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359616, 359966, 360444 (SFD)BUILDING PERMIT — PERMIT NO. DEPARTMENT OF BUILDING & SAFETY FIELD DST 359616 COUNTY OF RIVERSIDE I /! I + CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES G $ 9• UNITS Owner IST FL. SQ. FT. @ 2ND. FL. SQ. FT. � YARD SPKLR SYSTEM Pop SQ F7 @ . e -:o [ MOBI1EHQME SVC., BAR SINK � � GAR. SQ. FT. � r / POWER OUTLET ROOF DRAINS CAR P. SQ. FT. @ Cop $ Use of Permit ♦ DRAINAGE PIPING WALL SQ. FT. @ Parcel -•No. / se/Case / "' (.' '�*� No. DRINKING FOUNTAIN SQ. FT. @ PI. Ck. Fee Set Backs URINAL ESTIMATED CONSTRUCTION VALUATION $ r-<> --L— Construction Fee Dbl $ WATER PIPING NOTE: Not tp.,be used as propeM tax volyation r SWIM POOL,- PVT ++ FLOOR DRAIN MECHANICAL FEES SWIM POOL, COMM WATER SOFTENER VENT SYSTEM FAN EVAP. COOL HOOD Type !/ SIGN WASHER (AUTO)(DISH) APPLIANCE DRYER Dill S Bond Amt. S Const. Lender Address GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED Zip Final Dote Inspector Supplim ntal ermit Numb LAUNDRY TRAY AIR HANDLING UNIT CFM IDLE METER KITCHEN SINK ABSORPTION SYSTEM B.T.U. Mileage Fee $ TEMP USE PERMIT SVC WATER CLOSET COMPRESSOR HP Owner/Agent POLE,TEMP/PERM LAVATORY HEATING SYSTEM FORCED GRAVITY Tel. AMPERES SERV ENT SHOWER BOILER B.T.U. SQ. FT. @ t BATH TUB • * .. SQ. FT. @ t WATER HEATER t SQ. FT. RESID @1 t/.t SEWAGE DISPOSAL - r { ' ♦, SQ. FT. GAR @ %c HOUSE SEWER �--- "* license# (�i� GAS PIPING PERMIT t i ' E PERMIT FEE PERMIT FEE DBL, '.R „TOTAL FEES MOB. HM. FEE MICRO FEE MECH. FEE _ PL. CK. FEE CONST. FEE ELECT. FEE SMI FEE FEE PLUMB. ]1EE PERMIT NO. 3596 Job Address Space Zip Owner � Community /f ( i / A Valuation $ Date ✓ e f^ Dist. 17-1 Off. F.C.C. MH Permit Fee S Micro Film Fee Cop $ Use of Permit ♦ f [•,/ , C �t.,, Parcel -•No. / se/Case / "' (.' '�*� No. Ck. By Mech. Fee Dbl $ PI. Ck. Fee Set Backs lot Size Yl r-<> --L— Construction Fee Dbl $ Legal Description g P /, G, '� ,r J 4. i j / / / / F S S R Electrical Fee Dbl $ Zone Restrictions , / Group Type !/ SMI Fee s Plumbing Fee Dill S Bond Amt. S Const. Lender Address Plan No. Plan Checker Branch City Zip Final Dote Inspector Supplim ntal ermit Numb Unit Sp. Insp. Fee s Demo!. Fee $ Registr. Fee s Mileage Fee $ Witness Fee $ Reinsp. Fee $ Owner/Agent Tel. Zip Total Fees M.O. $- N.C. Cash Check .Address - _ • , , City Zip Received by Contractor ) y'.'i •.f/-/,'/ t.' / `/ Tel. fr#,, 4 r•=�'- license# (�i� Trees required!! Sewage System i Address ` � / � :t? :: > r City ,4 f�/ r . ' , Zi r v T , , •p U. t.., ..P , wer District rm 284-208 (Rev.8/78j + THIS 4MIT-SHAU. BECOME VOID IF WRK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF WORK verified by: FOR 120 PAYS 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 ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA. r �. r NO. OPERATION DATE INSPECTOR NO. OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS 1 Set Back 33 Ventilation System 2 Ftgs & Frms 34 Plenums & Ducts 2A Slob 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. Clearance 7 Framing 40 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. P' ADDITIONAL INFORMATION t - - - - SEWAGE SYSTEM SIZE & LOCATION 11 Exterior Lath 12 Internal Lath 12A Drywall 13 Finish Grade INSULATION Thick R Value 7A Walls (Batts) 12B Ceiling (Batts) —12C. Ceiling (Blown) •14 Final PLUMBING APPROVALS 15 Ground Plumb 16- Woier 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 P/L P/ t 26 Power Pole 27 Conduit 28 Service Entrance 29 Wiring 29A Grounding Wire 298 Bonding 30 Fixtures 31 Service '32 Final ,a STREET NAME BUILDING PERMIT PERMIT NO. 359966 r DEPARTMENT OF BUILDING & SAFETY. COUNTY OF RIVERSIDE , T - FIELD �i CONSTRUCTION ESTIMATE ' .. NO. ELECTRICAL FEES NO. PLUMBING FEES _ r $ Comrnunity /L �� , ( 't t t "A, T" UNITS IST FL. SQ. FT. @ T Dist. Off. F.C.C. / 2ND. FL. SQ. FT. @ Micro Film Fee ' YARD SPKLR SYSTEM .� POR.' " ' ^ " — "` SQ.'FT. @ Use/Case 5;9 MOBILEHOME SVC. a BAR SINK GAR. SQ. FT. @ � SG POWER OUTLET ROOF DRAINS CAR P. SQ. FT. @ Construction Fee Dbl $ Legal Description J� / / /� j~ _ CT • �G � �'^'�� <:7( 'o DRAINAGE PIPING WALL SQ. FT. @ Electrical Fee Dbl $ DRINKING FOUNTAIN SQ. FT. @ Type URINAL ESTIMATED CONSTRUCTION VALUATION $+/^ : Bond Amt. E WATER PIPING -NOU:_,Npt,jo;be used as property,tax voluatioq . • .. r a SWIM POOL, PVT .+ r -.+ FLOOR DRAIN MECHANICAL FEES Sp. Insp. Fee $ SWIM POOL, COMM WATER SOFTENER VENT SYSTEM FAN EVAP. COOL HOOD Supplimental Permit Numbers i t SIGN WASHER (AUTO)(DISH) APPLIANCE DRYER Address City Zip Witness Fee $ GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED Owner/Agent Tel. LAUNDRY TRAY AIR HANDLING UNIT CFM Total fees ` "' S• " . IDLE METER KITCHEN SINK ABSORPTION SYSTEM B.T.U. M.O. N.C. 0 Cash El Check TEMP USE PERMIT SVC WATER CLOSET COMPRESSOR HP Tel. POLE,TEMP/PERM LAVATORY HEATING SYSTEM FORCED GRAVITY Sewage System AMPERES SERV ENT SHOWER BOILER B.T.U. Zip SQ. FT. @ t BATH TUB SQ. FT. @ c WATER HEATER SO. FT. RESID @1'hc SEWAGE DISPOSAL SO. FT. GAR @ 3: c HOUSE SEWER GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBt.e TOTAL FEES _ MOB.HM.FEE a MICRO FEE _ MECH. FEE PL. CK. FEE CONST. FEE R ELECT. FEE SMI fEE FEE PLUMB. FEE PERMIT NO.Job 359966 ' .. Address Space - ..._. Zip Owner Comrnunity /L �� , ( 't t t "A, T" Valuation E Datte/ 7 Dist. Off. F.C.C. MH.Permit Fee $ Micro Film Fee Cop $ Use of Permit t `. �R , r-��(• 4 �fjr� ,�I �� ' �^ Parcel No.. �i5 Use/Case 5;9 No. rR% Ck. By AR Mech. Fee Dbl $ PI. Ck. Fee f 1 i Set Backs I Lot Size C•-�i //e �y V Construction Fee Dbl $ Legal Description J� / / /� j~ _ CT • �G � �'^'�� <:7( 'o f >t S S R Electrical Fee Dbl $ Zone Re%ttions / - Group Type SMI Fee $ Plumbing Fee Dbl $ Bond Amt. E Plan No. Plan Checker t I -Dote ,�•%' Inspec Unit Sp. Insp. Fee $ Demol. Fee E Const. Lender Branch Supplimental Permit Numbers i t Regisir. Fee $ Mileage Fee $ Address City Zip Witness Fee $ Reinzp. Feef Owner/Agent Tel. Zip Total fees ` "' S• " . Address _. �• t , - `-� 1�L ,.i -� City .,r ... j• /, % Zip M.O. N.C. 0 Cash El Check Received by !• ' �'12 Contractor Tel. License# Trees required J Sewage System ) Address _ City Zip Sewer District a Form 284-206 (Rev.8/78) t 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. I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATICLNS HAS DONE SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE3fATE 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 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 7 Framing 40 Fire Dampei 8 Vents 41 Smoke Detection Device 9 Garage Fire Wall 42 Commercial Hood 10 Fireplace P. L. 43 Final 10A Fireplace T.O. P'N_ NO ADDITIONAL INFORMATION SEWAGE SYSTEM SIZE & LOCATION 11 Exterior Lath 12 Internal Lath 12A Drywall 13 Finish Grade INSULATION Thick R 1 Value 7A Walls (Batts) 12B 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 25 Final Tank Pit L.Line P/L 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 PERMIT NO. OWNER Job Aadress (. : Space Zip Owner917S3 359 9 6.6., -- R, 0' Community A �/Y` ... . _ .. ... �� Valuation S _- - Date !7 Dist. Off F.C.C. ,. . .. • MH Permit Fee $ ' � Micro'Film Fee Cop Use bfPermit _'V 4[.J Diol � 4 -e Parcel No. Use/Gose No. Ck. By ach. Fee Dbl $ Pl. {k, Fee $ Set Backs - S S R Resttictions Group t Lot Size S0?(/4) Type 0 • - Cbnstruction Fee . •. Dbl S . legal Description f- /a ..L /.� . ji� --%' [J .Zone O Eleciricol Fee , Dbl $ SMI Fee - S` G (/:^ vt (Plumbing Fee Dbl $ - Bond Amt. $ Plon No. Plan Checker Final Date Inspector Unit Sp, lnsp. Fee- $ Demol. Fee $ Consl.;Lender '-.Bronch- 'Supplimentol Permit Numbers - y Registr. Fee j loileoge Fee j' - Address ' • City, Zip Witnesl Fee i $ .Reinsp. Fee, j Owner/Aaelrt, 1 Tel. Zip Total Fees.,- ` _._ ' S'^ .r ..•... .. .Adore#s - . r . . 4 ,......r ►` , .. �C.::. Received byCont Tel License# Trees required - r wage System Address City, Zip Sewer District ' Form 284.208 (Rev.8/781 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:BEQOMIE VOID. . I HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE WITH THE LAWS OF RIVERSIDE COUNTY ANQ,THE STATE OF;CALIFORNIA. 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. 'DEPARTMENT OF BUILDING AND SAFETY COUNTY OF 'RIVERSIDE CLAIM OF: /� C O r� r. ADDRESS: CITY AND STATE DATE: ON THE TREASURER OF THE COUNTY OF RIVERSIDE, STATE OF CALIFORNIA Instructions: Permittee will furnish the following information: (1) Permit Number-�-f —:970,/ . (2) Date Issued (3) Total Fees Paid $ f/& (4) Reason for Refund 9A,,k/. /`/LL C Sid I CERTIFY THAT THIS CLAIM IS TRUE AND CORRECT, AND THAT NO PART HEREOF HAS BEEN -.PREVIOUSLY PAID BY THE COUNTY OF RIVERSIDE. r Claimant's Signature (.Do not write below this line) Date: April 26• .1979 General Fund: 1001-284-1231 FROM: DEPARTMENT OF BUILDING AND SAFETY TO: AUDITOR -CONTROLLER, COUNTY OF RIVERSIDE Please issue to the above indicated claimant a refund -6f_$ 50.50 , on the above permit deposited under Treasurer's Receipt No. -= '= ri�z�ycs , dated 4 i0 -?9 AUTHORITY: Ordinance No. 457, Section 7, Subsection E Approved -D ` r the following reason: (strike out words not applicable) A0004ut purche$ed duplicate permit: 359966, 4-S-79 to Permit 359626 3.22479: Attach64 copy for ccroa9 ref�reaoe. Chief Building I -p ctor, ell > . Director_ of Buildind Safety BUILDING PERMIT PERMIT NO. i. 360.444• DEPARTMENT OF BUILDING & SAFI COUNTY OF RIVERSIDE CONSTRUCTION ESTIMATE Owner - NO. ELECTRICA IST FL.SQ. FT. @ j 2ND. FL. SQ. FT. @ pYi POR. SQ. FT. @ GAR. SQ. FT. @ CAR P. SQ. FT. @ WALL' `e Q. SQ. FT. @ ESTIMATED CONSTRUCTION VALUATION $ g UNITS MOBILEHOME SVC. POWER OUTLET NOTE: Not to be used as property fox valuation Micro Film Fee Cop $ SWIM POOL, PVT MECHANICAL FEES Use/Case No. SWIM POOL, COMM 'VENT SYSTEM FAN EVAP. COOL oz HOOD x SIGN APPLIANCE DRYER Legal Description • F /'•• F, ��r ;,�.��'t�li ryf .� 5 FURNACE UNIT WALL FLOOR SUSPENDED Zone Restrictions lop Group AIR -HANDLING UNIT CFM SMI Fee $ IDLE METER ABSORPTION SYSTEM B.T.U. Pion No. TEMP USE PERMIT SVC COMPRESSOR / HP In POLE,TEMP/PERM HEATING SYSTEM FORCED GRAVITY. Demol. Fee $ MPERES SERV ENT BOILER B.T.U., a. SQ. FT.'@ �+..• ..r 't -!;.v. «nl �t-* t�•ae - - ,,,. r 'v SQ.FT' ''@ • .. Owner/AgenOr // /�f (/ ��t Tel. Zip 2 SO. FT. RESID @ 1 t/. Total Fees $Address M.O. N.C. Cash Check SQ. FT. GAR @ s/. Received by C. Contractor ... - r . . . • r. Tel. License# PERMIT FEE ' Sewage System I s Z Ooo'e'V'o LL Address � PERMIT FEE DBL. TOTAL'FEES MOB. HM. FEE MICRO FEE /Ji 'C F E PL. CK. FEE CONST. FEE - PERMIT NO. - _ ' ' `' �" 360444 " Job Address'` ' ' • • • • * •'r - Spbce Zip u _. r 11, r > , Owner - CommunityValuation $ B•�^ Date Dist. Of{ F. MH. Permit Fee $ Micro Film Fee Cop $ Use of -permit �• G Parcel No. Use/Case No. Ck. By Mech. Fee Dbl $ Pl. Ck. Fee $ Set a`cks lot Size Construction Fee Dbl $ y Electrical Fee Dbl $ t Legal Description • F /'•• F, ��r ;,�.��'t�li ryf .� 5 S R Zone Restrictions lop Group Type SMI Fee $ Plumbing Fee Dbl $ Bond Amt. $ Pion No. Plan Checker Mote T-3 0 v In Unit Sp. Insp. Fee $ Demol. Fee $ Const. Lender Branch Supplimentol Permit Numbers - Registr. Fee $ Mileage Fee $ Address City Zip i Witness Fee $ Reinsp. Fee $ Owner/AgenOr // /�f (/ ��t Tel. Zip Total Fees $Address M.O. N.C. Cash Check City Zip Received by C. Contractor ... - r . . . • r. Tel. License# Trees required `. w+, .. , —,-. r .. Sewage System I s Z Ooo'e'V'o LL Address � City Zip • THIS PERMIT SHALL BECOME VOID IF WOf K IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF WORK vbrified by: FOR 120 DAYS SHALL ALSO CAUSE. PERMIT TO BECOME VOID. A I HEREBY AGREE THATII WITH THIS PERMIT WILL BE DONE IN ACCORDANCE WITH ' t THE LAWS OF RIVERSIDE AIAN E TE C7rCALIFORNIA. Sewer District ` C • `� 1 t \� ► 1,-I I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE SO IN J ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA. Form 284-208 (Rev.8/78) t NO. OPERATION DATE INSPECTOR NO. OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS 1 Set Back 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. Clearance 7 Framing 40 Fire Damper 8 Vents 41 Smoke Detection Device 9 Garage Fire Wall 42 Commercial Hood 10 Fireplace P. L. 43 Final 10A Fireplace T. 0. N OP'N ADDITIONAL INFORMATION SEWAGE SYSTEM SIZE & LOCATION 11 Exterior Lath 12 Internal Lath 12A Drywall 13 Finish Grade INSULATION Thick R Value 7A Walls (Batts) 12B Ceiling (Batts) I 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 • 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 • l a STREET NAME NOTICE: THIS IS NOT A BUILDING PERMIT DISTRICT APPLICATION TO CONSTRUCT Permit No DEPARTMENT -OF BUILDING AND SAFETY COUNTY OF RIVERSIDE Owner. I_ Architect____— Contractor_ --__ Address.`.. - _ Address___ Address_ __. City- - .- _ City.—_- City _ Phone_ �_ __ _ _ _ _ _ Phone - _ Phone _ 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 done within the County R/W O without an encroachment permit. NOW, therefore, it is agreed that l (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_ r s f SIGNATURE AND DATE __.._ OF OWNER 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. USE OF STRUCTURE JOB ADDRESS ' - SINGLE FAMILY DUPLEX y I Z LEGAL DESCRIPTION OF PROPERTY APARTMENTS AGRIC. C� W COMMERCIAL INDUSTRIAL L1 '^ C � COMMUNITY ALTERATIONS C'Z NO. OF SUBMITTED PLANS OF PERMIT E�[USE 7 a CASE NO. _ l7 p Z NO. OF PARKING SPACES REQUIRED NO. OF BUILDINGS NOW EXISTING - ---- - _-- Q ZONE -- SETBACKS: FRONT SIDE REAR J m GRADING PERMIT REQUIRED? YES ❑ NO ❑ LOT SIZE SET BACK,ORDINANCE # ___ OF FEET REQUIRED ON STREET DATE SIGNATURE OF LAND USE OFFICIAL r' t" DEDICATION REQUIRED: YES ❑ NO ❑ NO. OF FEET _ LuCURB AND GUTTER REQUIRED: YES ❑ NO ❑ �' S ' '' `''' STREET H W CAN CURB AND GUTTER FEASIBLY BE INSTALLED? YES ❑ NO ❑ HAS AN ACCEPTABLE APPLICATION BEEN MADE FOR PERMIT FOR DRIVEWAY AND STREET GIMPROVEMENT? ENCROACHMENT YES � NO ❑ °L DATE _ r �rI % �( SIGNATURE OF ROAD DEPT. OFFICIAL t •-�+ `+ )�' r' ` - L z 7, 2 SEWAGE DISPOSAL 42--- ��- _ W F NT " - ` WATER POLLUTION REMARKS Vn FLOOD CONTROL W AIR POLLUTION 09 _ � DIV OF HWY c a _ YOUR PROPERTY MAY BE SUBJECT TO d c — FLOOD. RIVERSIDE COUNTY ASSUMES NO RESPONSIBILITY IN EVENT OF FLOOD. 284 199 9 74 CANARY -FILE, PINK -APPLICANT PERMIT NO. OWNER, Job Address �� ` ` • ` + • • a '' "Space Zip Owner v 360444 - _ ,Cpmniunity . - - .. + M,Hal,wµgn. .., y Dates Dist Off. F.C.C. MH Permit Fee s Micro Film Fee Cop $ Use at Permit I / �.�124 Parcel No. r 7 Use/Case No. Ck. By Mech. Fee - _ Dbl $'� Set Backs Lm Size PI. Ck. Fee j "—-'G ^"•K Legal Description - ' F . S S R Construction Fee Dbl $ - . ` Electrical Fee Dbl s/M Zang Restrictions Group Type SMI Fee $ Plumbing Fee DbI $ Bond Amt. Plan No. Plan Checker Final Dote Inspector Unit Sp. insp. Fee $ $ +— - Denial. Fee $ Const. lender r '+Brpnch Supplimental Permit Numbers Regisir. Fee $ Mileage Fee g Address - -City Zip Witness Fee $ Reinsp. Fee y OwneNAgen,- Tel. Zip Tocol Fees sAddress •- 'City - Zip M.O. N.C: Cash Chec Received by Contractor ., - .Tel, License# Trees required - Sewage System Address '. City Zip ♦ . . 'rio77Q U. Sewer District Form 284-208 (Rev.BL 8p 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 TkAT ALL WORK W t(5*ACTION WI*THl$ PEhWT WILL BE DONE IN ACCORDANCE WITH THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA. I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED T41PLANS AND SPECIFICATIONS HAS DONE SO IN ` ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA. DEPARTMENT OF BUILDING AND SAFETY COUNTY OF RIVERSIDE - CLAIM OF: �` �� DATE: r�� l o� ADDRESS: CITY AND STATE CU ON THE TREASURER OF THE COUNTY OF RIVERSIDE, STATE OF CALIFORNIA Im5tructions: Permittee will furnish the following information: 3� (1) Permit Number � (2) . Date Issued2—? (3) Total Fees Paid (4) Reason for Refund A 4Zgl— AQLi�PEy /i/OT % -z) I CERTIFY THAT THIS CLAIM IS TRUE AND CORRECT, AND THAT. NO PART HEREOF HAS BEEN PREVIOUSLY PAID BY THE COUNTY OF RIVERSIDE. Claimant's Signature (Do not write below this line) Date:►ugi?"79 General Fund: 1001-284-1231 FROM: DEPARTMENT OF BUILDING AND SAFETY TO: AUDITOR -CONTROLLER, COUNTY OF RIVERSIDE Please .issue to the above indicated claimant a refund of105, on the above permit deposited under Treasurer's Receipt No. dated AUTHORITY: Ordinance No. 457, Section 7, Subsection E Approve kD�22 Meed for the following reason: (strike out words not applicable) No inspOctions made. (Ownerns decided not to 'build) Chief Building Ins �or (,Ai`reVo-,v.rff.il ' X d}safety 284.88 Rev. I0rn/69