No Permit Number (BLCK)APPLICANT NAME (L. F, MI)
1
ADDRESS-'.
CITY/COMMUNITY/STATE/ZIP
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JOB SITE AODRESSr
AVE F'9',Qff3'i
CITY/COMMUNITY/STATE/ZIP
o
17
BOK
PAG
PRC
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TRACT
LOT
MODI
SB
TRACT NAME
OWNER NAME (L. F. MI)
CONTRACTOR -FIRM NAM;,
ADDRESS
Cin'!COMMUNITV /STATE/Z IP_
.HONE #
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LICNC ft
'AR*C/ENG"FIRM NAME',
ADDRESS
CITY/COMMUNITY/STATE/ZIP
PHONE 0
LICNC 0
USE OF PERMIT
BL
21'3
FSB SSB SSB R
OFC
ZONE ORE #
LOT SZ
END
SIDE
FORM 284-208 (2/81)
APPL/PRMT # PS / DATE,
/9 1008202
1
1_,...H.
T-1 Z
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TOTAL
FEE
INSPECTOR'S CQPV
10082021:
NO.
OPERATION
DATE
INSPECTOR
NO.
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
1
Set Back
33
Ventilation System j
2
Ftgs 8 Frms
34
Plenums 8 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
Goroge Fire Wall
42
Commercial Hood
10
Fireplace P. L.
43
Final
IDA
Fireplace T. 0.
°o
ADDITIONAL INFORMATION
-
SEWAGE SYSTEM SIZE & LOCATION
11 Exterior Lath
12 Interpol Loth
12A Drywall
13 Finish Grade
INSULATION Thick R
Value
7A Walls (Botts)
12B Ceiling (Batts)
12C Ceiling (Blown)
14 Final 177 'tJ
. - - 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
e
Tank Pit L. Line '
REAR OF PROPERTY LINE
ELECTRICAL APPROVALS
P/L
t
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
APPLICATION TO CONSTRUCT
DEPARTMENT OF BUILDING AND SAFETY
r ^ COUNTY OF RIVERSIDE -
/IS �-
DISTRICT
Permit No
284 199A 9/74
CANARY—FILE, PINK—APPLICANT
rc
Owner t c — _. —_—_. Contractor_
Addre ess___ Address --
City, ��/G�CL_"�^ City_— City_—_ _
s--
Phone7 - '('f 3 4?� Phone _ Phone— ----.—_.._
W
(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. 1.
DATE Z42 SIGNATURE OF OWNER AND/OR AGEN r/ r
Approval by Signature from the Following Departments Listed Below
Must Be Obtained Prior to the Issuing of a Construction Permit.
ISPACE N0.
1 ' USE OF STRUCTURE
JOB ADDRESS J
SINGLE FAMILY DUPLEX Ej
>_
Zi�CG'y2\i
n /
LEGA DESCRIPTION OF PROPERTY � — Q
APARTMENTS AGRIC.
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Q
COMMERCIAL INDUSTRIAL ❑
COMMUNITY ' ALTERATIONS ❑
C
Z
P —
NO. OF SUBMITTED PLANS USE OF PERMIT
CASE NO.
p Z
NO. OF PA ING SPACES REQUIRED _ NO. OF BUILDINGS NOW EXISTING
Q 0
ZONE 'Z" SETBACKS: FRONT SIDE REAR
J
m
GRADING PERMIT REQUIRED? YES ❑ NO ❑ LOT SIZE
SETBACK ORRDINANCE N OF FEET REQUIRED ON STREET
DATE _,Z 0 SIGNATURE OF LAND USE OFFICIAL
EET—
YES p„_NO C NO._OF FEET--
_D.EDICATION_REQUIRED _
.
z
Lu
CURB AND GUTTER REQUIRED: YES ❑ NO ❑ —STREETcc
cc
4
CAN CURB AND GUTTER FEASIBLY BE INSTALLED? YES ❑ NO ❑
W
HAS AN ACCEPTABLE APPLICATION BEEN MADE FOR ENCROACHMENT PERMIT FOR DRIVEWAY AND STREET
CIMPROVEMENT?
YES ❑ NO ❑
°C
DATE _ SIGNATURE OF ROAD DEPT. OFFICIAL
Z
SWIMMING POOLS PUBLIC
SWAGE DISPOSAL
Q
_
FOOD ESTABLISHMENT
WATER POLLUTION REMARKS
vt FLOOD CONTROL—
ONTROLI–
I.-
AIR POLLUTION
z
z
_ t- DIV OF HWY
c a — YOUR PROPERTY MAY BE SUBJECT TO
c '` FLOOD. RIVERSIDE COUNTY ASSUMES
NO RESPONSIBILITY IN EVENT OF FLOOD.
284 199A 9/74
CANARY—FILE, PINK—APPLICANT