351212 (3&4)BUILDING PERMIT DEPARTMENT OF BUILDING & SAFETY FIELD OFFICE
PERMITNO.
351212
PERMIT NO.
351212
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COUNTY OF RIVERSIDE
-
Owner
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DST
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CONSTRUCTION ESTIMATE
Community
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NO. E_ECTRICAL FEES
NO. PLUMBING FEES
Dote
�a
.1 SL F L. a
2ND FL.
POR.
GAR.SQ.
CARP.
WALL
ESTIMATED CONSTRUCTION
SQ. FT. - $
F.C.
UI -ITS
SQ. FT. a � YARD SPKLR SYSTEM
,Micro Film Fee
SQ. FT. ® _ MOBILEHOME SVC. BAR SINK
Use of Permit 'k I �-
- "
PC'WER OUTLET ROOF DRAINS
FT.
Porcel No.
J
SQ. FT. @ DRAINAGE PIPING
Mech. Fee Dial $
DRINKING FOUNTAIN
SQ. FT. (a}
Set Backs
SQ. FT. URINAL
Construction Fee Dbl $
VALUATION $ 742 G3 WATER PIPING
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NOTE: Not to be used as property tax valuation
S�S
SWIM POOL, PVT
FLOOR DRAIN
Electrical Fee Dbl $
Zone
MECHANICAL FEES
Typpee,*�
.fL�..
SIA IMPOOL, COMM
WATER SOFTENER
SMI Fee $
Plumbing Fee
VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD
Bond Amt.
$
SICN
WASHER (AUTO) (DISH)
Plan Checker Chrrecker
anSp.
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-
APPLIANCE .❑ DRYER
Inspector
GARBAGE DISPOSAL
Insp. Fee $
Dental. Fee
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR '❑ SUSPENDED
- Const. Lender -
Address _
• • Branch
City
LAUNDRY TRAY
Regisir. Fee $
Mileage Fee $
AIR HANDLING UNIT CFM
Reinsp. Fee
IDLE METER
KITCHEN SINK
ABSORPTION SYSTEM O B.T.U.
Zip
TEMP USE PERMIT SVC
WATER CLOSET
$
Address
COMPRESSOR OHP
PO_E,TEMP/PERM
LAVATORY
M.O. ❑ N.C. ❑ Cash ❑ Che
Received by
HEATING SYSTEM ❑ FORCED ❑ GRAVITY
Contractor
J�
AMPERES SERV ENT
SHOWER
Tel. -
BOILER B.T.U.
Trees required
SQ. FT. Q ¢
BATH TUB
Address
City
/1140J L7
SQ., FT. Ga ¢
WATER HEATER
SQ FT. RESID Q 1 %tr
SEWAGE DISPOSAL
SQ. FT. GAR GNtr
HOUSE SEWER
GAS PIPING
PERMIT FEE r
PERMIT FEE
PERMIT FEE
.DBL.
TOTAL FEES
MOB. MM. FEE
MICRO FEE
MECH. FEE
PL. CK. FE.CONST.
s
FEE ELECT: FEE
SMI FEE
FEE
PLUMB. FEE
PERMITNO.
351212
Supp. Permit
Job Address
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Space ;,Wl
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p
-
Owner
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Community
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_
Valuation
$ ��
Dote
�a
Dist..
Off.
.L
F.C.
MH Permit Fee $
,Micro Film Fee
Cop $
Use of Permit 'k I �-
- "
Porcel No.
J
Use Np`.�•� �Ck.by
Mech. Fee Dial $
PI. Ck. Fee $
Set Backs
Lot S//ze
Construction Fee Dbl $
Legal Description
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F.c�Q
S�S
S/ 7
Electrical Fee Dbl $
Zone
Grp
Ado
Typpee,*�
.fL�..
Unit
SMI Fee $
Plumbing Fee
Dbl $ -
Bond Amt.
$
Plan No. <
`f"'
Plan Checker Chrrecker
anSp.
! �
-
Finnal-Date /
V 14 !
Inspector
Insp. Fee $
Dental. Fee
$
- Const. Lender -
Address _
• • Branch
City
'I certify that in the performopce of the work for which this permit is issued I shall
not employ any person in any manner so as to became subject to the workmen's com-
pensotion laws of California."
Zip Owner Signature -
Builder Signature
Regisir. Fee $
Mileage Fee $
Witness Fee $
Reinsp. Fee
$
Owner/Agent
Tel.
Zip
Total Fees
$
Address
City
Zi
M.O. ❑ N.C. ❑ Cash ❑ Che
Received by
-
Contractor
J�
Tel. -
License If
Trees required
Sewage System
-
Address
City
/1140J L7
Zip
Workers' Comp.
yes ❑ no ❑
T LL P THIS PERMtT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF verified by:
Sewer District
WORK FOR 120 DAYS SHALL ALA�RYIBECOME VOID.
I HEREBY AGREE THAT AL((Cf�yVj�J�(QORK IN C>^fNECT WITH THIS PERMIT WILL BE DONE IN ACCORDANCE '
WITH THE LAWS OF RIVERSIDE COUNTY'A
AFD 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
OO s CALIFORNIA.