303754 (ELEC)BUILDING PERMIT DEPARTMENT OF BUILDING & SAFETY FIELD OFFICE
PERMIT NO.
PERM IT NO.
3O37541
c COUNTY OF RIVERSIDE
1F.
DST
11
CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES
1 ST FL. SQ.
2ND FL.
FOR. SQ.
GAR. SQ.
CAR P. SQ.
WALL . EE SQ.
ESTIMATED CONSTRUCTION
FT. Q $ UNITS
SQ. FT. @ YARD SPKLR SYSTEM
FT. (a} MOBILEHOME SVC. BAR SINK
FT. @ POWER OUTLET ROOF DRAINS
FT. @ DRAINAGE PIPING
FT. 8 DRINKING FOUNTAIN
SQ. FT. ,� URINAL
VALUATION $ t WATER PIPING
NOTE: Not to be used as property tax valuation. SWIM POOL, PVT FLOOR DRAIN
MECHANICAL FEES SWIM POOL, COMM WATER SOFTENER
MH Permit Fee $
VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD SIGN WASHER IAUTOI (DISH)
Cop E
APPLIANCE ❑ DRYER GARBAGE DISPOSAL
se of ermit
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED -` LAUNDRY TRAY
No.
AIR HANDLING UNIT CFM IDLE METER KITCHEN SINK
Mech. Fee Dbl b
ABSORPTION SYSTEM O B.T.U. TEMP USE PERMIT SVC WATER CLOSET
COMPRESSOR HP POLE, TEMP/PERM LAVATORY
GrL „��.Q /�j„'f S �G,� _
HEATING SYSTEM ❑ FORCED ❑ GRAVITY AMPERES SERV ENT SHOWER
BOILER B.T.U. SQ. FT. B ¢ BATH TUB
Pl. Ck. Fee y
` SQ. FT. ¢ WATER HEATER -
I
SQ. FT. RESID @ 1'Atr SEWAGE DISPOSAL
Legal. Description
A
SQ. FT. GAR p 1/.¢ HOUSE SEWER
SMI Fee E
GAS PIPING ,
Dbl E
PERMIT FEE PERMIT FEE PERMIT FEE
Bond Amt.
g
DBL.
I TO AL FEES
jmos.Hm.F;1
MICRO FEE MECH. FEE 15L. CK: FEE
- CONST. FEE EL T. SMI FEE
FEE PLUMB. FEE
PERMIT NO.
Supp. Permit
Job
Job Address Space Zip Owner
13037541
C
Community Valuation Dote sL
xil•,,. ' $
f F.C.
3
MH Permit Fee $
Micro Film Fee
Cop E
se of ermit
Parcel No. fUse
No.
Ck.by
Mech. Fee Dbl b
GrL „��.Q /�j„'f S �G,� _
Pl. Ck. Fee y
Set Backs - Lot Size
F S 5 i
Zon Grp Type Unit
I
Construction Fee Dbl b
Legal. Description
A
Electrical Fee Dbl $ -
SMI Fee E
Plumbing Fee
Dbl E
Bond Amt.
g
Plan No.
Plan Ch c r
Final Date
I error
Sp. Insp. Fee E
Denial. Fee
E
Const. Lender Branch 'I certify that in the performance of the work for which this permit is issued I shalt
not employ any person in any manner so as to become subject lathe workmen s com•
_ - pensation laws of California.'
Address - City Zip
Owner Signature
_ Builder Signature
Registr. Fee $
Mileage Fee E
Witness Fee $
Reinsp. Fee
8
Owner/Agent
Tel.
Zip
Total Fees
- S
Address
City -
Zip
M.O. ❑ N.C. ❑ Cash heck ❑
Received by
Contra Tel. License q
Trees required
j
t•^•/+
Sewage System
A d e s City Zip
Workers' Comp.
yes no ❑
T
LL
P
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN' 12t} DAYS. CESSATION OF
verdied by.
Sewer District
WORK FOR 120 DAYS 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 LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA.
—A
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
Form 284.2081Rev.4JOs s
CALIFORNIA.