301831 (SFD)• ��
DE PARTMENT.OFFIELD OFFICE -BUILDING & SAFETY �' '
BUILDING PERMIT,
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•PERMITNO."
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DST
' - CONSTRUCTION ESTIMATE
VALUATIO
NO. ELECTRICAL FEES
DST
NO. PLUMBING FEES
1 ST FL-, -
2ND FL. R' "'
POR.fi
GAR.
CAR P. '
WALL
'
ESTIMATED CONSTRUCTION
SQ. FL @ $
�.-
E UNITS
USE OF PERMIT,
y ,
/FF..pC.
SUPP. TO PERMIT
SQ. FL @ ., , • YARD SPKLR SYSTEM,
M.IT NO.
SO., FT. @ MOBILEHOME SVC. BAR SINK
sq -FT. @ POWER`OUTLET,.'. ROOF DRAINS
COPIES
SQ. FT. .@ DRAINAGE PIPING
SQ. FT. @ ' DRINKING FOUNTAIN
LEGAL DESCRIPTION f
SQ. FT. @ URINAL
VALUATION - $ �y , • 11�2ji WATER PIPING
NOTE:.Not to be used as property tax valuation.
SWIM POOL, PVT
DBL
FLOOR DRAIN
USE NO.
MECHANICAL FEES
SET BACK
SWIM POOL-, COMM'
GRP
WATER SOFTENER
CK BY
VENT SYSTEM FANS ❑ EVAP. COOL . Cy HOOD
®,Q
SIGN -
,
WASHER(AUTO) SH'
a�
•
APPLIANCE DRY
„' - p®
GARBAGE DISPOS L
Q
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ,❑ SUSPENDED ,
LAUNDRY TRAY
AIR HANDLING UNIT_ CFM,.
IDLE METER
KITCHEN SINK i
,, `
ABSORPTION SYSTEM 0 B.T.U.
'
TEMP USE PERM SVC
i
WATER CLOSET
COMPRESSOR .+ HP
Sa.
POLE," TEMP/PERM
FINAL DATE �j INSyECTOR
LAVATORY
F(EATING SYSTEM FORCED. ❑ GRAVITY
BOILER B.T.U.
PAMPERES SERV ENT
2 .firAy �SQ. FT. @. ¢
SHOWER .
BATH TUB
a
CONSTRUCTION FEE
DBL$
SQ. FT: `@ ' aWATER
HEATER
RANCH OFFICE
NO' NDER INVOLVED
+ 'E
SQ.FT.RESID @ 11/4¢
SEWAGE DISPOSAL
_T
`ELECTRICAL FEE
•
DBL ''
_ -
SQ.FT.GAR @ 3/4¢
4:E 7
HOUSE SEWER
' •
STATE < '
GAS PIPING
STRONG MOTION -,
FEET
PERMIT FEE'PERMIT
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v
PERMIT FEE
R•ACTOR 1 ✓ ` � J I
FEE
(3
-DBL. "
TOTAL FEES
IMOB.HM.FEEI
,�. 'yMICRO' FEE
MO. FEE
PL. CK. FEE
CONST. FEE
ELECT. FEE
x2
SMI FEE'
• FEE
PLUMB. FEE
_
J. -F M A M. J J •A S. O N' .D
JOB ADDRESS
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COMMUNITY •" -
VALUATIO
DATE
DST
OFFIce
,M H PERMIT FEE
$
USE OF PERMIT,
y ,
/FF..pC.
SUPP. TO PERMIT
PE
M.IT NO.
,,MICROFILM FEE'
COPIES
$'-
BOOK PAGEVPFRCEL
LEGAL DESCRIPTION f
(MECHANICAL FEE
DBL
$ ;
USE NO.
ZONE
SET BACK
LOT SIZE
GRP
TYPE
CK BY
'PLAN CHECK FEE$
BOND AMT.
PLAN NO.
PLAN CHECKER
FINAL DATE �j INSyECTOR
CONSTRUCTION FEE
DBL$
NAME OF CONST. LENDER
RANCH OFFICE
NO' NDER INVOLVED
`ELECTRICAL FEE
•
DBL ''
_ -
$
4:E 7
ADDRESS CITY
' •
STATE < '
STRONG MOTION -,
FEET
$
v
OWNER/AGENTS SIGNATURE CON
R•ACTOR 1 ✓ ` � J I
;INSTRUMENTATION
'!SPECIAL INSP
:DEMOLITION .
FEE
$"
ADDRESS „ • - ADDRESSSp.���LLL
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'REGISTRATION
*
s
/'
PLUMBING FEE
DBL
$
CITY ZIP CODE CITY
- ,,�i ZIP CODE
t�
+,
A)
,TOTAL FEES '. $
TEL. NO.• AREA
CODE TEL
NO. • AREA CODE
LICENSE P
� Q
CASH❑CHECK .O.❑N.C.❑ .
_G6
'>`RECEIVED BY ; TREES REQUIRED
r.
p T SHALL'BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF
R 20 DAYS SHALL ALSO CAUSE: PERMIT TO BECOME VOID.'
Y AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCET
VEB.,
jiSEWAGE SYSTEM.
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P
HLAWS OF RIVERSIDE 'COUNTY AND THE STATE OF CALIFORNIA, I ALSO AGREE TO CARRY
� � v4 • � •\.-C Y IIIC LM YYJ Vr IIIC JIMIC Vf ,
' 1 CALIFORNIA COVERING CONTRACTORS IS ALSO GUARANTEED. .-
1 I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE
FORM 284-208 (REV; 6-761 +, �? - SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE
* �` y3 OF CALIFORNIA. . I '