354132 (ELEC)BUILRING PERMIT
t PERMIT NO.
354132
DEPARTMENT OF BUILDING &• SAFETY
COUNTY OF RIVERSIDE
FIELD'
CONSTRUCTION
ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. .r
� f �
• 2ND. FL.
/$
SQ. fj1'.,@. _ ... -
- UNITS
• '
Community /✓
! _
SQ: FT. @
YARD SPKLR SYSTEM
I t 1
r POR! �r
SQ. F//'T. @
MOBILEHOME SVC.
F.C.C.
BAR SINK _
t GAR.
SQ. IFT. @
POWER OUTLET
ROOF DRAINS
CAR P. •-
1 (}WALLSQ
/
SQ.'FT. @ '
Cl!-By
.! .J
Mech. Fee, Dbl E
DRAINAGE PIPING `
FT (� D•'� :5 7 1,e— D'L`
DRINKING'FOUNTAIN
SQ. FT. @
ESTIMATED CONSTRUCTION VALUATION $
ConstructioA'Fee Dbl E 4+ �•
legal Description ;
l�� e/
c7 3.V..J"f l!• t/�,CI ,x";;07 _
URINAL
WATER PIPING
NOTE: Not to be used as property tax valuation
SWIM POOL, PVT
Zone Restrictions
� .
FLOOR -DRAIN
MECHANICAL FEES"' • •;
T "'" "' '" SWIM POOL, COMM—`
" " - '"
€. WATER"Sbf'rErtER`'
NT SYSTEM ; r FAN EVAP. COOL' HOOD ?''
SIGN
r WASHER (AUTO)(DISH)
WLIANqll DRYER !
Plan Checker
_
Final �D a Ins or �i•
sV �.7
GARBAGE DISPOSAL, '
FURNACE) I UNIT WALL FLOOR SUSPENDED •
t
Sp. Insp,jFeety., f
}
Demol. Fee' %I
".' LAUNDRY TRAY.
AIR HANDLING UNIT CFM k
IDLE METER
Const. Lender Branch
r KITCHEN SINK
ABSORPTION SYSTEM ; _ B.T.U.
TEMP USE PERMIT SVC
Mileage Fee ' E
f WATER CLOSET
COMPRESSOR ( .GHP ;
POLE,TEMP/PERM
'
LAVATORY
HEATII4G,SYSTEM FORCED GRAVITY
AMPERES SERV ENT
Tel.
•`17 3 I 1
SHOWER
BOILERJ' ' } B.T.U.
SQ. FT. @ C
` `
BATHTUB
9
SQ. FT. @ C
City
.... �`'!�'f+= Gsrt.�S.:,�
WATER HEATER
'
SQ. FT. RESID @1'/a
SEWAGE DISPOSAL
,.. !
S0. FT. GAR @ '/. C
Tel.
HOUSE SEWER
yk 1
I! /
Tr4es required
S�vy'age System
^.
GAS PIPING
PERAAMFEE'
Address
PER FEE
i o
PERMIT FEE'
DELI
TOTAL FEES
MOB.HMFEE
MICRO FEE -
MECH. FEE PL. CK. FEE
CONST. FEE
ELECT. FEE
SMI FEE
FEE PLUMB. FEE
PERMIT NO.
•
-,
'Job Address/�
Space
Zip
Owne/r�} -
• '
Community /✓
Valuation
-
Dote /
Dyt%
Off...
F.C.C.
n-
JMH Permit Fee % $
tmicro Film Fee-
Cop $
Use of Permit -
Parcel No.
Use/Case No.
Cl!-By
.! .J
Mech. Fee, Dbl E
PI. Ck. Fee' $
Set Backs _
Lot Size
ConstructioA'Fee Dbl E 4+ �•
legal Description ;
l�� e/
c7 3.V..J"f l!• t/�,CI ,x";;07 _
F S S _
R
r(t.
Electrical,F.ee :/ Dbl E /.��'
Zone Restrictions
� .
Group'
Type
•
SMI Fee; � f
Plumbing Fee ". '.
Dbl E
Bond Amt.
f
Plan No. 4
Plan Checker
_
Final �D a Ins or �i•
sV �.7
Unit
'
t
Sp. Insp,jFeety., f
}
Demol. Fee' %I
E
Const. Lender Branch
Supplimental Permit Numbers
.M .:w .. n
�..y.'•.
,Regisir. Feet
Mileage Fee ' E
Zi -
Address City P
4I r- .�,1'' i .. wM .s. Y♦1♦M"�11 p.w
Witness Fee f
Reinsp. Fee
f
Owner/Agent
Tel.
•`17 3 I 1
Zip
Total Fees
E
Address
. ��,'' fc 14iC `
- 1 ' * ' / — '/ Al
6� 7-
City
.... �`'!�'f+= Gsrt.�S.:,�
Zip
v' r
:f:.:3"i
.M O. N.C. Cash C eck
Rece;y'.l by
�•
'
Contractor
Tel.
License#
I! /
Tr4es required
S�vy'age System
Address
City Zip
' C T LL P THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF WORK verified by:
Sewer District q. FOR 120 DAYS SHALL, ALSO CAUSE PERMIT TO BECOME -VOID., w • .. rr , , z p f .,ti ,,u.� ?;.ice
t " I HEREBY AGREE THAT ALL WORK I 1 "�yNITH� THIS PERMIT WILL BE DONE IN ACCORDANCE WITH
THE LAWS OF RIVERSIDE COUNTY Cll%;R NIA. '
I HEREBY CERTIFY THAT THE INDNIDUAL W O PREPARED THE PLANS AND SPECIFICATIONS HAS DONE SO IN
J. 284=208 (Rev.B/78)I ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA.
NOTICE TO APPLICANT
In conformity with the provisions of State of California Labor Code Section43800, the applicant shall have on file or file with the Riverside County
Department of Building and Safety a certificate as designated in Items I or II belo(v, or shall indicate Item III, IV, or V, whichever is applicable.
CERTIFICATE OF APPLICANT
Please mark the appropriate block:
', ❑ II• Certificate of Consent to self -insure issued by the Director of Industrial Relations.
t ❑ Copy on file ❑ Copy submitted
,,1 ❑' II. Certificate of Workers' Compensation Insurance issued by an admitted insurer..
f ❑ Copy oA file ❑ Copy submitted
III. The cost of the -work to be performed is $100 or less.
!U IV. I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become
subject to the Workers' Compensation laws of California. I further certify that, in the event I become subject to the Workers' Compensa-
tion provisions of the Labor Code that I will comply forthwith with the provisions of Labor Code Section 3700, et seq., and understand
i that, if I do not comply, the permit shall be deemed revoked.
1r ❑
V. I certify as the owner (or the agent of the owner) that in the performance of the work for which this permit is issued
I have engaged
contractor. (Contractor must have on file, or submit certificate required by I or II above:)
Applicant's Signature
Date
Permit No.
1 Address and location where work is to be performed
1
{ 284-141 Rev. 6/77
BUILDING PERMIT
PERMIT NO. DEPARTMENT OF BUILDING 8 SAFETY
354132 COUNTY OF RIVERSIDE
'FIELD OFFICE ST D -
IIGG�4.�✓/.
CONSTRUCTION
ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
t 'IST FL.
2ND. FL.
FOR.
GAR.
CAR P.
WALL
ESTIMATED CONSTRUCTION
SQ. FTS'@` $
UNITS
F.G.C.
SQ. FT, @
YARD SPKLR SYSTEM
MOBILEHOME SVC.
SQ. FT. @
BAR SINK.
POWER OUTLET
SQ. FT. @
ROOF DRAINS
SQ. FT, @
DRAINAGE PIPING
SQ. FT. @ VL
DRINKING FOUNTAIN
SQ FT @
URINAL
VALUATION
WATER PIPING
NOTE: Not to be used as property tax valuation
SWIM POOL, PVT
FLOOR DRAIN
MECHAN1CACFEES' ' ' '
' ' SWIM POOL, COMM
WA7ER'SOFTENER• '
VENT SYSTEM FAN EVAP. COOL HOOD
SIGN
WASHER (AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
Zone Restrictions
A2 - 1
LAUNDRY TRAY
AIR HANDLING UNIT CFM
IDLE METER
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET
COMPRESSOR • HP
POLE,TEMP/PERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SQ. FT. @ c
BATH TUB "
t
SQ. FT. @ C
WATER HEATER
S0. FT. RESID @ 1'/. c
SEWAGE DISPOSAL
Tel.
SQ. FT. GAR @ 'G C
HOUSE SEWER
-`
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE "
DBL.
TOTAL FEES
MOB, HM. FEE
MICRO FEE
MECH. FEE PL. CK. FEE
I CONST. FEE ELECT. E
SMI FEE
FEE PLUMB. FEE
Space
PZW7.0a
Zip
:ta 3
Owner
/Y%t g� 411,
Valuation
DateDjs
F.G.C.
$
a h�
Parcel No.
Use/Case No.
Ck. By
771/-/.7/
Set Backs
Lot Size
F
S
SR
J�
�✓;�d
Cl/
Zone Restrictions
A2 - 1
Group
Type
a -
�— ,
In ctor
Unit
—7
Supplimental Permit Numbers
t
Zip
Tel. Zip
'Y73 - 74S4!
City Zip
Tel.
License#
City Zip
VOT COMMENCED WITHIN 12o DAYS. CESSATION OF WORK
COME VOID- - - .. .
9tCITMTHIS PERMIT WILL BE DONE IN ACCORDANCE WITH
E IA.
DREPARED THE PLANS AND SPECIFICATIONS HAS DONE SO IN
IESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA.
verified by: