385037 (RR)PERMIT NO. DEPARTMENT OF BUILDING & SAFETY DST
385037 COUNTY OF RIVERSIDE FIELD I I J.I
I
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
PERMIT NO..
IST FL. SQ. FT. @ `p
UNITS
Owner
2ND. FL. SQ. FT. @
1385037
YARD SPKLR SYSTEM
POR. SQ. FT. @
MOBILEHOME SVC.
BAR SINK
GAR. SQ. FT. @
POWER OUTLET
ROOF DRAINS
CAR P. SQ. FT. @
F.C.C.
DRAINAGE PIPING
WALL SQ. FT. @
DRINKING FOUNTAIN
FT. �
.i'..��
,
URINAL
_
V. ESTIMATED CONSTRUCTION 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
/T"�' /[/ - ^,
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
��
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.
SQ. FT. @ C
BATH TUB
SQ. FT. @ c
WATER HEATER
Group
SQ. FT. RESID @1'hc
SEWAGE DISPOSAL
SQ. FT. GAR @ 3/4 c
HOUSE SEWER
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL.
TOTAL FEES
MOB. HM. FEE
MICRO FEE
MECH. FEE PL. CK. FEECONST.
FEE ELECT. FEE
SMI FEE
FEE PLUMB. FEE
Plan No.
Plan Checker
Final Dote Q
n
v ✓Z-^�
Inspector ^
Unit
F
Sp. Insp. Fee
$
$
Ire
PERMIT NO..
Job Address Space
Zip
Owner
1385037
Community
Valuation
Dote
Dist.
~Off.
F.C.C.
MH Permit Fee
$
s
_
Micro Film Fee
Cops
04'67 Perm
Parcel No.
Use/Cas LJo.
Ck. By
Mech. Fee
Dbl $
/T"�' /[/ - ^,
_ n
�73
��
PI. Ck. Fee
$
/
Set acks
lot Size
Construction Fee
Dbl $ i
Legal Description
F S S R
Electrical Fee
Dbl s
`
Zone Restrictions
Group
Type
'�•ft'in lcl� (•� (G
SMI Fee
$
Plumbing Fee
Dbl $
Bond Amt.
Plan No.
Plan Checker
Final Dote Q
n
v ✓Z-^�
Inspector ^
Unit
Sp. Insp. Fee
$
$
Demol. Fee
$
Const. Lender Branch
Supplimental Pe�bers
Registr. Fee
$
Mileage Fee
$
Address City Zip
Witness Fee
$
Reinsp. Fee
$
Owner/Agent
Tel.
Zip
Zip
Total Fees
sAddress
City
M. 0. N.C.
Cash Chck
e
Received by
Co ioctoi' `� "' `—
Tel.
License#
Trees requ it —44
.r
Sewage System
'Add, sr
city Z�
T
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THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF WORK
verified by:
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.
I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE SO IN
`
LL
ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA.
Form 284-208 (Rev.B 8) P s
Form 284-208 (Rev. 141)
NO.
OPERATION DATE
INSPECTOR
NO.
OPERATION
DATE INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
1
Set Back
33
Ventilation System
2
Ftgs & Frms
34 Plenums 8 Ducts
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 a _to -7
39
Appl. Clearance
7
Framing 1
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.
P'
ADDITIONAL INFORMATION
SEWAGE SYSTEM SIZE & LOCATION
13 Exterior Loth
12 Internal Lath
12A Drywall
13 Finish Grade
INSULATION Thick R
Value
7A Walls (Batts)
12B Ceiling (Batts)
12C Ceiling (Blown)
14 Final C— 1-9y.
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
Tank Pit L.Line
REAR OF PROPERTY LINE
ELECTRICAL APPROVALS
PSL
P)
e
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
Owner Architect —_ _ Contracto�r.
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Address—%�7 G�SeN ��_ Address___ Address 7/ fjL'&�46Z4�
City xZ: — City
Phone 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
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 un it 1 e) have
complied with all laws of the County of Riverside and the State of California governing said property.
DATE ----- SIGNATURE OF OWNER AND/OR AGEN
Approval by Signature from the Following Departments Liste Below
Must Be Obtained Prior to the issuing of a Construction Permit.
(7 ��� I SPACE NO.
7 �J 1 USE OF STRUCTURE
JOB ADDRESS � 7 —`�t� �f—I✓ t" Vim—
}
SINGLE FAMILY . DUPLEX
LE AL DESCRIPTION OF PRO ERTY_//_=� ��/_/_
APARTMENTS AGRIC.
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— COMMERCIAL INDUSTRIAL ❑
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COMMUNITY Gc—
ALTERATIONS
NO. OF SUBMITTED PLANS — USE OF PERMIT O O L �
4CASE
NO. Elly -tel ,l NGL _
p Z
NO. OF PARKING SPACES REQUIRED .— NO. OF BUILDINGS NOW EXISTING
Q
ZONE SETBA6KS: FRONT SIDE REAR
J
m
GRADING PERMIT REQUIRED? YES ❑ NO ❑ LOT SIZE
SETBACK ORDINANCE # OF FEET REQUIRED ON STREET
DATE- ` SIGNATURE OF LAND USE OFFICIAL _
F
DEDICATION REQUIRED: YES ❑ NO ❑ NO. OF FEET—
CURB AND GUTTER REQUIRED: YES ❑ NO ❑ —STREET
d
CAN CURB AND GUTTER FEASIBLY BE INSTALLED? YES ❑ NO ❑
W
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HAS AN ACCEPTABLE APPLICATION BEEN MADE FOR ENCROACHMENT PERMIT FOR DRIVEWAY AND STREET
10
C
IMPROVEMENT? YES ElNO ❑
°C
DATE SIGNATURE OF ROAD .DEPT. OFFICIAL
Z
SWIMMING POOLS PUBLIC
t—
JW
SEWAGE DISPOSALLu
t
—
FOOD ESTABLISHMENT
0
I
WATER POLLUTION REMARKS
FLOOD CONTROL—
Fes-
z AIR POLLUTION
p: W
W DIV OF HWY t 1AM
c - YOUR PROPERTY MAY BE SUBJECT TO
o.
o FLOOD. RIVERSIDE COUNTY ASSUMES
NO RESPONSIBILITY IN EVENT OF FLOOD.
284 199A 9/74 CANARY—FILE, PINK—APPLICANT
BUILDING PERMIT
PERMIT NO. DEPARTMENT OF BUILDING & SAFETY FIELD OFFICE DST
385037
COUNTY OF RIVERSIDEF,
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL.
2ND. FL.
POR.
GAR.
CAR P.
WALL
ESTIMATED CON RUCTION
SQ. FT. @ $
UNITS
MH Permit Fee §
SQ. FT. @
YARD SPKLR SYSTEM
MOBILEHOME SVC.
SQ, FT. @
BAR SINK
SQ. FT. @ POWER OUTLET
ROOF DRAINS
SQ. FT. @
DRAINAGE PIPING
SQ. FT. @
DRINKING FOUNTAIN
Q. FT. @ +M+v�
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
Bond Amt.
$
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
Plan Checker
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.
SQ. FT. @ t
BATH TUB
§
SQ. FT. @ c
WATER HEATER
Tel.
SQ. FT. RESID @1'/.c
SEWAGE DISPOSAL
Total Fees
M. 0. N.C.
SQ. FT. GAR @ 1%c
HOUSE SEWER
City
Zip
GAS PIPING
PERMIT FEE
ractor
PERMIT FEE
PERMIT FEE
D%..
TOTAL FEES .
MOB. HM. FEE
MICRO FEE
MECH. FEE PL. CK. FEE
I CONST. FEE ELECT. FEE
SMI FEE
FEE PLUMB. FEE
1PERMIT NO.
-38503 7
Job Address
Community
Valuation
§
Space Zip Owner
Date Dist. Off.
..,,,.,,,,. �_
F.C.C.
MH Permit Fee §
Micro Film Fee
Cop §
Use
nof ermi
If/
/V
C•�-�
Parcel No.
��„
Use/Case No.
Ck. By
Mech. Fee Dbl §
PL Ck. Fee §
^� et acks
Lot Size
Construction Fee
Electrical Fee
Dbl §
Dbl §
Lego! Description
/ �
/
(O/ JC///ev
A+ Y
F IS S R
Zone Restrictions
Group
Type
SMI Fee §
Plumbing Fee
Dbl §
Bond Amt.
$
Plan
No.
Plan Checker
Final Date
Inspector
Unit
Sp. Insp. Fee §
Demo!. Fee
§
Const. Lender
Branch
Supplimental Permit Numbers IT
Registr. Fee §
Mileage Fee §
Address City Zip
Witness Fee §
Reinsp. Fee
§
Owner/Agent
Tel.
Zip
Total Fees
M. 0. N.C.
§
Cash Check
Addr,�
1
City
Zip
Received by,Co
ractor
r
Tel.
LicenseM
Trees requir
Sewage System
Address
City Zip
T LL P
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF WORK verified by:
Sewer District FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
C i 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
Form 284-208 (Ray.B/78) p s
ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA.
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