360418 (SFD)P"'m'
360418
OWNER,
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Owner
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voluOligo Date
Dist. Off.
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MH Permit Fee
Micro Film Fee Cop $
Use of Permit 'F
6
Parcel No. jF
[Use/Cose No.
Ck. B y
.Mecl�. Fee Dbl $ Za
Pl. Ck. Fee $
Set Backs
I Lot Size
Construction Fee DbI .$
Electrical Fee 1 $
SMI Fee $
Legal Description
4;�7
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icne Restrictions
Group
Type
Plumbing Fee DbI $
Bond Amt.
$
Pion No.
Plan Checker
Final Date
nspector
Unit
Sp. Insp. Fee $
Dental. Fee $
ConstAencler
Brqnch
SU pplimental Permit Numbers
Rdgistr. Fee 1$
Mileage Fee $
Address Ci . ty zip�
Witness Fee $
Rein5p. Fee $
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Tel,
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Zip
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Tolol Fees $
Addre�
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Zip
M. 0. C] N. E] Cash C] CKeck,[a
Red;i�ed by
Trees required
Cont,,,.ct.r
Tel.
License#
Sewage System
Address
city
Zip
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Sewer District
Form 284-208 (Rev.8/78;
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF WORK �erifiecl by:
FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
I HEREBYAGOtE:THA.T ALC'WOF(KIN t6t4kc"n6K WjfHTAIS PEkM)T WILL BE DONE IN ACCORDANCE WITH
THE LAWS OF RIVER$IDE COUNTY AND THE,STATE OF CALIFORNIA.
I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANEt AND SPECIFICATIONS HAS DONE SO IN
ACCORDANCE WITH.SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA.