296656 (SPIN)DEPARTMENT.OF BUILDING & SAFETY FIELD OFFICE
BUILDING PERMIT A.
J F M A M J 1 A S 0 N D
PERMIT NO.
296656
COUNTY OF RIVERSIDE
1
DST
CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES
1 ST FL.
2ND FL.
POR.
GAR.
CAR P.
WALL SQ.
ESTIMATED CONSTRUCTION
SQ. FT. @ $ UNITS
SQ. FT. @ YARD SPKLR SYSTEM
SQ. FT.. @ MOBILEHOME SVC. BAR SINK
SQ. FT. @ POWER OUTLET ROOF DRAINS
SQ. FT. @ DRAINAGE PIPING
FT. @ DRINKING FOUNTAIN
SQ. FT. @ URINAL
VALUATION $ - WATER PIPING
NOTE: Not to be used os property tax valuation SWIM POOL, PVT FLOOR DRAIN
USE OF ERM
MECHANICAL FEES swim POOL, COMM WATER SOFTENER
SUP . TO PERMIT PERMITNO.
VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD SIGN WASHER (AUTO) (DISH)
APPLIANCE ❑ DRYER GARBAGE DISPOSAL
FURNACE ❑ UNIT ❑ WALL ❑FLOOR ❑ SUSPENDED LAUNDRY TRAY
AIR HANDLING UNIT CFM IDLE METER KITCHEN SINK
ABSORPTION SYSTEM 0 B.T.U. TEMP USE PERM SVC WATER CLOSET
_
COMPRESSOR HP POLE, TEMP/PERM LAVATORY -
HEATING SYSTEM ❑ FORCED ❑ GRAVITY AMPERES SERV ENT SHOWER
BOILER T. U. SQ.FT. @ a BATH TUB
SQ.FT. @ a WATER HEATER
SQ.FT.RESID @ 1I/4a SEWAGE DISPOSAL
SQ.FT.GAR @ 3/4a HOUSE SEWER
MICROFILM FEE
COPIES
GAS PIPING
PERMIT FEE
PERMIT FEE PERMIT FEE •'
OBL.
I TOTAL FEES
jMOB.HM.FEEj
MICRO FEE MECH, FEE PL. CK. FEE
I CONST. FEE ELECT. FEE SMI FEE
- FEE PLUMB. FEE
tGA-D�
J F M A M J 1 A S 0 N D
JOB ADDRESS I SP NO
I
OWNER
-
G77
76
77
COMMUNITY VALUATION
DATE O OFFICE
If $
` A
�
"i
78
M H PERMIT FEE
$
USE OF ERM
F.C.
SUP . TO PERMIT PERMITNO.
a
_
,l
MICROFILM FEE
COPIES
$
BOOK PAerE PARCEL
LEGAL DESCRIPTION
MECHANICAL FEE
DBL
$
USE NO.
ZONE
SET BA
LOT SIZE 6RP
TYPECK Y
I
S
S
R
I ss
PLAN CHECK FEE
$
BOND AMT.
PLAN NO.
PLAN CHECKER
FINAL DATE
INSPECTOR
J
CONSTRUCTION FEE
DBL
$
NAME OF CONST. LENDER BRANCH
OFFICE
NO LENDER INVOLVED
All
ELECTRICAL FEE
DBL
$
ADDRESS CITY
STATE
STRONG MOTION
$
OWNER/AGENTS SIGNATURE CONTRACTOR
INSTRUMENTATION FEE
'SPECIAL:NSP
$
ADDRESS ADDRESS,
DEMOLITION
REGISTRATION
EE
PLUMBING FEE
DBL
$
CITY ZIP CODE CITY
ZIP CODE
xl
TOTAL FEES $
TEL. NO.
AREA CODE TEL.
NO. AREA CODE
LICENSE R
rich
CASH ECK❑ O.❑N.C.❑
Jr�
RECEIVED BY TREES REQUIRED
HIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF
nkts
ORK FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID".
HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE
SEWAGE SYSTEMI
T LL
P
WITH THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, I ALSO AGREE TO CARRY
COMPENSATION
INSURANCE UPON MY EMPLOYEES. COMPLIANCE WITH THE LAWS OF THE STATE OF
CALIFORNIA COVERING CONTRACTORS IS ALSO GUARANTEED.
I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE
FORM 284-208 (REV. e-76) SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE
OF CALIFORNIA.