303501 (SFD)i
DEPARTMENT OF BUILDING & SAFETY ri�w vrri�,�
BUILDING PERMIT
J F M A M J J A S O N D
PERMIT NO.
COUNTY OF RIVERSIDE5011
asiiT
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CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES
1 ST FL. 12 2A
2ND FL.
POR.
GAR.
CAR P. SQ.
WALL SQ.
ESTIMATED CONSTRUCTION
SQ. FT. @ $ UNITS
SQ. FT. @ YARD SPKLR SYSTEM
SQ. FT. @ AJO MOBILEHOME SVC. BAR SINK
SQ. FT. @ POWER OUTLET ROOF DRAINS
FT. @ DRAINAGE PIPING
FT. @ DRINKING FOUNTAIN
SQ. FT. @ URINAL
VALUATION $ �4 WATER PIPING
NOTE: Not to be used as property tax valuation SWIM POOL, PVT FLOOR DRAIN
USE OF PERMIT
MECHANICAL FEES SWIM POOL, COMM WATER SOFTENER
SUPP. TO PERM119
VENT SYSTEM WFAN ❑ EVAP. COOL [HOOD SIGN WASHER (AUTO) (Dllib�
MIT
APPLIANCE ENRYER GARBAGE DISPOSAL
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED Of LAUNDRY TRAY
AIR HANDLING UNIT CFM IDLE METER KITCHEN SINK
COPIES
ABSORPTION SYSTEM B.T.U. TEMP USE PERM SVC WATER CLOSET
COMPRESSOR HP4 POLE, TEMP/PERM AVATORY Aj
GAL DESCRIPTION .y
3! %v#R /r
HEATING SYSTEM [/FORCED ❑GRAVITYAMPERES SERV ENT SHOWER
DBL
BOILER B.T.U. SQ.FT. @ a XBATH TUB
4
SQ.FT. @ a WATER HEATER
SET BACK
Q.FT.RESID @ 11/aa SEWAGE DISPOSAL
TYPE
SQ.FT.GAR @ 3/44 HOUSE SEWER
GAS PIPING
S
PERMIT FEE PERMIT FEE-1.1AIA .4PERMIT FEE
qyj
PLAN CHECK FEE
OBL. I
TOTAL FEES
�..
MOB.HM.FEE
MICRO FEE MECH, FEE PL. CK. FEE
—�
CONST. FEE ELECT. FEE SMI FEE
, � �2 :2L
FEE PLUMB. FEE
o0
J F M A M J J A S O N D
JOB ADDRESS SP NO
,/ I
- 7q •-
OWNER
76"_t
77
COMMUNITY
��l1
VALUATION
""
DATE ST
7 (J 7
OFFICE
78
MH PERMIT FEE
$
USE OF PERMIT
F.C.
��
SUPP. TO PERM119
PE
MIT
NO.
MICROFILM FEE
COPIES
$
PA E PARCEL'
d
GAL DESCRIPTION .y
3! %v#R /r
MECHANICAL FEE
DBL
$
4
USE NO. ZONE /l
! I
SET BACK
LOT SIZE
TYPE
CK BY
S
S
R
PLAN CHECK FEE
$
BOND AMT.
PLAN NO.
Yqj
PLAN CHECKER
-
FINAL DATE INSPE OR
�n-,5 7d
CONSTRUCTION FEE
DBL
$
NAME OF CONST. LENDER BRANCH
OFFICE
NO LENOE INVOLVED
ELECTRICAL FEE
DBL
$
ADDRESS CITY
STATE
STRONG MOTION
INSTRUMENTATION FEE
$
OWNER/AGENTS SIGNATURE rADDf?-ES7S
ONT TOR a I4` 'C
F i
SPECIAL INSP
DEMOLITION
REGISTRATION
FEE
$
ADDRESS
a•'
464
�]
PLUMBING FEE
DBL
$
CITY ZIP CODE CITY
ZIP CODE
TOTAL FEES $
CASH ❑CHECK .O.❑N.C. !.+ 3
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TEL. NO. AREA CODE TEL NO. AREA CO E LICENSE P
T IT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF
0 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
GREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE
THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, I ALSO AGREE TO CARRY
RECEIVED BY ;' TREES REQUIRED
SEWAGE SYSTEM l
T+� LL P �ly/
L.VMrtNZIAIIVN INDUKANL•t UPVN MY tMPLVYttS. C.UMPLIANCt WIIH IHL LAWS OF 1Ht SIAItUI-
CALIFORNIA COVERING CONTRACTORS IS ALSO GUARANTEED.
I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE
FORM 284-208 IREV. 6.761 SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE
OF CALIFORNIA.