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403985, 404359 (SFD)03985 DEPARTMENT OF BUILDING & SAFETY COUNTY OF RIVERSIDE FIELD",-,; CONS TRUCTION ESTIMATE verifled by: NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. 2ND. FL. FOR. voloa GAR. CAR P. WALL ESTIMATED CONSTRUCTION SO. FT. UNITS Dist. SO. FT. YARD SPKLR SYSTEM SO. FT. @ MOBILEHOME SVC. BAR SINK POWER OUTLET SO. FT. ROOF DRAINS SQ. FT. @ DRAINAGE PIPING SO. FT. @ DRINKING FOUNTAIN SO. FT. @ URINAL VALUATION WATER PIPING NOTE: Not to be used as property tax valuation IS IS/ IR SWIM POOL, ��,T FLOOR DRAIN MECHANICAL FEES T pe SWIM POOL, C Omm WATER SOFTENER VENT SYSTEM FAN EVAP. COOL HOOD PlapCh cker SIGN WASHER (AUTO)(DISH) APPLIANCE DRYER Sp. Insp. Fee Demol. Fee S GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED Regist, Fee S Mileage Fee S LAUNDRY TRAY AIR HANDLING UNIT CFM Reinsp. Fee $ [j$ IDLE METER KITCHEN SINK ABSORPTION SYSTEM B.T.U. Total Fees TEMP USE PERMIT SVC WATER CLOSET COMPRESSOR HP Received by,1�7 POLE, TEMP/PERM LAVATORY HEATING SYSTEM FORCED GRAVITY Trees AMPERES SERV ENT SHOWER BOILER B.T.U. SO. FT. @ 4 BATH TUB SO. FT. @ c WATER HEATER SO. FT. RESID @ I 'Aa SEWAGE DISPOSAL SO. FT. GAR @ 3/4 a HOUSE SEWER GAS PIPING PERMIT FEE PERM! FEE PERMIT FEE DBL. TOTAL OB. HM. FEE IM MICRO'FEE I MECH. FEE PL. CK. CONST. FEE ELECT. FEE SMI FEE FEE PLUM& FEE 4039 PERMIT NO. verifled by: Job_Adjre!> pace I zip J -az) ev 0. e.r Community Valuation I Date Dist. I Off. F.C.C. MK Permit Fee S Micro Film Fee Cop S Use of Permit Parcel No. Use/Case No. Ck. By Mach. Fee DbI $ Pl. Ck. Fee S Set Back, Lot Si.. — le ( I Construction Fee Dbl $ Legal Description k W'� y 4P17 F 61 IS IS/ IR Electrical Fee Dbl S Zone Restrictions Group T pe SMI Fee Plumbing Fee Dbl $ Bond Amt. PlapCh cker act r Unit Sp. Insp. Fee Demol. Fee S Const. tender Branch Suf6plimentol Permit Numbers Regist, Fee S Mileage Fee S Address City Zip / Witness Fee $ Reinsp. Fee $ [j$ Owner/Agent Tel. Zip Total Fees Address Pty Zip M.O. E) �V.C. Cash Check.,g] Received by,1�7 C Tel. -2, 7.1 Trees Sewage system Address City Zip T LL P Sewer District For. 284-208 Iftev. 1/80) THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF WORK verifled 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. I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE SO IN ACCORDANC E 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 I Set Bock 33 Ventilation System 2 Ftgs & 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. Cle rance 7 Framing 40 Fire Damper 8 Vents 41 Smoke Detection De�ice 9 Geroge Fire Wall 42 Commercial Hood 10 Fireplace P. L. 43 Final 10A Fireplace T.O. OP`N NO. ADDITIONAL INFORMATION SEWAGE SYSTEM SIZE & LOCATION 11 Exterior Loth 12 Internal Loth 12A Drywall 13 Finish Grade "R" INSULATION Thick Value 7A Wells (Botts) 12B Ceiling (Botts) 12C Ceiling (Blown) 14 Final PLUMBINGAPPROVALS 15 Ground Plumb I� Water Piping 17 Rough Plumb 18 Vents 19 Sewage Disposal 20 Sewer 21 Water Heater 22 Water Softener 23 Water Ser�ice 24 Gas Test 25 Final Tank Pit AlhL q Line - 471 REAR OF PROPERTY LINE ELECTRICAL APPROVALS P/L P/ I f . I 26 Power Pole 27 Conduit 28 Seice Entrance 29 Wiring 29A Grounding Wire 298 Bonding 30 Fixtures 31 Service 32 Final I I I STREET NAME PERMIT NO. DEPARTMENT OF BUILDING t& SAFETYn FIELD DST 04359 COUNTY OF RIVERSIDE PERMIT NO. 404359 CONSTRUCTION ESTIMATE lob Address �• NO. ELECTRICAL FEES NO. PLUMBING FEES . 1ST FL. 2ND. 2ND. FL. ,. POR. ��� S/ "f GAR. P CAR P. WALL ESTIMATED CONSTRUCTION SO. FT. @ Community UNITS ValuationDote $ !!! ��v+r 1 ✓iU YARD SPKLR SYSTEM SO. FT. @ 011, C Q. FT. @ ` 1 MOBILEHOME SVC. BAR SINK MH Permit Fee $ SO. FT. @ ✓ 0� POWER OUTLET ROOF DRAINS Cop $ SQ. FT. @ DRAINAGE PIPING Use of Permit s La ascription !1 5---'" k. t C SQ. FT. @ DRINKING FOUNTAIN Parcel No. Use/Ca 774 (� SO. FT. @ URINAL Mach. Fee Dbl $ VALUATION Is Z 4 WATER PIPING, F NOTE: Not to be used as property tax valuation p F �.�5 � 5 - S R :) `/) SWIM`POOL, PVT Zone frictions {y/R.�as\/ V G AS. _ FLOOR DRAIN SMI Fee § ' Plumbing Fee MECHANICAL FEES !1 SWIM POOL, COMM Plan No. WATER SOFTENER Checker VENT SYSTEM FAN EVAP. COOL HOOD I SIGN Sp. Insp. Fee $ Demol. Fee WASHER (AUTO)(DISH) '' APPLIANCE DRYER Supplimental Permit umbers ' , ��GJJ� ✓ Registr. Fee $ GARBAGE DISPOSAL Address Cit Zi Y P FURNACE UNIT WALL FLOOR SUSPENDED § Owner/Agent -- .,• LAUNDRY TRAY Tel. AIR HANDLING UNIT CFM IDLE METER $ KITCHEN SINK �rT. ABSORPTION SYSTEM B.T.U. City TEMP USE PERMIT SVC .O. N.C. Co h Check O WATER CLOSET COMPRESSOR HP POLE, TEMP/PERM Tel. /L ^� Licensell LAVATORY HEATING SYSTEM FORCED GRAVITY 0, ' AMPERES SERV ENTQ /Address � d" +D � SHOWER r V BOILER B.T.U. SO. FT. @ a BATH TUB (� SQ. FT. @ a WATER HEATER "} �i SO. FT.RESID @ l tAa � J / SEWAGE DISPOSAL ✓ r S0. FT. GAR @ t/.a HOUSE SEWER GAS PIPING 5` ' PERMIT FEE PERMIT FEE j!' - PERMIT FEE P DBL. TOTAL FE 5'MOB. HM. FEE MICRO'FEE H. FES PL. E CS. FE ; —CONST- CONST-F'E;j � r.�E • 5ml - _ FF,E�/;. . .F FEE _PLUM. �s FEE PERMIT NO. 404359 lob Address �• _- - +rf Ao rh' Space "Zip �'T•-. i. r ::t-1�u i Community ValuationDote $ !!! ��v+r 1 ✓iU Dist. 011, F.C.C. MH Permit Fee $ Micro Film Fee Cop $ Use of Permit s La ascription !1 5---'" k. t C �� i � y `` 7)Q'. �!1 1 QI Parcel No. Use/Ca 774 (� Ck. By ' 1 Mach. Fee Dbl $ r Pl. Ck. Fee $ Construction Fee Obl $ (� Set Bocks - lot Size `Type p F �.�5 � 5 - S R :) `/) Electrical Fee Del $ Zone frictions {y/R.�as\/ V G AS. _ SMI Fee § ' Plumbing Fee Dbl $ !1 Bond Amt. $ Plan No. Plan Checker Final Dote D- Inspector /J Unit Sp. Insp. Fee $ Demol. Fee $ ' Const. Lender Branch Supplimental Permit umbers ' , ��GJJ� ✓ Registr. Fee $ Mileage Fee $ Address Cit Zi Y P Witness Fee § Reinsp. Fee § Owner/Agent -- .,• , - Tel. Zip Totol Fees $ Address �'' City Zip. .O. N.C. Co h Check Received by J l�, ^t Tel. /L ^� Licensell Trees required Sewage System 1- C�.1 � � r `` jjv`,`{/"• j+ t �L� Jia r /Address � d" +D � City;Zip •�"'TV � .� t' "j c� li � ° THIS PERMIT SHALL BECOME VOID"IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF WORK FOR 120,DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID. ' Se r District - ,,, `•THEREBY AGREE THAT ALL WORK IN COPINECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE WITH THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA. H EBY IFY THAT THE INtF�/IDJAL�J`7;"�QREPAREDyTHE'PLANS AND SPECIFICATIONS HAS DONE SO IN Form 284-208 (Rev. I/80) NCE WITH SECTION 5541•%OF THE BMSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA. _ .t j�; •y .h verilied'by: NO. OPERATION DATE INSPICTOR INO. OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS 1 2 Set Back Ftgs 8 Frms /r� I J� 33 34 Ventilation System Plenums 8 Ducts f0 0 2A Slab Grade t� d� d 7 35 Furnace Comport. 3' Steel 36 Inlets 8 Outlets _O�2 Z 4 Grout Blocks 37 Combustion Air 5 Bond Beams 38 Compressor 6 7 Roof Deck Framing / ' y [ (/ / 39 40 Appl. Clearance 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. NO ADDITIONAL INFORMATION - SEWAGE SYSTEM SIZE & LOCATION 11 Exterior Lath 12 Internal loth , 12A Drywall //�.%• S( 13 Finish Grade O— — Z INSULATION Thick R Value 7A Walk (Batts) 12B Ceiling (Botts) 12C Ceiling (Blown) 14 Final 15 Ground Plumb- r_�-��-� 16 Water Piping 17 ' Rough Plumb 18 Vents 19 Sewage Disposal nn 20 Sewer 21 Water Heater 7o—I —SjZ 22 Water Softener ., 23 Water Service 24 Gas Test '25 Final a� Z Pit / 'g-) L. Line REAR OF PROPERTY LINE ELECTRICAL APPROVALS P%L°e ` _ A , . '3� P/ r Fy 26 Power Pole 27 Conduit 28 Service Entrance 29 Wiring 29A Grounding Wire la `L 29B Bonding 30 Fixtures 31 Service 32 Final , j� /,2- NOTICE: THIS\ IS NOT A BUILDING PERMIT APPLICATION TO CONSTRUCT DEPARTMENT OF BUILDING AND SAFETY COUNTY OF RIVERSIDE Owner r y Approval by Signature from the Following Departments Listed Below Must Be Obtained Prior to the Issuing of a Construction Permit. Address 4." C, City Phone `� Architect 7"" Address % O� City Phone u 7 DISTRICT Permit No f r Contractor_ tom_"Lid, '. -.0 . , Address-- City- Phone ddress_City_Phone J� 4 7- Z Z S O W I (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 do wi in the County R/ ~/J O without an encroachment permit. / NOW, therefore, it is agreed that I (we) will not occupy said property and will not cause said property o be cupied until 1 0 ave complied with all laws of the County of Riverside and the State of California governing said property. DATE �C) SIGNATURE OF OWNER AND/OR AGENT I- r y Approval by Signature from the Following Departments Listed Below Must Be Obtained Prior to the Issuing of a Construction Permit. NO. OF FEET.- SPACE NO. AND GUTTER REQUIRED: YES ❑ NO ❑ ,.USE OF STRUCTUJtE JOB ADDRESS SINGLE FAMILY UPLE•X �] Z W LEGAL DESCRIPTION OF PROPERT �-� f �`� !moi-1'iL.10 — .Y - ARTMENTS AGRIC. INSTALLED? YES ❑ NO ❑ H r /! y HAS AN ACCEPTABLE APPLICATION BEEN MADE FOR ENCROACHMENT PERMIT FOR DRIVEWAY AND STREET Q OMMERCIAL INDUSTRIAL GG Z COMMUNITY ALTERATIONS NO. OF SUBMITTED PLANS -__—_ USE OF PERMITe2,6 DATE �U3 _� Q CASE NO. WIMMIN t7 p Z a _ NO. OF PA KING PACES REQUIRED r� NO. OF BUILDINGS NOW EXISTING ZONE SETBACKS: FRONT o fO SID REAR /7� _ J m GRADING PERMIT REQUIRED? YES ❑ NO ❑ LOT SIZE IN, c,...�:dR�;�N.�SEENT A SETBA%Cr ORDINANCE __— OF '-'FEET REQUIRED ON STREET DAT ` j _ SIGNATURE OF LAND USE OFFICI I- DEDICATION REQUIRED: YES ❑ NO ❑ NO. OF FEET.- iCURB AND GUTTER REQUIRED: YES ❑ NO ❑ STREET �-Cr)o i CAN CURB AND GUTTER FEASIBLY BE INSTALLED? YES ❑ NO ❑ W HAS AN ACCEPTABLE APPLICATION BEEN MADE FOR ENCROACHMENT PERMIT FOR DRIVEWAY AND STREET IMPROVEMENT? YESNO ❑ °C DATE �U3 _� SIGNATURE OF ROAD DEPT. OFFICIA I WIMMIN r? - = f- Q W LIC SEWAGE DISPOSAL _ �^ ad c,...�:dR�;�N.�SEENT A _ j-- Z 284 199 9/74 0 WA[frER PbLLUTI( FLOOD CONTROL AIR POLLUTION DIV OF HWY REMARKS M YOUR PROPERTY MAY BE SUBJECT TO FLOOD. RIVERSIDE COUNTY ASSUMES NO RESPONSIBILITY IN EVENT OF FLOOD. CANARY—FILE, PINK—APPLICANT DEPARTMENT OF BUILDING AND SAFETY APPLICATION CERTIFICATE COUNTY OF RIVERSIDE PERMIT N Effective July 1, 1980, Chapter 1301 Section 19825,of the H"Ith and Safety Code requires the execu- tion of the following applicable declarations prior to the issuance of a building permit. Please print or type.and sign below:- LICENSED CONTRACTORS DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code,and my license is in full force and effect. License Class 16 / License No. Date r /- G-cw Contractor ,C=_ C '19f� , 0 OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reasons: [� I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. If I sell within one- year of completion, I understand I"will have the burden of proving I did not build or improve for•the purpose of sale (Sec. 7031.5;'8.&P.C.). I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, B.&P.C.). [:J I am exempt under Section , B.&P.C. for this reason: Date Owner Q WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to self -insure, or a Certificate of Workers' Compensation Insurance, or a certified copy thereof'(Sec. 3800, Lab. Code). . Policy No. 6e_30 - 3-7?- 10 Z50,� Insurance c� cP? A4., T 0 Certified copy is hereby furnished. Certified copy is filed with the County of Riverside, Department of Building and Safety. Date / Applicant I re: ;rte C L a CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if permit val'uation is for $100.00 or less.) 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 understand that if after making this Certificate of Exemption, I should become subject to the Workers' Compensation provisions of the labor code, I must forthwith comply with such provisions or this permit shall be deemed .revoked. Date Applicant CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for -the performance of the work for which this permit is issued (Sec. 3097, Civ. Code). ` Lender's Name Lender's Address DIVISION OF INDUSTRIAL -SAFETY PERMIT CERTIFICATION Q' I hereby certify that no excavation five (5) or more feet in depth into which a person is re- quired to descend, will be made i6 connection with work authorized by this permit, and that no building, structure, scaffolding, falsework, or demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap 3.2, Grp 2, Art 2, Sec 341, Title 8, C.A.C.) As owner -builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety, as noted above, unless such person has a permit to do such work from that division. M Division of Industrial Safety Permit No. Date Applicant CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY I certify I have read this application -and state that the information given is correct. I agree to comply with all state laws and county ordinances relating torbuilding construction, and authorize a representative of the County of,Riversi'de, Department of Building and Safety to enter upon the pro- perty -for which I have applied fortth•s permit for the=purpose of making inspection Signature of Applicant/Agent Date Print Applicant/Agent Name 284-2000 7/80 APPLIqTIG4-I ,RR. TRETE PLANTING I -(we), the undersigned, hereby certify and acknowledge that 1 (wvi have read the application and agree that if trees are required under River- side County Ordinance No. 457, the applicant agrees 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 agreed that the prop- erty owner shall cause the property lines to be surveyed in tho event no survey stakes can be found. Further, it is agreed that the County of Riverside shall assume no responsibility should trees have to be removed due to lot line errors. s Owners Name "CE Building Permit No.�� Mailing Address 430 ZsyCity �r�Yd Stat Zip tel. Job Address �� T� /eve ,��!� Community /�l Legal Description _.T4= Assessor's Book Page `� Type Structure u/ JF LU Type of Soils water available �Roa Dep). Plot Plan No. Z X Type of existing trees in road rightt--off—way D v Trees preferred by applicant (1) / r/ -//L OLL! (2) L (3) <-- Date Owner's Signature Planning Commission Case No. ROAD DEPARTMENT APPROVAL Approved specieseo t /j �D4. O/91Gt�.[.l11 umber of trees oW Spacing of trees 7 Distance from lot lines: Front �17,c.g/o, /?/,4 S ide WO Additional requirements &Y -o., /7WPA A h 0, a i, Date Building and Safety n tified Signature REQUEST FOR EXCEPTION Reason 0 >- Z � LU CLL J N m oa .6 J. (attach additiondl page if necessary) Request for hearing: YES F-1 Owner's Signature (Forward application to Planning Dept. if exception requested) NO REQUEST FOR HEARING .Planning Dept. Concur ❑ Non -concur ❑ Explanation Date Signature Road Dept. Concur ❑ Non -Concur ❑ Date Signature REQUEST FOR HEARING AND COMMITTEE DECISION Date hearing established Date hearing notice mailed to owner Approved ❑ Disapproved ❑ Date Owner notified of decision Date Building & Safety notified Signature k `l _ BUILDING PERMIT PERMIT NO - 404359 DEPARTMENT OF BUILDING & SAFETY FIELD OFFICE �DST COUNTY OF RIVERSIDE CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. 126U 2ND. FL. FOR. GAR. CAR P. WALL ESTIMATED CONSTRUCTION SQ. FT. CTO / UNITS PERMIT NO. 4 0 4 3 5 9 SO. FT. @ YARD SPKLR SYSTEM SO.,FT. @ MOBILEHOME SVC. BAR SINK SQ. FT. @ S�ri 5 POWER OUTLET ROOF DRAINS SQ. FT. @ DRAINAGE PIPING Community SO. FT. @ DRINKING FOUNTAIN Date SQ. FT. @ URINAL F.C.C. VALUATION $ WATER PIPING NOTE: Not to be used as property tax valuation SWIM POOL, PVT FLOOR DRAIN MECHANICAL FEES SWIM POOL, COMM WATER SOFTENER MH Permit Fee VENT SYSTEM FAN EVAP. COOL `HOOD SIGN WASHER (AUTO)(DISH) APPLIANCE DRYER Micro Film Fee Cop $ GARBAGE DISPOSAL - FURNACE UNIT WALL fLOOR SUSPENDED Use/CoA NIS. Ck. By LAUNDRY TRAY .PI. Ck. Fee AIR HANDLING UNIT CFM IDLE METER KITCHEN SINK Lot Size ABSORPTION SYSTEM B.T.U. Construction Fee TEMP USE PERMIT SVC WATER CLOSET �'"1 *da- COMPRESSOR HP R To POLE, TEMP/PERM - LAVATORY -� HEATING SYSTEM FORCED GRAVITY \J` i�+IC/ Zone R tri<tions AMPERES SERV ENT SHOWER SMI Fee BOILER B.T.U. SO. FT. @ a BATH TUB Plumbing Fee SO. FT. @ a WATER HEATER Ian No. Plan Checker Final Date6a d S0. FT. RESID @ 1 t/<a' SEWAGE DISPOSAL I Unit Sp. Insp. Fee S0. FT,. GAR @ 1/4a HOUSE SEWER S GAS PIPING —0 PERMIT FEE Dermal. Fee $ PERMIT FEE 7PERMIT FEE Supplimentol Permit Numbers - DBL. TOTAL FEMOB. HM. FEE MICRO FEE H. FEE PL. CKJE CONST. FEE ELEA 7FE.;,SMI F FEE PL U B. FEE N ll P THIS AERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 12TDAYS. CESSATION OF WORK ve,,fi d b Se er 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. /_' I H EBY 1'IFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE SO IN Form 284-208 (Rev. 1/80) tC►�� �/ �t CE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA. Job Address t\ Space Z'�� Owner PERMIT NO. 4 0 4 3 5 9 �/ .+ Community Valuation Date Dist. Off. F.C.C. I MH Permit Fee S S Micro Film Fee Cop $ Use of Permit - ar<el No. ' — d (� Use/CoA NIS. Ck. By Mech. Fee Dbl S .PI. Ck. Fee S Set Backs Lot Size Construction Fee DistS LeI cr tion �'"1 *da- F $ S r II R To Electrical Fee DietS Air \J` i�+IC/ Zone R tri<tions GiCup Type SMI Fee S Plumbing Fee Diet S M Bond Amt. Ian No. Plan Checker Final Date6a d Insp cto I Unit Sp. Insp. Fee $ S Dermal. Fee $ Const. tender Branch Supplimentol Permit Numbers - Regist, Fee S Mileage Fee S Address City Zip Witness Fee S Reinsp. Fee g Owner/Agent / ` Tel. Zip Total Fees S Address City Zip J 1%4.0. Gl N.C. Co Check Received bN, I—Re r Tel. Licens0l Trees required Sewage System Address ' y Zip © � N ll P THIS AERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 12TDAYS. CESSATION OF WORK ve,,fi d b Se er 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. /_' I H EBY 1'IFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE SO IN Form 284-208 (Rev. 1/80) tC►�� �/ �t CE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA.