Bonding 30 fixtures -Z-^ 31 Service 32 Final f. STREET NAME s - - ,e -mar' + .. ' v '• `• '•.1 NOTICE:- THIS IS. NOT A BUILDING PERMIT DIST RI CT J APPLICATION TO CONSTRUCT t DEPARTMENT OF BUILDING A14iD SAFETY COUNTY 'OF RIV.ER,SIDE -..�':. 2841:199 9/74 -J CANARY —FILE; PINK— ePLICANT i Owner P,irehitect11 =3+G5fi_ ''!'I'f.'z/Cr Coritractor��y/'�G Cf_ Address Address-! i4ddressL city<L�� c;,>L,1>r rr._ Cttyr�;r d+f�u�C crt,, .9 Phone '� Sr Phone, G `1 "Phone S 7 7] I (we) the uide►.gned,:hereby rrrt�fy and a[krior.tedge that I,(we) have re appt�cafion and agree that. if Curb and Gutter, and _/ ing,.and/or Dedication .of:rii ht of way is required bV. -Jhe County of Riyers� /f{e Rrperside Caunfy 'Department of Building: and Safes — Fiave•tieen -work �. Z - •=.3 - - shall not make a fnaG Inspection, until: said requirements. met I,.-' -ako aware that no is to be done withini ,fhe County R%(W O 1; without an en:roachment permit. NOW,, therefore; rt is a reed that-I'(we) viih:not OctuQY �d Druperty and will' no' cause, sai�d..R� -now, a to -be .occupied =until ; (we) have cinpl,ed with all laws of `County of Riverside and*tf11ea9tate o} California governing said.p or pert?: DATE ,.':SIGNATU.RE::O-F,OWNER-AND/OR AGENT= �/J ,. - / ft ! PProval by Eighatu a^from the Following Departrnenta Gated Below Must Be Obtained 'Prior fo `Nie•,Issuing of a-:Corititruetion Permit SPACE USE OF STRUCTURE :. JOB�ADDRESS f a 14 = I �"-- :7Et3r !�'',! ;- :.SINGLE FAMILY DU.PLE.X 0 1 X F. 'O11m--•,rt••` LEGAL DESCRIPTION F PROP RTY -� t� !; AP.ARTM'ENT.S FAGRIC Q`- �;c.,.i�z+,-. 'o'..,, - , .fes •% _ - _ 4.COMMERCIA,''L INDUSTRIAL El ��p AITY LTERATIONS [] US OFrgEF�M`I,Ta� =� �' N(�OFSU,BMISTEDs� AN = W 1A CASE N0. 'a+ ® f - - rN0 OF FARKING`'SRA ES REQU.IREO N0..'0 F BUILDINGS NOWEXISTING'. �. p i ` ZONE '� tETBACKS:- FRONT, SIDE 's REAR f mi GRADING''PERMIT REQUIRED?- YES n NO' ❑ SIZE ,.LOT' _ 'SETBACK ORDINANCE # -OF - FEET'REQUIRED ON - STREET DATE,—_ '! - SIGNATURE OF L'AND.US,E:OFFICIAL! r -- F t� DEDICATION REQUIRED -'O YES NO ❑ "'NO. OF FEET__— l 1� FAL ru" V CURB .AND GUTTER REQUIRED' Y.ES 'p NO: ❑ ''�?`.iir} REET L'r d CAN CURB' AND GUTTER FEASIBLY BE..ANSTALLEDd _ Y ES.Q NO ❑ t HAS AN ACCEPTABLE, APPLICATION.:BEE MADE" FOR ENCROACHMENT PERMIT FOR DR�W�f OD STREET IMPROV:EA�AEty�f' ES O` ❑ , ��1^C-�, r '' . --'�J � J�-t�✓t� DATE ! SIGNATURE OF 'ROAD DEPT OFFICIA _ SWIMMING POOLS PUB I,4 � Us wSEWAGE: DISPOSA `- ��- =.•_FOOD. ESTABL•ISHM_ ENT 'WATER ',POLLUTION REMA�tK$" - �w FLOOD CONTROL Lr_ W AYR POLLUTION . - - -� W DIV OF HWY - o YOUR TTO YOU OPERTY MAY BE SUBJEC_ o--- "'`' FLOOD.='•RJVERSIDE COUNTY ASSUMES �- _ - - 'NO RESPONSIBILITY IN'EVENT OF FLOOD. 2841:199 9/74 -J CANARY —FILE; PINK— ePLICANT i .. ne W 3 O ad 0c tl > J LL 544 m' od �! d = W Z � Z a .`.1 O IL g< 7 .. APPLICATION FOR TREE PLANTING 1_(we), the undersigned,, hereby certify and acknowledge that I (we) have read the application and agree that: if trees, are required under Rimer - side County Ordinance No., 457, the applicant agrees to install said trees priorto,final inspection. Itis understood that no final inspection will be given until said requirements have been met or exception has been granted by the County. Now, therefore, it is aggreed that the prop- erty owner shall cause the property lines to be surveyed in the event no survey stokes can be found. Further, it is agreed that the County of Riverside shall assume no responsibility shopild tr es have to be rem ved due to lot line errors. Owner's Name / R.' 11 Permit. No. Mailing Address. �- 45 City / State Zip_ ZZ Job Address 4 S fiC !c: Wil " L/¢ Q ':) "-/?- Community 4-10- 4�A2' Legal Description r Z Assessor's Map, Book 8 Rage Type Structure Type of Soil Is water available Road Dept. Plot Plan No. Type of existing trees in road right—of—way Trees, preferred by appli' t (.1 T/�iL L L%L (2) L s` (3) Date Owner's Signature Planning Commission Case No.. -� ROAD DEPARTMENT APPROVAL Approved species Olea eurouaea (Olive) Number of treedt 1 siacing,of trees Distance from lot lines: Front 2' in R/W Side Additional requirements Per plot plan on reverse. Date Building and Safety notified 6/79 Signature REQUEST -FOR EXCEPTION Reason Request for hearing: YES,❑ Owner's Signature (attach additional page (Forward application to Planning Dept: if exception requested) NO1 REQUEST FOR HEARING. Planning Dept. Concur ❑ Non -concur ❑ Explanation Date Signature Road Dept. Concur ❑ Non -Concur ❑ Date Signature v REQUEST FOR HEARING AND COMMITTEE DECISION z. Z'd Date hearing established Date hearing notice mailed to owner us .j Approved ❑ Disapproved ❑; Date Owner notified of decision IL Date Building& Safety notified Signature BUILDING PERMIT WATER HEATER Zip �J��- PERMIT NO. DEPARTMENT OF BUILDING S ,FIELD OFFICE `•D 366915 ,SAFETY' COUNTY OF RIVERSIDE' • .. Uselof Permit ' - -- r "Pcieccel GT �� 4,V l CONSTRUCTION ESTIMA NO ELECTRlC;4L,FEES, - _ _ . , ;NO ` PLWNIBING FEES �Q .1ST g $ ~ ate* UNITS TOTACFEESJ� .MOB.HM.FEE 1-_ .FEEMECH:,Fkli � � 00 . _� FL :SQ. FT. ®/ .. -SMI' u � - FEE PLUMB. Amt., $ - 2ND: FL. SQ. FT. @.- Plan er// - ' [ /%/mss = YARD SPKLR SYSTEM Unit ISond Sp. Insp: Fee : s _ _ POR. SQ. FT. @ �— . MOBILEHOAAE SVC Registr, Fee is Address .City zip GAR. SW9 SO. FT. fZ �� PPMR OUTLET ROOF DRAINS 7etpl Faete �,5�' ' CARP., .SQ. FT'.. @' CatY - _ ` , .Zip. - �6f iE,j p R e _ .� . • : DRAINAQE PIPING «. _ 'Contractor �c� , .7 E' fet '' ' % T' - Vlrees'required waga'Systerri - is 400 p<T. u. uKK444 DRINKING FOUNTAIN .CIS - Zip , . .WALL `SQ.'FT: Q Sewer District L. i SQ. FT. - URINAL ESTIMATED CONSTRUCTION VALUATION $ % a�.r WATER;PIPING r NOTE' .Not,to.be used as property tpx;yaluafion SWIMPOOL, PVT FLOOR DRAIN too it MECHANICAL FEES ,swim POOL, COMM, WATER SOFTENER i;T SYSTEM FAN' EVAP. COOL' HOOD SIGN WASHER (AUTO H) i' APPLIANCE DRYER 3 Q GARBAGE DISPOSAL 2 d ' FURNACE UNIT WALL FLOOR SUSPENDED, _ _ . •'LAUNDRY TRAY AIR:HANDLINGUNIT CFM iDLEIMETER "'.' `"t ` r"` 91TCHEN SINK' #BSORPTION SY TEM JI. U., TEMP USE' PERMIT;SV_ C ' WATER CLOSET �OMPRESSOR. - I f HP-' _7 © POLETEMP/PERM LAVATORY HEATING'SYSTEM FORCED GRAVITY . -� AMPERES" SERV'ENT' SHOWER O BOILER B..T.U. SQ FT' g BATH TUB ' - P,ERMIT'NO. 3669151 WATER HEATER Zip �J��- Cam' mty t n SEWAGE: -DISPOSAL O ►' SQ. FT. GAR # .> f OH. IYgUSESEWER. :Permit Fee S /tj Microfilm Fee Cop i Uselof Permit ' - -- r "Pcieccel GT �� 4,V l N7o. j - A GAS, PIPING'0#r1Ce-.;7S' S PERMIT FEE Q PERMIT FEE • >- �Q PERMIT FEE'.. 3 G, DBL - TOTACFEESJ� .MOB.HM.FEE 1-_ .FEEMECH:,Fkli � � 00 . _� -CONST F�E.��� LELECT. FEE -SMI' u � - FEE PLUMB. Amt., $ - PlanNo. j e/� • �� Plan er// - ' [ /%/mss - P,ERMIT'NO. 3669151 Job Address •Space Zip �J��- Cam' mty t n Valuation d �r S.' � Date ,�D`ist. `44, OH. EIC G. .f :Permit Fee S /tj Microfilm Fee Cop i Uselof Permit ' - -- r "Pcieccel GT �� 4,V l N7o. j - A Use/Case .Np• Ck. By Meeh. Fee DbI 'r S .Pl. :Ck.'.F,ee Is S00 cks. - - - -Lot Si . 5 _+� 7 Constiucttoh:Fee Dbl Is 2a - legal Description - ';F- 'Zona.R 4,07 G • 'S S R /vi rt,.• Electrical Fee Dbl i 00 7 tricltoas Group Type ' ,SMI Fee Plumbing Fee Dbl = Amt., $ - PlanNo. j e/� • �� Plan er// - ' [ /%/mss Final Dale - 2-14 70- Inspector Unit ISond Sp. Insp: Fee : s Demol. Fee $ Const., Lender Branch 'Supplimental Permit Numbers; , Registr, Fee is Mileage Fee, y. Address .City zip Witness Fee . ; Rei_nsp: Fee_ i. Own - - Tel. -) Zip 7etpl Faete �,5�' Aildmss�.� -.. - 111 V :_../ /�' v .. «o= iq CatY - _ ` , .Zip. - �6f iE,j p R s M.O. -Cash Check iReeeiGed by, 'Contractor �c� , .7 E' fet '' ' Licpn;eY 16016ev'2. - Vlrees'required waga'Systerri - is 400 p<T. u. uKK444 AdAiess - .CIS - Zip , . THIS'PERMIT SHALL BECOME VOID9-F WORK IS NOT COMMENCED'' WITHIN 120 DAYS. CESSATION,OFWORK verified tiy:'� FOR 1,20.DAYS SHALL A U PE TO BECOME VOID: 1' HEREBY AGREE TFON WITH THIS PERMIT WILL BE DONE' IN ACCORDANCEWLTH THE LAWS OF RIVERSIDE COUN ANDTHE STATE OF.CALIFORNIA _ ... HEREBY.CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE -PLANS AND SPECIFICATIONS HAS DONE -SO IN . Sewer District L. RDANCE WITH'SE&ION 5541 OF THE BUSINESS AN0''PROFESSIONS*CODE OF,THE STATE OF"CAUFORN(A . t�ormr284-208 (Rev.B/78) ;©s _