353928 (SATT)DU3LU1nv rCKMII
PERMIT NO. -DEPARTMENT OF .BUILDING & SAFETY_ FIELD.,
8
L 3-5 3 9 2 COUNTY OF RIVERSIDE !�
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�` CONSTRUCTION
ESTIMATE
Job Add r ` / r Space
NO. , ,.t.+ ELECTRICAL,FEES.,, ,.a NO.
Y. ..,-,.PLUMBING. FEES
;.;':
IST FL.
2ND. FL.
FOR.
GAR.
CAR P.
WALL
SQ. FT. @
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UNITS
F.C.C.
MH.Permit Fee §
SQ. FT..@- ' YARD SPKLR SYSTEM
Use of Permit •I {„a 4'h"^
jy ...6 �{fy� j%�,
MOBILEHOME SVC. BAR SINK"
SQ. FT. @ ._ �.�+ '
n °G ' POWER OUTLET ROOF DRAINS
SQ. FT. @
Use/Case No. Ck. B Y '
SQ. FT. @ DRAINAGE PIPING
PI. Ck. Fee $
SQ. FT. @ • DRINKING FOUNTAIN
Lot S4 -
«
SQ. FT.'@
ESTIMATED CONSTRUCTION VALUATION" $
t.� ..
F s
URINAL
WATER PIPING
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NOTE: Not to be used as property tax valuation
Zon ion-sElectrical
r
SWIM POOL, PVT
FLOOR DRAIN
SMI Fee $
MECHANICAL -FEES
Bond Amt.
$
SWIM POOL, COMM
WATER SOFTENER
at r1
`�
VENT SYSTEM FAN • EVAP. -iCOOV i -,A*tt.y�'HCiODW...'.
wri�' ,5?�,y't ..•-'�r.,w•• SIGN t "wt -t �:.,- ;. ,F� .+.. r.s,i:fo_
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APPLIANCE DRYER I - ',�r j
Supplimental Permit Numbers -
'
_
..
Registr. Fee $
GARBAGE DISPOSAL
`.
FURNACE UNIT WALL FLOOR" SUSPENDED" •
Reinsp. Fee $
Owner/Agent%-
,'-I
LAUNDRY TRAY
f
AIR HANDLING UNIT+ CFM
a
IDLE METER
KITCHEN SINK
T
ABSORPTION SYSTEM ' EL: T. U. , ±
Tel.
TEMP USE PERMIT SVC
WATER CLOSET
Sewage System
COMPRESSOR 'HP-
POLE;TEMP/PERM
LAVATORY
T
HEATING SYSTEM FORCED L' GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SQ. FT. @ t
BATH TUB
' SQ. FT. @ t `
WATER HEATER"
S0. FT. RESID @1 /.t
SEWAGE DISPOSAL
SQ. FT. GAR @ '/. t
HOUSE SEWER
GAS PIPING
PERMIT FEE _ •
PERMIT FEE •, y
PERMIT FEE
yw
DBL.
TOTA�-Ly FEES
MOB. .HM, FEE
", MICRO FEE
MECH. FEE,�!1.
•CCK. EE
CONST. FEE ELECT. FEE SMI FEE
FEE PLUMB. FEE
PERMIT NO.
3539281
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Job Add r ` / r Space
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Comm um ,�•�.
Valuation
Dcle
6
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ODP•`•
F.C.C.
MH.Permit Fee §
Micro Film Fee' Cop §
Use of Permit •I {„a 4'h"^
jy ...6 �{fy� j%�,
Parcel No. -
Use/Case No. Ck. B Y '
Mech. FeeDbl E ,•�
PI. Ck. Fee $
Set Backs _
Lot S4 -
«
Construction Fee Dbl $
Legal,DDescription ,- -
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tt1
F s
S
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Fee Dbl $
Zon ion-sElectrical
r
Group
-
Type
,r
SMI Fee $
Plumbing Fee Dbl $
Bond Amt.
$
Pla}a p., , 1
�••
Plan Checker
at r1
`�
Ins
Unit
Sp. Insp. Fee § '
Dental. Fee $ -
Const. -lender - - Branch
Supplimental Permit Numbers -
'
_
..
Registr. Fee $
Mileage Fee $
Address Cit Zip
nel
Witness Fee $
Reinsp. Fee $
Owner/Agent%-
,'-I
r - Zip'
37
: -•a `- _ ' -
Total Fees $
-
AddressyF`.
• �.
-A
-Alp
p ,'A, 1,L-R.,q :5 'o
City /- ' Zip
t, P
M. 0. N.C. Cosh Q Ch/k
Received by _ ku% - -P
Contractor
-
Tel.
License#
Trees required
Sewage System
Address
i
i
City - _Zip,
T LL Pt
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 ►q,. �� .. I HEREBY AGREE THAT ALL,WORK IN.CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE WrTH.o,.k
J THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA. R
r
I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE SO IN
1 ACCORDANCE WITH SECTION 5.541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA.
Form 284-208 (Rev.8/78)
NO.
OPERATION DATE
INSPECTOR NO.
OPERATION
DATE INSPECTOR
Service Entrance
BUILDING APPROVALS
Wiring
MECHANICAL APPROVALS
1
Set Back
33
Ventilation System
2
Ftgs 8 Frms
34
P enums 8 Ducts
2A
Slab Grade
35
Firnace Compert.
3
Steel
36
Inlets 6 Outlets
4
Grout Blocks
37
Combustion Air
5
Bond Beams
38
Compressor
6
Roof Deck
39
Appl. Clearance_
7
Framing
40
F re Damper
8
Vents ,
41
S-noke Detection Device
9
Garage Fire Wall
42
Commercial Hood
10
Fireplace P. L.
43
Final
10A
Fireplace T.O.
P'N
ADDITIONAL INFORMATION
11
Exterior Lath
12
Internal Lath
12A
Drywall
13
Finish Grade
INSULATION Thick R
Value
7A
Walls (Batts)
12B
Ceiling (Batts)
12C
Ceiling (Blown) "
14
Final
PLUMBING APPROVALS
15
Ground Plumb
16
Water Piping
17
Rough Plumb
18
Vents
19
Sewage Disposal
20
Sewer
21
Water Heater
22
Water Softener
t
23
Water Service
24
Gas Test
SEWAGE SYSTEM SIZE & LOCATION
25
final
26
Power Pole
27
Conduit
28
Service Entrance
29
Wiring
29A
Grounding Wire
29B
Bonding
30
Fixtures
31
Service
32
Final
s
ELECTRICAL- APPROVALS
STREET NAME
MIT
PER N t
-Job A t
ddress,, f�, sp&�
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Communily'
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$
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MH.Permit Fee
_'4
-7
Micro Film Fee co
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WeYCose'N.:--
Lk. By
M6; - Fee DbI $
1,
Pl. Ck. Fee $ •�4:
,s6f.Bocks
L?! 1i �
Construction Flpe DbI $ 2
bption:r,
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:7
Electrical Fee Dbl $'f.
n,- tr�ictan
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ype
SMI Fee
Plumbing FeDbI
Bon -Arnt. t- 1�? 7.
J -
Ch.`ckler�
nol Dote
Inspector ".15-1-
Sp InFee $
Demol. Fee 1$
4 m& - n
tol
.Regisir. Fee $
Mileage Fee $
Address- ' Zip
7TWitness Fee $
Reinsp. Fee $
•
gent
vox +'
ziV3 7
Total Fees $
zip'..
•
M.O. N. C. Cash Ch
-7
Received by t
C4njiqc1ar*1"
'License#
Trees required
Sewage System
7Ad8ritss
clty•,
Sbvwer District
Form 284-208 (Rev.8/78)
t THIS. PI
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I: HEF
ACCOR
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!COME 1IP6IFWOR
" 'K IS NOT COMMENCED, WITHIN 'l2b'DAYS: ,CESSATION '.OF WORK =verified by:
LL .LSq<AUWPERMIT10 BECOME VOID,
THAT ALL WOFK'1(4 CONNECTION WIT8jdI4',ef$
..u_k.DONE IN
KtI5r.d60NTY'AN6_,TkeSTATE OF CALIFORNIA;iz
THAT t IbNDIVIDL'(A*LWHO PREPAREDTHE PLANS AND SPECIFICATIONS HAS DONE ":60 IN-.`-,
+- SECTION ,_FS4I.'OF:,THE BUSINESS AND PROFESSIONS CODE OF, THE STATE OF CALIFORNIA. -
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DEPARTMENT OF ffiVAG AND SAFETY c
'(WNTY OF RIVERSIDE
CLAIM OF: DATE:
ADDRESS:
CITY AND' STATE' X19?rry°-r;�'.', Iz xJ-
`ON THE TREASURER OF THE COUNTY OF RIVERSIDE, STATE OF
r� CALIFORNIA
Instructions: Permittee will furnish the` following information: i
(1) Permit. Number
(2) Date Issued
1
(3) Total. Fees Paid
i
13
(4) Reason for Refunds �°� �� �r/i «�Drcc:�,i✓ r
I CERTIFY THAT' THIS CLAIM IS TRUE AND CORRECT, AND THAT NO PART HEREOF HAS
BEEN PREVIOUSLY PAID BY THE COUNTY OF RIVERSIDE.
Claimant's Signature t, -
' (jDo not write below this line) - t
Date: vnrczb 20, 1979 General Fund: 1001-284-123.1
FROM: DEPARTMENT OF BUILDING AND SAFETY
TO: AUDITOR -CONTROLLER, COUNTY OF RIVERSIDE
Please issue to. the above indicated claimant a refund of $ 46.5(D , on the
permit deposited under Treasurer's Receipt No. (in6297 , dated 346 79 z`
AUTHORITY: Ordinance -No. 457, Section 7, Subsection E
Approvwed for the following reason:.(strike out words not applicable)
.(Xmex withdrat4 Pldin� ortor to. -Plan C.1 -Leak.
ing and Safety
above
f�
•
1.
4
r
above