303517 (SFD). DEPARTMENT OF BUILDING & SAFETY FIELD OFFICE
BUILDING PERMIT
J F M A M J J A S O N D
PERMIT NO.
3013517
OWNER
[,,,•..
t.VVI\1'1 Vr RIYGR.;Iur.
COMMUNITY
DST
CONSTRUCTION ESTIMATE
DST
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1 ST FL.
2ND FL.
FOR. 47^
GAR.
CAR P. "
WALL
ESTIMATED CONSTRUCTION
SQ: F.T. @ $
SQ. FT. @
I/
UNITS
YARD SPKLR SYSTEM
M H PERMIT FEE
SQ. F.T. @ MOBILEHOME SVC. BAR SINK
$
SQ. FT. @ POWER OUTLET ROOF DRAINS
USE OF PERMIT
SQ. FT. @ DRAINAGE PIPING
SUPP. TO PERMI
SO.. FT. @ DRINKING FOUNTAIN
NO.
SQ. FT. @ URINAL
VALUATION $ ��� WATER PIPING
COPIES
NOTE: Not to be used os property tax valuation
SWIM POOL, PVT
FLOOR DRAIN
MECHANICAL FEES
SWIM POOL, COMM
WATER SOFTENER
MECHANICAL FEE
DBL
VENT SYSTEM*FAN ❑'EVAP.000L EjfHQOD
SIGN
WASHER (AUTO) (0J54
SET BACK
LO
APPLIANCE WRYER
TfY'PE%
BY
GARBAGE DISPOSAL
FURNACE Cl UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
1111E
�R
LAUNDRY TRAY
AIR HANDLING UNIT CFM
IDLE METER
KITCHEN SINK
ABSORPTION SYSTEM 0 B.T.U.
nF/
TEMP USE PERM SVC
WATER CLOSET
/
I -!'.�C
COMPRESSOR HP
��^
POLE, TEMP/PERM
LAVATORY
41,A
HEATING SYSTEM ❑ FORCED- ❑ GRAVITY
PLAN CHECK FEE
AMPERES SERV ENT _
SHOWER'
BOND AMT.
BOILER B.T.U.
PLAN CHECKER
SQ. FT. @
XBATH TUB
SQ. FT. @ a
WATER HEATER
CONSTRUCTION FEE
Q.FT.RESID @ 11/4a
SEWAGE DISPOSAL
NAME OF CONST. LENDER BRANCH
OFFICE
NO LE ER INVOLVED
SQ.FT.GAR @/4a
jig
HOUSE SEWER
'
GAS PIPING
DBL
$
PERMIT FEE
ADDRESS CITY
PERMIT FEE
PERMIT FEE
DBL.
TOTAL FEES
MOB.HM.FEE
MICRO FEE
ME .FEE
PC CK. FEE
CONST. FEE
EL C .FEE SMI FEE
FEE
PLUMB. FEE
J F M A M J J A S O N D
JOB ADDRESS SP NO
I
OWNER
[,,,•..
76
77
COMMUNITY
VALUATION'
DA E
DST
OFFICE
$ dodo
7/01J77
I/
X
78,o
M H PERMIT FEE
$
USE OF PERMIT
F.C.
SUPP. TO PERMI
3 PE$ IIT
NO.
517,
MICROFILM FEE
COPIES
$ ',
B OK PA E PARC
LEGAL DESC IPTI N
MECHANICAL FEE
DBL
$
USE NO.
SET BACK
LO
GRP GRP
TfY'PE%
BY
•
1111E
�R
ICK
nF/
/
I -!'.�C
S -
S
R�•J�B-O
'
41,A
PLAN CHECK FEE
$
BOND AMT.
PLAN NO.
PLAN CHECKER
FINAL DATE INSP
OR
CONSTRUCTION FEE
DBL
$
NAME OF CONST. LENDER BRANCH
OFFICE
NO LE ER INVOLVED
ELECTRICAL FEE ,
DBL
$
ADDRESS CITY
STATE
SAO-,
Ny
.STRONG MOTION
$
OWNER/AGENTS SIGNATURE.. • - CONTRACTOR
- ] l
INSTRUMENTATION FEE °
'SPECIAL INSP .
$
ADDRESS ADDRESS'
DEMOLITON
FEE
REGISTRATION
f
Ad
PLUMBING FEE
DBL
$
CITY ZIP CODE CIT7
ZIP CODE
TOTAL FEES $
TEL. NO.. AREA
CODE TEL,
NO.
-AREA CODE
LICENSE 4
CASH❑CHECK[kA.O. N.C. cp-O
%"Y
d -
7)4.
y 1197
RECEIVED BY X TREES REQUIRED
SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF
K 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
Y AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE
:'SEWAGE SYSTEM
%J9�il
11Y1�•
THE LAWS OF RIVERSIDE
T LL
P
COUNTY AND THE STATE OF CALIFORNIA, I ALSO AGREE TO CARRY
�r-11 ml Lrv1rwl"w, Ll 11i 1= 1111 Inc Lr�Yra yr Inc a Aicvr
CALIFORNIA COVERING CONTRACTORS IS ALSO GUARANTEED.
I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE
FORM zea-zoe (REV. e-76) - SO IN ACCORDANCE WITH SECTION 5541 Of THE BUSINESS AND PROFESSIONS CODE OF THE STATE
OF CALIFORNIA.