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A009628 (SFD)FIELD ,_ DEPARTMENT OF BUILDING & SAFETY ERMO. 6046 A 2 PERMITTYPE COUNTY OF RIVERSIDE Additional Information: ACTORY BUILT HOUSING MOBILE HOME INSTALLATION anufacturer ,� MH Manuf. New ❑ odel Designation Size Relocated ❑ t nit Serial No. Total Fees $ Ian Approval No. nsig. Serial No. f:k mak,. Moving ewage System T � 1 1 p Permission is hereby granted to move the structure, described below, in Width Length , Height Total Fees $ jj GRADING #1 Number of #2 Sections #3 Cut Fill otal Fees $ Present Location Community County ELOCATION INSPECTION Destination Present location Community County Total Fees $ oral Fees $ k` Per it No. IAO�'9628 Job Address a f SP # _ � Zip I Qpw.ner PIon Check Community ,� Valuation is gate , Dis �Oif P.C. Reinspection Use•of Permit Parcel No. Lot _., 1, _ Size DY160 Factory- Built Set backs Use Permit p Lr „� ( Grading Bond k, -.e $ Grp Type Unit y Mobile home Engineer License # Final Date Inspector Env. Assmt. Requirement Relocations Escrow Company Bra � Total Fees $ Address City Zip Cash Check MO NC Owner/Agent Tel. Receiu by l�Do e'7 Adyess ,(� i�OX 7q Citt Zipo /7 Re ated' Permits) Contractor/ Mover Tel. ' workers' comp. W- yes ❑ no ❑ Address City Zip [certify that in the performance of the work for which this permit is This permit shall become void if work is not commenced within 120 days. Cessation of work for 120 days sed I shall not employ any person in any manner so as to beta ub- 'sholl also cause permit to become void. ect to the workers' compensation laws of Colifor9 F' hereby agree that all work in connection with this permit will be done in accordance with the lows of / �r werside County and the State of California. I hereby certify that the individual who prepared the plans and Owner Signoture �'y r — ' ci icotions hos done so in accordance with Section 5541 of the Business and Professions Code of the Builder Signature State of California. FORM 284-208A 5-77 (E)M 2>1 NO. OPERATION DATE INSPECTOR NO. OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS 1 Set Back _ 33 Ventilation System 2 Ftgs & Frms. -Z _ 34 Plenums & Ducts 2A Slab Grade 35 Furnace Comport. 3 Steel _ 36 Inlets & Outlets 4 Grout Blocks V 37 Combustion Air 5 Bond Beams 38 Compressor 6 Roof Deck 39 Appl. Clearance 7 Framing 40 Fire Damper 8 Vents 41 Smoke Detention Device 9 Garage Fire Wall 42 Commercial Hood 10 Fireplace P.L. 43 Final 10A Fireplace T.O. No" ADDITIONAL INFORMATION SEWAGE SYSTEM SIZE & LOCATION 1 1 Exterior loth 12 Internal Loth 12A Drywall 13 Finish Grade INSULATION Thick R Value 7A Walls (Botts) 128 Ceiling IBottsl 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 z _7117 Tank 760 Pit & ?C�l Z L. Line PSL REAR OF PROPERTY LINE ELECTRICAL APPROVALS P/ 3 26 Power Pole 27" Conduit 28 Service Entrance 29 Wiring 29A Grounding Wire 29B Bonding 30 Fixtures 31 Service 32 Final � � STREET NAMT-I—II�7 DEPARTMENT OF BUILDING AND SAFETY COUNTY OF RIVERSIDE NOTICE TO APPLICANT In conformity with the provisions of State of'California Labor Code Section 3800, the applicant shall have on file or file with the Riverside County Department of Building and Safety a certificate as designated in Items I or II below, or shall indicate Item III, IV or V, whichever is applicable. CERTIFICATE OF APPLICANT Please mark the appropriate block: I. Certificate of Consent to self -insure issued by the Director of Industrial Relations. E Copy on file Copy submitted F7 II. Certificate of Workers' Compensation Insurance issued by . an admitted insurer. Copy on file = Copy submitted III. The cost of the work to be performed is $100 or less. IV. I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation laws .of California. I further certify that, in the event I become subject to the Workers' Compensation provisions of the Labor Code that I will comply forthwith with the provisions of Labor Code Section 3700, et seq., and understand that, if I do not comply, the permit shall be deemed revoked. n V. I certify as the owner -(or the agent of the owner) that in the performance of the work for which this permit is issued I have engaged , contractor. (Contractor must have on file, or submit r certificate required by I or II above.) Applicant's Signature Date Address and location e�— / _ , 284-141 Rev. 6/77 Permit No. ,ere work i to be perfo 7 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—APPLICANT � Owner/�� L ,� &e- ' ,r V/C rchitect Contractor Address, �h 7y Address Address— 5.4 tfj -- C//l1 SNA 4a /moi-' CitykA kI City City_ PhonePhone Phone 2 I (we) the undersigned, hereby certify and acknowledge that I (we) have read the application and agree that if Curb and Gutter, and W Z 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 Permit. ISP CE NO. - USE OF STRUCTURE JOB ADDRESS nn SINGLE FAMILY .DUPLEX f LEG DESCRIPTION OF PROPERTY 6 Qac ARTMENTS AGRIC. Z O '^ r MERCIAL INDUSTRIAL CC� Z COMMUNI ALTERATIONS ❑ NO. OF SUBMIT � PLANS — USE 0 P I N Q CASE NO. n ? ° NO. OF PARKING SPACES REQUIRED N0. OF BUIL, NGS NOW EXIST—�_-_ a ZONE Z SETBACKS: FRONT 24) SIDE � S' REAR - J m GRADING PERMIT REQUIRED? YES E]NOXj LOT SIZE ` SETBACK ORDINANCE /i+- OF FEET REQUIRED ON _ DATE -1_ SIGNATURE OF LAND USE OFFICIAL --- F DEDICATION REQUIRED: YES ❑ NO ❑ NO. OF FEET_— CURB AND GUTTER REQUIRED: YES ❑ NO ❑ —STREET t— oe W CAN CURB AND GUTTER FEASIBLY BE INSTALLED? YES ❑ NOj❑ HAS AN ACCEPTABLE AP ICATION BEEN MADE FOR ENCROACHMENT PERMIT F R DRIVEWAY AND STREET' CES IMPROVEMEN ? YNO ❑ °C DATE7 Y SIGNATURE OF ROAD DEPT. OFFICIA = L/ SWIMMING POOLS PUBLIC W SEWAGE DISPOSAL _ FOOD ESTABLISHMENT r I _ WATER POLLUTION REMARKS �n FLOOD CONTROL Wat POLLUTION f iAIR _ DIV OF HWY p a _ YOUR PROPERTY MAY BE SUBJECT TO _. d o FLOOD. RIVERSIDE COUNTY ASSUMES NO RESPONSIBILITY IN EVENT OF FLOOD. 284 199 9/74 - CANARY—FILE, PINK—APPLICANT x =RAi ^�"=�f RIVERSIDE COUNTY DEPARTMENT OF PUBLIC HEALTH? "may, w DIVISION OF ENVIRONMENTAL HEALTH Food Establishment Sewage Disposal ,._._._ Trailer Park � Gal. Septic Tank _-Motel, Apt., Hotel Sq. Ft. of Leach Line Dwelling _� x/ __� Seepage'.Pit�� Commercial Building Connection' to, Sewer':- K_ ewer')'`$ Swimming Pool .Z .,,_, No on-site regQnerating water softening d'eviEes may be discharged into the individual -sewage dispmat system herewith approved w'sci�eu clearance fro:r the Water Quality Control Board, /Water supply serving'this.instaliation must be from an aoprcv_nd source. � A_11 sewage disposal.. installation must conform with rcquir!ments of current Vnlff,vy Prquffnbta�.g• CWve ,--Any cutting, grading, or filling in excess of fJuo (4) feet will nullify sewage cfr's of apPcowa.F, Approval -has been obtained from the Regional Water Quality Control Board tot tostal9'atioo of. the ww.. age disposal system. i This is to certify that the Riverside County Department of ublic Health approves fo o+:e acteYn CCttsf[+itct $ or installation th item(. ) checked above. t ` J PERMIT NO. PERMITTYPE A009"61` dditional motion: DEPARTMENT OF BUILDING & SAFETY COUNTY OF RIVERSIDE FIELD OFFICE -�W FACTORY BUILT HOUSING MOBILE HOME INSTALLATION _Manufacturer MH Manuf. New ❑ Model Designation Size Relocated ❑ Unit Serial No. Total Fees $ [Plan Approval No. Insig. Serial No. Z) .,.� .- Moving Sewage System T ^^ 1 1 p (p j Permission is hereby granted to move the structure, described below, in Width Length Height Total Fees $ A47 ..•- GRADING ` #1 Number of #2 Sections #3 Cut Fill .Total Fees $ � Present Location Community County RELOCATION INSPECTION C Destination Present location Community County Total Fees $ Total Fees $ Permit No. Jo Address SP 1 Zip., Ow,nPr. FPlan Check Com unity VgLuation 7 $ 1. to� Di O P.C. ;Reinspection Use of Perm t Parcel No. Lot 93— 64?�— rL Size 0 YLO), ,Factory- Built Set backs Use Permit N Leg es ip n ---- o (0 .-)- .Gradin g $Bondke� Grp Type Unit Mobile home Engineer License # Final Date Ja •Z�' %y In ector Env. Assmt. Requirement ,Relocations Escrow Company Br nch Address City Zip o NC Owner/Agent / 501VL�Dp�e Tel. 4by 7Adress f `i'` -- / -a. Sox 741 XAII/Clf v -5/ f A/ �� / I Citi` (li Zip � O Contractor/Mover Tel. workerscomp. 'r yes ❑ no ❑ Address City Zip :I certify that in the performance of the work for which this permit is This permit shall become void if work is not commenced within 120 days. Cessation of work for 120 days issued I shall not employ any person in any manner so as to bei sub- sholl also cause permit to become void. ject to the workers' compensation laws of Cali r 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 Owner Signature "' a ications has done so in accordance with Section 5541 of the Business and Professions Code of the t. Builder Signature State of Colifo.nia. FORM 284-208A 5-77 (E)M