376189 (RPL)BUILDING. PERMIT
1PERMIT NO. • - DEPARTMENT OF BUILDING & SAFETY DST]
.:3 7 618 9 COUNTY OF RIVERSIDE FIELD
CONSTRUCTION
ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
• .IST FL.
' ,2ND. FL.
SQ. FT. @
UNITS
.
Community , _
.�, / y7 _ __
Valuation
§ r�
SQ. F.T. @ YARD SPKLR SYSTEM
ist.•
4
FOR.
.GAR.
CAR P.
WALL
•
SQ. FT..@
MOBILEHOME SVC.
Micro Film Fee'
BAR SINK
POWER OUTLET ROOF DRAINS
SQ. FT. @
SQ. FT. @ DRAINAGE PIPING
l
SQ. FT. @ DRINKING FOUNTAIN
Mech. Fee Dial $
URINAL
SQ. FT. @`
- Set Bockr
ESTIMATED. CONSTRUCTION VALUATION S
J
Construction Fee �
Electrical Fee
WATER PIPING
NOTE: Not to be used as property tax valuation
SWIM POOL, PVT
F
'^'�•• 1 � "�
r FLOOR DRAIN
r
MECHANICAL FEES
Swim POOL, COMM
Plumbing Fee
WATER SOFTENER
VENT SYSTEM FAN . EVAP. COOL HOOD
SIGN
Plan Checker
WASHER (AUTO)(DISH)
Final Dater r
APPLIANCE DRYER
Unit' -
GARBAGE DISPOSAL
Demol. Fee
FURNACE UNIT WALL FLOOR. . SUSPENDED
Const. Lender + Branch
LAUNDRY TRAY
Supplimental it Numbers
t
+/•� ,�
J s (/
AIR HANDLING UNIT CFM
IDLE METER
Mileage Fee $
KITCHEN SINK
Witness Fee $
ABSORPTION SYSTEM - B.T.U.
_ TEMP USE PERMIT SVC
WATER CLOSET
COMPRESSOR HP
POLE,TEMP/PERM
LAVATORY
n
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
Zip
-
BOILER B: T.U.e
SQ. FT. @ c
_
BATHTUB
i d _
Tel. -
'" I
SQ. FT. @ t
Trees re uired..
WATER HEATER
-
(�
SQ: FT. RESID @1'/.0
Cil
/J/J�
SEWAGE DISPOSAL
r
' SQ. FT. GAR @''/. c
4
HOUSE SEWER
_
•
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL.
TOTAL FEES
MOB. HM. FEE
MICRO FEE
MECH. FEE PL. CK. FEE
CONST. FEEELECT.
FEE
SMI FEE
FEE
PLUMB. FEE
_ PERMIT NO.
3 7 6,11
: 8 9.
Job Address-
- `
Space Zip
:� _•,
•Date
Owner
r
-.
.
Community , _
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Valuation
§ r�
- -
_
ist.•
4
L,
't9tt.,
'""^'"'�
{ F.C.C. '
MH.Permit Fee $
Micro Film Fee'
Copl$
Use ermi - - -
, `
Parcel No.
Use /Case No.
Ck. By
Mech. Fee Dial $
PI. Ck. Fee $
- Set Bockr
Lot Size
J
Construction Fee �
Electrical Fee
Dbl $
Dbl $
Leal Description
//g,, %
1',r.4-.•t�� 7
F
'^'�•• 1 � "�
Zone Restrictions
Group ,Type
,
SMI Fee $
Plumbing Fee
Dbl $
Bond mt�-- .
§
Plari No.
Plan Checker
Final Dater r
Inspector
Unit' -
Sp: Insp. Fee $
Demol. Fee
$
Const. Lender + Branch
Supplimental it Numbers
t
+/•� ,�
J s (/
'
'1
•�
}
Registr. Fee §
Mileage Fee $
Address City Zip
Witness Fee $
Reinsp. Fee
$
Owner/Agent -
Tel. .,
• Zip
4.
Total Fees
$
, 7""•.
Address -
' !
Y -•,/'
City
Zip
-
M.O. sN.C. Cash Check
Received.by -�.
_
Co t cio rs.! s�.",w%
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i d _
Tel. -
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License#
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Trees re uired..
Sewage System
-
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Address • ..� {
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Cil
/J/J�
i tyZip
T LL P THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF WORK/ verified by:
Sewer District FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.. t`
I HEREBY AGREE THAT ALL WORK IN CONNECTION WITH'THIS PERMIT WILL BE DONE IN ACCORDANCE WITH t
r 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
tr l ACCORDANCE WITH�SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA.
,(Form 284-208 (Re,8/78 "' .�- -
NO.
OPERATION DATE
INSPECTOR
NO.
OPERATION
DATE INSPECTOR
29
BUILDING APPROVALS
29A
Grounding Wire
MECHANICAL APPROVALS
1
Set Back
Fixture's
33
Ventilation System
2
Figs & Frms
34
P enums & Ducts
2A
Slab Grade
35
Furnace Comport.
3
Steel
36
Inlets & Outlets
4
Grout Blocks
37
Combustion Air
5'
Bond Beams
38
Compressor
6
Roof Deck
39
Appl. Clearance
7
Framing
40
Fire Damper
8
Vents
41
Smoke Detection Device
9
Garage Fire Wall
42
Commercial Homed
10
Fireplace P. L.
43
Final
10A
Fireplace T. 0. E]
P'
,
ADDITIONAL INFORMATION
SEWAGE SYSTEM SIZE 8& LOCATION
11 ' Exterior Lath
12 Internal Lath
12A I Drywall
13 Finish Grade
INSULATION Thick R
Value
7A Walls (Batts)
12B Ceiling (Batts)
12C Ceiling (Blown)
14 Final 0
PLUMBING APPROVALS
-15--Ground Plumb
16 Water Piping
17 Rough Plumb
18 Vents
19 Sewage Disposal
20 Sewer
21 Water Heater
22 Water Softener
23 Water Service
24
25
Gas Test
GasFinalTank
I
I
Pit L.Line
ELECTRICAL APPROVALS
26
Power Pole
27
Conduit
28
Service Entrance
29
Wiring
29A
Grounding Wire
29B
Bonding
30
Fixture's
31
32
Service
Final
t�
REAR OF PROPERTY LINE
P/L P/L
STREET NAME
BUILDING PERMIT —
PERMIT NO. DEPARTMENT OF BUILDING & SAFETY FIELD OFFICE _DST
3761819 COUNTY OF RIVERSIDEF,
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SQ. FT. @ $
UNITS
Voluotion
2ND. FL. SQ. FT. @
Dist.
YARD SPKLR SYSTEM
POR. SQ. FT. @
MOBILEHOME SVC.
BAR SINK
GAR. SQ. FT. @
POWER OUTLET
ROOF DRAINS
CAR P. SQ. FT. @
Mech. Fee Dbl $
DRAINAGE PIPING
WALL SQ.FT. @"
Lot Size
r y�
(J (✓
DRINKING FOUNTAIN
SQ. FT. @
F - S 2-0 S�
�.scriptio/n
URINAL
ESTIMATED CONSTRUCTION VALUATION $
Group
WATER PIPING
NOTE: Not to be used as property tax valuation
SWIM POOL, PVT
FLIDOR DRAIN
MECHANICAL FEES
SWIM POOL, COMM
WATER SOFTENER,
VENT SYSTEM FAN EVAP. COOL HOOD
SIGN
WASHER (AUTO)(DISH)
APPLIANCE DRYER
Supplimental Permit Numbers
r+••-/ / �/'
S o
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
City Zip
LAUNDRY TRAY
AIR HANDLING UNIT CFM
IDLE METER
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET
COMPRESSOR HP
POLE,TEMP/PERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SQ. FT. @ c
BATH TUB
Address 04 �/j. /� �y +�. -
Ct 7 0 , � 4' 4_
SQ. FT. @ c
WATER HEATER
S0. FT. RESID @1'/ c
SEWAGE DISPOSAL
SQ. FT. GAR @ s/. c
HOUSE SEWER
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL.
TOTAL FEES
MOB.HM.FEE
MICRO FEE
MECH. FEE PL. CK. FEE
CONST. E ELECT. FEE
SMI FEE
FEE PLUMB. FEE
PERMIT NO.
X76189
Job Address Space
- _ -
-
Zip
ys-
Owner
_
Communily /^
Alt 7�4_
Voluotion
Date
&:.
Dist.
Off.
F.C.C.
MH.Permit Fee $de
Micro Film Fee Cop $
Use of ermit% /y `
���✓� LAW C/�"��% `�+
Parcel No.
7
Use/Case No. -
Ck. By
Mech. Fee Dbl $
PI. Ck. Fee $`
Set Basks
Lot Size
r y�
(J (✓
Construction Fee Dbl $
Electrical Fee Dbl $
SMI Fee $
L/egal De
✓ 1 as^'ol!; 2-7 9
L-j+.r
F - S 2-0 S�
�.scriptio/n
Zone Restrictions
Group
Type
Plumbing Fee Dbl $ •
Bond Amt.
$
Plan No.
Plan Checker
Final Date
/eq —"9���
Inspector
Unit
Sp. Insp. Fee $
Demol. Fee $
Const. Lender Branch
Supplimental Permit Numbers
r+••-/ / �/'
S o
Registr. Fee $
Mileage Fee $Address
City Zip
Witness Fee $
Reinsp. Fee $
Owner/Agent
Tel. Zip
Totol Fees $
Address
City Zip
M.O. Cash Chec
Received by
Co roytoFL! lei ..��
%� /�% ,r�
i��.i a
Tel.
' 'LicenseN
2-2-/)
/
Trees required
Sewage System
Address 04 �/j. /� �y +�. -
Ct 7 0 , � 4' 4_
ity / Zip
lr•
r�
T LL P THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF WORK/ verified by:
Sewer District FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
I HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN 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
Form 284-208 (Re�.8,74,ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA.
Form 284-208 (Rev.B/78) s -