347339 (SFD)BUILDING PERMIT DEPARTMENT OF BUILDING & SAFETY FIELD OFFICE
PE RM IT NO.
I
34733 9
PERMI347339T NO.
Job Address Space Zip
-53-x- -
COUNTY OF RIVERSIDE
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Valuation
E
Date
�i
711S/T
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
i'
NO. PLUMBING FEES
' MH Permit Fee E
1ST FL. SQ.
2ND FL. SQ.
POR. SQ.
GAR. SQ.
CAR P. SQ.
WALL SQ.
SQ.
ESTIMATED CONSTRUCTION
FT. @ ` $
UNITS
Parcel No.
— _
Use No. Ck.by
A
PI. Ck. Fee E
I
FT. @ YARD SPKLR SYSTEM
Lot Size
MOBILEHOME SVC, BAR SINK
FT. (�
,�-
Descri al t
Le g p' on
1 ' /
j!� e�a •= Y as
FT.Cja POWER OUTLET ROOF DRAINS
S
FT. Ga DRAINAGE PIPING
moi'
FT. Ga DRINKING FOUNTAIN
Zone
le -1
FT. @ URINAL
Type
V
VALUATION $ WATER PIPING
NOTE: Not to be used as property tax valuation
SWIM POOL, PVT
Dbl E
FLOOR DRAIN
Bond Amt.
E
Pion No.
MECHANICAL FEES
SWIM POOL, COMM
ct r w U
WATER SOFTENER
_Sp. Insp. Fee E
Dental. Fee
Registr. Fee
VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD
SIGN
Const. Lender Branch 'I certify that in the performoPce of the work for which this permit is issued I shoR
not employ any person in any manner so as to become subject to the workmen's com.
pensoron lows of California."
Address City Zip Owner Signature
Builder Signature
WASHER (AUTO) (DISH)
Witness Fee E
Reinsp. Fee
APPLIANCE ❑ DRYER
Owner/Agent
GARBAGE DISPOSAL
Total Fees
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
Address
��[, -+�
City Zip
M.O. ❑ N.C. ❑ Cosh ❑ Check
Received by
Contractor
Tel.
License #
Trees required
Sewage System
T LL
Sewer District
Form 284.208 (Re, 4.771 Os
P
\
Address
City Zip
Workers' Comp.
yes ❑ no ❑
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF venfied by
WORK FOR 120 DAYS SHALL ALS&SE PWMIT T BECOME VOID.
I HEREBY AGREE THAT ALLY/5�P6RR`(F�J/�/b�1'NN TO WITH THIS PERMIT WILL BE DONE IN ACCORDANCE
WITH THE LAWS OF RIVERSIDE COUNTY A 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.