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309139 (AR)
BUILDING PERMIT DEPARTMENT.OF BUILDING .& SAFETY FIELD OFFICE PERMIT NO. 399139 PERMIT NO. 3913 COUNTY OF RIVERSIDE NH Permit Fee $ DST CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES IAech. Fee NC). PLUMBING FEES 1 ST FL. SQ. 2ND FL. POR. GAR. SQ. CAR P. SQ. ...WALL. SQ. + ESTIMATED CONSTRUCTION FT. Q $ UNITS ,construction Fee Dbl $n� SQ. FT. (a} �' YARD SPKLR SYSTEM Dbl $ SQ. F.T. @MOBILEHOME SVC. BAR SINK SMI,Fee. FT. POWER OUTLET ROOF DRAINS FT. DRAINAGE PIPING Dbl $ FT. DRINKING FOUNTAIN Q Ip. Insp. Fee SQ. FT. , URINAL VALUATION Is ew WATER PIPING $ ' NOTE: Not to be used as property tax valuation SWIM POOL, PVT $ FLOOR DRAIN IAileage Fee $ MECHANICAL FEES SWIM POOL, COMM $ WATER SOFTENER Ieinsp. Fee E VENT SYSTEM ❑ FAN ❑ EVAP:'000L ❑ HOOD SIGN WASHER (AUTO) (DISH) btol Fees APPLIANCE ' ❑ DRYER M.O. ❑ 4.C. ❑ Cash ❑ Check GARBAGE DISPOSAL FURNACE ❑ UNIT ❑ WALL ❑ FLOOR. ❑ SUSPENDED LAUNDRY TRAY AIR HANDLING UNIT CFM IDLE METER KITCHEN SINK ' ABSORPTION SYSTEM B.T.U. TEMP USE PERMIT SVC WATER CLOSET COMPRESSOR'—T� HP p POLE, TEMP/PERM ' LAVATORY- , HEATING SYSTEM ❑, FORCED ` ❑ GRAVITY• ' AMPERES SERV ENT SHOWER ` BOILER B.T.U. SQ. FT: 8 a BATH TUB - SQ. FT: @ ¢ WATER HEATER SQ. FT. RESID .� 1 tLr¢ SEWAGE DISPOSAL SQ. FT. GAR 3/.¢ HOUSE SEWER GAS PIPING PERMIT FEE -'3 e PERMIT FEE � y PERMIT FEE .DBL. TOT; FEES jM0B.HM.FEE[_77_;7E -- MECH; FE�O - -PL. CK;O C�%, FOE EO E T. FES I FSE FEE PLUMB. FEE PERMIT NO. 399139 Supp. Permit NH Permit Fee $ Nitro Film Fee Cop $ IAech. Fee Dbl it. Ck. Fee $ ,construction Fee Dbl $n� EIectricol Fee Dbl $ SMI,Fee. E 6lumbing Fee Dbl $ Ip. Insp. Fee $ >emol. Fee' $ legistr. Fee $ IAileage Fee $ FVitness Fee $ - Ieinsp. Fee E ' btol Fees M.O. ❑ 4.C. ❑ Cash ❑ Check teceived by frees required sewage System t T LL P =s=yeewer District +- Form 284.208 (Rev. 4.77) ©s Job Address . - Space1415j/,,7,o,-e� ner I ;,V-,2,05— 641k A1101nR ,,.tee $ Community f Valuations - Date - Diit. F.C. Use of Permit -P Parcel No. Use No. Ck.by. . �..l OA>9 41C: /46.4-1/7– Set Backs Lot Size Legal Description Vs J S R to�� Type Unit Bond Amt. - Pion No. 7n Checker Fin, Inspector Const. Lender Branch I certify that in the perf rmance of the wgpk Vr which ih,s permit is issued I'shall not employ any person in any manner so os mesubfect to the workmen s com- pensation laws of California.' . Address City Zip Owner S.gnolure Budder Signature Owner Ag Tel. Zip 373r -6/A5- 7/.0 AcIcIress , CityZipP Contractor - Tel. License P Address CityZip Workers' Comp. yes ❑ no ❑ THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF verd,ed by; 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. I•HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE i SO IN ACCORDANCE WITH SECTION 5541 OF. THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA.