14037 Blue Ribbon Ln T,.S P q st - W - o 9 0 0
CITY OF EASTVALE kDate:
No: Permit No:
Y Awy Su4re3 er i Oo: L
�o ECEIVEI] � n y
t l'v xrosee,,,em Date:
NOV 012010 t: mount:
4 k#::
C TY OF EASTVALE 0S3
Building combination Permit
Legal Description:
To Be Completed ByAppllcant
p . � Planning Case: F.
1`-e6t L: Rt: R
Property Address: - Assessor's Parcel Number; D
ProjecVfenant Na e: - ( O
Gn Unit#: Floor#:
Name:
Phon No. f Fax No.
PropeOwner Address: f 51 6
Email Address:
b LtJ Unit mb Zip Code
Name:
Ph a No. Fax No.
Applicant Address: "� ' $l 2°
A Um umber Zip Code -
Email Address: f Z y5
Name:
I /O P one actor Address. o. Fax No.
Contr q bg
T\t G CI - State Zip Code
on rectors uslness dense o. Contractor C State of California License No.
� Classinca'on:
lfiber of Squares;
..sere Footage
Description of Work: - -
e. Cost of W ork:$
Applicant's Signature 25'
Date:
To Be Cornpleled By City Staff Only
5 Completes sets of gully dimensioned,drawn to sale plans which nd Indicate
ica A R-Received or N/A-Not Applicable
.s
1 set of documents which include
❑ Title Sheet ❑ Elevations ❑ Electrical Plan
❑ Plot/Site Plan ElGeo Tech/Soils Report(on cd only)
❑ Roof Plan ❑ Mechanical Plan ❑ Title 24 Energy(on S'/,x 11)
❑ Foundation Plan ❑ Cross Section ❑ Plumbing Plan
❑ Structural Calculations
❑ Floor Plan ❑ Structural Framing Plan&Details ❑ Single Line diagram for elec.services over 400 AMP
❑ Shoring Plan ❑ Sound Report-Residential
Class Code: Indicai7i6;4Z7
truction Alteration•
Work Addition" Means/Methods
Retrofit' Revision to Etdsling Permir Required? YES NO Proposed Building Use(s):
Existing Building Use(s):#Buildings: #Stories: Will the Building Have a Basement?Bldg.Code Occupancy Group - Y of NIndicate ifAt Project YES w NO Indicate all Geo-tech.Haz.ZoneCompletion: Sprinklered that apply Coastal ZoneC rn O YES or NO Noise Zone
Required?
Listed on Historic Resources Inventory
CITY PLANNING STAFF ONLY
APPROVALS: Costal Commiss Arch.Review Board
Landmark Comm. Planning Comm.Zoning Administrator
Fee Exempt: City Project Elec.Vehicle Cha er
r9 Landmark Seismic Retrofit swat ase: idg,
F"^edite Project(s): Child Care City Project omdal "i
Green Building Landmark Affordable Housing
For Staff Use Only
Bulldin r5afet Pennil Specialist Cily Planning Civil n 9 meerin
9 EPWM-A min Transportation Mgmt. Rent Control
THANK YOU FOR HELPING US CREATE A BETTER COMMUNITY