303518 (SFD)DEPARTMENT OF BUILDING & SAFETY FIELD OFFICE
BUILDING PERMIT . a NT 0,
J F M 'A M J J A S O 1 N D
- PERMIT NO.
5181
OWNER
COU Y OF RIVERSIDE
77
COMMUNITY
VALUATION
DST
s
CONSTRUCTION ESTIMATE
OFFICE
NO. ELECTRICAL FEES
LA VU11M
NO. PLUMBING FEES
yy 9
7-11-
IST FL.
2ND FL.
FOR. t
GAR. r !�!
CAR P.
WALL
ESTIMATED CONSTRUCTION
SQ. FT. @..$ i "k c t
UNITS
M H PERMIT FEE
$
SQ. FT. @ YARD SPKLR SYSTEM
USE OF PERMIT
$Q. FT. @' MOBILEHOME SVC. BAR SINK
SUPP. TO PERMIT
y
SQ. FT. @ r_' SY) POWER OUTLET ROOF DRAINS
•.,> °�-.... ''�
NO.
SQ. FT. @ DRAINAGE PIPING
SQ. FT. @ DRINKING FOUNTAIN
SQ. FT. @ URINAL
VALUATION $ �74- EA WATER PIPING
NOTE: Not to be used as property tax valuation
303
SWIM POOL, PVT
18
FLOOR DRAIN
MICROFILM FEE
COPIES
MECHANICAL FEES
SWIM POOL, COMM
LEGAL DE RIPTION
WATER SOFTENER _
VENT SYSTEM @,FAN ❑ EVAP.000L (HOOD
017
SIGN
MECHANICAL FEE
WASHER (AUTO) (DISH)
$
APPLIANCE ODRYER
ZONE
SCcET BACK
LOTSIZEGRP
GARBAGE DISPOSAL
TYPE
CK BY
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
IDLE METER
KITCHEN SINK
r r
ABSORPTION SYSTEM B.T.U.
TEMP USE PERM SVC
`i WATER CLOSET
„ ry
r
I 2�
COMPRESSOR lid .+ HP
•»
POLE, TEMP/PERM
7
LAVATORY_
17
h R
HEATING SYSTEM �ORCED []GRAVITY
K, (
ct AMPERES SERV ENT
F
SHOWER '
PLAN NO.
PLAN CHECKER
BOILER T. U.
C OR
SQ.FT. @ 4
o!7 BATH TUB
SQ. FT. @ 4
WATER HEATER
DBL
'
NAME OF CONST. LENDER BRANCH
L),,SQ.FT.RESID @ 11/44
/�
SEWAGE DISPOSAL
s+}
%-:SQ.FT.GAR @ x/44
✓d
HOUSE SEWER
DBL
$
ADDRESS CITY
STATE
a
GAS PIPING
PERMIT FEE
�t
!
PERMIT FEE
„ay,
PERMIT FEE
'_^{ r q �,
DBL.
TOTAL FEES ,
MOB.HM.FEE
MICRO FEE
MECH. FEE
PL. 4:K. FEE -
CONST. FEE
ELECT. FEE
13MI FEE
FEE
PLUMB. FEE
J F M 'A M J J A S O 1 N D
JOB ADDRESS SP NO
I
52-745 Avenida ohre&M
OWNER
76
77
COMMUNITY
VALUATION
DATE
DST
OFFICE
LA VU11M
$ yy r�
25-970 �
yy 9
7-11-
�p
1
a
X78
M H PERMIT FEE
$
USE OF PERMIT
F.C.
SUPP. TO PERMIT
PERMIT
NO.
'
I1 t
303
18
MICROFILM FEE
COPIES
$
BOOK P GE PARCEL
LEGAL DE RIPTION
017
tat 4, block 172, Itnit: 17
MECHANICAL FEE
DBL
$
USE NO.
ZONE
SCcET BACK
LOTSIZEGRP
TYPE
CK BY
r
I 2�
S W
S
}y
R Z '�
7
17
h R
PLAN CHECK FEE
$
BOND AMT.
PLAN NO.
PLAN CHECKER
FINAL DATE INS(
C OR
CONSTRUCTION FEE
DBL
$
NAME OF CONST. LENDER BRANCH
OFFICE
N0INVOLVED
705.R
ELECTRICAL FEE
DBL
$
ADDRESS CITY
STATE
STRONG MOTION
$OR
>
OWNER/AGENTS SIGNATURE CONTRACT
�`
INSTRUMENTATION FEE^fp�
'SPECIAL
$
ADDRESS ADDRESS
INSP
DEMOLITON
FEE
REGISTRATION
valm xy law
PLUMBING FEE
DBL
$
CITY ZIP CODE CITY
ZIP CODE
fii{ Yfs A
TOTAL FEES $
TEL. NO. AREA
CODE TEL.
NO. ARE GO E
LICENSE u
. J
CASH❑CHECK : O.❑N.C. rt �. () 5
?1'41
4
�r j 1
,RECEIVED BY ~ TREES REQUIRED
IT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAY5. CESSATION OF
®RK 20 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE
SEWAGE SYSTEM
•!
T a ,- ALL
p l�, v i /dE.
LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, I ALSO AGREE TO CARRY
rr)AAOLIJc ATInkl 1-1
- v. �-vivr unrva..c vvlln Inc LM VYJ V� InC JINIC Vr
CALIFORNIA COVERING CONTRACTORS IS ALSO GUARANTEED.
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
FORM 264-206 (REV. 6-761 OF CALIFORNIA.