403345 (BLCK)BU1lU11VV YtKMII
ERMIT NDEPARTMENT OF BUILDING & SAFETY FIELD DST
140�3405'
COUNTY OF RIVERSIDE
/i1
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL.
2ND. FL.
POR.
GAR.
CAR P.
WALL
ESTIMATED CONSTRUCTION
SO. FT. @ $
UNITS
SO. FT. @
YARD SPKLR SYSTEM
SO. FT. @ MOBILEHOME SVC.
BAR SINK
POWER OUTLET
SO. FT. @
ROOF DRAINS
SO. FT. @
DRAINAGE PIPING
SO. FT. @
DRINKING FOUNTAIN
SO. FT. @
URINAL
VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
SWIM POOL, PVT
FLOOR DRAIN
MECHANICAL FEES
SWIM POOL, COMM
WATER SOFTENER
VENT SYSTEM FAN EVAP. COOL HOOD
SIGN
WASHER (AUTO)(DISH) a
APPLIANCE DRYER
GARBAGE DISPOSAL t
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 HP
POLE, TEMP/PERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SO. FT. @ a
BATH TUB
Set FSacks
SO. FT. @ a
WATER HEATER
Legal Deicr'iption
S0. FT. RESID @ 1 t/<a
SEWAGE DISPOSAL
S0. FT. GAR @ 3/44
HOUSE SEWER
GAS PIPING t
PERMIT FEE
Zone Restrictions
PERMIT FEE
PERMIT FEE
DBL.
TOTAL FEES
MOB. HM. FEE
MICRO FEE
MECH. FEE PL. CK. FEE
CONST. FEE ELECT. FEE
SMI FEE
FEE PLUMB. FEE
PERMIT NO.
-Job Address - - - - --� -- - y Space
ZipOwner
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Community
Valuation
Date
Dist.
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F.C.C.
r
MH Permit Fee $;,,rd/
LAS I f + �
$
Micro Film Fee Cop $
Use of Permit
Parcel No. +�
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Use/Case No.
Ck. By
Mach. Fee" Dbl S
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PI. Ck. Fee S
Set FSacks
Lot Size
Construction Fee Dbl S r r
Legal Deicr'iption
ri. r S,-
Electrical Fee Dbl $
Zone Restrictions
Group
Type
SMI Fee
Plumbing Fee Dbl S
BondAmt.
'Pion No.
Plan Checker
Final Date
In for
Unit
Sp. Insp. Fee
$
S
OVA
Demo]. Fee S
Const. Lender Branch
Supplimentol Permit Numbers
/
�� .••7 "�
Registr. Fee $
Mileage Fee $
Address City Zip
-
Witness Fee g
.I
,
Reinsp. Fee $
Owner/Agent /� / r: =�. r�.L ,
Tel. Zip
Total Fees S ^� i"
Address ,/g -
+'� i
City Zip '
7...... . ,
,
M.O. N.C. ) CosW Check �•
Received by "'r
Contractor
Tel. ` J
LicenseR
'
Trees required
Sewage System
Address
City Zip
;
T I.I. P THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF WORK
FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
Sewer District
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 HE BY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE SO IN
Form 284.208 (Rev. 1/80) RDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE. OF THE STATE OF CALIFORNIA.
verified by:
NO.
OPERATION
DATE
INSPECTOR
NO.
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
1
Set Back
33
Ventilation System
2
Ftgs 6 Frms
34
Plenums 8 Ducts
2A
Slab Grade
35
Furnace Comport.
3
Steel
36
Inlets 8 Outlets
4
Grout Blocks
37
Combustion Air
5
Bond Beams
38
Compressor
6
Roof Deck
39
Appl. Clearance
7
Framing
/.2 %,-4
40
Fire Damper
8
Vents
41
Smoke Detection Device
9
Garage Fire Wall
42
Commercial Hood
10
Fireplace P. L.
43
Final
10A
Fireplace T. 0.
°o
ADDITIONAL INFORMATION
t '}
SEWAGE SYSTEM SIZE & LOCATION
11 Exterior Lath
12 Internal Lath
12A Drywall
13 Finish Grade
INSULATION Thick R
Value
7A Walls (Batts)
12B Ceiling (Botts)
12C Ceiling (Blown)
14 Final
PLUMBING. APPROVALS
15 Ground Plumb
16 Water Piping
17 Rough Plumb
18 Vents
19 Sewage Disposal
20 Sewer
21 Water Heater
22 Water Softener
23 Water Service
24 Gas Test
25
Final
Y
Tank Pit L. Line
REAR OF PROPERTY LINE
ELECTRICAL APPROVALS
P/L
P/
26 Power Pole
27 Conduit
28 Service Entrance
29 Wiring
29A Grounding Wire
29B Bonding
30 Fixtures
31 Service
32 Final
STREET NAME
PERMIT NO.
403345
PERMIT NO. ,
4 0 3 3 4 5
Job Address - Space
�.5�
DEPARTMENT OF BUILDING & SAFETY
COUNTY OF RIVERSIDE
FIELD OFFICE
Community - -
Valuation
S
CONSTRUCTION ESTIMATE
NO. ELECTRICAL,FEES
NO. PLUMBING, FEES
1 ST FL:
2ND. FL.
POR.
' GAR.
CAR P�
WAIL
ESTIMATED CONSTRUCTION
SQ. FT. @ $
UNITS
Use of Permit
.arm
% �"`
i f /i J f t'�'�.l �. °f� ..
Parcel No. �r5 -
•" •s'�rf
SQ. FT. @ YARD SPKLR SYSTEM
Ck. By
SO. FT. @ MOBILEHOME_SVC. BAR SINK
PI. Ck. Fee - 5
SQ. FT. @ POWER OUTLET ROOF DRAINS
Lot Size
SQ. FT. @ - DRAINAGE PIPING
Legal OLicnpttiion�...
„},(2 LL "'.� :e ' wn•
SO. FT. _@ DRINKING FOUNTAIN
Electrical Fee Dbl 5
SQ. FT. @ URINAL••
'
VALUATION $ WATER PIPING
SMI Fee; g'.
NOTE: Not to be used'os property tax valuation
SWIM POOL, PVT •
FLOOR DRAIN
y
MECHANICAL FEES
SWIM POOL, COMM
WATER SOFTENER.
Insp.. Fee�Q
VENT SYSTEM ` FAN' EVAP. COOL HOOD
SIGN
. WASHER (AUTO)(DISH)
Is
APPLIANCE DRYER
Address City - Zip
GARBAGE- DISPOSAL
Reinsp. Fee S
FURNACE UNIT WALL FLOOR SUSPENDED
Tel._ - Zip
'4•/
• LAUNDRY TRAY ., 0
Total Fees S
AIR HANDLING UNIT - CFM
IDLE METER
KITCHEN SINK
••
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET
Trees required r
COMPRESSOR HP
POLE, TEMP/PERM •
LAVATORY
_ .•
• � �,�
HEATING SYSTEM' FORCED GRAVITY
AMPERES SERV ENT
SHOWER
.BOILER'. B.T.U.
SQ. FT: @ e
BATH TUB
SO. FT. @ a -
WATER HEATER `
SO. FT. RESID @a 1 Ya¢:
SEWAGE DISPOSAL
SO.FT. GAR @ 3/4a
HOUSE SEWER
"
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL.
TOTAL FEES
MOB. HM. FEE
MICRO'FEE.
MECH. FEE PL. CK. FEE
CONST. FEE ELECT. FEE
SMI FEE
FEE
PLUMB. FEE `
PERMIT NO.
403345
Job Address - Space
�.5�
Zip
Owner ,
Community - -
Valuation
S
Date
'^
Dist.
Off.
F.C.C.
MH Permit Fee S�t
Micro Film Fee Cop S
Use of Permit
.arm
% �"`
i f /i J f t'�'�.l �. °f� ..
Parcel No. �r5 -
•" •s'�rf
Use/Cosa No.
Ck. By
Mach. Fee Dbl S
PI. Ck. Fee - 5
Set Backs '
Lot Size
Construction Fee DBI S f,`If'.
Legal OLicnpttiion�...
„},(2 LL "'.� :e ' wn•
F S S - R
Electrical Fee Dbl 5
Zone .Restrictions 1
I
Group
Cs,
Type '
SMI Fee; g'.
Plumbing Fee' s Dbl S
'Plumbing
Boo/ mt.
,an No,
Plan Checker t
Final Date
-
Inspector,,
J.Unit
Insp.. Fee�Q
Demol. Fee . S
Const. Lender Branch
r
Supplimentol Permit Numbers - s
' s
.,cy
Regisir. Fee S
-Mileage Fee $ •
Address City - Zip
Reinsp. Fee S
Owner/Agent -,.h Y ..
Tel._ - Zip
'4•/
Total Fees S
Address
"'� l+is
City+ �• Zip
f • 1 ..Ca
• M.O. N.C. Cosi Check
�.
Raceived'byt
Contractor
Tel. S'. '' •
AicensO
Trees required r
Sewage System n� �
'l(ocNa�tjA�
Address
G'ry Zip
_ .•
• � �,�
I. T LL P . THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF WORK : , verified.by:
Sewer District FOR 120 DAYS SHALL ALSO CAUSE PER TO BECOME VOID.
_ I HEREBY AGREE THAT ALL WORK IN CONNECTION WITH -THIS PERMIT WILL BE DONE IN ACCORDANCE WITH �t
THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA. ..
`00 1 H BY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS'DONE SO IN
Form 284208 (Rev. ,1/80) • RDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE. OF THE STATE OF CALIFORNIA. "