341115 (SFD)BUILDING PERMIT jift DEPARTMENT OF BUILDING & SAFETY Aek FIELD OFFICE
PERMIT NO.
341115
PERMIT NO.
34111
i JW
COUNTY OF RIVERSIDE
"
Community
��!/
DST
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
Off.
— Z'''
NO. .PLUMBING FEES
1ST FL....
2ND FL.
POR.
GAR. SQ.
CAR P.
WALL
' ESTIMATED CONSTRUCTION
SQ. FT. 8 $
UNITS '
AH Permit Fee`4,7$
Micro Film Fee Cop $
Use of Permit -
�.y
• 77 i r � Gc.�
SQ. FT. ® YARD SPKLR SYSTEM
Use No.
SQ, FT. MOBILEHOME SVC. BAR SINK
Aech. Fee Dbl $
POWER OUTLET ROOF DRAINS "
FT. ®
Sei Backs
SQ. FT. @ DRAINAGE PIPING
:onstruction Fee Dbl $
ilectricol Fee Dbl $
1
SQ. FT. Q + DRINKING FOUNTAIN
SQ. FT. URINAL
VALUATION $ WATER PIPING
Zone
NOTE: Not to be used as property tax voluotion
SWIM POOL, PVT
Unit
FLOOR DRAIN
iMl Fee $
tlumbing Fee Dbl $ T
MECHANICAL FEES
SWIM POOL, COMM
Plan Checker
WATER SOFTENER
Inspector
`
VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD
SIGN
Const. Lender - Branch 'I certify that in the performance of the work for which this permit is issued I shall
not employ any person in any manner so as to become subject to the workmen's com.
- - pemotan laws of California,' '
Address City Zip Owner Signature
Builder Signorure '
WASHER (AUTO) (DISH)
Aileoge Fee , $
Mitness Fee $.
APPLIANCE ❑ DRYER
Owner/Age n r
Tel. ,. Zip
GARBAGE DISPOSAL
otol Fees $
Address
FURNACE ❑ UNIT- (3 WALL ❑ FLOOR ❑ SUSPENDED
M.O. ❑ N.C. ❑ Cosh ❑ Check
leceived byCo^tractor.
LAUNDRY TRAY
Tel.
License P
.
AIR HANDLING UNIT I CFM
IDLE METER
Address
KITCHEN SINK'
Workers' Comp.
yes ❑' •no ❑
THIS PERMIT ,SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS, CESSATION OF- verifiedby:
WORK 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 RIVEQSIDE 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.
ABSORPTION SYSTEM B.T:U.
TEMP USE PERMIT SVC
WATER CLOSET
COMPRESSOR HP
POLE, TEMP/PERM
LAVATORY '
HEATING SYSTEM . ❑ FORCED ❑ GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SQ. FT. @ ¢
BATH TUB
SQ. FT. ¢
WATER HEATER
SQ. FT. RESID @ l t/.¢
SEWAGE DISPOSAL
SQ. FT. GAR G Y.¢
HOUSE SEWER
' GAS PIPING '
PERMIT FEE
PERMIT FEE
PERMIT FEE
QaL.
- TOTAL FEES
s MOB: HM. FEE
- MICRO FEE'
MEC/HH. FEE PL. CK. FEE
CONST. FEE
ELECT. FEE
SMI FEE
.FEE
PLUMB. FEE
j
PERMIT NO.
341115
Supp. Permit
.s
Job Address Space Zip
�-� _ - — -
Owner '
S All -
Community
��!/
Valuation
y
Dote
.�
Dist.
./ !
Off.
— Z'''
F.C.
AH Permit Fee`4,7$
Micro Film Fee Cop $
Use of Permit -
�.y
• 77 i r � Gc.�
Parcel No.
l — l'
Use No.
Ck.by
Aech. Fee Dbl $
rl. Ck. Fee $
Sei Backs
Lot Size .
:onstruction Fee Dbl $
ilectricol Fee Dbl $
1
Legal Description.
f/
Ii;v-
Zone
Grp
Type
Unit
iMl Fee $
tlumbing Fee Dbl $ T
Bond Amt.•
Plan No.
Plan Checker
Final Dote
-Z 7L
Inspector
`
-
ip. Insp. Fee $$
)emol. Fee $
Const. Lender - Branch 'I certify that in the performance of the work for which this permit is issued I shall
not employ any person in any manner so as to become subject to the workmen's com.
- - pemotan laws of California,' '
Address City Zip Owner Signature
Builder Signorure '
legistr. Fee $
Aileoge Fee , $
Mitness Fee $.
leinsp. Fee $
Owner/Age n r
Tel. ,. Zip
otol Fees $
Address
City Zip
M.O. ❑ N.C. ❑ Cosh ❑ Check
leceived byCo^tractor.
-
Tel.
License P
.
Tees required w
lewoge System
&P x/
Address
City Zip
Workers' Comp.
yes ❑' •no ❑
THIS PERMIT ,SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS, CESSATION OF- verifiedby:
WORK 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 RIVEQSIDE 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.
fewer District
'orm 284.208 (Rev. 4.77) Os