242643 (SPIN)BUILDINGPERMIT
VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD
DEPARTMENT OF BUILDING & SAFETY
COUNTY -OF RIVERSIDE
N.O. ELECTRICAL FEE'S
UNITS.
MOBILEHOME SVC,
POWER OUTLET
SWIM POOL, PVT
SWIM POOL. COMM
'SIGN
FIELD OFFICE
NO. PLUMBING F
BOILER O B.1
BAR SINK
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
FLOOR DRAIN
WATER SOFTENER
WASHER (AUTO) (DISW
APPLIANCE GARBAGE DISPOSAL
CONSTRUCTION ESTIMATE
IST FL.
SQ -FT.
2ND FL,
SO. FT.
POR.
SQ. FT.
OAR.,
SQ. FT.
CAR P.
SQ.FT,
WALL
SO FT.
SQ. FT.
ESTIMATED CONSTRUCTION VALUATION $
NOTE: Not
to be used as property tax valuation
VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD
DEPARTMENT OF BUILDING & SAFETY
COUNTY -OF RIVERSIDE
N.O. ELECTRICAL FEE'S
UNITS.
MOBILEHOME SVC,
POWER OUTLET
SWIM POOL, PVT
SWIM POOL. COMM
'SIGN
FIELD OFFICE
NO. PLUMBING F
BOILER O B.1
BAR SINK
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
FLOOR DRAIN
WATER SOFTENER
WASHER (AUTO) (DISW
IL w t- -
APPLIANCE GARBAGE DISPOSAL
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR' Cl SUSPENDED LAUNDRY TRAY
AIR HANDLING UNIT I CFM IDLE METER KITCHEN SINK
ABSORPTION SYSTEM B.T.U. TEMP USE PERM SVC WATER CLOSET
COMPRESSOR 0 HP POLE, TEMP/PERM LAVATORY
HEATING SYSTEM O FORCED p GRAVITY AMPERES',SERV ENT SHOWER
SQ FT ® ¢; BATH TUB
SQ FT ® a WATER HEATER
SQ FT".RES1.D ®. I a SEWAGE DISPOSAL
SQ FT GARAGE @ %4 HOUSE SEWER
PERMIT FEE TEMP'ELEC:S,VC GAS PIPING
MOBILE'HOME PERMIT FEE is I
PERMIT FEE PERMIT FEE -
PEiiMrr NO. -
TOTAL FEES
MOB. HM. FEE
MICRO FEE
MECH, FEE
DBL.
PL- CK. EEE
CONST. FEE
DBL.
ELECT. FEE
11513L
I SMI FEE
1f�,PLUMB.
FEE
DBL
J _ F M A M J A S O N
�_ o�ayaDORESS J- SP NO
/ . % / - . 11
_ ow
73
74
USE OF'PERMITp
F. r-
J
DATE
P MI NO.
242643
75
M H PERMIT FEE
$
c MMUNITY
DST
UNITS
ROOMS
lVALUATION
SURP.. TO PERMIT
OFFICE
MICROFILM FEE
COPIES
$
LEGAL DESCRIPTION
�4 Rti J6'i[ f?%
MECHANICAL FEE
DBL
$
SE[ BACK
LOTSIZE ZONEUSE'NO:
GRP
TYPE I CK �Y
PLAN CHECK FEE
$
BOND AMT.
PLAN NO:
-FLTN—CHECKER
FINAL DATE INSPECTOR
CONSTRUCTION FEE
DBL
$
NAME OF QdNST. LENDER BRANCH
OFFICE
NO LENDEAANVOLV
ELECTRICAL FEE
DBL
$
ADDRESS cm
STATE
MI FEE
$
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 12 YS.CESSA-
TION OF WORK FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
I HEREBY AGREE THAT ALL WORK-IN CONNECTION WITH THIS PERMIT WILL BE DONE IN AC.
CORDANCE WITH THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, I ALSO
AGREE TO CARRY COMPENSATION INSURANCE UPON MY EMPLOY. COMPLIANCE WITH THE
ES
LAWS OF THE STATE OF'CALIFORNIA COVERING CONTRACTORS 1S ALSO GUARANTEED.
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.
,�
PL'UMBIN FEE
DBL
$
TOTAL FEES
$
,o'o
OWNER/AGENT'S SIGNATURE I x� �_ ,
rzo &JrA
CONTRACTOR
CASH CHECK [3.4
M.O. ❑ N:C. ❑
ADDRESS
1 6j9A M . .
ADDRESS
1 RECEIVED BY
TREES REGUIRED
..
SEWAGE SYSTEM
LL P
C_ I - - ZIP CODE
A
CITY - ZIP CODE
INFO NATION
FORAM 484 2q8 [Rev 9-73r Os
T .. NO
TEL NO, LICENSE
IL w t- -