334727 (SFD)BUILDING PERMIT DEPARTMENT OF BUILDING & SAFETY & FIELD OFFICE
PERMIT NO.
3 3 4 72 7
PERMIT NO..COUNTY
33477
Job Address
�a-aa6 �v'e
OF RIVERSIDE
Zip
Owner
DST
r//
CONSTRUCTION ESTIMATE
Dote
��6
NO. ELECTRICAL FEES
NO.
PLUMBING FEES
1ST FL. SQ.
2ND FL.
FOR. as�
GAR. oZ SQ.
CAR P. SQ.
WALL SQ.
ESTIMATED CONSTRUCTION
FT. Ga a $ '� �>!% '�
UNITS
Use of Permit /
/�' �� �f
( G//•^
Parcel No.
O/O
SQ. FT. 8 YARD SPKLR SYSTEM
: Meth. Fee Dbl $ a0
y
SQ. FT. 1& 1 OaT � MOBILEHOME SVC. BAR SINK
Set Bocks Lor Size
Grp T Unit
FT. CW 26 A — POWER OUTLET ROOF DRAINS
Legal Description
d 13 &-,1/
FT. Ga DRAINAGE PIPING
'. SMI Fee $ d
DRINKING FOUNTAIN
FT.
Dbl 5
SQ. FT, Ga URINAL
Bond Amt.
S
VALUATION $ 98�� WATER PIPING
p
NOTE: Not to be used as property tax valuation
Final Date
l0 - 3 - 79
SWIM POOL, PVT
t
i Sp. Insp. Fee 5
FLOOR DRAIN
5
MECHANICAL FEES
I certify thm to the pe or e f 4�or.whi
not employ any person m any o lett
penscnon laws of Caldormo.
Owner Sig oture
Budder Signoturc
SWIM POOL, COMM
Registr. Fee 5
i
I -Mileage Fee 5
WATER SOFTENER
Reinsp. Fee
$
VENT SYSTEM ❑ FAN ❑ EVAP. COOL )n HOOD
3ev
SIGN
Tel.
Zip
WASHER IAUT*DISHI
-Total Fees
$
APPLIANCE ;& DRYER
3
Zip
M.O.❑N.C. ❑ Cash C3 Che
Received by
Contractor
Tel.
License q
Trees required
Sewage System ,/�
/A:91:
" / y� �
Address
City Zip
Workers* Comp.
yes ❑ ho ❑
T LL P THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF verified by
Sewer District WORK FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
L_ I HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE
WITH THE LAWS OF RIVEJSIDE 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
Form 284.208 (Rev. 4.77) 0s CALIFORNIA.