303340 (SFD)DEPARTMENT OF BUILDING & SAFETY FIELD OFFICE
BUILDING PERMIT �^e IUTv P%e RlveRelnr
PERMIT NO.
3033401
JOB ADDRESS I SP NO
1
53-835 Ave. D.Laz I
.VVI\11 Vr RIIIGR7I VG
76
77
COMMUNITY
DST
1//l
CONSTRUCTION ESTIMATE
OFFICE
NO. ELECTRICAL FEES
Lal uipta
NO. PLUMBING FEES
6-30-77 11
1ST FL. SQ.
2ND FL.
POR.
GAR.
CAR P. SQ.
WALL SQ.
ESTIMATED CONSTRUCTION
FT. @
„
UNITS
$
USE OF PERMIT
SQ. FT. @ YARD SPKLR SYSTEM
SUPP, TO PERMIT
SQ. FT. @ MOBILEHOME SVC. BAR SINK
NO,
SQ. FT. @ POWER OUTLET ROOF DRAINS
FT. @ DRAINAGE PIPING
FT. @ DRINKING FOUNTAIN
SQ. FT. @ URINAL
001
VALUATION Is WATER PIPING
303341
NOTE: Not to be used as property tax valuation
SWIM POOL, PVT
MICROFILM FEE
FLOOR DRAIN
$
MECHANICAL FEES
BOOK PAGE PARCEL
SWIM POOL, COMM
WATER SOFTENER
VENT SYSTEM WAN ❑ EVAP. COOL IX400D
4-
SIGN
MECHANICAL FEE
WASHER (AUTO H)
$
APPLIANCE RYER
USE NO.
ZONE
SET BACK
IGARBAGE DISPOSAL
eav
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
CK BY
LAUNDRY TRAY
40
AIR HANDLING UNIT CFM
IDLE METER
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
T.
TEMP USE PERM SVC
WATER CLOSET
COMPRESSOR � HP
HEATING SYSTEM .— ORCED [:)GRAVITYMPERES
6�
POLE,"TEMP/PERM
SERV ENT
LAVATORY
SHOWER
S 5' R 13
BOILER B.T.U.
R-3
SQ.FT. @ Q
b S
BATH TUB
$
SQ.FT. @ a
PLAN NO.
WATER HEATER
FINAL DATE INSP
R
Q. FT. RES] D @ I V44
G'
SEWAGE DISPOSAL
Q.FT.GAR @ 1/44
HOUSE SEWER
DBL
$
NAME OF CONST. LENDER BRANCH
OFFICE
NV NDER INVOLVED
GAS PIPING
PERMIT FEE
t�
PERMIT FEE
PERMIT FEE
DBL
DBL.
I TOTAL FEE�S�ys
MOB.HM.FEE
MICRO FEE
MtiW. FEEL.
CK, FEE
I CONST. FEE
ELECTFEE
SMI F7E . _ZF
FEE
PL . FEE I+�
J F M A M 1 J A S O N D
P
JOB ADDRESS I SP NO
1
53-835 Ave. D.Laz I
OWNER ,
Dr.IT-ITDev.
76
77
COMMUNITY
VALUATION
DATE DST
OFFICE
Lal uipta
25,344 W
6-30-77 11
Iadit
78
M H PERMIT FEE
$
USE OF PERMIT
F.C.
SUPP, TO PERMIT
PERMIT
NO,
dwelling att. arae
001
29 421
303341
MICROFILM FEE
COPIES
$
BOOK PAGE PARCEL
LEGAL DESCRIPTION
4-
t 4. block 199, Putt 19
MECHANICAL FEE
DBL
$
USE NO.
ZONE
SET BACK
LOT SIZE
GRP
TYPE
CK BY
40
—7n
T.
it -1
5`
S 5' R 13
50X100
R-3
V-
b S
PLAN CHECK FEE
$
BOND AMT.
PLAN NO.
PLAN CHECKER
FINAL DATE INSP
R
— / 7
CONSTRUCTION FEE
DBL
$
NAME OF CONST. LENDER BRANCH
OFFICE
NV NDER INVOLVED
t�
ELECTRICAL FEE
DBL
$
ADDRESS CITY
STATE
STRONG MOTION
$
OWNE R/AGENr5-SIG NATURE ` CONTRACTOR
INSTRUMENTATION FEE
Driscoll Dev. Con'.
SPECIAL INSP
$
ADDRESS ADDRESS
DEMOLITION
FEE
REGISTRATION
ax 9
PLUMBING FEE
DBL
$
cl ZIP CODE CITY
ZIP CODE
TOTAL FEES
$
TEL. NO. AREA
CODE T.L.
NO.
AREA CODE
LICENSE n
CASH QCHECK .O.ON.C.❑
a /564-11.59
RECEIVED BY -'
TREES REQUIRED
IT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF
K F 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
I HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE
WITH
SEWAGE SYSTEM li1/r
/
�%//�
T L
p .G"
THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, I ALSO AGREE TO CARRY
COMPENSATION INSURANCE
U ON MY EMPLOYEES. COMPLIANCE WITH THE LAWS OF Inc STATE OF
CALIFORNIA COVERING CONTRACTORS IS ALSO GUARANTEED.
I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE
FORM 284-208
(REV. 6-76) SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE
OF CALIFORNIA.