369183, 375343 (SFD)BUILDING PEOffff-_
PERMIT NO.
369183
DEPARTMENT OF BUILDING & SAFETY
COUNTY OF RIVERSIDE
FIELD MD
CONSTRUCTION
ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL.. ::-
2ND. FL.
POR.
t GAR. '�
CAR P.
WALL
ESTIMATED CONSTRUCTION
SQ• FT. @ $ r
UNITS-
y4LIV
SQ. FT. Q
YARD SPKLR SYSTEM
MOBILEHOME SVC.
SQ. FT. @
BAR SINK
SQ. FT. @ 4 5-P POWER. OUTLET.
ROOF DRAINS
SQ. FT.
DRAINAGE PIPING.
SQ. FT.
DRINKING FOUNTAIN
SQ. FT: @
URINAL
VALUATION $
WATER PIPING
NOTE: Not to la 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)(DISH)
APPLIANCE DRYER '
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
Plan No,
LAUNDRY TRAY
AIR HANDLING'UNIT' CFM
IDLE METER
KITCHEN SINK '
ABSORPTION SYSTEM ' T. U.
TEMP USE PERMIT SVC
WATER CLOSET
COMPRESSOR HP
POLE;TEMP/PERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B:T:U.
SQ. FT. @ t
BATH TUB
Mileage Fee =
SQ. FT: @ c,
WATER HEATER
Reinsp. Fee $
3Q. FT. RESID @I /.t
SEWAGE DISPOSAL
50. FT. GAR Q % c
HOUSE SEWER
'Zip' .
M.O. N.C.: Cash Check
Received by
Co to , r -
Tel. LleenseB.
-'
Trees required
- -
•- •'
_
Sewage,sysiem -
-
Address
_
- City ZiP
�'• T U. P
ewer District
Wr f 281-208 (Rev.8/781
TTH&PERMIT'SHALL BECOME .VOID IF WORK IS NOTCOMMENCED WITHIN 120 DAYS. CESSATION OF WORK verified by:
_ --FOR 1120-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'THEINDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS.DONE SO IN r
ACCORDANCE WITH.SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF.CALIFORNIA. �/�
NO.
OPERATION
DATE
INSPECTOR
NO.
OPERATION
DATE
INSPECTOR
S6 OLDONG APPROVALS
RAIECHANOCAL APPROVAU
1
Set Bock
33
Ventilation System
2
Figs & Frms -
34 Plenums & Ducts
2A
Slab Grade
35 Furnace Compart.
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. Cj
43
Final
IDA
Fireplace T.O.
OP'N
NO,
_
A1®®OTIONAL ONFORMATOOM
SEWAGE SYSTOM SIZE & LOCATOOM
11 Exterior Lath
12 Internal Loth
12A Drywall
13 Finish Grade
INSULATION Thick R
Value
7A Walls (Batts)
12B Ceiling (Botts)
I2C Ceiling (Blown)
14 Final
PLUPAO BMG 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 LLine
REAR OF PROPERTY LINE
IELECTROCAL APPROVALS
PSL
P/
26 Power Pole
27 Conduit
28 Service Entrance
29 Wiring
29A Grounding Wire
29B Banding
30 Fixtures
31 Service
32 Final
it
STREET NAME
BUILDING PERMIT
PERMIT NO:
369183
s
DEPARTMENT OF BUILDMHO .& SAFETY
COUNTY OFf RIVERSIDE
FIELD OFFICE
DST
CONSTRUCTIOWESTIMATE
' PERMIT NO.,
36918.3
NO:: ELECTRICAL FEES
NO, .PLUMBING OES
$ 74
UNITS"
l
LST FL. SQ, FT. @
�,AKPermit Fee S
Micro Film Fee
2ND. F6. _ - Sp;. FT: ® -
se"of•P mit -
:Legol escr t(on f
"" 7W+� -
7.9
YARD SPKLR SYSTEM
POR SQ FT.
MOBILEHOME SVC.
BAR'SINK
GAR. SQ, FT. @ `��
POWEWOUTLET'
ROOF DRAINS
CAR' P. SQ: FT. @
F ` 5 S R
d
DRAINAGE PIPING
WALL SQ FT.
Group Type
DRINKING FOUNTAIN
SQ. FT. ®
Dbl E-
URINAL
ESTIMATEDiCONsTRUCTION VALUATION $ r—:5
SIZ
WATER PIPING
i NOTE: Noi to be ,used os property tax Valuation
SWIM:POOL,. PVT
FLOOR DRAIN
MECHANICAL FEES
SWIM POOL, COMM '
WATER SOFTENER
VENT, SYSTEM FAN EVAP. COOL HOODr
SIGN
WASHER (AUTO)(DISH)
M_ PLIANCE, DRYER
Branch -
GARBAGE DISPOSAL
FURNACE UNIT - WALL. FLOOR SUSPENDED
-
LAUNDRY TRAY
AIR HANDL'ING;UNIT CFM
IDLE METER
KITCHEN SINK
?kBSORPTION SYSTEM B.T.U'.
TEMP USE PERMRSVC
WATER CLOSET
''COMPRESSOR HP
POLEJEMP/PERM
LAVATORY
;EATING_ SY$TE_M FORCED GRAVITY+'
AMPERES SERV ENT
SHOWER
OILER ° B;T.U.
SQ. FT. Q c
BATH TUB
Contrdc or'
SQ, FT. '@ t
WATER HEATER
SQ, FT, 01D 071/ec
SEWAGE DISPOSAL
SQ:. ;FT.. GAR" 0 V4 C
:HOUSE SEWER
-Address
GAS Pi PING
PERMIT' FEE'
Zip
PERMIT, FEE
PERMIT FEE
DBL.
TOTAL FEES
-MOSMAILFEE
MICRO FEE
MECH. FEE PL; Q(: FEE "-
CONST. -FEE ELECT. FEE
;SMI FEE "FEE PLUMB. FEE
T LL" P THIS PER SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. 'CESSATION'OFWORK veriflecl by.
ySewer District- - FOR "120' DAYS "SHALL ALSO CAUSE PERMIT TO' BECOME VOID..
ii • d
I HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE-*ITH
THE LAOF,RIVERSIDE"CO.UNTY AND THE, STATE OF CALIFORNIA.
LHEREBY CE
RT,IFY'THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS;DONE,SO IN t
ACCORDANCE'WITH SECTION 5541, OF THE BUSINESS ANDRP-ROFESSIONS CODE OF THE STATE OF CALIFORNIA.
Forrn484-208 '(Rev.") ®s� - - -.
' PERMIT NO.,
36918.3
Job Address
Community'
Space Zip Owner
Valuation Dote
✓
Dist. Off:
�,AKPermit Fee S
Micro Film Fee
Cops
se"of•P mit -
:Legol escr t(on f
"" 7W+� -
7.9
'TorceT.No:.
'Zone
_ --G
Use/Case No.
_
jCk. By,
e45 -�
:}.Meth. Fee•` Obis
fCk..Fee f
' --
[:hstrudion Fee Dbl S
Set.Backs
lot Size
!.%
F ` 5 S R
d
_
Elect"ricdl;FseDbl E
�Restriclions' -
Group Type
Plumbing Fee_
Dbl E-
Bond Amt.
s
Plan No.
Plan k�er/•,//�j,
(f����/l��V�
ti_ 'Final
Dgtb
Inspector
Unii
,
Sp. ".insp. Fee - -
.'De`molt Fee
f
Const.'l.ender - -
Branch -
'Supplimental Permit Numbers.
-
1
-
;Regist. ,Fee
fAileage;Fse =
AddressCity Zip
:�;1NHness.Fse.
__ ..
-einsp. Fee
$
Owner/Agent
gess
n
"fell.
City
&
-
Zip -
Zip
tal'Fees
M.O: N.C;: Co&K�Q Check
j_Rgteived by
-
Contrdc or'
License#
'3 ees•required
`age System
X 11
-Address
-
city
Zip
T LL" P THIS PER SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. 'CESSATION'OFWORK veriflecl by.
ySewer District- - FOR "120' DAYS "SHALL ALSO CAUSE PERMIT TO' BECOME VOID..
ii • d
I HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE-*ITH
THE LAOF,RIVERSIDE"CO.UNTY AND THE, STATE OF CALIFORNIA.
LHEREBY CE
RT,IFY'THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS;DONE,SO IN t
ACCORDANCE'WITH SECTION 5541, OF THE BUSINESS ANDRP-ROFESSIONS CODE OF THE STATE OF CALIFORNIA.
Forrn484-208 '(Rev.") ®s� - - -.
PERMIT NO.
375343
DEPARTMENT OF BUILDING & SAFETY
COUNTY OVRIVERSIDE .
FIELD MIT,
CONSTRUCTION
ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
� $
d
UNITS
IST FL.
SQ. FT.
. mmunity
Valuation
Date
2ND. FL
SQ. FT. @
F: C.C.
YARD SPKLR SYSTEM
SQ. FT. ® ' - J ^3
/ G•1
MOBILEHOME SVC.
BAR SINK
�~
FOR. /
$Q, FT, @�
-�{ tii '�
POWER'OUTLET
ROOF DRAINS
`
GAR. y'
SQ. FT. @
DRAINAGE PIPING
Cop $
CAR P.
SQ. FT: @
Parcel No:
se/Ca a Ao.
DRINKING FOUNTAIN
1)
WALL
,
SQ: FT. @"
��� L%
URINAL
Construction Fee
VALUATION $
w�
Legal Description
WATER PIPING
R
ESTIMATED. CONSTRUCTION
NOTE: Not to be used as property tax valuation `r
Electrical;Fee
SWIM POOL; PVT
FLOOR DRAIN
/� �j
L
MECHANICAL FEES
Croup
SWIM POOL, COMM
WATER SOFTENER
SMI.Fee
VENT SYSTEM FAN EVAP. COOL_,HOOD
-
SIGN
WASHER (AUTO)(DISH)
-
APPLIANCE DRYER
211
.Plumbing. FeeD61
GARBAGE DISPOSAL
~•
FUR!^DACE UNIT WALL FLOOR SUSPENDED
4aa
Plan Checker
LAUNDRY TRAY
°�''
~�
AIR HANDLING UNIT CFM
-
IDLE METER'
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP'USE PERMIT SVC
ATER CLOSET
COMPRESSOR . a �� HP
POLE,TEMP/PERM
LAVATORY
HEATING SYSTEM F2SgD GRAVITY '
AMPERES SERV ENT ,
SHOWER
BOILER B.T.U.
SQ. FT. @ t
BATH TUB
.a '
Const. Lender Branch
Sup[p/li�m�en�ttaal�l Permit Numbers
SQ. FT. @ ' t
WATER HEATER
,, � SQ. FT. REM @ 11/. c
SEWAG_E.-DISPOSAL-
is
$
..t `SO, FT: GAR @ ?/. c. d
1 HOUSE SEWER
Witness Fee
$
GAS PIPING
PERMIT FEE
Reinsp. Fee
PERMIT FEE
PERMIT FEF
Owner/ 'go nt •�� „•. } ' f{�
t
DBL:
TOTAL,FEES
MOB. HM. FEE
MICRO FEE
ARIECH.–FEF
PL. CK. FEE
CONST: FEE ftew.
ASMI FEE
FEE
Total Feesis
A ress
City,
~`'''
Zip
M.O.
N.C. El CwhEl
Check
+q r dt
Mr
-
Received by
ctor
LicenseY
'
Trees required
Sew ge.System
Address
.
City Zi P
T
LL
P Ip
THIS "PERMIT SHALL BECOME"VOID IF WORK IS,NOTICOMMENCED WITHIN 120 DAYS. CESSATION OF WORK verified by:
Sewer DisirR
FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID..-
1 HEREBY AGREE THAT ALL WORK, IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE WITH
THE LAWS OF RIVERSIDE COUNTY'ANG.- THE }§TATE Oli CALIFORNIA.
HEREBY, CERTIFY THAT THE INDIVli .;' L WHO PREPARED THE PLANS,AND SPECIFICATIONS HAS DONE SO41,6*� �•
- ""�"�
ACCORDANCE WITH SECTIQN 5541. Or -THE BUSI;yESS.AND PROFESSIONS CODE.OF THE STATE:�OF CALIFORNIA.
`
Form 284-208,(R _,
p s
NO.
OPERATION
DATE
INSPECTOR '� .
NO.
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
1
Set Back
_ -?C7
33
Ventilation System Z
2
Figs 8 Frms
It—IV _
34 Plenums & Ducts
2A
Slab Grade
��D_ �4�
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
,9 1
40
Fire Damper
8
Vents
41
Smoke Detection Device
9
Garage Fire Wall _ Z 1 ^
42
Commercial. Hood
10
Fireplace
P, L. Z_
43
Final !d
10A
Fireplace
T, 0. q0 5=�(,I-NO.
OP'N ADDITIONAL INFORMATION
Re7UP-A, /C !id 10" a%"O dot/ /7
SS
U 15 ILA P-
SEWAGE SYSTEM SIZE & LOCATION
I l Exterior lath . 2 -
12 Internal Lath
12A Drywall / �ZgQ ,-
13 Finish Grade
INSULATION
..R.,
Thick Value
7A Walls (Batts)
12B Ceiling (Batts)
12C Ceiling (Blown)
14 Final —
PLUMBING APPROVALS`
I5 Ground Plumb — — — — — — —-
16 Wafer Piping
17 Rough Plumb fF
18 Vents
19 Sewage Disposal _
20 Sewer
21 Water Heater
22 Water Softener
23 Water Service Z g
24 Gas Test —1 -g _ %iLT/,M%i�
25
Final
,
Tank OO Pit ZD L.Line
REAR OF PROPERTY LINE
P/L i P)
` 1
,l
ELECTRICAL APPROVALS
26 Power Pole
27 Conduit
28 Service Entrance
29 Wiring Z -/
29A Grounding Wire
29B Bonding
30 Fixtures
z 14o7,1—g
31 Service
lb
Final
i J�
j STREET NAME LiACIE 112A
0
fill
NOTICE: THIS IS NOT A BUILDING- PERMIT
APPLICATION TO CONSTRUCT
___.DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF RIVERSIDE
DISTRICT
Permit No
284 199 9/74
CANARY—FILE, PINK—'A FLICANT
�,g
7 Own Architect P7Contractor
AddressAddiesq Address— So
Address—
city Cir r—ul
City -
P
Phone Ph6ne Phone
I (we) the' undersigned, hereby certify and ailknowtedge that I have'read the applicatilon and .agree that if Curb and Gutter, and
Z
Paving, and/or Dedication of right of way is required by the County of Riverside; the Riverside, County Department of Building and Safety
shall not make a,Final Inspection until ;said requirementsn met, am also Aware . 'that no work is to be done'within the County R/W
. ka.,�ebee
0
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
the
complied with all laws of County of Riverside and the State of California, governing said pro�y
DATE SIGNATURE' OF OWNER AND/OR AGEN"
Approval 'by Signature from the'Jollowing Departments Listed Below
Must Be Obtained'Prior.to the Issuing of A Construction Permit.
SPACE-N'O,.
USE OF STRUCTURE
JOB ADDRESS -
SINGLE FAMILY DUPLEX DESCRIPTION OF PROPERTYx
&L
e -7 APARTMENTS AGRIC:. El
COMMERCIAL INDUSTRIAL
CIJMMUNi.TY
ALTERATIONS'
-NO. OF SUBMIf-FE6:PLANS USE OF RERMIT
-CASE NO.
x
x
NO. OF BUILDINGS NOW-UISTING
A
ZONE ET SIDE
BACKS FRONT REAR
.J
GRADING.PERMIT REQUIRED? YES [:1 NO ❑ LOT SIZE
SETBACKORDINANCE. # OF FEET R E UIREDOW. STREET
DATE SIGNATURE OF`LAND USE OFFICIAL
DEDIC ";.RkQU.jRgP:,._yjES EL NO E] NO OF FEET -
AT! Qj�
z
CURB .,AND ,-,GUTTER REQjVIfZEDI' .:YES .0 NO, [I T
'D
W
GUTTEk FEASIBLY BE IN ED? -YES D iN
CAN_'CURB AN&L 0
HAS MA15-E FOR EN �ND STR
ACCEPTABLE ARP6.C-AT1QN BEEN ACHMENT • PERMIT ;FOR . DRIVEWAY,j
NO,
MPROV T?� YES 9!( (1
SIGNATURE OF ROAD DEPT. QG41CIAL�
V
6.4 7
:C
I ZA" 0
-
z 0;0;
r—L
hm *19 00 a 04�
^--.7 irdfpja f W
.j OLLUTION REMARKS_
12 FLOOD CONTROL
W AIR POLLUTION
at, Will
X DIVOFLHWY
77,
YOUR PROPERTY MAY BE SUBJECT TO
FLOOD. R.IVERS'IDE COUNTY ASSUMES
.0 NO RESPONSIBILITY IN EVENT OF FLOOD.-
.1 le,
284 199 9/74
CANARY—FILE, PINK—'A FLICANT
oc
W
z
O
APPLICATION FOR'TREE
PLANTING
I (we), the undersigned, hereby- certify and acknowledge that I, (we) have read the application and agree.that if. trees are required.under River.
side County Ordinance No. 457; the applicant ogress to install said trees prior to final inspection. It is 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 a@@reed that the "prop.
arty owner shall cause the property lines to be, surveyed in the event no'survey stakes can be found. Furtherit is agreed that"ihe County of
Riverside, shall assume no respJIonsibilitt/y should trees have to be removed due to lot line errord. y7
Owner's Name /0 10' K'gnb ^` ui lding P.-.-;, o. sJ —1
Mailing Address oo ' 6/ Ci Stats Zips, Si2(v6/
Job Address C 19-141, 42.9- UI Community V /v
Legal Description, �.
Assessor's Map, Book & Pogs. (G2h�" d Type StructureL�Fz-c- f/V it
Type of Soil,S/R�Is water avoilableRoad Dept. Plot Plan No.
Type -of existing trees in right -of -w9
Trees preferred by applicant (1) Q'` f�--, (2) (3)
:Date —� r % � `r � � Owner's Signature
Planning Commission Case No.
ROAD DEPARTMENT.APPROVAL
Approved species Olea europaea (Olive) Number of trees l
<d Spacing of trees Distance from lot lines: Front n R Side
W c Additional requirements Per plot plan on reverse. No street trees wi e p ante
within 10 of driveways.
Date Building and Safety
notified 'J/./ V Signature
REQUEST FOR EXCEPTION
Reason
zLU�
IL
(attach additional page if necessary)
m'n
.6
Request for hearing: YES ❑
Owner's Signature
(Forward applieaii'on to Planning Dept. if exception requested)
NO REQUEST FOR HEARING
Planning Dept.
f
� iZ
Concur ❑ Non -concur ,❑ Explanation
a
Date
Signature
Z
J O
Road Dept.
-
IL tY
Concur ❑ Non -Concur ❑'
Date
Signature
REQUEST FOR. HEARING AND COMMITTEE DECISION -
z.
Zd
Date hearing estab.lish.ed
'Date hearing notice Mailedtoowner
_j
Approved ❑ Disapproved ❑
Date Owner notified ofdecision
iZ
Date Building & Safety notified
Signature
7�,
PERMIT 90.
PERMIT NO.
5
dob.Address
DEPARTMENT OF BUILDING & SAFETY
COUNTY OF RIVERSIDEr,,_
FIELD OFFICE
DST'
CONSTRUCTION ESTIMATE
3
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL,
2ND. FL. —.SQ.
FOR.
GAR.
CAR P:
WALL
ESTIMATED -CONSTRUCTION
SQ. FT. Q,
F:GC.
UNITS
MH.,Perrryil,Fee.
FT. (g3
YARD SPKLR SYSTEM.
SQ. FT. @}'Je 0� MOBILEHOME SVC.
SQ. FT. @ .I POWER OUTLET
BAR SINK
ROOF DRAINS
SQ. FT. @
DRAINAGE PIPING
SQ. FT: Q
DRINKING FOUNTAIN
SQ FF
URINAL
VALUATION $ f�
VYATER.RIPING
NOTE: Not,;to.be used as property tax valuation
L'ot ize
R
V
SWIM POOL, PVT
FLOOR DRAIN
MECHANICAL FEES
SWIM POOL, COMM
WATER SOFTENER
VENT'S'kTEM FAN . EVAP.. COOL OD
SIGN
WASHER (AUTO)(D1SH)
APPLIANCE YER
Electrical Fee
Dbl $
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
SMI Fee
LAUNDRY'TRAY
AIR HANDLING. UNIT CFM
—
IDLE METER
KITCHEN SINK
ABSORPTION SYSTEM 8J.U.
Db_I Is dR
TEMPUSE PERMIT SVC
MATER CLOSET
COMPRESSOR_ f% ' HP
Find Date
POCE,TEMP/PERM
LAVATORY
HEATING SYSTEM D GRAVITY
MPERES; SERV ENT
j SHOWER
BOILER B.T.U.
SQ. FT, 0 c
BATHTUB
SQ. FT. Q c
WATER HEATER
Demol. Fee
SCon}L,Cender
SQ. FT. RESID @11/.c
SQ. FT. GAR r@ 4. c
SEWAGE SEWAGE DISPOSAL lip
HOUSE SEWER
Registr..,F.ee
GAS PIPING
PERMIT FEE
Witness Fee
PERMIT FEE
PERMIT FEE
DBL.
TOTAL FEES
MOB:HM.FEE
MICRO
H:
Qa
PL CK. FEE.
c
CONST. FEE EL .
COP AJ
_ SMI FEE
I.
'..I -
FEE P.LU B.
PERMITNO.
13,7534
dob.Address
Space .Zip Owner
3
Commmunily Valuation
S
Date
hist. Off.
F:GC.
MH.,Perrryil,Fee.
$
4
'1e"'� .r' �•
Micro Film Fee
Cop E
Use of Permit
T
Div A7r �
Parcel No.
RJ �,
ise/Cate Acs.
■
Ck. y
'
Mech: Fee Dbl S
Set Backs
F 'S [S
L'ot ize
R
V
,
PI. Ck. Fee E'
i. `,yII,
Legal Desaipllon
'Construction Fee
.DEI =
C__
/
Electrical Fee
Dbl $
�%�• f�
Zone.�Restrfctions [Gtbu� Type
SMI Fee
s
J T � / 1/
—
+
Plumbing, .Fee
Db_I Is dR
Bond Amt:
Plan No.
Plcm�Checker'
Find Date
Inspect
Unit
'Sp- Insp, Fee
OPP
s
$
Demol. Fee
SCon}L,Cender
Branch
Supplemental Permlt.Numbers
Registr..,F.ee
.Mileage Fee $
Address City Zip
Witness Fee
Reiiap. Fee
S
Owner/ A ._ /('re
Tel..
�.
Zip
Torol•Feea
' dress '- -
City-
-
Zip
M.O.,
N.C. Cash Check
Received by
on. rpclor
Ucen'seM
frees required
-
sewoge'System
Addren
City
Zip
'
T. LL P�p
Sewer'distrill
Form284--208.'(Re p s ��clo-1
THIS PERMIT SHALL BECOME VOID IF WORK ISNOT COMMENCED WITHIN 120 DAYS. CESSATION OF WORK iefified 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 a
THE LAWS OF RIVERSIDECOUNTY 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.