349278 (ELEC)BUILDING PERMIT DEPARTMENT OF BUILDING & SAFETY Aft FIELD OFFICE
PERMIT NO.
34927$
PERMITNO.
1349278
COUNTY OF RIVERSIDE
DST
1W
CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES
1ST FL. SQ.
2ND FL. SQ.
POR.
GAR. SQ.
CAR P. SQ.
WALL SQ.
ESTIMATED CONSTRUCTION
$ UNITS
FT. UNITS
FT. YARD SPKLR SYSTEM
SQ. FT.Cia MOBILEHOME SVC. BAR SINK
FT. (ay POWER OUTLET ROOF DRAINS
FT. DRAINAGE PIPING
FT. Ga DRINKING FOUNTAIN
SQ. FT. Ga 64-n" .5'r Jie Q -V URINAL
VALUATION $ WATER PIPING
NOTE: Not to be used as property tax valuation SWIM POOL, PVT FLOOR DRAIN
MH Permit Fee $
MECHANICAL FEES SWIM POOL, COMM WATER SOFTENER
VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD SIGN WASHER (AUTO) (DISH)
Parcel No.
.ry
/� �. ��� a
APPLIANCE ❑ DRYER GARBAGE DISPOSAL
Mech. Fee Dbl $
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED LAUNDRY TRAY
Set Backs
AIR HANDLING UNIT CFM IDLE METER KITCHEN SINK
Construction Fee Dbl E /
ABSORPTION SYSTEM � B.T.U. TEMP USE PERMIT SVC WATER CLOSET
F
COMPRESSOR O HP POLE, TEMP/PERM LAVATORY
5
HEATING SYSTEM ❑ FORCED ❑ GRAVITY AMPERES SERV ENT SHOWER
Electrical Fee Dbl $
BOILER [�� B.T.U. SQ. FT. Ga ¢ BATH TUB
Grp
SQ. FT. Ga ¢ WATER HEATER
Unit
SQ. FT. RESID Gm 1'A ¢ SEWAGE DISPOSAL
SMI Fee E
SQ. FT. GAR Ga 1/.¢ HOUSE SEWER
Dbl E
GAS PIPING
an No.
PERMIT FEE
PERMIT FEE ERMIT FEE
Ins ctor
1-�5BL.77AL
FEES
IM08. HM. FEE
MICRO FEE MECH. FEE PL. CK. FEE
I CONST. FEE ELECT. FEE SMI FEE
FEE PLUMB. FEE
PERMIT NO.
34927$
Supp. Permit
3
Job Address Space
-s -az- _
Zip
�17�-
Owner
/Z„,��� �
Community
A41 A
Valuation
$
Date
�y J—
Dist.
//
Off,
T
F.C.
MH Permit Fee $
'Micro Film Fee Cop $
Use of Permit
_
Parcel No.
.ry
/� �. ��� a
Use No. Ck. by
4
Mech. Fee Dbl $
!PI. Ck. Fee E
Set Backs
Lot Size
Construction Fee Dbl E /
Legal Description
,�, �y� % a
F
S
5
R
Electrical Fee Dbl $
Zone
Grp
Type
Unit
SMI Fee E
Plumbing Fee
Dbl E
on Amt
$
an No.
an Checker
Feil Dof�//�
Ins ctor
Sp. Insp. Fee $
Demol. Fee
$
Const. Lender Branch -I certify that in the performance of rKelwork for which this permit is issued I shall
not employ any person in any manner soled to become subject to the workmen's com-
pensotion lows of California.”
Address City Zip Owner Signature
Builder Signature
,Registr. Fee $
Mileage Fee $
.Witness Fee $
Reinsp. Fee
$
Owner/Agent
Tel. Zip
Total Fees$
/
Address
City Zip
M.O. ❑ N.C. ❑ Cash C] Check
Received by
Trees require
Contfactor ,rte i
d �"
Tel.
j �C _
424
License #
3 5 'z93 C
Sewage System
T LL P
Address % /
afo t' �N�i
City per! ,,A Zip
'"•�7/'"' � SST
-Workers' Comp.
yes ❑ no ❑
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF verified by
WORK FOR 120 DAYS SHALL PERTOME VOID.
I HEREBY AGREE THA I ON WITH THIS PERMIT WILL BE DONE IN ACCORDANCE r -
WITH THE LAWS OF RIVERSIDE COUNTY NO 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
FFF
Form 284.208 (Rev. 4.77) Os