368639 (SPIN)' ov�wmvrc�cros�
PERMIT No. DEPARTMENT OF BUILDING B. SAFETY FIELD DST
3 8 8 6 39
COUNTY OF RIVERSIDE
—]
CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES
IT-
I FL. SQ. FT. @ $ UNITS
2ND. FL. SQ. FT. @
YARD SPKLR SYSTEM
POR. SQ. FT. @
MOBILEHOME SVC. BAR SINK
GAR. SQ. FT. @ POWER OUTLET ROOF DRAINS
CAR P. SQ. FT. @
DRAINAGE PIPING
WALL SQ. FT. @ DRINKING FOUNTAIN
SQ. FT. @ URINAL
ESTIMATED CONSTRUCTION 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 GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRY TRAY
AIR HANDLING UNIT CFM IDLE METER KITCHEN SINK
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. @ c BATH TUB
SQ. FT. @ c WATER HEATER
SQ. FT. RESID @1/.c SEWAGE DISPOSAL
SQ.FT.GAR @ 1%c HOUSE SEWER
GAS PIPING
PERMIT FEE PERMIT FEE PERMIT FEE
DBL. TOTAL FEES MOB.HM.FEE MICRO FEE MECH.FEEPL.CK.FEE CONST.FEE ELECT.FEE SMI FEE
/� FEE PLUMB.FEE
1
PERMIT NO. Job Address Space Zip Owner
368639
Co .unity aluation Date Dist. O�f. `�.C. .
MH Permit Fee $ l $ "'�
Micro Film Fee Cop ; Ufe of Permit '' Parcel No. c se/Cas Ck. y-
Meth.Fee Dbl $ �..�f� [ ;P,-/;P,-/ A— l K4,1
PI.Ck.Fee $ �,:( ^• Set Backs Lot Size
i .. �.. F S ° R
Construction Fee Dbl E L escription t
Electrical Fee Dbl $ {' Zoestrictions Group Type
e R
SMI Fee E �/) !-25 '/y—,,1IlZ
Plumbing Fee Dbl E Bond Amt. Plan No. Plon Checker a ate Inspe Unit
Sp.Insp.Fee b E ter_ ,.y
5-29�9 0'.'�'
Dental.Fee $ Const.Lender Branch Supplimenta r it k4imb.rs
Registr.Fee $
Address City Zip
Mileage Fee $
Witness Fee $
Reinsp.Fee $ Owner/Agent �+� Tel. Zip
Total Fees E , .✓� Address r City Zip
M.O. N.C.0 Cosh Check
Received by Contractor's 7 -''' '72 Te . License#Trees
uired
Sewage System Address 111111111111III11111111178 City Zip
IE
T LL f 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.
. J
P I HEREBY AGREE THAN I WITH THIS PERMIT WILL BE DONE IN ACCORDANCE WITH
THE LAWS OF RIVERSI A�D fHE50`!'ALIFOp_'!A.
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.
_Form 284-208(Rev.8/78)
NO. OPERATION DATE INSPECTOR NOOPERATION DATE INSPECTOR
BUILDING APPROVALS MECHANICAL APPROVALS
1 Set Back 33 Ventilation System
2 Ftgs& Frms 34 Plenums&Ducts
2A Slab Grade 35 Furnace Comport.
3 Steel 36 Inlets&Outlets
4 Grout Blocks 37 Combustion Air
5 Bond Beams S-Z`7 79 38 Compressor
6 Roof Deck3 Appl. Clearance
7 Framing 40 Fire Damper
8 Vents 1 Smoke Detection Device
9 Garage Fire Wall 42 Commercial Hood
10 Fireplace P.L. 43 Final
10A Fireplace T.O. FI ADDITIONAL INFORMATION
11 Exterior Lath
12 Internal Lath
12A Drywall liOup ,4
13 Finish Grade
INSULATION Thick R
en.�b c�'F�1n�a.alb�• C.E�T.
Value
7A Walls(Batts)
12B Ceiling(Batts)
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 SEWAGE SYSTEM SIZE & LOCATION
Tank Pit L.Line
REAR OF PROPERTY LINE
ELECTRICAL APPROVALS
26 Power Pole
27 Conduit
28 Service Entrance
29 Wiring
29A Grounding Wire PSL PSL
29B Bonding
30 Fixtures
31 Service
32 Final
STREET NAME