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341268 (SFD)
BUILDING PERMIT Aft DEPARTMENT OF BUILDING & SAFETY Aft FIELD OFFICE PERMIT NO. 3 412 6819 PERMIT NO. 341268 mrCOUNTY OF RIVERSIDE Owner Community '9 �,� /�.7yq Valuation $ DST CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES F.C. NO. PLUMBING FEES 1ST FL. SQ. 2ND FL. SQ. POR. SQ. GAR. SQ. CAR P. SQ. WALL SQ. SQ. ESTIMATED CONSTRUCTION FT.. (al $ UNITS Parcel No. 4 7V Use No. ICZ.byIMicro YARD SPKLR SYSTEM FT. Ca3 PI. Ck. Fee2 $ FT. @— MOBILEHOME SVC. BAR SINK Lot Size "S FT. @ POWER OUTLET ROOF DRAINS Legal Description t ' /, l FT. Cal DRAINAGE PIPING S DRINKING FOUNTAIN FT. C3 R FT. ® URINAL Type VALUATION $ WATER PIPING NOTE: Not to be used as property tax voluotion SWIM POOL, PVT Bond Amt. $ FLOOR DRAIN Plan Checker Final Date 7f MECHANICAL FEES SWIM POOL, COMM 5p. Insp. Fee $ WATER SOFTENER shall Const. Lender Branch "I certify that in the performance of the work for which this permit is issuedT70-11 not employ any person in any manner so as to become subject to the workmen's com. pensotmn jaws of California. Address City Zip Owner Signature / Budder Signature Registr. Fee E VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD SIGN Reinsp. Fee $ WASHER (AUTO)((DISH) Tel. Zip APPLIANCE ❑ DRYER Address , 4G L L City Zip Are rr GARBAGE DISPOSAL eceived by X le Contractor FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED License H tees required .41 LAUNDRY TRAY Address City Zip AIR HANDLING UNIT CFM IDLE METER "ewer District t \� Form 284.208 (Rev. 4.77) ©S KITCHEN SINK ABSORPTION SYSTEM B.T.U. TEMP USE PERMIT SVC WATER CLOSET - COMPRESSOR HP POLE, TEMP/PERM LAVATORY HEATING SYSTEM ❑ FORCED ❑ GRAVITY AMPERES SERV ENT SHOWER BOILER � B.T.U. SQ. FT. Ga ¢ BATH TUB SQ. FT. (a, ¢ WATER HEATER SQ. FT. RESID Ga 1'/.¢ SEWAGE DISPOSAL SQ. FT. GAR 6 IA HOUSE SEWER GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE ,,, [__7ALEES MOB. NM. FEE MICRO FEE MECH. FEE PL. CK. FEE CONST. FEE ije ELECT. FEE SMI FEE FEE PLUMB. FEE PERMIT NO. 3 412 6819 Supp. Permit ' Job Address_ _ Space -- -,� Zip Owner Community '9 �,� /�.7yq Valuation $ Dote a Dist. // Off. F.C. !MH Permit Fee $ Film Fee Cop E Use of Permit f/�� Parcel No. 4 7V Use No. ICZ.byIMicro Mech. Fee P4D $ PI. Ck. Fee2 $ Se acks Lot Size "S Construction Fee /QJ2L. $ .Electrical Fee Legal Description t ' /, l F S S -- R Zone Grp Type Unit SMI Fee E Plumbing Fee/ D E Bond Amt. $ Plan No. '30 Plan Checker Final Date 7f Inspector 5p. Insp. Fee $ Demol. Fee $ shall Const. Lender Branch "I certify that in the performance of the work for which this permit is issuedT70-11 not employ any person in any manner so as to become subject to the workmen's com. pensotmn jaws of California. Address City Zip Owner Signature / Budder Signature Registr. Fee E Mileage Fee $ Witness Fee $ Reinsp. Fee $ Owner/Agent /;' f �f �f Tel. Zip Ifotol Fees $ Address , 4G L L City Zip Are rr M.O. ❑ N.C. ❑ Cash ❑ Check eceived by X le Contractor Tel. License H tees required .41 wage System / x /,t -/Yes T LL P Address City Zip Workers' Comp. ❑ no ❑ THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF verthed by WORK FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID. I HEREBY AGREE THAT ALL ON T N WITH THIS PERMIT WILL BE DONE IN ACCORDANCE WITH THE LAWSOF RIVGQSIDE C T��F CALIFORNIA. 1 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. "ewer District t \� Form 284.208 (Rev. 4.77) ©S