PAT (304409)BUILDING PERMIT DEPARTMENT OF BUILDING & SAFETY .11111161 FIELD OFFICE
PERMITNO.
304409
PERMIT NO.
304409
COUNTY OF RIVERSIDE
DST
CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES
1ST FL. SQ.
2ND FL.
FOR.
GAR. SQ.
CAR P. SQ.
WALL SQ.
ESTIMATED CONSTRUCTION
FT. Q $ UNITS
SQ. FT. (a} YARD SPKLR SYSTEM
SQ. FT. (a} l MOBILEHOME SVC. BAR SINK
POWER OUTLET ROOF DRAINS
FT. Q
FT. DRAINAGE PIPING
FT. (a} DRINKING FOUNTAIN
SQ. FT. Ct3 URINAL
VALUATION $ N WATER PIPING
7.69
NOTE: Not to be used as property tax valuation SWIM POOL, PVT FLOOR DRAIN
Dist.
MECHANICAL FEES SWIM POOL, COMM WATER SOFTENER
F.C.
O�
VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD SIGN WASHER (AUTO) (DISH)
APPLIANCE ❑ DRYER GARBAGE DISPOSAL
MH Permit Fee s
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED LAUNDRY TRAY
Cop $
AIR HANDLING UNIT _ CFM IDLE METER KITCHEN SINK
A r O +- ,/
'r L
ABSORPTION SYSTEM O B.T.U. TEMP USE PERMIT SVC WATER CLOSET
Parcel No. 1
COMPRESSOR HP POLE, TEMP/PERM LAVATORY
HEATING SYSTEM ❑ FORCED ❑ GRAVITY AMPERES SERV ENT SHOWER
'Meth. Fee Dbl $:1
BOILER � B.T.U. SQ. FT, p ¢ BATH TUB
Set Bocks
SQ. FT. Ca ¢ WATER HEATER
SQ. FT. RESID @ 1 t/.¢ SEWAGE DISPOSAL
Legal Descriptin
o
0 T r
SQ. FT. GAR C '/.¢ HOUSE SEWER
GAS PIPING
S
PERMIT FEE
PERMIT FEE PERMIT FEE
Fee Dbl $
i
DBL.
TO rkLL�FEE§MOB.
rt M. FEE
MICRO FEE MECH. FEE PL CK. FEE
CONST. FEE ELECT. FEE SMI FEE
� , res
FEE PLUMB. FEE
PERMITNO.
304409
Supp. Permit
Job Address
Space Zip
Owner
Ll
j
Community
_
Valuation
$74
Iu'
!
Dj�/�
Dist.
Off.
F.C.
O�
MH Permit Fee s
Micro Film Fee
Cop $
Use of Permit
h
A r O +- ,/
'r L
Parcel No. 1
Use No.
by
'Meth. Fee Dbl $:1
;PI. Ck. Fee $
Set Bocks
Lot Size
Construction Fee Dbl $
`Electrical
Legal Descriptin
o
0 T r
RZI v
F
S
S
R
Fee Dbl $
i
Zone
i
Grp
Type
Unit
:SMI Fee $
Plumbing Fee
Dbl E
Bond Amt.
$
Plan No.
Plan Checker
Final Dote
�� �, I ' ,
I
In r; t r
�E
'Sp. Insp. Fee $
Demol. Fee
$
Const. Lender
Address
Branch
City
F
—i
'I certify that in the performance of the vA,% for which this permit is issued I shag
not employ any person to any manner so os to become subject to the workmen s com-
pensation lows of California
Zip 4
Owner SignotureOC
Builder Signaturr.
Registr. Fee $
Mileage Fee $
Witness Fee $
Reinsp. Fee
$
Owner/Agent
Tel,
Zip
Total Fees
$
Address
,
City
Zip
M.O. ❑ N.C. ❑ Cash ❑ Check
Received by
Trees required
Contractor
Tel.
License #
Sewage System
O.
AdTress
City/ �fl Zip
i.. (/7
Workers'
yes
Comp.
no ❑
m
Sewer District
Form 284.208 (Rev. 4.771 Os
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF er,hed by.
WORK FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
1 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.
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.