351433 (PAT)' BUILDING PERMIT �, a� DEPARTMENT.OF:BUILDING & SAFETY FIELD OFFICE' '-
•
PERMIT No.
351433:
COUNTY OF RIVERSIDE
�� ... . - . • , -• A•.- ,-.•�.' -�,�
DST
_CONSTRUCTION ESTIMATE - NO.� .ELECTRICAL'FEES :: NO. PLUMBING FEES.
'1ST FL. SQ:
' .( 2ND FL.,- -
•.,POR. SJ.
GAR. SQ.
r _ CAR P. j„ -- - SQ.'
WALL ; ' SQ.
f.
ESTIMATED CONSTRUCTION:VALUATION
FT. ® ' $ UNITS 4 -
SQ. FT.^ (a}. ° ' YARD SPKLR SYSTEM
FT. @ Ott0a• 4 MOBILEHOME SVC. BAR SINK i
.
POWER OUTLET. ROOF DRAINS
FT. 8
FT. • @ - DRAINAGE PIPING ..
FT.., (a3 DRINKING FOUNTAIN
_ URINAL' ;
SQ:' FT.
= $ / WATER PIPING~ '
NOTE: Not to be,used as property tax valuation SWIM POOL, PVT FLOOR DRAIN
'
4 ..,MECHANICAL FEES SWIM POOL, COMM =s. WATER SOFTENER'
- -
VENT SYSTEM Q FAN ❑ EVAP. COOL ❑HOW SIGN WASHER (AUTO) (DISH) ,
~
APPLIANCE - ❑DRYER GARBAGE DISPOSAL '
PI. Ck. Fee '$
FURNACE ❑ UNIT 'Q WALL ❑ FLOOR ❑ SUSPENDED - LAUNDRY TRAY`
Electrical Fee Dbl $
AIR HANDLING UNIT CFM IDLE METER KITCHEN SINK ,
-�
ABSORPTION SYSTEM 0 B.T.U:. TEMP USE PERMIT SVC WATER CLOSET
Bond Amt.
$
COMPRESSOR, 0 HP POLE, TEMP/PERM LAVATORY,
Plan Checker
r
HEATINGSYSTEM ',,❑ FORCED_ ❑,GRAVITY AMPERES SERV ENT SHOWER
Fin Date • -
i {_.�� •
BOILER B.T.U.• . SQ. FT. Ga ¢ BATH TUBe'
.
.
SQ. FT. Ga ¢ WATER HEATER
,SP'Insp. Fee E
''SQ. FT. RESID 1'Aa SEWAGE DISPOSAL
SQ. FT. GAR Ca, '/.¢ HOUSE SEW ER,
• - "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 become subject to the workmen's com.
pensation laws of California." , s•
• - Owner Signature -. `5 _ .. ' - »•
- Builder Signature
` t
GAS PIPING
'Witness Fee $ _
PERMIT FEE
PERMIT FEE PERMIT FEE _ •
Owner/Agent -
Xae
DBL.TOTAL
FEES
t
. 1t0B. HM. FEE
MICRO FEE MECH. FEE. 'PL: CK.. FEE'-
-
CONST. FEE. 'ELECT. FEE SMI FEE
Sao=
FEE-..PLUMB..FEE''
PERMIT NO.
35 143 3
Supp. Permit
Job Address
Space Zip
9a
Owner
Community f - Valuation�/
�'% ��f^M //y'�/`� ' E
.-
���7"`_ ��
Dote .
�fJ�
Dist..
100,
Off.
__Z,
.F. C.
.MH Permit Fee $
.Micro Film Fee - Cop $
- -
Use of Permit i• _ ,- ,, - Parcel No. ILIeNo.
�d .. / —,,!917
- Set Backs- - Lot Size
Legal Description ° F '� S 5 _ R '- „•
/ +•/♦�j�')N i Zone ,Grp Type Unit
64 %% �+J'rL• I�f/Y(:�' �� ..
Ck.by
-
_
,
.Meth. fee - Dbl $`
PI. Ck. Fee '$
Construction Fee Dbl $
Electrical Fee Dbl $
_
SMI Fee _ E
'Plumbing Fee DbI $
•-
Bond Amt.
$
Plan No.
Plan Checker
r
Fin Date • -
i {_.�� •
Inspector j
/j1J.f C- .J
.
.
•'
.-
,SP'Insp. Fee E
�Derrol. Fee ... 0, $
Const. Lender .., Branch-..,
- -
Y� - V _
Addres ^ _
• - "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 become subject to the workmen's com.
pensation laws of California." , s•
• - Owner Signature -. `5 _ .. ' - »•
- Builder Signature
_
�Registr. Fee E
'Mileage Fee $
'Witness Fee $ _
;Reinsp. Fee $
-
Owner/Agent -
Xae
Tel.
---Zip.
-Total Fees "' ` $
ai �.
Address -
.... - _ _ r�^"'� -` ,r ` '� GUd
City %�• -
•�/�%C:�'H//1�%YQ •..
Zip
. M.O. ❑ N.C. ❑ C±A Check
Received by
Contractor
- _ - _ - •
Tel.
-
License #
.
'Trees required - - .•
Sewage System ' -
_ ^ .._ .- . ..
_ ».... , .
Address -
• s
City _ Zip
Workers'
yes ❑
Comp.
no ❑
T a - LL • 'P THIS:PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN' 120 DAYS. CESSATION OF r' Yerified by:
WORK FOR 120 DAYS SHALL'ALSO C �PERTSTO;W?ME VOID.Sewer District -DII-HEREBY. AGREE -THAT ALLTfD1Q. THIS..PERMIT WILL BE DONE,IN ACCORDANCE"
WITHTHE LAWS OF RIV6RSIDE COUNTY ATE OF CALIFORNIA, c ' -
i' ' ..
I HEREBY'CERTIFY THAT. THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE
r SO IN ACCORDANCE. WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE`•OF -THE STATE OF • -
Form 284.208 (Rev. 4.771..Os • CALIFORNIA. -