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304307 (SPIN)
BUILDING PERMIT DEPARTMENT OF BUILDING & SAFETY FIELD OFFICE - PERMIT NO. 30430' ': COUNTY OF RIVERSIDEr r % _ DST CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SQ. 2ND FL., POR. GAR. SQ..FT. CAR P. SQ. WALL SQ. ESTIMATED CONSTRUCTION FT. Qct $ UNITS r, YARD SPKLR SYSTEM $Q. FT. (}a • MOBILEHOME SVC. BAR SINK SQ. FT. (a} @ POWER OUTLET ROOF DRAINS FT. @ 'DRAINAGE PIPING FT. @ DRINKING FOUNTAIN SQ. FT. URINAL VALUATION $ WATER PIPING NOTE: Not to be used as property tax voluation SWIM POOL, PVT FLOOR DRAIN MECHANICAL FEES SWIM POOL, COMM WATER SOFTENER Parcel,No. se No. '` 7 VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD SIGN WASHER (AUTO) (DISH) Mech. Fee Dbl APPLIANCE ❑ DRYER GARBAGE DISPOSAL PL Ck. Fee FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED LAUNDRY TRAY Se Backs AIR HANDLING UNIT CFM IDLE METER KITCHEN SINK Construction Fee Dbl $4 ABSORPTION SYSTEM 0 B.T.U. TEMP USE PERMIT SVC WATER CLOSET Legal Description e / COMPRESSOR HP POLE, TEMP/PERM LAVATORY S/ HEATING SYSTEM ❑ FORCED ❑ GRAVITY AMPERES SERV ENT SHOWER " /rD 'Y BOILER =:� B.T.U. 50. FT. 8 ¢ BATH TUB SQ. FT. @ it WATER HEATER Grp SQ. FT. RESID Q 1 y.¢ SEWAGE DISPOSAL Unit , ' SQ. FT. GAR 8- '/.¢ HOUSE SEWER SMI Fee $ GAS PIPING Plumbing Fee PERMIT FEE PERMIT FEE PERMIT FEE DBL. TOTAL FEES MOB. HM. FEE 1, MICRO FEE MECH. FEE FL. CK. FEE .. CONST. FEE ELECT. FEE SMI FEE - � LUMS. FEE 'OU PP ' . _ _ . _ — _ _ — v — -+r- ^ _ I - . , — - - PERMIT NO. F 3 Supp. Permit Job Address Space o Zip- Owner, - , Community Valuation $ Date rsi. . �Jff. F.C. MH Permit Fee - Micro Film Fee Cop Use of permit - P _ Parcel,No. se No. '` 7 Ck.by Mech. Fee Dbl PL Ck. Fee Se Backs Lot Size y� z f �.I Q 1/ "'� Construction Fee Dbl $4 Legal Description e / f>2,0 S/ S •+_ " /rD 'Y Electrical Fee Dbl $ Zone Grp Type ' Unit , SMI Fee $ Plumbing Fee Dbl $ Bond Amt $ No. f Plan Checker Final Dater , ^� S + / o-'1 1 ector Sp. Insp. Fee $ Demo[. Fee $ Const. Lender Branch -, 'I certify that in the performance of the work for whvclt this per u I -all • - not employ any person in ony manner so as + ome sub t io men s om- - pensation lows of California. - Address City Zip Owner Signature _ Builder Signature Registr. Fee $ Mileage Fee $ Witness Fee $ Reinsp. Fee $ C>10 Owner/Agent Tel. - Zip � 1 Total Fees $ O Address 3 G y _ Zi �f P M.O. ❑ N.C. ❑ Cash eck ❑ Received b Contractor - Tel. 'License # Trees re079k re Sewage System T - LL _ Sewer District cm Form 284.208 IRev. 4.771 ©s P Address - City Zip ' Workers' Comp. yes ❑ no ❑. THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF "enfied 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 W 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 SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND. PROFESSIONS CODE OF THE STATE OF CALIFORNIA.