375031 (PLBG)BUILDING PERMIT
PERMIT NO. DEPARTMENT OF BUILDING & SAFETY DST
3750311- COUNTY OF RIVERSIDE FIELD
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CONSTRUCTION
ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL.
2ND. FL.
POR.
GAR.
CAR P.
WALL
ESTIMATED CONSTRUCTION
SQ. FT. @
UNITS
' A
�U l rn v
YARD SPKLR SYSTEM
SQ. FT. @
MOBILEHOME SVC. BAR SINK
SQ. FT. @
Date
SQ. FT. @ POWER OUTLET ROOF DRAINS
Dist.
DRAINAGE PIPING
SQ. FT. @
F.C.C.
DRINKING FOUNTAIN
SQ. FT. @
Micro Film Fee
URINAL
SQ. FT. @
@
VALUATION WATER PIPING
$
r
NOTE: Not to be used as property tax valuation
SWIM POOL, PVT
FLOOR DRAIN
Mech. Fee Dbl E
MECHANICAL FEES
SWIM POOL, COMM
WATER SOFTENER
VEN'SYSTEM FAN EVAP. COOL HOOD
SIGN
WASHER (AUTO)(DISH)
SMI Fee E
APPLIANCE DRYER
Dbl $
GARBAGE DISPOSAL
Bond Amt.
$
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
Final
AIR HANDLING UNIT CFM
IDLE METER
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET
COMPRESSOR HP
POLE,TEMP/PERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
Address City Zip
BOILER B.T.U.
SQ. FT. @ c
BATH TUB
Owner/Agent
+
SQ. FT. @ c
WATER HEATER
Zip
S0. FT. RESID @1'/.c
SEWAGE DISPOSAL
E
/ :,ti
S0. FT. GAR @ s/. c
HOUSE SEWER
ZIP
M.O. N.C. Cash t0 eckl
T GAS PIPING
7 s n
PERMIT FEE
PERMIT FEE
PERMIT FEE
License#
DBL.
//TOTAL FEES
MOB. HM. FEE
MICRO FEE
MECH. FEE PL. CK. FEE
CONST. FEE ELECT. FEE
SMI FEE
FEE
PLU B. FEE
PERMIT NO.
375031
Job Address
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Space
Zip
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Owner
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Community
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Valuation
E
Date
Dist.
bff.
F.C.C.
MH.Permit Fee E
Micro Film Fee
Cop $
Use of Permit
q / ; �l�
F l j•••
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Parcel No. ' r
1�
7� � •(�s
Use/Case No.
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Ck. By
fk�r'
Mech. Fee Dbl E
Pl. Ck. Fee $
Set Backs
F S S
Zone Restrictions Group
(tit ^
—Date40'
Lot Size
R
Type
Construction Fee Dbl E
Legal Description
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L'J� / ��G• ��f CUL �-�' �f I�
Electrical Fee Dbl $
SMI Fee E
Plumbing Fee
Dbl $
/� �]
Bond Amt.
$
Plan No.
Plan Checker
Final
Inspector
>Inz�
d
Unit
Sp. Insp. Fee E
Dental. Fee
$
Const. Lender
Branch
Supplime I rmit Numbers
/
Regisir. Fee $
Mileage Fee $
Address City Zip
Witness Fee $
Reinsp. Fee
$
Owner/Agent
+
Tel.
Zip
Total Fees
E
/ :,ti
r
Address
ZIP
M.O. N.C. Cash t0 eckl
Received by ,.T -r ,
h "`
Contractor
Tel.
License#
Trees required
Sewage System
Address
City
Zip
+
T LL P
Sewer District
Form 284-208 (Re,11/78) P s
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. t
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.
NO.
OPERATION DATE
INSPECTOR
NO.
OPERATION
DATE INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
1
Set Back
33
Ventilation System
2
Ftgs 8 Frms
34
Plenums & Ducts 4
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 L
7
Framing
40
Fire Damper
8
Vents
41
Smoke Detection Device
9
Garage Fire Wall
42
Commercial Hood
10
Fireplace P. L.
43
Final
IDA
Fireplace T. 0.
FI
ADDITIONAL INFORMATION
- - - - - - - - -
SEWAGE SYSTEM SIZE 8 LOCATION
11 Exterior Lath
12 Internal Lath
12A Drywall
13 Finish Grade
INSULATION Thick R
Value
7A Walls (Batts)
128 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
Q—(d
25
Final
=�= /
Tank Pit L.Line
PSL
REAR 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
NOTICE: THIS IS NOT A BUILDING PERMIT DISTRICT
APPLICATION TO CONSTRUCT Permit No
DEPARTMENT OF BUILDING AND SAFETY •
COUNTY OF RIVERSIDE
284 .199A 9/74 CANARY—FILE, PINK—APPLICANT
Owne 1 N13�rchitect —_ _ Contractor--
Ad re ddress
YUP 5°CBt1ress___ Address—
City6A— City__ City-
City
hone—
-Phone Phone _ Phone--
II (we) the undersigned, hereby certify and acknowledge that I (we) have read the application 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
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.
I SPACE NO.
_ _ 1 USE OF STRUCTURE
JOB ADDRESS _./oS,�f%�� — SINGLE FAMILY DUPLEX
DES C —
Z H
LEGAL PTn OF PROPERTY �1—� --_ — APARTMENTS AGRIC.
N Q
� COMMERCIAL INDUSTRIAL El
COMMUNITY .
ALTERATIONS n
C
Z
NO. OF SUBMITTED PLANS — USE OF PERMIT .42
N Q
0
CASE NO. _
p Z
NO. OF P KING SPACES REQUIRED _ _ NO. OF BUILDINGS W EXISTING —
ZONE ETBA6KS: FRONT SIDE REAR _
J D
GR DING PERMIT REQUIRED? YES ❑ NO ❑ LOT SIZE
SETBACK ORDINANCE # OF FEET REQUIRED ON STREET
DATE �SIGNATURE OF LAND USE OFFICIA
DEDICATION REQUIRED: YES ❑ NO ❑ NO. OF FEET_—
F
W
CURB AND GUTTER REQUIRED: YES ❑ NO ❑ STREET
cc
a
W
CAN CURB AND GUTTER FEASIBLY BE INSTALLED? YES ❑ NO ❑
HAS AN ACCEPTABLE APPLICATION BEEN MADE FOR ENCROACHMENT PERMIT FOR DRIVEWAY AND STREET
D
IMPROVEMENT? YES ❑ NO ❑
°C
DATE _ SIGNATURE OF ROAD DEPT. OFFICIAL—
x
SWIMMING POOLS PUBLIC
WSEWAGE
DISPOSAL
FOOD ESTABLISHMENT
_
WATER POLLUTION REMARKS
N FLOOD CONTROL
t-
W AIR POLLUTION
W
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