360045 (BLCK)PERMIT NODEPARTMENT OF BUILDING & SAFETY
3600-45COUNTY OF RIVERSIDE FIELD DST
CONSTRUCTION
ESTIMATEQ
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL.
2ND. FL.
POR.
SQ, FT, @ P
UNITS
SQ. FT. @
YARD SPKLR SYSTEM
SQ. FT. @ _ , MOBILEHOME SVC.
BAR SINK
GAR.
CAR P.
WALL
ESTIMATED CONSTRUCTION
SQ, FT, @
POWER OUTLET
ROOF DRAINS
SQ. FT. @
DRAINAGE PIPING
SQ. FT. @ %
DRINKING FOUNTAIN
SQ. FT. @
URINAL
VALUATION $
WATER PIPING
NOTE;.Nol lobe used as property tox.voluation
SWIM POOL, PVT '.
FLOOR DRAIN
MECHANICAL FEES
SWIM POOL, COMM
WATER SOFTENER
VENT SYSTEM FAN EVAP. COOL HOOD
SIGN
WASHER (AUTO)(DISH)
APPLIANCE DRYER
S R
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
Group
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. @ t
BATH TUB
Const. Lender
SQ. FT. @ c
WATER HEATER
SupplimentaI it Numbers
SQ. FT. RESID @lt/.c
SEWAGE DISPOSAL
Mileage Fee $
SQ. FT. GAR @ 3/4 c
HOUSE SEWER
Reinsp. Fee
$
Owner/Agent �•
GAS PIPING
PERMIT FEE
Tel. •
PERMIT FEE
PERMIT FEE
DBL.
TOTAL FFES .
MOB. HM. FEE
MICRO FEE
MECH. FEE PL. CK. FEE
CONST. FEE -, ELECT. FEE
SMI FEE
„FEE PLUMB. FEE
PERMIT NO.
360045
Job Address
Space
Zip
Owner
-�
Community
43 ..
_
Value ion
$
Dae
i
Off.
F.C.C.
MH Permit Fee $
Micro Film Fee
Cop $
Use of feiAt
_�� U
` /'�C'•"'
Parcel No.
Use/Cas o.
Ck. By
Mech. Fee Dbl $
PI. Ck. Fee $
t:t vcks
Lot Size19
J J
Construction Fee Dbl S
Legal Description
_.. !
F S
S R
Electrical Fee Dbl $
Zone Restrictions
Group
Type
SMI Fee $
Plumbing Fee
Dial $
Bond Amt.
$
Plan No.
1
Plan Checker
1
Fi//n l Date Inspector
a (/►
Unit
Sp. Insp. Fee $
Demol. Fee
S
Const. Lender
Branch
SupplimentaI it Numbers
Registr. Fee
Mileage Fee $
Address City Zip
Witness Fee $
Reinsp. Fee
$
Owner/Agent �•
�' -
–,..•
Tel. •
Zip
'Total. -Fees
$
Address
'/ Cr •
City • a'Zr
Zip
v
M. 0. N.C. Cash Check
Received by
Contractor dr'
v
Tel. 0i r
License#
Trees required OF k3
Sewage System
Address
City Zip
—T- ♦ i U. P THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF WORK verified by:
Sewer District FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
I HEREBY AGREE THAT ALL W I TH THIS PERMIT WILL BE DONE IN ACCORDANCE WITH
iTHE LAWS OF RIVERSIDE COU D HE S ATE OFC"I i�ORNIA.
I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PIANS AND SPECIFICATIONS HAS DONE SO IN
ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA.
Form 284-208 (Rev.8/78j �q
NO.
OPERATION
DATE
INSPECTOR
NO.
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
1
Set Back
33
Ventilation System
2
Ftgs 8 Frms
34—, Plenums 8 Ducts
2A
Slob Grade
35 Furnace Comport.
3
Steel
36 Inlets 8 Outlets
4
Grout Blocks
37 Combustion Air
5
Bond Beams
38 Compressor
6
Roof Deck
39
Appl. Clearance
7
Framing
40 Fire Damper
8
Vents
41 Smoke.Deiection Device
9
Garage Fire Wall
42 !�ommeicial Hood
10
Fireplace P. L.
43
Final
IDA
Fireplace T.0.
OP'N
NO.
ADDITIONAL INFORMATION
_
r —
SEWAGE SYSTEM SIZE & LOCATION
11 Exterior Lath
12 Internal Lath
-- —
12A Drywall
13 Finish Grade
INSULATION Thick
R
Value
7A Walls (Batts)
12B Ceiling (Batts)
12C Ceiling (Blown)
14 Final
.PLUMBING APPROVALS
15 Ground Plumb
16 Woter Piping
17 Rough Plumb
18 Vents
19 Sewage Disposal
20 Sewer
21 Water Heater
22 Water Softener
23 Water Service
24 .Gas Test
zs
Final
Tank Pit L.Line
P/L
REAR OF PROPERTY LINE
ELECTRICAL APPROVALS
P/
26 Power Pole '
27 Conduit
28 Service Entrance `
29 Wiring
29A Grounding•Wire
298Bonding
30 - Fixtures
31 Sgrvice ,
32 Fincil
STREET NAME
a ' BUILDING PERMIT FLEW OFFICE
PERMIT No. DEPARTMENT OF BUILDING & SAFETY MDST
6OO4 5 COUNTY OF'RIVERSIDE
CONSTRUCTION
ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
.IST FL.
2ND. FL.
POR. '
GAR.
WALL
CAR P..SQ.jT.
ESTIMATED CONSTRUCTION
SQ. FT. @ $
UNITS
SQ. FT. @
YARD SPKLR SYSTEM
SQ: FT. @ MOBILEHOME SVC. - ..
BAR SINK
SQ. FT. @ POWER OUTLET
ROOF DRAINS
Q. FT. @ t
DRAINAGE PIPING
Q. FT. @
DRINKING FOUNTAIN
@. ._
URINAL
VALUATION $
WATER PIPING
"NOTE:'P4ot to -be used as prbperty tax Val0atidn
SWIM POOL, PNIT A
FLOOR DRAIN
MECHANICAL FEES
SWIM POOL, COMM
WATER SOFTENER
VENT SYSTEM FAN EVAP. COOL HOOD
SIGN
WASHER (AUTO)(DISH)
APPLIANCE DRYER
legal Description f
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
&ctricol Fee Dbl $
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
EIOILER B.T.U.
SQ. FT. @ c
BATH TUB
Pion Checker
SQ FT.. @ c
WATER HEATER I'
Unit
SQ. FT, RESID @I,/, c
SEWAGE DISPOSAL
r
SQ. FT. GAR @ '/. c
HOUSE SEWER
t Regisir. Fee $
.'Mileage Fee S
Address City Zip
•- �.' �
GAS PIPING
AkMIT FEE
PERMIT FEE
PERMIT FEE
DBI,.A
TOTAL FEES
MOB. HMFEE
" ' MICRO FEE
MECH. FEE Pl. CK. FEE
CONST. FEE ELECT. FEE
SMI FEE
FEE PLUMB. FEE
MIT NO.
Job Address Space Zip Owner
r: 30045.
-
•
Community Valuation Date Dist. Off. F.C.C.
�/j 1 // L-7- 1
Gi/' it $
MH Permit Fee _ $
Micro Film Fee Cop $
Use of Permit
Porcel No.
Use/Case No.
Ck. By
EMech.
Fee . Dbl $
,J( L�
G x
Set Backs
Lot Size
�PI. Ck. Fee$
Construction Fee Dbl $
legal Description f
S I
S R
&ctricol Fee Dbl $
�
�l17 Cp 3�'�lry
Zone Restrictions
Group
Type
'-SA
Fee $
. Plurgbing Fee Dbl $
Bond Amt.
$
Plan No.
Pion Checker
Final Dote
In ecI f
Unit
.'Sp- ln'sp. Fee $
Deinol. Fee $
Const. Lender Branch
Supplimental Permit Numbers
,
✓ �/ ���
t Regisir. Fee $
.'Mileage Fee S
Address City Zip
•- �.' �
Witness Fee $
r 'n Fee $
Owne,./Agent r / - �[/ 7`�
Zip
J Toto ees • - 9
Address - -
City Zip
'Aft.O.Cl N.C. 0 Cash
Check'
Received'by
Contractor
Tel
Licensell
required
+,+wTrees
Seage System
Address
Zip
T",
7
LL
P
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED W THIN 120 DAYS. CESSATION OF WORK verified by -
"FOR 120 DAYS SHALL ALSO CAUS RMIT TO BECOME
�� VOID.
Sewer District
1 HEREBY AGREE THAT ALL IbfFtlFLy VTHIS PERMIT WILL BE DONE IN ACCORDANCE WITH
I'
THE LAWS OF RIVERSIDE COUNTY AND THE ATE 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.
rvr,n cov-aw tRev.w of -Y_ — r ���Y