335013 (SFD)BUILDING PERMIT DEPARTMENT OF BUILDING & SAFETY
PERMIT No. COUNTY OF RIVERSIDE
335013
NO. ELECTRICAL FEES
UNITS
ve MOBILEHOME SVC.
T9 �POWER OUTLET
SWIM POOL. PVT
FIELD OFFICE
NO. PLUMBING FEES
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
FLOOR DRAIN
CONSTRUCTION ESTIMATE
Job Address •'�
77 3 y6-�
SWIM POOL, COMM
3 a a n
u $
Owner
1 ST FL.
SQ. FT. (ay 4
f.
� / 'y
2ND FL.
SQ. FT.
$
FOR.
f, U SQ. FT. ®� tin
Q'
WASHER IAUTOTDISHI
e'
GAR.
SQ. FT. (rt}
!�£
CAR P.
SQ. FT. (�
Mech. Fee Dbl E S v
WALL
SQ. FT. CaJ
Lot Size
Construction Fee Dbl E 00
SQ. FT.
FURNACE ❑ UNIT 0 WALL [D FLOOR 0 SUSPENDED
ESTIMATED CONSTRUCTION VALUATION $ 7
s/f
NOTE: Not to be used as property tax valuation
/S`�.IGD
NO. ELECTRICAL FEES
UNITS
ve MOBILEHOME SVC.
T9 �POWER OUTLET
SWIM POOL. PVT
FIELD OFFICE
NO. PLUMBING FEES
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
FLOOR DRAIN
PERMIT NO.
3 350133 5 013
MECHANICAL FEES
Job Address •'�
77 3 y6-�
SWIM POOL, COMM
Owner
WATER SOFTENER
Community Col Valuation)
G G! � �� �
� / 'y
Dole !
VENT SYSTEM Z FAN ❑ EVAP. COOL n HOOD
$
SIGN
!
WASHER IAUTOTDISHI
Micro Film Fee Cop E
Use of Permit
/,r /.ly /
. ./ [f/l,.
// �t � � Gr
APPLIANCE
DRYER
/
Ck.by
Mech. Fee Dbl E S v
rPl. Ck. FeeL'
t t (,�(� E � �
GARBAGE DISPOSAL
Lot Size
Construction Fee Dbl E 00
Legal les� Description'
— 40
2—
FURNACE ❑ UNIT 0 WALL [D FLOOR 0 SUSPENDED
s/f
sr��
/S`�.IGD
LAUNDRY TRAY
Zone
Gr
3
Type
�„�
AIR HANDLING UNIT CFM
IDLE METER
Plumbing Fee Dbl E
341 s"a
KITCHEN SINK
Plan No.
Plan Checker �
-,01W
Final Date
ABSORPTION SYSTEM
B.T.U.
Sp. Insp. Fee E
TEMP USE PERMIT SVC
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.
pensanon laws of California. '
Address City Zip Owner Signature
Builder Signature
WATER CLOSET
Mileage Fee E
Witness Fee E
Reinsp. Fee E
COMPRESSOR
HP
-541
POLE, TEMP/PERM
Tocol Fees E
aj f 3
LAVATORY
Zip
6 jJ
Received by(�
HEATING SYSTEM FORCED 0 GRAVITY
ffD
AMPERES SERV ENT
#
Trees required
SHOWER
6O
`C' yam, / Zip
I/Y S P r ��6� �Jf %�!
BOILER � B.T.U.
SQ. FT. ¢
BATH TUB
SQ. FT. ¢
t
WATER HEATER
(1 SQ. FT. RESID Ga 1'Ait
y(� ��
p
SEWAGE DISPOSAL
"d
,illll, SQ. FT. GAR Ga Y.
�.
HOUSE SEWER
!
r
GAS PIPING
PERMIT FEE
3
PERMIT FEE
PERMIT FEE
DBL.
I TOTAL FE
/5
MOB. MM. FEE
MICRO FEE
- MECH. FEE
PL. CK. FEE
CONST. FEE
ELECT. FEE
t�9 -
SMI FEE
f �1
FEE
PLUMB. FEE
37�lo
PERMIT NO.
3 350133 5 013
Supp. Permit
Job Address •'�
77 3 y6-�
Space Zip
Owner
Community Col Valuation)
G G! � �� �
� / 'y
Dole !
Dist.
-C�>F'f''
F.C.
- �
MH Permit Fee E
Micro Film Fee Cop E
Use of Permit
/,r /.ly /
. ./ [f/l,.
// �t � � Gr
Parcel
�"No.
) /' 3— /a 1/ el o
Use No.
Ck.by
Mech. Fee Dbl E S v
rPl. Ck. FeeL'
t t (,�(� E � �
Set Backs
Lot Size
Construction Fee Dbl E 00
Legal les� Description'
— 40
2—
s/f
sr��
/S`�.IGD
Electrical Fee Dbl E! i
Zone
Gr
3
Type
�„�
Unit
SMI Fee b t ,
Plumbing Fee Dbl E
341 s"a
Bond Amt.
Plan No.
Plan Checker �
-,01W
Final Date
Inspect
Sp. Insp. Fee E
Demol. Fee E
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.
pensanon laws of California. '
Address City Zip Owner Signature
Builder Signature
Reg istr. Fee E
Mileage Fee E
Witness Fee E
Reinsp. Fee E
Owner/Agent
17 A
Tel. Zip
Tocol Fees E
aj f 3
Address
Zip
M.O.[3 N.C. C] Cash ❑ Check
Received by(�
f E'it
Contrajc�t/Qr
• 41 ;r
Tel. hlicense
3,91--771
1„!
#
Trees required
Sewage System
Address ,{ q % /^�)�
/3.x:5 �{J 1f� f �l% ` ° �f 6r 'l.
`C' yam, / Zip
I/Y S P r ��6� �Jf %�!
Workers' Comp.
yes 0 no C]
tv LL w ti /' IHIb FLRMII SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF verified by
Sewer District WORK FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
t I HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE
WITH THE LAWS OF RIVG6SIDE 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
Form 284.208 (Rev. 477) @)s CALIFORNIA.