SFD (304098)BUILDING PERMIT DEPARTMENT OF BUILDING 8 SAFETY FIELD OFFICE
PERMIT NO.
1304098
PERMIT NO.
304090
COUNTY OF'RIVERSIDE -
DST
CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES
1ST FL. SQ.
2ND FL. SQ.
FOR. SQ.
GAR. SQ.
CAR P. SQ.
WALL SQ.
SQ.
ESTIMATED CONSTRUCTION
FT. Q $ r UNITS
FT. ® YARD SPKLR SYSTEM
FT. @ dlW MOBILEHOME SVC. BAR SINK
FT. @ y'a POWER OUTLET ROOF DRAINS
FT; (a} DRAINAGE PIPING
FT. DRINKING FOUNTAIN
FT. URINAL
VALUATION $ o_G 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) QW)
Ck.by
APPLIANCE DRYER GARBAGE DISPOSAL
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED LAUNDRY TRAY
Bocks
AIR HANDLING UNIT CFM IDLE METER KITCHEN SINK
Lot Size
ABSORPTION SYSTEM O B.T.U. TEMP USE PERMIT SVC WATER CLOSET
Dbl E
Dbl
$
COMPRESSOR 1 , � HP POLE, TEMP/PERM LAVATORY
F
HEATING SYSTM FORCED ❑ GRAVITY AMPERES SERV ENT SHOWER
BOILER B.T.U. SQ. FT. p ¢ BATH TUB
Zone
SQ. FT. Ga ¢ WATER HEATER
Type
I tV
SQ. FT. RESID (a} 1'/.it SEWAGE DISPOSAL
Unit
_
SQ. FT. GAR C/.¢ HOUSE SEWER
;Plumbing Fee
%Sp. Imp. Fee
GAS PIPING
Bond Amt.
$
PERMIT FEE PERMIT FEEPERMIT FEE
Plan Checker
DBL.
TOTAL FEES
114108. HM..FEE
MICRO'FEE H. PL. CK. FEE
CONST. FEE E SMI FEE
FEEJ PL S. F E '
PERMIT NO.
1304098
Supp. Permit
Job Address � Space Zip Owner
- z�_
Community Valuation Date
G 00 �j 77
7 O
f
M�s
Dist. Off. F.C.
// �Q
MH Permit Fee $
;Micro Film Fee
Cop $
Use of -Permit -
AF»t./L—Q st %/ �,i7I
parcel No.
2
Use No,
Ck.by
Mech. Fee Dbl $
fa 41 11
pl. Ck. Fee $
Set
Bocks
Lot Size
Construction Fee
lElectricol Fee
SMI Fee
r
Dbl E
Dbl
$
Legal Description
_
�% / L �7 [ % �"7
F
Zone
Grr
p
Type
I tV
Unit
_
;Plumbing Fee
%Sp. Imp. Fee
Dbl E
$
Bond Amt.
$
Plan No.
Plan Checker
Final Date
Inspect r
Dental. Fee
E
Const. lender Branch . 'I cenrfy that in the performance of th ork for which this permit is issued I shall
not employ any person 'n any manner so r o become subject to the workmen s tom.
pensation lows of Col.forma.
Address City Zip Owner Signature
Budder Siqnature
'Registr. Fee $
,Mileage Fee $
`Witness Fee $
�Re insp. Fee
$
Owner/Agent
Tel.
Zip
1
[
Total Fees $
• M.O. ❑ N.C. ❑ Cosh Check
Address
City
Zip
=Received by
Contrac
Tel.
License q
3
'Trees required
Sewage System
Ad ressAr
oe
Ciry
Zip Workers' Comp.
yes�JD °O 0
iii
Sewer District
611`*•, i . - .__
Form 284.208 (Rev. 477) Os
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS CESSATION OF -rd.ed by.
WORK FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
I 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.
t 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