346722 (SFD)BUILDING PERMIT glim, DEPARTMENT OF BUILDING & SAFETY ,i FIELD OFFICE
PERMIT NO.
346722
MH Permit Fee b
Micro Film Fee Cop b
Mech. Fee Dbl b
PI. Ck. Fee AQ 4
Construction Fee Dbl 4
Elearicol Fee rDb
4
SMI Fee b
Plumbing Fee b
Sp. Imp. Fee b
Demol. Fee 4
Registr. Fee 4
Mileage Fee b
Witness Fee §
Reinsp. Fee b
Total Fees 4
M.O. ❑ N.C. ❑ Cash
Received by Jrl
Trees required
Supp. Permit
PERMITNO.
346722
/oars
COUNTY OF RIVERSIDE
Owner
P
�f
CONSTRUCTION ESTIMATE
Form 284.2081Rev. 4.771 &s
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. 02 SQ.
2ND FL.
FOR. SQ.
GAR. SQ.
CAR P. SQ.
WALL SQ.
SQ.
ESTIMATED CONSTRUCTION
FT. @Z $
UNITS
Dote
a� 7�'
Dist.
//
SQ. FT. @ YARD SPKLR SYSTEM
F.C.
Qp/
MOBILEHOME SVC. BAR SINK
FT. (a3 �
Use of Permit
iD
FT. Cia POWER OUTLET ROOF DRAINS
GO '�
FT. @ DRAINAGE PIPING
Use No.
FT. @ DRINKING FOUNTAIN
FT. Ga' URINAL
VALUATION $ dne 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 IAUTOICISH1
Type
APPLIANCE DRYER
�A$
GARBAGE DISPOSAL
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
Plan No.
IDLE METER
j KITCHEN SINK
p for
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET
1-?-q--7q
COMPRESSORr HP
yt
POLE, TEMP/PERM
LAVATORY
.3,5-7/
HEATING SYSTEM FORCED ❑ GRAVITY
/7
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
Branch
SQ. FT. Ga ¢
BATH TUB
not employ any person in any monner so as to become subject to the workmen's
pensation laws of California."
com.
SQ. FT. tg ¢
WATER HEATER
Owner Signature
gCSQ. FT. RESID Ga 1'/.¢
-� SEWAGE DISPOSAL
Owner/Agent i
SQ. FT. GAR % Y.¢
HOUSE SEWER
heckZ
GAS PIPING
City
Zip
PERMIT FEE
p
PERMIT FEE
PERMIT FEE
DBL.
TOY%F&WMOB.
��
HM. FEE
MICRO FEE -
MaZH. FEE
PL. CK. FEE
CONST. FEE
ELECT. FEE SMI FEE
FEE
B. FEE
PERMIT NO.
346722
MH Permit Fee b
Micro Film Fee Cop b
Mech. Fee Dbl b
PI. Ck. Fee AQ 4
Construction Fee Dbl 4
Elearicol Fee rDb
4
SMI Fee b
Plumbing Fee b
Sp. Imp. Fee b
Demol. Fee 4
Registr. Fee 4
Mileage Fee b
Witness Fee §
Reinsp. Fee b
Total Fees 4
M.O. ❑ N.C. ❑ Cash
Received by Jrl
Trees required
Supp. Permit
Job Address
/oars
Space Zip
Owner
P
Sewer District
Form 284.2081Rev. 4.771 &s
I '0 1 7 -
Community
Community
/19 e wmo✓ v
Valuation
b oT �� 3�
Dote
a� 7�'
Dist.
//
Off.
_T
F.C.
Qp/
Use of Permit
Parcel No.
Use No.
Ck.by
.rG /47r
Set Backs
Lot Size
`�
O. Legal Descriptionq
S �
Type
Unit
�A$
Bond Amt.
Plan No.
an Checker
Final Dote I
p for
1-?-q--7q
.3,5-7/
451v«1"V5
Const. Lender
Branch
I I certify that in the performance of the work for which this permit is issued I sholl
not employ any person in any monner so as to become subject to the workmen's
pensation laws of California."
com.
Address
Qty Zip
Owner Signature
Builder Signature
Owner/Agent i
Tel.
Zip
heckZ
Address
73 e11l 4—:k- 4p s
City
Zip
X
Contractor
Tel.
License It
Sewage System
Addres
/oars
Gx
T LL
P
Sewer District
Form 284.2081Rev. 4.771 &s
S City Zip Workers' Comp.
yes ❑ no ❑
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF verified by
WORK FOR 120 DAYS SHALL ALSO SEWNIT�T'OOBBECCOOME VOID.
I HEREBY AGREE THAT ALL QECfi>JIQ WITH THIS PERMIT WILL BE DONE IN ACCORDANCE
WITH THE LAWS OF RIVERSIDE COUNTY AN THE 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.