351554 (SFD) Plan CheckBUILDING PERMIT
PERMIT NO.
554 1
CONSTRUCTION ESTIMATE
1ST FL.
SQ. FT....
2ND FL.
SQ. FT. @
_
FOR. vi
SQ. FT.
GAR.
SQ. FT. (ay 410-1
CAR P.
SQ. FT. @
WALL
SQ. FT. Ga
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
SQ. FT. @
ESTIMATED CONSTRUCTION
VALUATION
NOTE: Not to be used Os property tax valuation
0 DEPARTMENT OF BUILDING & SAFETY
COUNTY OF RIVERSIDE
'NO. I ELECTRICAL FEES
Gr� UNITS
MOBILEHOME SVC.
POWER OUTLET
SWIM POOL. PVT
FIELD OFFICE
NO. I PLUMBING FEES
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
FInnR DRAIN
//
1 PERMITNO.
35155
MECHANICAL FEES
SWIM POOL, COMM
WATER SOFTENER
Owner
l/Ov,"",
VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD
SIGN
WASHER IAUTOI (DISH)
APPLIANCE ❑ DRYER
Dist.
GARBAGE DISPOSAL
F.C.
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
LAUNDRY TRAY
Micro Film Fee
AIR HANDLING UNIT CFM
IDLE METER
KITCHEN SINK
Parcel No.
-1
T 7,i /—/.7) J
`V
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET
t Backs
Set
COMPRESSOR HP
POLE, TEMP/PERM
LAVATORY
�
HEATING SYSTEM ❑ FORCED ❑ GRAVITY
AMPERES SERV ENT
SHOWER
BOILER � B.T.U.
SQ. FT.
BATH TUB
Tyf%
Unit/
.
SO. FT. ¢
WATER HEATER
!Plumbing Fee
Dbl $
SQ. FT. RESID 6 1 v.¢
SEWAGE DISPOSAL
Plan Checker
Final Date Inspector
T
SQ. FT. GAR C 1A it
HOUSE SEWER
i$p. Imp. Fee E
iDemol. Fee
$
GAS PIPING
;Registr. Fee $
PERMIT FEE
PERMIT FEE
PERMIT FEE
$
DBL.
TOTAL FEES ]MOB.
'
HM. FEE
MICRO FEE
MECH. FEE PL. FEE
'VG/ /
CONST. FEE ELECT. FEE
SMI FEE
FEE PLUMB. FEE
1 PERMITNO.
35155
Supp. Permit
Job Address
SpaceZip
�;bzzs-3
Owner
l/Ov,"",
Community Valuation
f"s /'�J t044• A- / I{,,j., V $
Dote
Dist.
Off.
F.C.
"MH Permit Fee $
Micro Film Fee
Cop E
Use of Permit �7Ci(e
�/ (.fy,�
Parcel No.
-1
T 7,i /—/.7) J
`V
Use No. Ck.by
Mech. Fee Dbl $
iPl. Ck. Fee E
t Backs
Set
Lot Size
J�
,Construction Fee DbI E
Legal Description
_ ,/j� / A� /I' �.
I�LJ/ 3 d •J `✓T��ii'
�
Fv?O
S
SS"
I Electrical Fee Dbl E
Zone Ie
Grp
/�
Tyf%
Unit/
.
:SMI Fee $
!Plumbing Fee
Dbl $
Bond Amt.
$
Plan No.
Plan Checker
Final Date Inspector
T
,
i$p. Imp. Fee E
iDemol. Fee
$
Const. Lender Branch 'I certify that in the performable of the work for hich this permit is issued I shall
not employ any person in any manner so as to become subject to the workmen's com-
pensation laws of Cal ifornio.'
Address City Zip Owner Signature
Builder Signature
;Registr. Fee $
iMileage Fee $
i Witness Fee $
iReinsp. Fee
$
Owner/Agent
Tel.
Zip
.Total Fees
$ he
Address
City
Zip
j M.O. ❑ N.C. ❑ Cash ❑ Check
'Received by
Trees required
Contractor
•rr'Y
Tel.
!fi O
License #
•Sewage Syyssteem�...w
Address /�
City /
Zip
Workers' Comp.
yes ❑ no ❑
T LL P
District
Form 284.2081Rev. 4.77) Os
Inta rtltMn Z)HALL bt(-U At VOID It WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF verified by:
WORK FOR 120 DAYS SHALLW�A++��USE PERMIT TO BECOME VOID.
I HEREBY AGREE THAT tE67SiRK��WITH THIS PERMIT WILL BE DONE IN ACCORDANCE
WITH THE LAWS OF RIV6RSIDE ZOUNTY AND THE STATE OF CALIFORNIA.
HEREBY CERTIFY THAT TiE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE
SO I N ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF
CALIFORNIA.