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341110 (SATT)BUILDING PERMIT . e Ask DEPARTMENT OF BUILDING & SAFETY �Ak FIELD OFFICE PERM IT NO. 341110 PERMIT NO. 34.1110 Job Address - - - Space Zip COUNTY OF RIVERSIDE Owner - - Community Valuation • - DST CONSTRUCTION. ESTIMATE , NO. ELECTRICAL FEES F.C. NO. PLUMBING FEES ' 1 ST FL^ SQ. • 2ND FL._ FOR. GAR. SQ. CAR P. WALL ESTIMATED CONSTRUCTION FT. .® $ UNI .$ Micro Film Fee Cop $ Use of Permit . -I �'=%Y'�t% ' �""�1r1 L G �., Parcel No. • _ SQ. FT' @ t YARD SPKLR SYSTEM , Ck. by SQ. FT. @ MOE•ILEHOME SVC. BAR SINK It. Ck. Fee $ - FT. @ POWER OUTLET ROOF DRAINS =onstruaion Fee . Dbl $ SQ. FT.. (t} DRAINAGE PIPING Electrical Fee Dbl $ $Q. FT. Q - DRINKING FOUNTAIN'.. Grp SQ. FT. URINAL Unit } VALUATION $ WATER PIPING SMI Fee $ NOTE: Not to be used as property tax valuation SWIM POOL, PVT Plan No. FLOOR DRAIN Final Date Inspe MECHANICAL FEES SWIM POOL, COMM )emol. Fee $ WATER SOFTENER Registr. Fee $ +, Mileage Fee$ , - VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD SIG" Owner gen % kj WASHER (AUTO)IDISHI"'- Fatal Fees' $' M.O. ❑ N.C. ❑ -Cash Check APPLIANCE ❑ DRYER • City Zip. 2eceived by - GARBAGE DISPOSAL Tel. License # FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED Sewoge System - `I/ LL 4 X�T Address - - • - LAUNDRY TRAY Workers' Comp. yes ❑ no ❑ r AIRHANDLINGUNIT CFM IDLEMETER KITCHEN SINK ABSORPTION SYSTEM 0 B.T.U. TEM2 USE PERMIT SVC WATER CLOSET ' COMPRESSOR - 0 HP POLE, TEMP/PERM LAVATORY HEATING SYSTEM - ❑ FORCED ❑ GRAVITY AMPERES SERV ENT SHOWER BOILER- � B.T.U. SQ. FT. p ¢ BATH TUB SQ. FT. Cat ¢ WATER HEATER SQ. fT. RESID @ I ,/.¢ SEWAGE DISPOSAL SCS. FT. GAR B 'G¢ HOUSE SEWER GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE TOTAL FEES MOB. HM. FEE ;MICRO FEE MECH. FEf PL. CK!FEE. CONST. FEE ELECT. FEE SMI FEE t FEE PLUMB'. FEE PERM IT NO. 341110 Supp. Permit ��- Job Address - - - Space Zip - Owner - - Community Valuation • - Date Dist. Off. F.C. MH Permit Fee Micro Film Fee Cop $ Use of Permit . -I �'=%Y'�t% ' �""�1r1 L G �., Parcel No. • _ Use No. - Ck. by Mech. Fee Dbl $ It. Ck. Fee $ - Set Backs I Lot Size . F__)I S- . J _ .,�2?• ley =onstruaion Fee . Dbl $ Legal Description - '. 4e77 -111,L.... 2 3O0 ' �l� Electrical Fee Dbl $ Zone �, Grp Type Unit } .. SMI Fee $ Numbing Fee Dbl $ Bond Amt. $ Plan No. Plan Checker Final Date Inspe , Sp. Insp. Fee $ )emol. Fee $ Const. Lender _ Branch "'L certify that in the performorme of the work for which this permit is issued I sholl not employ.any person in any manner so as to become subject to the workmen's com- - pensoiion lows of California." - ddress - City Zip •� Owner Signature y - Builder Signature Registr. Fee $ +, Mileage Fee$ , - Witness Fee $ Reinsp. Fee $ Owner gen % kj Tel. •, Zip Fatal Fees' $' M.O. ❑ N.C. ❑ -Cash Check Address City Zip. 2eceived by - Contractor Tel. License # frees required Sewoge System - `I/ LL 4 X�T Address - - • - City,. Zip _.. Workers' Comp. yes ❑ no ❑ THIS PERMIT SHALL BECOME -VOID -IF N,ORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF venfied by: WORK FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.; e-. I HEREBY'AGREETHAT ALL WORK IN CCNNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE WITH THE CAWS OF RIVSQSIDE COUNTY AND -HE STATE OF CALIFORNIA. I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE SO IN ACCORDANCE WITH SECTION 5541 DF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA. kwe/District- - • Form 284.208 (Rev. 4.77) ©S+f «