351376 (BLCK)BUILDING PERMIT Aft DEPARTMENT OF BUILDING & SAFETY Aft FIELD OFFICE
PERMIT NO.
1351376
1'
COUNTY OF RIVERSIDE
FDST
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
I ST FL. SQ.
2ND FL.
POR.
GAR, SQ.
CAR P.
WALL
ESTIMATED CONSTRUCTION
FT. & $
UNITS
SQ. FT. @
YARD SPKLR SYSTEM
SQ. FT. @- MOBILEHOME SVC.
BARSINK
FT. @ POWER OUTLET
ROOF DRAINS
SQ. FT.
DRAINAGE PIPING
SQ. FT. @ alw-
DRINKING FOUNTAIN
SQ. FT. @
URINAL
VALUATION $
WATER PIPING
NOTE: Not to be used os property tox valuotion
SWIM POOL, PVT
FLOOR DRAIN
MECHANICAL FEES
SWIM POOL, COMM
WATER SOFTENER
VENT SYSTEM C] FAN C] EVAP. COOL [1 HOOD'
SIGN
WASHER (AUTO) (DISH)
APPLIANCE [:] DRYER
GARBAGE DISPOSAL
FURNACE 0 UNIT 0 WALL 0 FLOOR (:] SUSPENDED
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 0 FORCED C] GRAVITY
AMPERES SERV ENT
SHOWER
BOILER [�� B.T.U.
SQ. FT. C
BATHTUB
SQ. FT.
WATER HEATER
SO. FT. RESID @ I 'Ac
SEWAGE DISPOSAL
SQ. FT. GAR @ 14 a
HOUSE SEWER
GAS PIPING
PERMIT FEE
PERM11 FEE
PERMIT FEE
DEL.
I TZ:��MOS.
HM. FEEI
MICRO FEE
MEC -HL FEE PL.CK.FEE
1,00�FEE
ELECT. FEE
SMIFEE
FEE PLUMB'FFE
PERMIT NO.
3513 761
Supp. Permit
Job Address
za�'
ID4e2"
Space
Zip
Ow er
_%!2b2
Community
1'.'7&
Valuation
s
Dote
-Dist.
Off.
F.0
H Permit Fee
�Aicro Film Fee
Cop
Use of Permit
PC
Parcel No.
Use No. Ck. by
Mech. Fee DbI
P1. Ck. Fee
B.,
Lot S�ize
Construction Fee DbI $ AID
Legal Description
F
F
S
lectricol Fee DbI
r_
Zo
Zone
_ / I
Grp
Type
Unit
I
-
LIMI Fee $
,01urnbing Fee
DbI $
Bond Amt.
Plan No.
Plan Checker
161
Final Dote
-
�p. Insp. Fee $
$
Const. Lender
C'
Branch
City
'I cer4ify that in the performopce of the,work for which this pe rmit is issued I shall
not employ any person in any manner so as to become subi ect to the workmen*s com-
pensation laws of California.'*
Zip Owner Signature
A Builder'Signoture
$
qAddress
lWitness Fee
einsp. Fee
$
0,
Owner/Agent
Tel. zip
.,a,
$ /,g;j6�j,
Address
� -
City Zip
. I . .
M.C. N.C. 0 Cash 0 ��k C]
kecei�ed by
Contractor
Ire
Tel..
License #
ITrees required
�wo
rge System
Address
City Zip
Workers'Comp.
yes 0 no 0
T LL P THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF verified byz
District WORK FOR 120 DAYS SHALL ALS%USE
4P RMIT TO BECOME VOID.
I HEREBY A - GREE THAT a?e UNTY AN TH �C�ITH THIS.PERMIT WILL BE I DONE IN ACCORDANCE
WITH THE LAWS OF RIVSRSIDE COUNTY AN THE STATE OF CALIFORNIA.
Form 284-208 (Rev. 4.771 0S
So � HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE, PLAN . 5 AND SPECIFICATIONS HAS DONE
N ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF
CALIFORNIA.