328827 (GRD)777
BUILDING PERMIT -Amk DEPARTMENT OF BUILDING & SAFETY jgk FIELD OFFICE
PERMIT NO.
328827
PERMITNO.
328827
W
COUNTY OF RIVERSIDE
Owner
�i
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
Date
as"'
1ST FL. SQ.
2ND FL.
POR.
GAR. SQ.
CAR P. SQ.
WALL SQ.
ESTIMATED CONSTRUCTION
FT. $
/1�
UNITS
MH Permit Fee E��l
Micro Film Fee
YARD SPKLR SYSTEM
SQ. FT.
Use of Permit
`L
HV
SQ. FT. @ MOBILEHOME SVC. BAR SINK
parcel No.
,w�� `„.c, POWER OUTLET ROOF DRAINS
FT. (+�
Use No.
.
FT. (a} DRAINAGE PIPING
Ck.by
DRINKING FOUNTAIN
FT. 8
PI. Ck. Fee E
SQ. FT. URINAL
Lot Size
VALUATION $ WATER PIPING
Construction Fee Dbl E
NOTE: Not to be used as property tax valuation
F ipa..
SWIM POOL, PVT
.!,i—
FLOOR DRAIN
Electrical Fee Dbt $l
one
Zone j
MECHANICAL FEES
Type
SWIM POOL, COMM
WATER SOFTENER
Plumbing Fee
Dbl E
VENT SYSTEM,7 IR FAN ❑ EVAP. COOL fio HOOD'
Plan No.
136?j
SIGN
Plan Checker
117
WASHER (AUTO ISH)
In for
APPLIANCE DRYER
Sp. Insp. Fee E
Fee
GARBAGE DISPOSAL
Const. Lender
Address
Branch I certify that to the performance of
not employ any person in any manner
pensation lows of California."
City Zip Owner Signature
t
/ Builder Signature
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
s
n's com.
Registr. Fee E
Mileage Fee E
LAUNDRY TRAY
Reinsp. Fee
E
AIR HANDLING UNIT CFM
�'
IDLE METER
KITCHEN SINK
Total Fees
ABSORPTION SYSTEM O B.T.U.
Address
TEMP USE PERMIT SVC
City
WATER CLOSET
Zip
M.O. ❑ N.C. ❑ Cosh ❑ Chec
COMPRESSOR [ HP
POLE, TEMP/PERM
LAVATORY
License N
HEATING SYSTEM jJ FORCED ❑ GRAVITY
Sewage System
`�!�
AMPERES SERV ENT
Address
SHOWER
City
Zip
BOILER B.T.U.
IF
SQ. FT. Ga ¢
BATH TUB
SQ. FT. G ¢
Of WATERHEATER
Q. FT. RESID Ga 1'/.¢SEWAGE
30
DISPOSAL
SQ. FT. GAR (59 /.c
HOUSE SEWER
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBI.
I TOTAL FEESr4ae.
aZ� i�
HM, FEE
MICRO FEE
MECH. FEE
PL. CK. FEE
CONST. FEE
EL . FEE
SMIFEE
FEE
PERMIT NO.
328827
Supp. Permit
Job Address
-
Space Zip
zz
Owner
Community
Valuation
s � Srj
Date
as"'
Dist.
Off.
F.C. J
MH Permit Fee E��l
Micro Film Fee
Cop E
Use of Permit
`L
HV
Q �I / R'`
r�j�
parcel No.
Use No.
Ck.by
Mech. Fee Dbl E (jp�yl
PI. Ck. Fee E
Set Backs
Lot Size
Construction Fee Dbl E
Legal Description
tom^ �/f� l j
// 7.V�
�`!
F ipa..
Q S...S
.!,i—
Electrical Fee Dbt $l
one
Zone j
Grp�j
Type
Unit
SMI Fee E
Plumbing Fee
Dbl E
Bond Amt.
E
Plan No.
136?j
Plan Checker
117
'Da cam _ _/l
�`�Demol.
In for
Sp. Insp. Fee E
Fee
E
Const. Lender
Address
Branch I certify that to the performance of
not employ any person in any manner
pensation lows of California."
City Zip Owner Signature
t
/ Builder Signature
K for whKn this permit is nsu
a came subject to t work
s
n's com.
Registr. Fee E
Mileage Fee E
Witness Fee E
Reinsp. Fee
E
Owner/Agent
-3-.W'.J
�'
Tel.
3
Zip
Total Fees
E
Address
City
Zip
M.O. ❑ N.C. ❑ Cosh ❑ Chec
Received by
Trees required
Contractor
Tel.
License N
Sewage System
`�!�
(�/7
/., y/ f� 1
Address
City
Zip
Workers' Comp.
yes ❑ no ❑
T LL P THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF verified by
WORK FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID,
1; Sewer District
Y. 1 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.
I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE
SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF
Form 284.208 (Rev. 4-77) Os CALIFORNIA.