344135 (SATT)BUILDING PERMIT DEPARTMENT OF BUILDING & SAFETY
Jj111111k FIELD OFFICE
PERM IT NO.
3441 35
31
PERMIT N.
34413
�
COUNTY OF RIVERSIDE
Owner
Community
I ` �/ nt�
CONSTRUCTION ESTIMATE
DoteDist.
;V/
NO. ELECTRICAL FEES
Off.
NO. PLUMBING FEES
1ST FL. SO.
2ND FL. -
POR. SQ.
GAR. SQ.
CAR P. SQ.
WALL SQ.
_
ESTIMATED CONSTRUCTION
FT. i $ i
UNITS
Micro Film Fee
Cop $
Use of Permit
SQ. FT. 8 YARD SPKLR SYSTEM
Parcel No.
7,7 Q
FT. (a} i �. MOBILEHOME SVC. BAR SINK
Mech. Fee Dbl E
FT. ® POWER OUTLET ROOF DRAINS
Set Backs
FT. @ DRAINAGE PIPING
;instruction Fee Db 1 E
FT. .(a} DRINKING FOUNTAIN
meq` t� �i 'Gr, /��,ry rte/
I G7 r 4i
SQ. FT. URINAL
S 1!h
VALUATION �. WATER PIPING
NOTE: Not to be used as property tax valuation
Zone
SWIM POOL, PVT
Type
FLOOR DRAIN
SMI Fee E
MECHANICAL FEES
Dbl $
SWIM POOL, COMM
Plan No. ^�
WATER SOFTENER
Final Date
Inspector
VENT SYSTEM ❑ FAN ❑ EVAP. COOL HOOD
��
SIGN
$ -
WASHER (AUT SH)
Branch "I certify that in the performaince 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 earn.
pensotion laws of California."
City Zip Owner Signature
Builder Signature '
Fee $
APPLIANCE DRYER
Witness Fee $
Reinsp. Fee
$
GARBAGE DISPOSAL
e l , VL' '
Tel. y �° -� Zip "
0 4>Z; 37`
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
Total Fees
$
Address/�J,�,/
^G
LAUNDRY TRAY
Cit
y t�...� Zip
M.O. ❑ N.C. ❑ Cash C] C p
AIR HANDLING UNIT CFM
OA
IDLE METER
KITCHEN SINK
License q
Trees required
ABSORPTION SYSTEM � B.T.U.
/A/
TEMP USE PERMIT SVC
r -
WATER CLOSET
Workers' Comp.
yes ❑ no ❑
COMPRESSOR _ HP
POLE, TEMP/PERM
LAVATORY
HEATING SYSTEM FORCED ❑ GRAVITY
is
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SQ. FT. Cay ¢
ATH TUB
SQ. FT. Ga ¢
WATER HEATER
RESID Ga l Y.¢
SEWAGE DISPOSAL
S�AWFT.
Q. FT. GAR C4 1/.¢
3
HOUSE SEWER
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL.
[WE),JM0B.HM.FEE1
MICRO FEE
MECH. K
PL. CK. FEE
CONST. FEE�
EL E T%
SM IF
FEE
PL FEE
PERM IT NO.
3441 35
31
Supp. Permit.
Job Address
Space Zip
Owner
Community
I ` �/ nt�
Valuation
$ may, 4�a "'
DoteDist.
;V/
Off.
F.C.
MH Permit Fee _ E
Micro Film Fee
Cop $
Use of Permit
A
ur'
Parcel No.
7,7 Q
Use No. Ck.by
c�
Mech. Fee Dbl E
Pl. Ck. Fee $
Set Backs
Lot Sil
;instruction Fee Db 1 E
legal Description
/ ___
I�l�/
meq` t� �i 'Gr, /��,ry rte/
I G7 r 4i
F G10
S 1!h
S
Electrical Fee Dbl $
Zone
Grp
Type
Unit
SMI Fee E
Plumbing Fee
Dbl $
Bond Amt.
$
Plan No. ^�
Plan Checker
Final Date
Inspector
Sp. Insp. Fee b
Demol. Fee
$ -
Const. Lender
Address
Branch "I certify that in the performaince 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 earn.
pensotion laws of California."
City Zip Owner Signature
Builder Signature '
Fee $
Mileage Fee $
Witness Fee $
Reinsp. Fee
$
Owner/Agent
/7 1 • ,
e l , VL' '
Tel. y �° -� Zip "
0 4>Z; 37`
Total Fees
$
Address/�J,�,/
^G
/'Iyv/ ���
Cit
y t�...� Zip
M.O. ❑ N.C. ❑ Cash C] C p
Received by
OA
Contractor
Tel
License q
Trees required
Sewage System
/A/
Address
r -
City Zip
Workers' Comp.
yes ❑ no ❑
T LL P
'Sewer District
Form 284.208 IRev. 4.771 &s
THIS PERMIT SHALL BECOME OID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF verrfied by:
ORK FOR 120 DAYS SHALL AL �ONNECTION
O BECOME VOID. r
I HEREBY AGREE THAT ALL O K IN WITH THIS PERMIT WILL BE GONE IN ACCORDANCE
WITH THE LAWS OF RIV5RSIDE COUNTY A D THE STATE OF CALIFORNIA.
HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE
SO 1 IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF
CALIFORNIA.