341261 (SATT)y t •f '
BUILDING PERMIT f fes,., DEPARTMENT OF BUILDING & SAFETY FIELD OFFICE
PERMIT NO. -
341261
PERNIIT N.C. C -r
f 41 '2
- _
COUNTY OF RIVERSIDE -
•
- - z -
Owner •
�;
D/ST
CONSTRUCTION ESTIMATE ti
;.�
NO: ELECTRICAL FEES
NO. PLUMBING FEES'
Dist.
IST FL. •'L SQ.
2ND FL..=.
's
POR.
' •
GAR: SQ.
CAR P. r ,
WALL t
rs
ESTIMATED CONSTRUCTION
FT. (a) �µ $,
* UNITS
MH Permit Fee
SQ. FT: & " + f x YARD SPKLR SYSTEM
-
SQ. FT, MOBILEHOMESVC . BAR SINK
Ck.by
. FT. ' @ a POWER OUTLET ROOF DRAINS
,
_
SQ. FT. - DRAINAGE PIPING
$ �.
SQ. FT.,, Q '• DRINKING FOUNTAIN
Plan No."
r ..
r
SQ. FT.C�3 URINAL
..
VALUATION $ -• WATER PIPING
-
NOTE: Not to be used as property tax valuation
-
SWIM POOL, PVT. "
$
FLOOR GRAIN
Branch-' "I certify that in the performance 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 lows of Colifotnior" s -
- City Zip • Owner Signature f
p .Builder Siynature "
' MECHANICAL -FEES
Witness Fee $
SWIMPOOL,,COMM
t
WATER SOFTENER'
-
-
Tel:, -
-
VENT SYSTEM 0 FAN C] EVAP. COOL 0—HOOD"
SIGN , , r
Address
WASHER (AUTO) (DISH) '
City h
Zip
APPLIANCE O DRYER
'' �f
Contractor
"• y
GARBAGE DISPOSAL
License #
FURNACE ❑UNIT' ❑ WALL FLOOR .❑ SUSPENDED
Sewage System
9 Ys - -
pp
Address
LAUNDRY TRAY :
- -
City - Zip �
+
Workers' Comp. .
yes C] no O
AIR HANDLING UNIT ' . _ CFM
IDLE METER
KITCHEN SINK - -'
ABSORPTION SYSTEM 0 B.T.U. •'
•• TEMP USE PERMIT SVC _
WATER CLOSET
COMPRESSOR HP
POLE, TEMP/PERM
LAVATORY
HEATING SYSTEM O FORCED `O'GRAVITY
AMPERES SERV ENT
SHOWER"
BOILER B.T.U. ' -
SQ. FT: p ¢
BATH TUB
SQ. FT.' Ca ¢
WATER HEATER
SQ. FT.'RESID @ 1 t/ tr
SEWAGE DISPOSAL `
SQ.'FT: GAR.
HOUSE SEWER r
-
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
'FEE
i.
TOTAL FEES
r MOB. NM. FEE;MICRO
FEE MECH. FEE
PL. CK. FEE
CONST. FEE
ELECT. FEE
.is
SMI FEE
• iPLUM
B. FEE
PERMIT NO. -
341261
Supp. Permit
Job Address;
_L
• '
o _
Space
Zip
Owner •
�;
^
Community - - -
L�. �J
Valuation
Date
Dist.
Off.
F.C.
MH Permit Fee
Micro Film Fee Cop
Use of Permit ' • ._• Parcel No. Use No.
•* Set Backs Lot Size
Legal DescriptionF - S SFee
• , /f y� Zone, Grp Type .. - Unit •
�G'%• ��% / ✓>�• d 47.J' �•!� pZ '/ �1
t
Ck.by
Aech.Fee sl. Ck. Fee
4j,
=onstruction Fee /"
/ D
WI Fee $
Plumbing Fee /
$ �.
Bond Amt.' -
$
Plan No."
r ..
Plan CheckerFi/n�JI
Dote
C -,q-'2 —'2 l
Inspee-cctttoorr ,(
V • KFC .
-
Sp. Insp. Fee $
Dental. Fee
$
Const Lender '
•
Address `
Branch-' "I certify that in the performance 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 lows of Colifotnior" s -
- City Zip • Owner Signature f
p .Builder Siynature "
Mileage Fee $
Witness Fee $
Reinsp. Fee
$
Owner/Agent
-
-
Tel:, -
-
Zip
-
Fatal Fees $
M.O. ❑ N.C. O Cosh ff Check
Address
City h
Zip
Received by
'' �f
Contractor
"• y
Tel.
License #
Frees required
Sewage System
9 Ys - -
pp
Address
" -
+
- -
City - Zip �
+
Workers' Comp. .
yes C] no O
LL Y -'
District
Form 284-208 (Rev. -4.771 Os '
THIS FERMII SHALT BECOME VOID IF,WORK 15 NOT COMMENCED WITHIN 120 DAYS. CESSATION OF venhed by:
WORK FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
1 I HEREBY AGREE THAT ALL WOR��lt9 EC WITH THIS PERMIT WILL BE DONE IN ACCORDANCE
L WITH THE LAWS RIV6�iSIDE COUN A fFORNIA.-
I HEREBY CERTIFY THAT'THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE
SO IN ACCORDANCE WITH SECTION 5541, OF THE BUSINESS AND PROFESSIONS, CODE OF THE STATE OF
CALIFORNIA.