404122 (BLCK)BUILDING PERMIT
PERMIT NO. DEPARTMENT OF BUILDING & SAFETY FIELD DST
k041 2 2I
COUNTY OF RIVERSIDE
f,
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL.
2ND. FL.
POR.
GAR.
CAR P.
WALL
ESTIMATED CONSTRUCTION
SQ. FT. .@ $
UNITS
Zip
�De(e'
SQ. FT. @
YARD SPKLR SYSTEM
SO. FT. @ MOBILEHOME SVC.
BAR SINK
SQ. FT. @ POWER OUTLET
ROOF DRAINS
SQ. FT. @
DRAINAGE PIPING
SQ. FT. @
DRINKING FOUNTAIN
SO. FT. @
URINAL
VALUATION$
WATER PIPING
NOTE: Not to be used as property tax valuation
SWIM POOL, PVT
FLOOR DRAIN
MECHANICAL FEES
SWIM POOL, COMM
WATER SOFTENER
VENT SYSTEM FAN EVAP. COOL . HOOD
SIGN
WASHER (AUTO)(DISH)
APPLIANCE DRYER
Lot Size
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
IDLE METER
KITCHEN SINK f
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. @ a
BATH TUB
Sp. Insp. Fee $
SQ. FT. @ a
WATER HEATER r
Const. Lender
S0. FT. RESID @ 1 t/<a
SEWAGE DISPOSAL
Supplimentol Permit Numbers
S0. FT. GAR @ V44
HOUSE SEWER
Mileage Fee $
Address City Zip
Witness Fee S
GAS PIPING
PERMIT FEE
Owner/Agent
rti
PERMIT FEE
PERMIT FEE
DBL. /
TOTAL FEESMOB.
HM. FEE
MICRO FEE
MECH. FEE Pl. CK. FEE
CONST. FEE ELECT. FEE
SMI FEE
FEE PLUMB. FEE
PERMIT NO.
404122
'
lob Address
Space
Zip
�De(e'
Owner
/
,
-/' ,
,e .- �-,.� s
Voluotion
S -
.•� Gatr
",
* ry
�; r!
.Dist.
,`
'OIL''
' F.C.C. !r
^
MH Permit Fee S
Micro Film Fee Cop S
Use of Permit.,{��
f p
�r!!i� L:%�Vf'' /✓[,.�.c �� +..•
.t
Porcel No. '"
Use/Casa No.
Ck. By
Mach. Fee Dbl 5
PI. Ck. Fee St,
Se Boc s
Lot Size
Construction Fee bl E,/'
J
Legal !tion`
., .,.-�, r
✓ %fG• �'� v.�
F S S
t
R
Electrical Fee Dbl 8
Zone Rest actions
Group
Type
SMI Fee S�..-
Plumbing Fee Dbl S
Bond Amt.
S
Plan'No:^
Pion Checker
Fin t /.,nor
�8
Unit
Sp. Insp. Fee $
Demol. Fee S
Const. Lender
Branch
Supplimentol Permit Numbers
Regist, Fee S
Mileage Fee $
Address City Zip
Witness Fee S
Reinsp. Fee $
Owner/Agent
rti
Tel.
Zip
Total FeesS _
Address
City, —y trd
Zip
M.O. N.C. ❑ Cash o Check
Received by �1
Confrssctor-'
�•^'` -- ,-G �J-ter `
J
Tel.
".License#
Tregs re• 's �f/�'L�r`
•; cif ^C�''
SgerSyitem
Address
City
Zip
T LL p THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF WORK
Sewer District SS 5 D y> FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
17 •1 4HEREBY AGREE THAT ALL WORK IN COMNECTIO14-WITH THIS PERMIT WILL BE DONE IN ACCORDANCE WITH Cl O Zeea��� d a 1 THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA.
I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE SO IN
Form 284.208 (`Rev. 1/80) H SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA.
verified by:
NO.
OPERATION
DATE
INSPECTOR
NO.
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
1
Set Back
j
33
Ventilation System
2
Ftgs 8 Frms
/
34
Plenums 8 Ducts
2A
Slab Grade
35
Furnace Comport.
3
Steel
�7
1
36
Inlets 8 Outlets
4
Grout Blocks
- 37
Combustion Air
5
Bond Beams
38
Compressor
6
Roof Deck
39
Apol. Clearance
7
Framing
40
Fire Damper
8
Vents
41
Smoke Detection Device
9
Garage Fire Wall
42
Commercial Hood
10
Fireplace P. L.
43
Final
loA
Fireplace T. 0.
°o
ADDITIONAL INFORMATION
� n S �•. n,�es
qx,C,.1� /V�
_
_
'
SEWAGE SYSTEM SIZE & LOCATION
11 Exterior Lath
12 Internal Lath
12A Drywall
173 •Finish Grade
INSULATION Thick R
Value
7A Walls (Botts)
12B Ceiling (Botts)
12C Ceiling (Blown)
14 Final
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
Tank Pit L. Line
REAR OF PROPERTY LINE
ELECTRICAL APPROVALS
P/L
P/
26 Power Pole
27 Conduit
28 Service Entrance
29 Wiring
29A Grounding Wire
29B Bonding
30 Fixtures
31 Service
32 Final
STREET NAME
f;.. r.--� -� wr--+-:-,.+t..+.r<r+..�r-^--�"Y-+••t sir.r.fi'a'c'p'�Pv+•..`^`+.Y._.... .. - .
- '-•',.c �Y,.►:*-„..��s-..»-: c. �..,�"..-;.�+,••.r,+y ...r+..�-�.i1t""'y;."`st. vC�!'�•'-ir•
PERMIT NO.
4:0 412 2
0 4122
Job Address
ucrAK i Mery i ur' I15V IILUINIU7 dz ZOArt 1 T
COUNTY OF RIVERSIDE
FIELD OFFICE
oST
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL.
2ND. FL.
' FOR.
GAR.
CARP.
WALL
t
,ESTIMATED CONSTRUCTION
SO. FT. :@ $
UNITS
Valuation
C.�
g _
,No.
SO. FT. @
YARD SPKLR SYSTEM
SO� FT. Cd MOBILEHOME-SVC.
BAR SINK '
SO: FT. @ POWER OUTLET
ROOF DRAINS
SO. FT. @
DRAINAGE PIPING
SO, FT. @ -
++ DRINKING FOUNTAIN
- _
SO. FT. @
URINAL
VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
SWIM POOL; PVT
FLOOR DRAIN
MECHANICAL FEES
SWIM POOL,, COMM
WATER SOFTENER.
VENT SYSTEM FAN EVAP. COOL' HOOD
SIGN
WASHER (AUTO)(DISH)
APPLIANCE DRYER',
Zone Residctions - i -
t
r
GARBAGE DISPOSAL
FURNACE, �• UNIT WALL . ,.FLOOR' SUSPENDED
LAUNDRY TRAY j
AIR HANDLING .UNIT CFM,
IDLE METER
• KITCHEN SINK i
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.
SO. FT. @ ¢
BATH TUB
SO.. 'FT. @ a
WATER*HEATER
Mileage Fee $' a -
SO. FT. RESID @ 1 14c
SEWAGE DISPOSAL
'
- 50. FT. GAR @ s/4a
HOUSE SEWER
Tel. t
GAS PIPING _
PERMIT FEE
Total Fees - $
PERM11 -FEE.
PERMIT FEE
DBL.
TOTAL
MOB. HM. FEE
MICRO•FEE
MECH.' FEE PL. CK. FEE.
CONST. FE ELECT. FEE
SMI FEE
FEE .PLUMB. FEE '
a
f;.. r.--� -� wr--+-:-,.+t..+.r<r+..�r-^--�"Y-+••t sir.r.fi'a'c'p'�Pv+•..`^`+.Y._.... .. - .
- '-•',.c �Y,.►:*-„..��s-..»-: c. �..,�"..-;.�+,••.r,+y ...r+..�-�.i1t""'y;."`st. vC�!'�•'-ir•
PERMIT NO.
4:0 412 2
,
Job Address
- `
��d
Sp o<e
Zip
Owner
%f.
F
f' -
Community
e -A
/ A
Valuation
C.�
g _
,No.
Diet.
F.C.C.
MH Permit Fee $
Micro Film Fee Cop S
Use of P,e(rmiit•�/''
�(J /, (�.
}
'�t` -/ /
`� N. Gz ��.�iJ �i1�L
Parcel _
',�� /•
J
Use/Cosa No: -
Ck. By
Mach. 'Fee Dbl g
PI. Ck. Fee S s ' -' ° -/
Set Backs
-lot Size
,
Construction Fee • I s'
Legal escnption '
f/ � �j�"C l /
'<' +++.•J!!Y
F
$ S
•
R
Electncol Fee - Del $
Zone Residctions - i -
t
r
Group
,
Type ,•
.
SMI Fee S
Plumbing Fee ♦. Del s.
Bond Amt. .
$
Plan _o`RIon
Checker
% _. .._�i(
l
inspector
-
Unit
Sp. Insp. Fee S V
Demol. Fee S., -'
Const. Lender
- `
Branch
Supplimental Permit Numbers
'
`
-
Registr. Fee g •
Mileage Fee $' a -
Address City Zip
-
Witness Fee. g
Reins.p. Fee $
Owner/Agent
-
Tel. t
Zip :
Total Fees - $
Address -
��
y
"���.
•
.?
Zip
M.O.. Q•N.C.Cj Cash E] Check
Received by -
Contractor
Tel.'
LicenseR
Tr
S ge ystem ' ' '
Address
City •
Zip.
T LL -.P ” - THIS PERMIT SHALL BECOME VOID IF WORK IS NOT -COMMENCED WITHIN 120 DAYS. CESSATION OF WORK verified by:
Sewer°District 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 RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA. • .`-
�/ot�„/��f HE EBY C_EERR J,FY THAT THE INDIVIDUAL"'WHO PREPARED THE PLANS .AND SPECIFICATIONS HAS DONE SO IN
Form"284-208 (Rev. 1/80) �QCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS. CODE OF THE STATE OF CALIFORNIA. r