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341002 (AR)BUILDING PERMIT ;Aft DEPARTMENT OF BUILDING & SAFETY ` FIELD OFFICE PERMITNO. 3410021 PERMIT NO. 1W COUNTY OF RIVERSIDE q' DST Valuation cC 341002 Di . Off. F.C. Qw2 MH Permit Fee $0gliIAZZ:e!�is CONSTRUCTION ESTIMATE Use of Permit //�� nn !� 9 do Jva V�R r %U aid �/ 11Za NO. ELECTRICAL FEES NO. PLUMBING FEES Ck.by r 1ST FL. SQ. FT. Q V $ rIaZ UNITS Lot Size Construction Fee Dbl E 26S. SQ FT Ga Pp F � S '� YARD SPKLR SYSTEM R FOR. SQ. FT. (B}_ Zone P,-/ MOBILEHOME SVC. BAR SINK Unit GAR. SQ. FT. .G^ SMI Fee $ ` { POWER OUTLET ROOF DRAINS Plan No. CAR P. SQ. FT. @ Final Dote — 2-1— —Demal. Inspector DRAINAGE PIPING Sp. Imp. Fee $ WALL SQ. FT. Ga Const. Lender Branch I certify that to the performance of the work for which this permit is issued I sholl ne! employ any person ,n any manner so as to become subject to the workmen's com- pensation laws of California Address—"1 /^ City Zip Owner Stgnawre // !\J ,/!/ �. Bolder Signature Registr. Fee $ DRINKING FOUNTAIN [ Witness Fee $ SQ. FT. Ga O^'ner7A9 Tel. Zip �o41 _' l�.�6L� URINAL f Total Fees s x IIII ESTIMATED CONSTRUCTION VALUATION $ 00 M.O. ❑ N.C. ❑ Cash ❑ Check WATER PIPING �Ly NOTE: Not to be used as property tax valuation License H SWIM POOL, PVT FLOOR DRAIN City Zip Workers' Comp. yes ❑ no ❑ MECHANICAL FEES Sewer District Form 284208 IRev. 4771 ®s SWIM POOL, COMM WATER SOFTENER VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD SIGN WASHER (AUTO) M1 APPLIANCE RYER GARBAGE DISPOSAL FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED LAUNDRY TRAY AIR HANDLING UNIT CFM IDLE METER KITCHEN SINK ABSORPTION SYSTEM O B.T.U. TEMP USE PERMIT SVC WATER CLOSET COMPRESSOR 0 HP POLE, TEMP/PERM LAVATORY HEATING SYSTEM FORCED ❑ GRAVITY AMPERES SERV ENT SHOWER BOILER B.T.U. SQ. FT. 6 ¢ BATH TUB SQ. FT. 6 ¢ WATER HEATER FT. RESID Ga 1'Air SEWAGE DISPOSAL SQ. FT. GAR Cai Y -c HOUSE SEWER GAS PIPING PERMIT FEE PERMIT FEE OO PERMIT FEE DBL. TOTAL FEES MOB. HM. FEE " MICRO F E MECN. FEE PL. CK. FEE CONST. FEE ELECT. FEE SMI FEE FEE PLUMB. FEE a �,,0 00i /9 /A pa PERMITNO. 3410021 SuppPermit Job Address Space Zip Owner Community Valuation cC Date r/O Di . Off. F.C. Qw2 MH Permit Fee $0gliIAZZ:e!�is Micro Film Fee Cop $ Use of Permit //�� nn !� 9 do Jva V�R r %U aid �/ 11Za Parcel No. A0 S-- 9Q Use No. Ck.by r Mech. Fee Dbl s I Pl. Ck. Fee $ A qn Set Backs Lot Size Construction Fee Dbl E Description ;_-I��-lo-/7�s.i�,C0a T" F � S '� S �}`- R iElectrical Fee Dbl $ Zone P,-/ Grp - fl -3 Type Unit SMI Fee $ ` { Plumbing Fee ON b AAJBond Plumbing Amt. $ Plan No. Plan Checker Final Dote — 2-1— —Demal. Inspector Sp. Imp. Fee $ Denial. Fee $ Const. Lender Branch I certify that to the performance of the work for which this permit is issued I sholl ne! employ any person ,n any manner so as to become subject to the workmen's com- pensation laws of California Address—"1 /^ City Zip Owner Stgnawre // !\J ,/!/ �. Bolder Signature Registr. Fee $ k Mileage Fee $ [ Witness Fee $ it Reinsp. Fee $ O^'ner7A9 Tel. Zip �o41 _' l�.�6L� f Total Fees s x IIII ress n City Zip M.O. ❑ N.C. ❑ Cash ❑ Check Received by Trees required Contractor Tel. % License H Sewage System T LL P Address City Zip Workers' Comp. yes ❑ no ❑ THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF vvJ,ed 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 IN ACCORDANCE WITH THE LAWS OF RIVEQSIDE 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 CALIFORNIA. Sewer District Form 284208 IRev. 4771 ®s