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341266 (SFD)
BUILDING PERMIT :Aft DEPARTMENT OF BUILDING & SAFETY Aft FIELD OFFICE PERM IT NO. 3P41 2661 3412PERMIT NO. 66 1W COUNTY OF RIVERSIDE DST ,/ CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SQ. 2ND FL. POR. GAR. SQ. CAR P. SQ. WALL SQ. SQ. ESTIMATED CONSTRUCTION FT. Q $ UNITS SQ. FT. Cr) YARD SPKLR SYSTEM SQ. FT. (ai MOBILEHOME SVC. BAR SINK FT. 8 POWER OUTLET ROOF DRAINS FT. @ DRAINAGE PIPING FT. Q DRINKING FOUNTAIN FT. @ URINAL VALUATION $ WATER PIPING NOTE: Not to be used as property tax valuation SWIM POOL, PVT FLOOR DRAIN Micro Film Fee Cop E MECHANICAL FEES SWIM POOL, COMM WATER SOFTENER Parcel No. _ VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD SIGN WASHER (AUTO) (DISH) Ck.b Y APPLIANCE ❑ DRYER GARBAGE DISPOSAL ,PI. Ck. Fee E FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED LAUNDRY TRAY Lot Size AIR HANDLING UNIT CFM IDLE METER KITCHEN SINK Legal Description 7 / h ) �} �0! V ��L �G✓�/TL1'� ABSORPTION SYSTEM � B.T.U. TEMP USE PERMIT SVC WATER CLOSET S COMPRESSOR 0 HP POLE, TEMP/PERM LAVATORY HEATING SYSTEM ❑ FORCED ❑ GRAVITY AMPERES SERV ENT SHOWER Type BOILER � B.T.U. SQ. FT. Ga ¢ BATH TUB SQ. FT. a WATER HEATER Bond Amt. E SQ. FT. RESID Ca 1'AIt SEWAGE DISPOSAL Plan Checker SQ. FT. GAR 6 '/.¢ HOUSE SEWER GAS PIPING Const Lender Branch I certify that In the Performance Of the work for which this permit is issued I shall cot employ any person ,n any manner so as to become subject to the workmen's com. pensanon laws of California. Address City Zip Owner Signature I Budder Signature PERMIT FEE PERMIT FEE PERMIT FEE Witness Fee E �L. ,[�AL/FEFS Owner/Agent MOB. HM. FEE MICRO FEE MECH. FEE PL. CK: FEE. CONST. FEE ELECT. FEE SMI FEE FEE PLUMB. FEE PERM IT NO. 3P41 2661 Supp. Permit Job Address Space _ Zip Z -- Owner Community Valuation E Dote al.>s-151 4a Dist. Off. F.C. . MH Permit Fee E Micro Film Fee Cop E i Use of Permit / / �i � Parcel No. _ Use No. Ck.b Y Meeh. Fee E ,PI. Ck. Fee E Se Boms Lot Size Construction Fee DtL.$ . Electrical FeeDbL -S` :SMI Fee E Legal Description 7 / h ) �} �0! V ��L �G✓�/TL1'� F S 5 �- Type Unit Plumbing Fee / D,„ E Sp. Sp. Insp. Fee E J Bond Amt. E Plana No. Plan Checker Finnaall.DDote 9 Inspector Demol. Fee E Const Lender Branch I certify that In the Performance Of the work for which this permit is issued I shall cot employ any person ,n any manner so as to become subject to the workmen's com. pensanon laws of California. Address City Zip Owner Signature I Budder Signature Registr. Fee E Mileage Fee E Witness Fee E Reinsp. Fee E Owner/Agent Tel. Zip Total Fees E_Address City Zip M.O. ❑ N.C. ❑ Cash ❑ Check, Received by Contractor Tel. License P Trees required 400, Is— Sewage System LL "Px Address City Zip 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 ALSO CAUSE PERMIT TO BECOME VOID, I HEREBY AGREE THAT A�JO��b '` E TION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE WITH THE LAWS OF RIVEQSID�i�J E 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 V Form 284-2081Rev. 4.77) ©s