398501 (BLCK)BUILDING PERMIT
PERMIT No. DEPARTMENT OF BUILDING & SAFETY FIELD sT
1398501 COUNTY OF RIVERSIDE
• CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL.
t'
2ND. FL.
FOR.
'GAR.'
CAR P.SQ.
WALL
/
L. en C iSQ.
ESTIMATED CONSTRUCTION
SQ. FT. @ $
UNITS
Valuation
8
SQ. FT. @
YARD SPKLR SYSTEM
SQ. FT. @ MOBILEHOME SVC.
BAR SINK
SQ. FT. @ POWER OUTLET
ROOF DRAINS
FT. @
DRAINAGE PIPING
SQ. FT. @
DRINKING FOUNTAIN
FT. @
URINAL
VALUATION $
WATER PIPING
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)(DISH)
APPLIANCE DRYER
Plan Checker
GARBAGE DISPOSAL t
FURNACE UNIT WALL FLOOR SUSPENDED
•, Sp. Insp. Fee $
LAUNDRY TRAY
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
BOILER B.T.U.
SO. FT. @ a
BATH TUB
Contractor
SO. FT. - @ a
WATER HEATER
Sewage System
SO. FT. RESID @ I'Ac
SEWAGE DISPOSAL
S0. FT. GAR s/4a
HOUSE SEWER
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL.
TO Al FEES
Al 1
MOB. HM. FEE
MICRO FEE
MECH. FEE PL. CK. FEE
CO/ST. FES ELECT. FEE
11
SMI FEE
FEE PLUMB. FEE
I
PERMIT NO.
-3
Job Address - Space
y tl /yer '���.
Zip
Ownor '
�1ii
Community
tI/%tJ�
Valuation
8
Dote
Div.r
F.C.C.
MH Permit Fee $
Micro Film Fee Cop $
Use of Permit
y / 1
�i'/0 ���'�f��V �•'�
Parcel No. Use/Casa No.
(„!� �t..J/ ^„/✓
Ck. •a
Mach. Fee Dbl $
PI. Ck.•Fee $
Set Backs
Lot Sire
Construction Fee Dbl $ /i G
C/
legal Description r „rte
/'`'� � •
;�
1 r /
F
S 5 R
yElectricol Fee Dbl $
u
Zone Restrict s G ou
r P
T e
YP '
KSMI Fee .. $
3PfU.p�bing Fee Dbl S
Bond Amt.
$
Plan No. •.
Plan Checker
Final Dote In cto
Unit '
•, Sp. Insp. Fee $
Dismal. Fee $
Const. Lender Branch
Supplimental Permit Numb rs
i
'
!i r. Fee $
Mileage
�- Mileage Fee $
Address City Zip
• Witness Fee $
Reinsp. Fee $
Owner/Agent" J) fs
Tel. Zip
Total Fees $ C
.r
Address C �j
../ ' V ' ...7�. /`�'C.... /�' %• F� 1�� �a
C�
City 1 /,, ) [ Zip
/'��// �'� /A)
M.O. CD N.C. Cash Check
Received by
Trees required
Contractor
Tel. '
LicenseR-
Sewage System
'Address
City Zip
T LL P THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF WORK
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 IN ACCORDANCE WITH
THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA.
REBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE SO IN
Form 284.208 (Rev. 1/80) ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA.
verified by:
' 4i
NO. OPERATION DATE
BUILDING APPROVALS
I Set Bock
2
Ftgs 8 Frms
27
28
2A
Slab Grade
Wiring
3
Steel
298
30
4
Grout Blocks
"Service
5
Bond Beom%
6
Roof Deck
7
Framing
8
Vents
9
Garage Fire Wall
• 10
Fireplace P. L.
10A
Fireplace T. 0.
11
Exterior lath
`t 12
.Internal Loth
I
12A
Drywall
1
13
Finish Grade "�
l
INSULATION
Thick R
Value
7A
Walls jBotts)
12B
Ceiling (Batts)
12C
Ceiling (Blown)
14
Final
I
_
w V15
- - -
PLUMBING, .
- - _ _
F Ground Plumb
16
Water Piping
17
Rough Plumb
18
Vents
19
Sewage Disposal
20
Sewer
21
Water Heater
F
Water Softener
23
Water Service
24
Gas Test
25
Final
ELECTRICAL APPROVALS
26
Power Pole
27
28
Conduit
Service Entrance
29
Wiring
29A
Grounding Wire
298
30
Bonding
Fixtures
.31,^`
"Service
32
Final
INSPECTOR
r t
NO. OPERATION DATE INSPECTOR
MECHANICAL APPROVALS
33 Ventilation System
34 Plenums 8 Ducts
35 Furnace Compart.
36 Inlets & Outlets i
37 Combustion Air
38 Compressor
39 Appl. Clearance
40 Fire Damper I r
41 Smoke Detection Device
42 Commercial Hood
43 Final
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NO.. ADDITIONAL INFORMATION
_ c
i
• 4
(
f
SEWAGE. SYSTEM SIZE & LOCATION
l .
Tank k Pit L. Line
t
REAR OF PROPERTY LINE
P/L P
I c '
a
i
1
STREET NAME
NOTICE: THIS IS NOT A BUILDING PERMIT
APPLICATION TO CONSTRUCT
DEPARTMENT OF BUILDING AND.SAFETY
COUNTY OF RIVERSIDE
9
DISTRICT k
Permit No
284 199A 9/74 - CANARY—FILE, PINK—APPLICANT
Owner �� Architect _ --_ Contractor--_. —
Addy s Address___ Address --
Cit City_ City ------
ity--_ _Phone
P I I o n ePhone _ Phone—
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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
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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
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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.
d` J 1 USE OF STRUCTURE
JOB ADDRESS _� SINGLE FAMILY DUPLEX
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LEQAL DESCRIPTION F PROPERTY 1�27 APARTMENTS AGRIC.
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--- COMMERCIAL INDUSTRIAL
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COMMUNITY ALTERATIONS n
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NO. OF SUBMITTED PLANS USE OF PERMIT
CASE NO.
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NO. OF P KING PACES REQUIRED -_ -- NO. OF BUILDINGS NOW EXISTING -- —
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ZON ETBACKS: FRONT SIDE REAR
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GRADING PERMIT REQUIRED? YES ❑ NO ❑ LOT SIZE —
SETBACK ORDINANCE # OF'FEET REQUIRED ON STREET
DATE— ,G2y1 SIGNATURE OF LAND USE OFFICIA _
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DEDICATION REQUIRED: YES ❑ NO ❑ NO. OF FEET_
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CURB AND GUTTER REQUIRED: YES ❑ NO ❑ STREET
N-
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CAN CURB AND GUTTER FEASIBLY BE INSTALLED? YES ❑ NO ❑
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HAS AN ACCEPTABLE APPLICATION BEEN MADE FOR ENCROACHMENT PERMIT FOR DRIVEWAY AND STREET
4
IMPROVEMENT? YES ❑ NO ❑
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DATE SIGNATURE OF ROAD DEPT. OFFICIAL
2
SWIMMING POOLS PUBLIC
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SEWAGE DISPOSAL
FOOD ESTABLISHMENT
S
WATER POLLUTION — REMARKS
to FLOOD CONTROL
t -
z AIR POLLUTION
a
_ t- DIV OF HWY
c a _ YOUR PROPERTY MAY BE SUBJECT TO
d
c FLOOD. RIVERSIDE COUNTY ASSUMES
NO RESPONSIBILITY IN EVENT OF FLOOD.
284 199A 9/74 - CANARY—FILE, PINK—APPLICANT