304386 (RPL)l* DEPARTMENT OF BUILDING & SAFETY'Am.. OFFICE
L BUILDING PERMIT _ 3 ,
PERMIT NO.
-SR
PERMIT NO
1"-304386
� COUNTY OF RIVERSIDE
v - Y
DST
CONSTRUCTION ESTIMATE, NO. ELECTRICAL FEES NO. PLUMBING FEES
1ST FL. - SQ.
2ND.FL.
POR.
GAR.SQ.
CAR P.
WALL `
y7
ESTIMATED CONSTRUCTION
FT., @ $ UNITS
SQ. FT. @ YARD SPKLR SYSTEM
SQ. FT. @ MOBILEHOME SVC. BAR SINK
FT. POWER OUTLET . ROOF DRAINS
DRAINAGE PIPING
SQ. FT. @'
SQ. FT. Q DRINKING FOUNTAIN
SQ. FT.i� p Q URINAL
VALUATION $ Cyp WATER PIPING
NOTE: Not to be used os property tax valuation SWIM POOL, PVT p 'FLOOR DRAIN
Date
MECHANICAL FEES SWIM POOL; COMM WATER SOFTENER
Dist.
VENT SYSTEM ❑ FAN ❑ EVAP. COOL -❑ HOOD SIGN WASHER (AUTO) (DISH)
~
APPLIANCE ❑ DRYER GARBAGE DISPOSAL
MH Permit Fee 8A_)ig
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED LAUNDRY TRAY
Use of Permit
- ���
AIR HANDLING UNIT CFM IDLE METER KITCHEN SINK
'
ABSORPTION SYSTEM 0 B.T.U. ` TEMP USE PERMIT SVC WATER CLOSET
asks -
S
COMPRESSOR 0 HP POLE, TEMP/PERM LAVATORY
Mech. Fee Dbl $
HEATING SYSTEM ❑ FORCED ❑ GRAVITY AMPERES SERV ENT SHOWER
.Construction Fee Dbl $Legal
:Electrical FeeON .$
SMI Fee - $
BOILER 0 B.T.U. SQ. FT. p ¢ BATH TUB
-
SQ. FT. @ ¢ WATER HEATER
Zone
SQ. FT. RESID p 1 t/.¢ SEWAGE DISPOSAL
SQ. .FT. GAR' p' '3/.¢ HOUSESEWER
t.
Unit
GAS PIPING
PERMIT FEE
PERMIT FEE 1,0 PERMIT FEE o
Pion No.
DBL
TOTALFEES EES
M
MIC RO•FEE - MECH: FEE. PL.•CK. FEE
mo
CONST. FEE EL_ CT:FEE SMI FEE
FEE PL MB. FEE•
PERMIT NO.
-SR
Supp. Permit
Job Address -
i%i
Space Zip
-
Owner
- .f
ommuniy
��
Valuati`onf.
Date
-
Dist.
ff. I F.C.
MH Permit Fee 8A_)ig
,Micro Film Fee Cop $
Use of Permit
- ���
+^/
/ � , / 14032.
or
. �'3Z •
Parcel No.
$ -
asks -
S
Use No. Ck. by
Lot Size
Vx `174
Mech. Fee Dbl $
.Pl. Ck. Fee $ Q�
.Construction Fee Dbl $Legal
:Electrical FeeON .$
SMI Fee - $
Description
¢1
-
Zone
Grp._
Type
t.
Unit
`
,Plumbing Fee Dbl 8
Bond Amt.
$
Pion No.
Plan Checker
Final Date
/ - 3 �'
? d
Inspect
rr
$p. Insp. Fee 8
IDemol. Fee
$ _ 4Const.
Lender
Address ,.
-
Branch
City
- 'I certify performance of th/
, y that to the p ere work for which tNs perm it is issued 1 shall
not employ any person in any manner so as to become subject to the workmen s com-
pensation lows of Collfomro.
Zip
Owner Signotu-
- Builder Signature
Registr. Fee g
Mileage Fee - $
Witness Fee S,
. Reinsp. Fee
8
Owner/Agent
Tel.
_
Zip
'Tocol Fees $
M.O. ❑ N.C. ❑ Cosh ❑ Chec
Address ' //qq q
`SJ r.5�/N
.)
A
�•"
- Zip 1
Received by
Trees required
Contractor
_ -
Tei.
License # J
1
Sewage System
-
Q
Address -
?
City
Zip
Workers' Comp.
yes ❑ no ❑{
T LL P ,
District
Form 284.208 (Re,*4-77) 0s -
THIS PERMIT SHALL BECOME VOID IF WORK 15 NOT COMMENCED WITHIN 120 DAYS. CESSATION 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 1111 ACCORDANCE
WITH THE LAWS OF RIVERSIDE 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.
,vii -ed by.