388036 (SPIN)OUILUINVT PLKInIll
DEPARTMENT OF BUILDING & SAFETY
PERMIT NO, -1 COUNTY OF RIVERSIDE
1388036
FIELD F7171
if I I
CONSTR CTION,8TIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
I ST FL.
2ND. FL.
SQ. FT. @ $
UNITS
Valuation
$
SQ. FT. @
YARD SPKLR SYSTEM
POR.
SQ. FT. @
MOBILEHOME SVC.
BAR SINK
GAR.
CAR P.
SQ. FT. @
POWER OUTLET
ROOF DRAINS
SQ. FT. @
DRAINAGE PIPING
WALL SQ. FT. @
SO. FT. @
ESTIMATED CONSTRUCTION VALUATION $
Lot Size
DRINKING FOUNTAIN
URINAL
WATER PIPING
NOTE: Not to be used as property tax valuation
SWIM POOL, PVT
FLOOR DRAIN
MECHANICAL FEES
SWIM POOL, COMM
WATER SOFTENER
VENT SYSTEM FAN EVAP. COOL HOOD
SIGN
WASHER (AUTO)(DISH)
APPLIANCE DRYER
Plan No.
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
Insp
LAUNDRY TRAY
AIR HANDLING UNIT CFM
IDLE METER
KITCHEN SINK
ABSORPTION SYSTEM B. T. U.
TEMP USE PERMIT SVC
WATER CLOSET
COMPRESSOR HIP
POLEJEMP/PERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B. T. U.
SQ. FT. @ c
BATH TUB
M -O -CS N.C,2 C.shQ C�eck
SQ. FT. @ c
WATER HEATER
Tel. Ll 4/,57 Y�
SO. FT. RESID @I)/, c
SEWAGE DISPOSAL
Sewage System "Ail
SQ. FT. GAR @ 1% c
HOUSE SEWER
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE/
DBL.
FEpf�_
MOB. HM. FEE
MICRO FEE
MECH. FEE PL. CK. FEE
CONST. FEE ELECT. FEE
SMI FEE
FEE PLUMB FEE
PERMIT NO.
13880361
Job Address,
4 0 IN t)03
Zip',
)j-, -
C-
Owner
Cozity
�-k - "xx k
Valuation
$
;9te
Dist.
-2a-
4 -
F.C.C.
MH.Permit Fee $
Micro Film Fee Cop $
Use of Permit
Z04.59,11C 4.-1 a.i,.
Parcel No.
121
Use/Cose No.
Ck. By
Mach. Fee DbI $
Pl. Ck. Fee $
Set Backs
Lot Size
Construction Fee Dbl $
Legal Descripfii n
17- (10) C,;3 t-
F
I IS R
Electrical Fee Dbl $
Zone ResfNtions
114, �
Group
Type
SMI Fee $
Plumbing Fee Dbl $
Bond Amt.
$
Plan No.
ker
Final Date ,
Insp
Unit
Sp. Insp. Fee $
Dental. Fee $
Const. Lender Branch
S6pplimentol Permit Numbers
3�-
Registr. Fee 1$
Mileage Fee $
Address City Zip
Witness Fee $
Reinsp. Fee $
Owner/Agent
Tel. Zip
Total Fees $
A d
AA�---
City Zip
M -O -CS N.C,2 C.shQ C�eck
Received by
&nt�c"
Tel. Ll 4/,57 Y�
License#
Trees required
Sewage System "Ail
Acldress�-
City zip
v -
T U. P THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF WORK �erifiecl by;
Sewer District FOR 120 DAYS SHALL ALSO CAUSE PER��C)ME VOID.
I HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE WITH
THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA.
I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PkEPARED THE PLANS AND SPECIFICATIONS HAS DONE SO IN
<-----ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA.
Form 2a4-208 (Re�.8/78)
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