341117 (SATT)BUILDING PERMIT i DEPARTMENT OF BUILDING & SAFETY FIELD OFFICE
- PE,tMIT NO. -
�14-1 1171
PERMIT NO.
3 4111 °�
• - COUNTY OF RIVERSIDE . - -' -
7ST
CONSTRUCTION ESTIMATE r NO. ELECTRICAL FEES NO. PLUMBING.FEES.
1ST FL. SQ.
2ND FL.
POR.
GAR. SQ.
CAR P.. , SQ.
- WALL
ESTIMATED CONSTRUCTION
FT. Q $ UNITS '
YARD SPKLR SYSTEM
SQ. FT.
.®,
MOBILEHOME SVC. BAR SINK
SQ. FT. (a}
POWER OUTLET ROOF DRAINS
FT.
FT: @ DRAINAGE PIPING
SQ. FT. ® DRINKING FOUNTAIN'
SQ. FT. @URINAL
VALUATION $ _ WATER PIPING
NOTE: Not to be used as property tax voluotion SWIM POOL, PVT FLOOR DRAIN
f MECHANICAL FEES SWIM POOL, COMM WATER SOFTENER
Micro
Micro Film Fee _Cop E-
VENT.SYSTEM.❑ FAN ❑ EVAP. COOL. [1 -HOOD'- SIGN WASHER (AUTO) IDISHI
Permit of
Use � f
/ `— �- tiK' 61� �`+✓ J!
•1
—.727V
APPLIANCE ❑ DRYER GARBAGE DISPOSAL
Use No.
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR 0 SUSPENDED + LAUNDRY -TRAY
k. by
AIR HANDLING UNIT CFM IDLE METER KITCHEN SINK
11. Ck. Fee E
ABSORPTION SYSTEM B.T.U. TEMP USE PERMIT SVC WATER CLOSET
Lot Size -
COMPRESSOR 0 HPPOLE, TEMP/PERM LAVATORY
Zonstruction Fee Dbl $
HEATING,SYSTEM ❑ FORCED ❑ GRAVITY AMPERES SERV ENT SHOWER
F
BOILER B.T.U. SQ. F.T. 8 ¢ BATH TUB
Ss'
SQ. FT. Ca ¢ WATER HEATER
(Electrical Fee Dbl $•�
zc/SMI
SQ. FT. RESID @ 1'G¢ SEWAGE DISPOSAL
Grp -
-
SQ. FT. GAR C Y. HOUSE SEWER -
Unit
GAS PIPING
Fee E
PERMIT FEE y PERMIT FEE PERMIT FEE
�.r
s OTAL FEES
JM0B,,HM,FEEJ
- MICROFEE MECH. FEE PL. CK. FEE
I.. CONST. FEE.- ELECT. FEE SMI FEE
FEE PLUMB. FEE
- PE,tMIT NO. -
�14-1 1171
Supp. Permit
Job Address - Space
Zip -
Owner -
Community
Valuation
Date
Xs
Dist.
0�
Off.
F.C.-
'
MH Permit Fee $/i
Micro
Micro Film Fee _Cop E-
Permit of
Use � f
/ `— �- tiK' 61� �`+✓ J!
•1
—.727V
Parcel No.
r
Use No.
k. by
Mech. Fee Dbl $
11. Ck. Fee E
Set BacksT -
Lot Size -
Zonstruction Fee Dbl $
Legal Description -
••�� ` -
G'7' �/ .Jl%) �.J ��F•/>� ��^
F
.� S
Ss'
R
(Electrical Fee Dbl $•�
zc/SMI
Zone
_.
Grp -
-
Type
`
Unit
Fee E
Plumbing Fee Dial $
Bond Ami.
$
Plan No.Plan
Checker ,
Final Dote
Insp r
'Sp. Insp. Fee b-
Demol. Fee E
-
Const. Lender Branch tl certify that in the performance of the work for which this permit is issued
- not -employ any person in any manner so as to become subject to the workmen's
- pensclion lows of California." '
Address City 'Zip Owner Signature
Builder Signature
I shall
corn.
IRegistr. Fee $
,Mileage Fee $
Witness Fee $
IReinsp. Fee E
Owner/Agen
- Tel.
Zip
Total Fees $
M.O. ❑ N.C. ❑ Cash
Check
Address
_ ^ L _
City
Zip
iReceived by
,,%
Contractor
Tel.
License N
`Trees required
ISewoge System
! T LL
P
Address - - -
City Zip
Workers'Comp.
yes ❑ no ❑
THIS PERMIT SHALL BECOME VOID .IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF- verified by:
RK FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
yoI HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE
WITH THE LAWS OF RIVEQSIDE'COUNTY AND THE STATE OF CALIFORNIA.
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.
Sewer District
I'
I:
Form 284.208 (Rev. 4.771 @$