399392 (BLCK)BUILDING PERMIT
PERMIT 10' 1
9392
DEPARTMENT OF BUILDING & SAFETY
COUNTY OF RIVERSIDE
FIELD
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES,
I ST FL.
2ND. FL.
13011.
GAR.
CAR P�.
WALL
t
ESTIMATED CONSTRUCTION
SO. FT. $
UNITS
I Zip
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SO. FT. @
YARD SPKLR SYSTEM
SO. FT. @ MOBILEHOME SVC.
BAR SINK
SO. FT. POWER OUTLET
ROOF DRAINS
SO. FT. @
DRAINAGE PIPING
SO. FT. @ I r;p
DRINKING FOUNTAIN
SO. FT. @
URINAL
VALUATION
WATER PIPING
NOTE: Not to be used as property tax �olucztion
SWIM POOL, PVT
FLOOR DRAIN
MECHANICAL FEES
SWIM POOL, COmm
WATER SOFTENER
VENT SYSTEM FAN EVAP. COOL HOOD
SIGN
WASHER (AUTO)(DISH)
APPLIANCE DRYER
Bond Amt.
$
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
Ion cl�eck`er
LAUNDRY TRAY
AIR HANDLING UNIT CFM
IDLE METER
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET
COMPRESSOR He
POLE, TEMP/PERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SO. FT. @
BATH TUB
Mileage Fee $
SO. FT. @
WATER HEATER
lteinsp.,Few $
SO. FT. RESID @ I 'Ac
SEWAGE DISPOSAL
SO. FT. GAR @ 3/4 c
HOUSE SEWER
TeL
Zip
GAS PIPING
PERMIT FEE
PERM11 FEE
PERMIT FEE
DBL.
TOTAL FEES
I / e.;
08. HM. FEE
IM
MICRO'FEE MECH. FEE
PL. CK. FEE
I CONST. FEE ELECT. FEE
SMI FEE
FEE PLUMB. FEE
ERMIT NO.
39P93
Job Address
AR R-77-
Comtfiunity
A
gz
Space
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ner
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An _r"
vf)ilt. f.�- IrC.C.
MH Permit Fee $
Micro Film Fee Cop S
Use of Pwm.,t
t' X
1--t
Pdrcb"o.
62:5
F
-4-
Cash No. Ck. By
a Ll 1) 1/,Cq J
S Lot Size
IR
IS IS
Mech. Fee DbI $
�
Pl. Ck. Fee S
Construction Fee Del S
indc
Legal Descriptio
Electrical Fee Dist S
Zone Restrictions
Grove
T pe
SMI Fee S
Plumbing Fee DbI $
Bond Amt.
$
Pion
No.
Ion cl�eck`er
Final 'Dot.
wz
KT
n,F
77,
unit
Sp. Insp. Fee S
Demol. Fee $
Const. Lender
-1p
Branch
Sup Ii
34?
I P Numbers
71
Registr. Fee $
Mileage Fee $
Address City Zip
Witness Fee $ %
lteinsp.,Few $
Owner/Agent
TeL
Zip
Total Fees
!:ify
zip.
M.O. 0 N.C. ��Ccvsh Check
Recei�ed by
Contractor
2�j
Tel.
q S'
License#
Trees required
Sewage System
...
City
Zip
.. T LL t—P THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF WORK
Sewer District FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME -VOID. -
-1 HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE WITH
THE LAWS OF RIV6RSIDE COUNTY AND THE STATE OF CALIFORNIA.
4 ;4_<_j,,HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE SO IN
-ACCORDANCE, WITH SECTION S541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA.
F r. 284-208 (kRe 1/80)
�edCiecl by:
NOliV:30'
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9WVN 139biS
DEPARTMENT OF BUILDING AND SAFETY e COUNTY OF RIVERSIDE
OFFICE DATE TIME PERMIT NUMBER
c
INSPECTION
REQUESTED
SPACE NO.
ADDRESS FOR:
A. M.
OWNER COMMUNITY
BUILDING
REMARKS:
PLUMBING I ELECTRICAL I MECHANICAIL
1�4�z Z_
OWN ER/CON TRACTOR TEL.NO.
Li P.M.
F-19ON
E] TUIES
WED
FRI
1
284-66 11/75
DEPARTMENT OF BUILDING -AND SAF9TY . COUNTY OF,RIVERSIDE
PERMIT NUMBER
TIME
�FFICE DATE =
/ �/S INSPECTION
3,9,90 ?,2-- REQUESTED
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