259737 (SATT)BUILDING PERMIT
CONSTRUCTION
1 ST FL. Z '� 7
/ESTIMATE
SO.FT. @ %�
2ND FL.
SQ. FT. @
_
�_'
`�
POR.
SQ. FT. @
GAR. `��'
SQ. FT. @ s
CAR P.
SQ.FT. @
!J
1
WALL
SQ. FT. @
WATER PIPING
SQ. FT. @
ESTIMATED CONSTRUCTION
VALUATION $
NOTE: Not to be used as property tax valuation
MECHANICAL FEES
DEPARTMENT OF BUILDING & SAFETY
COUNTY OF RIVERSIDE
NO. I ELECTRICAL FEES
UNI rS
j MOBILEHOME SVC.
POWER OUTLET
SWIM POOL, PVT
SWIM POOL. COMM
FIELD OFFICE
NO.
PLUMBING FEES
APPLIANCE kt ,7 k U GARBAGE DISPOSAL
BOILER � B.T.U.
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
1
URIIQ'JiL ,� ox x r
f
WATER PIPING
FLOOR DRAIN
WATER SOFTENER
DST
r/ J
Cd
VENT SYSTEMA FAN ❑ EVAP. COOL HOOD 001 SIGN WASHER IAUTOftDISHI 3040
APPLIANCE kt ,7 k U GARBAGE DISPOSAL
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED LAUNDRY TRAY
AIR HANDLING UNIT I CFM IDLE METER ! KITCHEN SINK f SG3
ABSORPTION SYSTEM 0 B.T.U. TEMP USE PERM SVC WATER CLOSET sU
COMPRESSOR HP 947 POLE, TEMP/PERM LAVATORY 5-0
HEATING SYSTEM FORCED ❑GRAVITY O AMPERES SERV ENT z O SHOWER 'S%
SQ FT @ ¢ �/ BATH TUB
SOFT @ ¢ / WATER HEATER O%
SQ FT RESID @ I ¢ 2 SEWAGE DISPOSAL
SQ FT GARAGE @ '/2¢ ! 71- HOUSE SEWER vim)
PERMIT FEE Q TEMP ELEC SVC GAS PIPING % V
MOBILE HOME PERMIT FEE is
PERMIT FEE PERMIT FEE 2 UIC:>
PERMIT NO.
TOTAL FEES IMOB.
HM. FEE
MICRO FEE
MECH. FEE
DBL.
/y P, ,"'EE
L7
CONST. FEE
DBL.
ELECT. FEE
t
DBL.
SMI FEE
FEE
PLUMB. FEE
DBL
J I F I M A I M I J I I A I S 0 1 N D
JOB ADDRESS SP NO
(Ii,* /.�
OWNG3`l-y 7A
97 . I
d73 Al 7-,t Al
74
USE OF PERMIT/ T /�
F.C.
DATE r3 !� P�M�0 37
M H PERMIT FEE
$
COMMUNITY OF
DST
UNITS
ROOMS
VALUATION
SUPP. TO PERMIT
OFFICE
r.4
I
Y
I
MICROFILM FEE
COPIES
$
LEGAL DESCRIPTION
MECHANICAL FEE
DBL
$
SETBACKLOT
SIZE ZONE
NO.♦
GRP
TYPE
CK BY
r
/
�U#SE
�!
S !�J R14)'
PLAN CHECK FEE
$
BOND AMT.
PLAN NO.
PLAN CHECKER
FINAL DATE
It ECTOR
CONSTRUCTION FEE
DBL
$
NAME OF CONST. LENDER BRANCH
OFFICE
NO LENDER INVOLVED
1 s `l
e
C iT / /� Tio.v, / 43 4 All<
ELECTRICAL FEE
DBL
$
ADDRESV CITY
%
STAT
SMI FEE
$
THIS PERMIT SHALL BECOMEhOID IF WORK IS NOT COM ENCED WITHIN 120 DAYS. CESSA•
7
TION OF 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 AC.
$
CORDANCE WITH THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, I ALSO
FEE
AGREE TO CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLIANCE WITH THE
LAWS OF THE STATE OF CALIFORNIA COVERING CONTRACTORS IS ALSO GUARANTEED.
1 HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED TH PLANS AND SPECIFICATIONS
PLUMBING FEE
DBL
$
�7
01)
HAS DONE SO IN ACCORDANCE WITH SECTION 55� F TH USIN SAN R ESSIONS CODE
OF THE STATE OF CALIFORNIA.
TOTAL FEES �
Vic, '��
.`.s
OWN--R/AGENT'S SIGNATURE C CT R
�F1
CASH ❑ CHECK I M.O ❑ N.C. ❑
ADDRESS
ADDRESS
���i� %J �C/4
RECEIVED BY (-�LofE'1
TREES REQUIRED
�
CITY ZIP CODE
CITY ZIP CODE
SEWAGE SYSTEM
T
LL P
&Cipjre, 1,-4 %3-d...+d ?A.¢ .
INFORMATION
TEL. NO.
TELL. NO. 1.1 NSE
p�
CORM 984 -?08 `Rev 9.73, OS /" � A IV -,
'5'2W 7 i G ���D_.