309390 (SFD)BUILDING PERMIT DEPARTMENT OF BUILDING & SAFETY ab, FIELD OFFICE
PERMITNO.
09390
PERMITNO.
11jy
3 0 9 ^ V g ^I
Job Address
-
COUNTY OF RIVER5I0E
Space
DST
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CONSTRUCTION
ESTIMATE
NO. ELECTRICAL FEES
QH��✓ :
NO. PLUMBING FEES
1 ST FL. SQ.
2ND FL. SQ.
POR. SQ.
GAR. SQ.
CAR P. SQ.
WALL SO.
SQ.
ESTIMATED CONSTRUCTION
FT. Oa �$
,Go
UNITS
F.C.
/
FT. @ YARD SPKLR SYSTEM
FT. @ ZI r` v� MOBILEHOME SVC. BAR SINK
MH Permit Fee E_�
FT. (a} Oi POWER OUTLET ROOF DRAINS
Cop E
FT. DRAINAGE PIPING
FT. DRINKING FOUNTAIN
FT. Cad URINAL
VALUATION $ _� WATER PIPING
NOTE: Not to be used as property tax valuation
Mech. Fee Dbl E
PI. Ck. Fee E
SWIM POOL, PVT
Lot Size
1
FLOOR DRAIN
Obl E
Dbl E
E
Legal Description
J
^d %
MECHANICAL FEES
/
v'N/r �4
SWIM POOL, COMM
w
WATER SOFTENER
S,r
I
VENT SYSTEM ja FAN ❑ EVAP. COOL HOOD
Grp
%�
SIGN
Unit
WASHER IAUTOIJAISHI
Plumbing Fee
Dbl E
APPLIANCE DRYER
Plan No.
rP1nChecker
GARBAGE DISPOSAL
Final DateInspectoSp.
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
Insp. Fee E
LAUNDRY TRAY
E
Const. Lender
Ad
AIR HANDLING UNIT CFM
Branch
Cit
IDLE METER
Registr. Fee _ E
KITCHEN SINK
Witness Fee - E
Reinsp. Fee
ABSORPTION SYSTEM O B.T.U.
Owner/Agem
TEMP USE PERMIT SVC
WATER CLOSET
Tel,
a --z- -
7 --
COMPRESSOR 1 HP
POLE, TEMP/PERM
E
LAVATORY
HEATINGSYST6A FORCED ❑GRAVITY
City
r AMPERES SERV ENT
Zip I
SHOWER
Received by
Trees required
BOILER � B.T.U.
SQ. FT. p ¢
BATH TUB
License p
Sewage System
SQ. FT. (ja ¢
Address
WATER HEATER
City
Zip
SQ. FT. RESID @ 1'h¢
SEWAGE DISPOSAL
SQ. FT. GAR Cat 'Ac
HOUSE SEWER
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL.
I TOTAL FEES
'p
MOB. HM. FEE
MICRO FEE
MECH. FEE
PL. CK. FEE
CONST. FEE
�
EL T. FEE
SMI FEE
FEE
PL MB. FEE
PERMITNO.
09390
Supp. Permit
Job Address
-
Space
Zip
Owner
-70L
Community
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Valuation
E J
�'
Date
0�7 77
Dist.Off.
F.C.
/
MH Permit Fee E_�
Micro Film Fee
Cop E
Use of Permit
r�
�I/LGi 'e L -,r,-
-
Parcel No.
3-�
Use No.
Ck.by
Mech. Fee Dbl E
PI. Ck. Fee E
Set Backs
Lot Size
1
Construction Fee
Electrical Fee
SMI Fee
Obl E
Dbl E
E
Legal Description
J
^d %
�lj ��L /� '�
/
v'N/r �4
w
E`
S,r
I
Zone
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Grp
%�
Type
It1
Unit
Plumbing Fee
Dbl E
Bond Amt.
E�
Plan No.
rP1nChecker
Final DateInspectoSp.
Insp. Fee E
Demol. Fee
E
Const. Lender
Ad
t
Branch
Cit
: tcemfy that .n the perionnance of th. n r whah rhes perms a rssued I shall
not employ any person in on manner so a o Uamme subtecr ro the workmen s com.
pensohon lows of California
Zip Owner Srgnawre
Bo•'der Sgnar„e
Registr. Fee _ E
Mileage Fee E
Witness Fee - E
Reinsp. Fee
E
Owner/Agem
/
Tel,
a --z- -
7 --
Zip
Total Fees
E
Address
City
Zip I
M.O. ❑ N.C. ❑ Cash ❑ Check
Received by
Trees required
Contractor
Tel.
License p
Sewage System
Address
City
Zip
Workers' Comp.
yes no 011
Sewer District
2a.x,63)-2y
Form 284-2081Rev.4 71 Ps
THI,i PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 72J DAYS CESSA..3N OF ,enheo,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 ;N 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 554: OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE CF
CALIFORNIA