347369 (RPL)t
BUILDING PERMIT fi :ar DEPARTMENT OF BUILDING & SAFETY FIELD OFFICE
PERMIT NO.Supp.
3473 6 9
PERM IT NO.
347369.
COUNTY OF RIVERSIDE '
!•T
CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES
IST.FL. SQ.
2ND Fl..
FOR. SQ.
GAR. SQ.
CAR P. SQ.
WALL SQ.
ESTIMATED CONSTRUCTION
FT. 8 $ UNITS
YARD SPKLR SYSTEM
SQ. FT. @
MOBILEHOME SVC. BAR SINK
FT. Q
POWER OUTLET ROOF DRAINS
FT. 8 '
_
FT. @ DRAINAGE PIPING
DRINKING FOUNTAIN
FT.
SQ FT. URINAL
VALUATION $ WATER PIPING
NOTE: Not to be used os property tox valuation SWIM POOL, PVT FLOOR DRAIN
Micro Film Fee
MECHANICAL FEES SWIM POOL, COMM WATER SOFTENER
VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD SIGN WASHER (AUTO) (DISH)
r
APPLIANCE ❑ DRYER GARBAGE DISPOSAL
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED LAUNDRY TRAY
Ck.by
AIR HANDLING UNIT CFM IDLE METER KITCHEN SINK
PI..Ck. Fee $
ABSORPTION SYSTEM B.T.U. TEMP USE PERMIT SVC WATER CLOSET
COMPRESSOR HP POLE, TEMP/PERM LAVATORY
Construction Fee Dbl E
HEATING SYSTEM ❑ FORCED ❑ GRAVITY AMPERES SERV ENT SHOWER
BOILER � B.T.U. SQ. FT. Ge ¢ BATH TUB
SQ. FT. (a, ¢ WATER HEATER
Electrical Fee Dbl $
SQ. FT. RESID G 1 '/.a SEWAGE DISPOSAL
Grp
SQ. FT. GAR '/.a HOUSE SEWER
GAS PIPING
PERMIT FEE PERMIT FEE PERMIT FEE
Plumbing Fee
DBL.
TOTAL FEES
Gv
MOB. HM. FEE
MICRO FEE MECH. FEE PL. CK. FEE
50 "�-
CONST. FEE ELECT. FEE SMI FEE
-S&-/3°�
1 G�
FEE PLUMB. FEE
e"
PERMIT NO.Supp.
3473 6 9
Permit
Job Address
� �3�
MEW
Space Zip
sg� �-
Owner
Community
�f%���f✓�y7�
Valuation Date
$ ��D `-
Dist.
�l
Off.
�
F.C.
Qa,
MH Permit Fee $
Micro Film Fee
Cop $
Use of Permit
Ltv��
r
Parcel No.
,
!,/ .7--ap
Use No.
Ck.by
Mech. Fee Dbl $
PI..Ck. Fee $
Set Backs
Lot Size
Construction Fee Dbl E
Legal Description
Electrical Fee Dbl $
Zone
L`
Grp
Type
Unit
SMI Fee E
Plumbing Fee
Dbl $
Bond Amt.
$
Plan No.
Plan Checker
'no Inspector
s
Sp, Insp. Fee $
Denial. Fee
$
Const Lender -
Address
Branch . "I certify that in the performance of.r . work for which this permit is issued I shall
- not employ any person in any manner so as to become subject to the workmen's com.
pensorion lows of Col ifomia."
City Zip Owner Signature
Builder Signature
Registr. Fee E
Mileage Fee $
Witness Fee $
Reinsp. Fee
E
Owner/Agent
Tel.
Zip
Total Fees
$
Address
..
City
Zip
M.O. ❑ N.C. ❑ C.,hW Ch ck ❑
Received by
frees required
Contractor y'1r.F _,Ej- / -
^/f �Yj_�' Ga,A �L
Tel.
License P
•�
Sewage System
Address
City /,/� 7
1.4 . i
Zip
Workers'Comp.
yes & no ❑
T LL P
Sewer District
Form 284.208(Rev.4.77) 0S
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF vvdied by:
WORK FOR 120 DAYS SHALL ALS(yQ1US ERANBECOME VOID.
I HEREBY AGREE THAT ALL/�j6jk IN N C WITH THIS PERMIT WILL BE DONE IN ACCORDANCE
WITH THE LAWS OF RIVERSIDE COUNTY A D 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.