304002 (ELEC)'E !
iDEPARTMENT OF BUILDING & SAFETY
BUILDING PERMIT ',� „�; FIELD OFFICE
PERMIT NO,
1304002
PERMIT NO. '//�y
304001,
Job Address
r
ommunity
COUNTY OF RIVERSIDE
- ,.
-
- F.C.
DST
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
MH Permit Fee, $-
1ST FL. SQ.
2ND FL.
POR. SQ.
GAR. SQ.
CARP. SQ.
WALL SQ.
SQ..FT.
ESTIMATED CONSTRUCTION
FT. Qa $
UNITS
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+
� �'QLF
Parcel No.
Set Backs
,
F S 5 R
Zone Grp Type
_
Use No.
Lot Size
Unit
SQ. FT. @ t. YARD SPKLR SYSTEM
Mech. Fee Dbl $
FT. MOBILEHOMESVC. BARSINK
Construction Fee Dbl $
- POWER OUTLET ROOF DRAINS
FT. (a}
Plumbing Fee
FT. @DRAINAGE PIPING
Bond Amt.'
S'
FT. 8 DRINKING FOUNTAIN
No.
Cel URINAL
Final Date
VALUATION is WATER PIPING
NOTE: Not to be used as property tax valuation
SWIM POOL, PVT
Sp. Insp. Fee $
FLOOR DRAIN
$
Const. Lender
Address
MECHANICAL FEES
SWIM POOL, COMM
Registr. Fee $
WATER SOFTENER
Witness Fee $
Reinsp. Fee
VENT SYSTEM 0 FAN 0 EVAP. COOL 0 HOOD
SIGN
-
WASHER (AUTO) (DISH)
Zip
APPLIANCE 0 DRYER
Total Fees
$
GARBAGE DISPOSAL
City
FURNACE 0 UNIT 0 WALL 0 FLOOR 0 SUSPENDED
Zip
M.O. 0 N.C. 0 Cosh 0 Chec
LAUNDRY TRAY
Cant -V
dre s
,+
AIR HANDLING UNIT CFM
IDLE METER
License p
Zip Wor ers
KITCHEN SINK
ABSORPTION SYSTEM O B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET
COMPRESSOR O HP
POLE, TEMP/PERM
LAVATORY
HEATING SYSTEM 0 FORCED 0 GRAVITY
AMPERES SERV ENT-
SHOWER
BOILER � B.T.U.
SQ. FT. 8 4
BATH TUB
SQ. FT. @ C
WATER HEATER
SQ. FT. RESID p 1'Att
SEWAGE DISPOSAL
SQ. FT. GAR Cw 1/.¢
HOUSE SEWER
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL.
TOTAL FEES
0?
MOS. HM. FEE
MICRO FEE
MECH. FEE L. CK. FEE.
. CONST. FEE
E T. FE E
Q.'Q
SMI FEEFEE
.
PLUMB. FEE
PERMIT NO,
1304002
Supp. Permit
Job Address
r
ommunity
_ Voluation
$
Space Zip Owner
Date
Dist. J Off.
- F.C.
MH Permit Fee, $-
Micro Film Fee
Cop $
se o Permit
(,.L �.
Legal Description
7s
S %,r�. ✓✓G� -
+
� �'QLF
Parcel No.
Set Backs
,
F S 5 R
Zone Grp Type
_
Use No.
Lot Size
Unit
Ck.by
Mech. Fee Dbl $
PI. Ck. Fee $
Construction Fee Dbl $
;Electrical Fee Dbl $
SMI Fee $Z(,f'
Plumbing Fee
Dbl $
Bond Amt.'
S'
Plan
No.
Plan Chec er
Final Date
Insp —or
Sp. Insp. Fee $
Demol. Fee
$
Const. Lender
Address
Branch 'I certify that to the performance of the work for which this permit is issued
not employ any person in any manner so as to become subject to the workmen
pensation laws of California.
City Zip
Owner Signature
Builder Signature
I shall
s com-
Registr. Fee $
Mileage Fee $
Witness Fee $
Reinsp. Fee
$ -
Owner/Agent
-
Tel.
Zip
Total Fees
$
Address
City
Zip
M.O. 0 N.C. 0 Cosh 0 Chec
Received by
Trees required
Sewage System
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dre s
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jig,rykyko,
Tel. -
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City
License p
Zip Wor ers
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T LL P
=.Sewer District
For. 284-208 (Rev. 4.771 I]s
' THIS PERMIT $HALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF verified by:
WORK FOR 120 DAY$ SHALL ALSO CAUSE PERMIT TO BECOME VOID.
I HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE
WITH THE LiWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA._
.... , ..�.-..._ - .,,. .—...�. . - _ ...��.sY M..��v.,..'... .,...Ka.: .,.._,_ ......__...�._..,.-..:.ate.. ��..,.- x
I 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.