SFD (304096)BUILDING PERMIT ;LCL DEPARTMENT OF BUILDING & SAFETY FIELD OFFICE
PERMM�,IT NO.
PER MITNO.
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30 40�Y'J97
Job Address
COUNTY OF RIVERSIDE
Space Zip
Owner
F,0T
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SQ.
2ND FL:
POR. SQ,
GAR. SQ.
CAR P. SQ.
WALL SQ.
ESTIMATED CONSTRUCTION
FT. @/yb $
SQ. FT. @ f
UNITS
'
YARD SPKLR SYSTEM
/IDate Dist.
ar? 7
FT. t1 .00 MOBILEHOME SVC. BAR SINK
F.C.
j
FT. @ SG 161.110 POWER OUTLET ROOF DRAINS.
FT. @ DRAINAGE PIPING
EMicro Film Fee
FT. Q DRINKING FOUNTAIN
Use of Permit
SQ. FT. @ URINAL
VALUATION $ �p WATER PIPING
NOTE: Not to be used as property tax valuation
Ck.by
SWIM POOL, PVT
FLOOR DRAIN
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MECHANICAL FEES
3�0Set
SWIM POOL, COMM
WATER SOFTENER
acks
VENT SYSTEM FAN ❑ EVAP. COOL 0 HOOD
,PI. Ck. Fee E
SIGN
gConstruction Fee Dbl E
WASHER (AUTO)1 DISH)
00
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
�Q Q
Zo_ne
LAUNDRY TRAY
Unit
AIR HANDLING UNIT CFM
Electrical Fee Dbl E
IDLE METER
'SMI Fee
KITCHEN SINK
�
ABSORPTION SYSTEM B.T.U.TEMP
USE PERMIT SVC
WATER CLOSET
Plumbing Fee
C
COMPRESSOR L .— HP
Bond Amt.
Eti
POLE, TEMP/PERM
Plan Checker
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LAVATORY It
Final Date
Inspecto
HEATING SYSTEM FORCED ❑ GRAVITY
:L
AMPERES SERV ENT
I
Dental. Fee
SHOWER
Const. Lender
-
Address
Branch
City Zip
BOILER B.T.U.
wwk for which this permit is issued I sholl
s to become subjeo to the workmen s com-
SQ. FT. @ ¢
`Mileage Fee E
BATH TUB
AReinsp. Fee
E
Owner/Agent
SQ. FT. ¢
Tel.
WATER HEATER
f'
;Total Fees
y
Address
SQ. FT. RESID @ 11/.¢
SQ. FT. GAR Ga P/.¢
SEWAGE DISPOSAL
HOUSE SEWER
Zip
M.O. ❑ N.C. ❑ ,Cosh ❑ CheckZ
GAS PIPING
I Received by
PERMIT FEE
PERMIT FEE
2
License N
;Trees required
:'Sewage System
DBI.
TOTAL FEES
].0.. HM. FEE
MICRO FEE
CH. FEE
L. CK. FEE
CONST. FEE
v;2-73
EL T. F
�FEE
FEE
PERMM�,IT NO.
Supp. Permit
Job Address
Space Zip
Owner
096
ommunityValuation
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E G!'Jj
/IDate Dist.
ar? 7
...Off.
F.C.
j
LMH Permit Fee E
EMicro Film Fee
Cop E
Use of Permit
Parcel No.
Use No.
Ck.by
iMech. Fee Dbl E
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3�0Set
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Lot Size
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,PI. Ck. Fee E
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gConstruction Fee Dbl E
Legal Description
S S
�Q Q
Zo_ne
rp Type
Unit
Electrical Fee Dbl E
1�aZTAS
'SMI Fee
E
�
J.
Plumbing Fee
C
Dbl E
Bond Amt.
Eti
Plan No.
Plan Checker
-%7y
Final Date
Inspecto
ISp. Insp. Fee E
Dental. Fee
E
Const. Lender
-
Address
Branch
City Zip
'I certify that in the performance oft
not employ any person in any manner s
pensation laws of Callfornio.'
Owner S.gnwure
Builder 5ignoture
wwk for which this permit is issued I sholl
s to become subjeo to the workmen s com-
jRegistr. Fee E
`Mileage Fee E
Witness Fee E
AReinsp. Fee
E
Owner/Agent
Tel.
Zip
f'
;Total Fees
y
Address
City
Zip
M.O. ❑ N.C. ❑ ,Cosh ❑ CheckZ
I Received by
Contract
Tel.
License N
;Trees required
:'Sewage System
d ressW
City
Zip Workers' Comp.
Ye no ❑
District
Form 284.208 (Re, 4.M OS
IHIJ YtKMII JMALL btULJMt VL) IU IF WUKK IS NUI COMMENCED WITHIN 120 DAYS. CESSATION OF
WORK FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
I HEREBY AGREE THAT ALL WORK I\ CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE
WITH THE LAWS OF RIVERSIDE COUNTY AND JHE STATE.OF CALIFORNIA.
I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE
50 IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF
CALIFORNIA.
ver,f ied by