280971 (SFD)BUILDING PERMIT
@�
JOB ADDRESS - SP NO
' 2 5,4N_r/w)6•%%4
DEPARTMENT OF BUILDING &SAFETY
FIELD OFFICE - -
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LAUNDRY TRAY_
AIR HANDLING -UNIT -1
COUNTY OF -RIVERSIDE
IDLE METER
KITCHEN SINK
ABSORPTION SYSTEM
B.T.U.
TEMP USE PERM SVC
DST
COMPRESSOR 0
HP
POLE, TEMP/PERM
LAVATORY
HEATING SYSTEM ❑ FORCED ❑ GRAVITY
CONSTRUCTION ESTIMATE
NO: ELECTRICAL FEES
NO. PLUMBING FEES
ROOMS
SQ FT @ a
1STFL.-97'P^
SQ.FT.
MICROFILM FEE
Jr i �.+ UNITS"
WATER HEATER
SO. FT.
@ •
SQ FT RESID @ 1 a
YARD SPKLR SYSTEM
2ND FL.
POR.
SQ. FT.
_@
S� MOBILEHOME SVC.
BARSINK
rr/3
GAR J 7
SQ FT
�,��
�
POWER OUTLET
ROOF DRAINS
CAR P. ISO.Fl. @
WALL SO. FT. @
SO. FT. @
ESTIMATED CONSTRUCTION VALUATION $Q..
NOTE: Not'to be used CIS property tax voluation
MECHANICAL FEES
VENT SYSTEM ❑ FAN ❑ EVAP. COOL �.❑ HOOD
SWIM POOL, PVT'
SWIM POOL, COMM
SIGN
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
FLOOR DRAIN
WATER SOFTENER
WASHFR (At ITC)) (DISHI
APPLIANCE
JOB ADDRESS - SP NO
' 2 5,4N_r/w)6•%%4
OWNER
GARBAGE DISPOSAL
FURNACE ❑ UNIT Cl WALL ❑ FLOOR ❑ SUSPENDED
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LAUNDRY TRAY_
AIR HANDLING -UNIT -1
CFM
IDLE METER
KITCHEN SINK
ABSORPTION SYSTEM
B.T.U.
TEMP USE PERM SVC
WATER CLOSET
COMPRESSOR 0
HP
POLE, TEMP/PERM
LAVATORY
HEATING SYSTEM ❑ FORCED ❑ GRAVITY
AMPERES SERV ENT
SHOWER
BOILER 0 B.T.U.
ROOMS
SQ FT @ a
BATH TUB
OFFICE
MICROFILM FEE
SQ FT @ a
WATER HEATER
ZAL DESCRIPTION
17- 330 -ma y iota /ate Qa ,
SQ FT RESID @ 1 a
SEWAGE DISPOSAL
$
SQ FT GARAGE @ 'h(t
HOUSE SEWER
PERMIT FEE "'
"
GRP
GAS PIPING
MOBILE HOME PERMIT FEE
Is
PERMIT FEE
PERMIT FEE
PERMIT NO.
280971
TOTAL FEES
94,gq,sv
MOB. HM.FEE
MIC�FEEMECH:
FEE
DBL.
PL. CK. FEE
CONST. FEE
DBL.
ELECT. FEE
DBL.
SMI FEE
FEE
' PLUMB. FEE
DBL.
J F I M A I M I J I J A I S 1 Q 1 N I D
JOB ADDRESS - SP NO
' 2 5,4N_r/w)6•%%4
OWNER
74
fC:•Zk�--
75
USE OF PERMIT IOVA) CA P G 4
«
F.C.
d/�l/�'6
P MI NO
� $ 0971
76
,����/y, . N-eAr, eJDA�
M H PERMIT FEE
$
COMMUNITYDST
14,,( afA)
UNITS
ROOMS
VALUATION
SUPP. TO PERMIT
OFFICE
MICROFILM FEE
COPIES
$
ZAL DESCRIPTION
17- 330 -ma y iota /ate Qa ,
MECHANICAL FEE
DBL
$
SET BACK
LOT SIZE ZOONjE
USE NO.
l
GRP
TYPE
CKK BY
IR
,1
-1
PJf J
PLAN CHECK FEE /s
/
�5 4
$
BOND AMT,
PLAN NO,
PLAN CHECKER
FINAL DATE
INSPEC OR
,
CONSTRUCTION FEE
DBL
$
NAME OF CONST. LENDER BRANCH
OFFICE
NO LENDER YNV LVED
ELECTRICAL FEE
DBL
$
ADDRESS CITY
STA#TE
i•
STRONG MOTION
$
OWNER/AGENT'S SIGNATURE
TRACTR x
INSTRUMENTATION FEE
4i" / C�A� Dev, c Q
$
ADDRESS
ADDRESS
FEE
t, 0,
PLUMBING FEE
DBL
$
CITY ZIPCODE
CI ZIP CODE
l0
TOTAL FEES
^
$
Y
��
---
TEL. NO.
TEL. NO. LICENSE
-. �Iry �I- 77/
CASH Cl CHECK M.O. ❑ N.C. ❑
d
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSA
TION OF WORK FOR 1'20 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
RECEIVED BY J rIFj
TREES REQUIRED
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 ALSC
SEWAGE SYSTEM
.fi�
X35
T
LL
P YJ
AGREE TO CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLIANCE WITH THI
I I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS
FORM 284-208 (Rev. 10-74) @L HAS DONE SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE
OF THE STATE OF CALIFORNIA.