350640 (SFD)BUILDING PERMIT WAdk DEPARTMENT OF BUILDING & SAFETY FIELD OFFICE
PERMITNO.
3506 4 0
PERMIT NO. 350640
COUNTY OF RIVERSIDE
Zip
-?-.S3
Owner
FT
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
Off. F.C.
NO. PLUMBING FEES
1ST FL. SQ.
2ND FL.
POR. /ZF SQ.
lOo�
GAR. SQ.
CAR P. SQ.
WALL SQ.
ESTIMATED CONSTRUCTION
L
�
FT. /fav $a7 p�
UNITS
Mech. Fee Obl E
PI. Ck. Fee E
Construction Fee Dbl E �q% d
SQ. FT. CC YARD SPKLR SYSTEM
'SMI Fee E
FT. Ga 7a MOBILEHOME SVC. BAR SINK
Bond Amt.
E
FT. 3 p0 .3 POWER OUTLET ROOF DRAINS
Plan Checker
/r ���✓�L
FT. DRAINAGE PIPING
FT. Ga DRINKING FOUNTAIN
j Demol. Fee
SQ. FT. Ga URINAL
Const. Lender Branch I certify that in the perffor which this permit is issued I shall
not employ any person in any manner so as to become subject to the workmen's com-
pensation lows of California.'
Address City Zip Owner Signature
r�' � —Iry (/s+ - Builder Signature
VALUATION %�� % WATER PIPING
a
NOTE: Not to be used as property tax valuation
SWIM POOL, PVT
b
FLOOR DRAIN
Tel. Zip
MECHANICAL FEES
SWIM POOL, COMM
Address ((�� // �[" p
— l j L7 l ( 1 �Jc l7
WATER SOFTENER
M.O. C] N.C. Cash
j Received by
VENT SYSTJA X Q FAN C] EVAP. COOL HOOD
SIGN
Tel.
WASHER (A I(DISH)
Trees required
Sewage System
�.4
T LL P
APPLIANCE DRYER
City Zip
Workers' Comp.
yes 0 no C]
GARBAGE DISPOSAL
A
FURNACE ❑ UNIT 0 WALL 0 FLOOR Cj SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
IDLE METER
KITCHEN SINK
�. �j
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
02 WATER CLOSET
COMPRESSO$3 O HP a+ t
POLE, TEMP/PERM
2 LAVATORY
HEATING SYSTEM X0 FORCED O GRAVITY d
dp AMPERES SERV ENT
y
SHOWER
BOILER � B.T.U.
SQ. FT. (y ¢
BATH TUB
0 D
SQ. FT. @ ¢
WATER HEATER
a
SQ. FT. RESID Ga 1 t/.¢
SEWAGE DISPOSAL
�Q
OZ SQ. FT. GAR Ca, s/.¢
,
HOUSE SEWER
GAS PIPING
PERMIT FEE d
PERMIT FEE
PERMIT FEE
d
DBL.
TOTAL FEES
aI -NT/
MOB. HM. FEE
MICRO FEE MECH. FEE
/ `II
PL. CK. FEE
I CONST. FEE
a/ '
ELECT. FEE
9 'a
SMI FEE
' '4
FEE
[,,;MB. FEE
PERMITNO.
3506 4 0
Supp. Permit
Job Address Space
7� �o Z��- 4o-,��
Zip
-?-.S3
Owner
Community
.LR •..is
Valuation Date
7
Dist.
Off. F.C.
MH Permit Fee E
Micro Film Fee Cop E
Use of Permit Parcel No. Use No. Ck.by
O
Set Backs Lot Size
tt
Legal Description ) +{ .. //l 41,!*-
7,�'�
�V�`��v`A� i ,!*- Zone Grp Type Unit
Mech. Fee Obl E
PI. Ck. Fee E
Construction Fee Dbl E �q% d
Electrical Fee Dbl E
'SMI Fee E
Plumbing Fee Dbl E
Bond Amt.
E
PlanNo.
/ ��Q
Plan Checker
/r ���✓�L
Final Dote j� speaor
/ 0
;Sp. Insp. Fee E
j Demol. Fee
E
Const. Lender Branch I certify that in the perffor which this permit is issued I shall
not employ any person in any manner so as to become subject to the workmen's com-
pensation lows of California.'
Address City Zip Owner Signature
r�' � —Iry (/s+ - Builder Signature
Registr. Fee E
I Mileage Fee E
I Witness Fee E
�Reinsp. Fee
b
Owner/A t
-�- -T /fu
Tel. Zip
iTotal Fees
E a/�
Address ((�� // �[" p
— l j L7 l ( 1 �Jc l7
tt Zip
! l�r�/%�
M.O. C] N.C. Cash
j Received by
Contractor
Tel.
License #
Trees required
Sewage System
�.4
T LL P
Address
City Zip
Workers' Comp.
yes 0 no C]
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS, CESSATION OF verified by.
WORK FOR 120 DAYS SH�kILSO USE P�O BECOME VOID.
I HEREBY AGREE T L I TION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE
WITH THE LAWSOF RIVERSIDE --OUWY AND THE STATE OF CALIFORNIA.
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 284-208 (Rev. 4.771 0f