351205 (GRES)BUILDING PERMIT DEPARTMENT OF BUILDING& SAFETY
PERM IT NO. COUNTY OF RIVERSIDE
CONSTRUCTION ESTIMATE
1ST FL."
SQ.. FT. Q $
2ND FL.
SQ. FT. @
POR.
SQ. FT.
GAR.
SQ. FT. ® "E-6
CAR P. _ -
SQ. FT. (a}
WALL
SQ. FT.
SQ. FT. @
ESTIMATED CONSTRUCTION
VALUATION $
NOTE: Not to be used as property tax valuation
NO. I ELECTRICAL FEES
UNITS
MOBILEHOME SVC.
POWER OUTLET.
SWIM POOL. PVT
FIELD OFFICE
NO. I PLUMBING FEES
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
FLOOR DRAIN r
PERMITNO.Supp.
351 0 5
MECHANICAL FEES
SWIM POOL, COMM
Zip Owner '
WATER SOFTENER
VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD
SIGN
/j
�(� `%�
!/
WASHER (AUTO) ( DISH)
Off.
APPLIANCE ❑ DRYER
GARBAGE DISPOSAL
"Micro Film Fee
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
Use of Permit
LAUNDRY TRAY
No./L3e451 Ck.by
�
AIR HANDLING UNIT CFM
IDLE METER
Set
KITCHEN SINK
ABSORPTION SYSTEM E=� B.T.U.
TEMP USE PERMIT SVC
Legal Description vX
r %/
���� / /./� /`e
WATER CLOSET
F %.5ZS Q
COMPRESSOR 0 HP
POLE, TEMP/PERM
Electrical Fee Dbl 8
LAVATORY
Type
IWO
HEATING SYSTEM ❑ FORCED ❑ GRAVITY
AMPERES SERV ENT
SMI Fee 8
SHOWER
Dbl $
BOILER B.T.U.
SQ. FT. ¢
Plan C e koT
BATH TUB
Final Date
o` tiin`the
Insp or
SQ. FT. a
WATER HEATER
Demol. Fee
$-
SQ. FT. RESID 6 1 %c
"I certify that performance of the work for which this permit is issued Is
not employ any person in any manner so as to become subject to the workmen's com-
pensation laws of California. -
Owner Signature
Builder Signature
SEWAGE DISPOSAL
Mileage Fee $
Witness Fee $
SQ. FT. GAR C Y.¢
$
HOUSE SEWER
Tel.
Zip
GAS PIPING
$
PERMIT FEE
PERMIT FEE
Cho
PERMIT FEE
Ch
M.O.❑ .C. ❑ Cash C]ec
DBL.
TOTAL FEES
/1 ,,
ntOe. HM. FEE
MICRO FEE MECH. FEE
PL. CK. FEE
�1 40o
CONST. FEE -
00
ELECT. FEE
4 ,3 _
SMI FEE
1-o
FEE PLUMB. FEE
PERMITNO.Supp.
351 0 5
Permit
357wa
Job Address Space
;795,1
Zip Owner '
Com nity
cZ�/V /
Valuation
$
/j
�(� `%�
!/
Dote Dist.
/ /� �-- / j 9 /,JZ
Off.
. F.C.�f
o/G+
MH Permit Fee $�
"Micro Film Fee
Cop $
Use of Permit
Parcel No. I Use
/—
`7� O%'SJ)�a�!
/'7"
No./L3e451 Ck.by
�
Mech. Fee Dbl $
PI. Ck. Fee $
Set
BBo`ckss
Lot Size
Construction Fee Dial 8
Legal Description vX
r %/
���� / /./� /`e
F %.5ZS Q
S
R;4A
Electrical Fee Dbl 8
Zone Grp
M
Type
IWO
Unit
SMI Fee 8
Plumbing Fee
Dbl $
Bond Amt.
$Y�
Plan No. _ /y^
Plan C e koT
Final Date
o` tiin`the
Insp or
Sp. Ins p. Fee $
Demol. Fee
$-
Const. Lender" Branch
- -
Address City Zip
"I certify that performance of the work for which this permit is issued Is
not employ any person in any manner so as to become subject to the workmen's com-
pensation laws of California. -
Owner Signature
Builder Signature
Registr. Fee $
Mileage Fee $
Witness Fee $
Reinsp. Fee
$
Owner/Agent
Tel.
Zip
Total Fees
$
Add '
City
Zip
Ch
M.O.❑ .C. ❑ Cash C]ec
Received
Contractor `
L!
Tel.
•/
License p
3ZO77
l�Worrkers'
Trees requited
r
Sewage System
Address
6'?
City/ / /� ^��..,[/ Zip
h/7� K+I•v! �T
Comp.
yes ❑ no ❑
T LL P
Sewer District `
Form 284.208 (Rev. 4-77) Os
Ltva f•tltmll JHALL BtL.UMt VUIU 11' WORK 15 NOT COMMENCED WITHIN 120 DAYS. CESSATION OF verified by:
WORK FOR 120 DAYS SHALL A CAU PERMIT TOO BECOME VOID. t,
I HEREBY AGREE THAT O CT WITH THIS PERMIT WILL BE DONE IN ACCORDANCE
WITH THE LAWS OF RIV6RSIDE 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.