351258 (CRES)BUILDING PERMIT DEPARTMENT OF BUILDING & SAFETY Aft FIELD OFFICE
PERMITNO.
35.1258
PERMITNO.
35128
COUNTY OF RIVERSIDE
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"CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES
1ST F,L. , 02 SQ.
2ND FL.
FOR.
GAR. SQ.
CAR P.
. WALL
ESTIMATED CONSTRUCTION
FT. Q y� $ �6 UNITS
SQ. FT. YARD SPKLR SYSTEM
SQ.. FT. (a3 MOBILEHOME SVC. BAR SINK
POWER OUTLET ROOF DRAINS
FT. '®
SQ. FT. , C�3 DRAINAGE PIPING
n DRINKING FOUNTAIN
SQ. FT.
SO. FT. @ URINAL
VALUATION $ -3 - WATER PIPING
NOTE: Not to be used as property.tox valuation SWIM POOL, PVT FLOOR DRAIN
F.G.
MECHANICAL FEES SWIM POOL, COMM WATER SOFTENER
VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD SIGN WASHER (AUTO) (DISH)
Micro Film Fee
APPLIANCE ❑ DRYER GARBAGE DISPOSAL
Use of Permit'
/
'
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED LAUNDRY TRAY
Parcel No.
_
AIR HANDLING UNIT CFM IDLE METER KITCHEN SINK
ABSORPTION SYSTEM B.T.U. TEMP USE PERMIT SVC WATER CLOSET
'Meth. Fee _ Dbl $
COMPRESSOR HP POLE, TEMP/PERM LAVATORY
>et Backs
HEATING SYSTEM ❑ FORCED ❑ GRAVITY AMPERES SERV ENT SHOWER
BOILER 0 B.T.U. SQ. FT. a BATH TUB
Description
%�%% �� I✓<
SQ. FT. Gn ¢ WATER HEATER
F o>AV
Q. FT. RESID @ 1'/.¢ SEWAGE DISPOSAL
S. 1
SQ. FT. GAR 6 '/.¢ HOUSE SEWER
Electrical Fee Dbl $
GAS PIPING
Grp
PERMIT FEE PERMIT FEE PERMIT FEE I - L
Unit
DBL.
TOTAL FEES
]M0B.HM.FEE[
.MICRO FEE MECH. FEE ,PL. CK. FEE[CONST.
j
FEE ELECT. FEE SMIFEE
FEE PLUMB. FEE .
PERMITNO.
35.1258
Supp. Permit
Job Address
a-
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Space
-
Zip
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Owner
_
Community_ _
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Valuation
$ .�� 3£f
Date
Dist.
Off.
F.G.
MH Permit Fee $
Micro Film Fee
Cop $
Use of Permit'
/
'
01-A.-,
Parcel No.
_
Use No. -
Ck. by
'Meth. Fee _ Dbl $
PI. Ck. Fee $
>et Backs
I Lot Size
�
Construction Fee Dbl $Legal
oZ
Description
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F o>AV
SZ
S. 1
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Electrical Fee Dbl $
Zone
�4 �
Grp
Type
Unit
'SMI Fee $
'Plumbing Fee
Dbl $
Bond Amt.
Plan No,
Plan Checker
Final Date
Inspector
Sp. Insp. Fee $
'Demol. Fee
$ JConst.
Lender --
Address
Branch
City
"1 certify that in the performance of the work for which this permit is issued I shall
not employ any person in any manner so as to become subject to the workmen's com.
• - pensotion lows of California."
,1 Zip Owner Signature .
Builder Signature
.Registr. Fee $
Mileage Fee $
'Witness Fee $
�Reinsp. Fee
$
Owner/Agent
i
Tel.
Zip
:Total Fees $
M.O. ❑ N.C. ❑ Cash ❑ eck ❑
Address
City f
Ih
Zip
Received by
Contractor
,
Tel.
License #
Trees required
Sewoge System
.. ....
..
Address.
-
City Zip
Workers' Comp.
Yes ❑ ' no ❑
.., 'T LL P
ISewer Distrix
y -
For. 284.208 (Rev. 4771 (55
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF verified by:
WORK FOR 120 DAYS SH ALSO AUSE PERMIT Tb BECOME VOID. I
J 4
•'I HEREBY AGREE T KION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE
WITH THE LAWS OF RIV6RSIDE COU TY AND THE STATE OF CALIFORNIA. r'
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
CALIFORNIA.