303541 (SFD)BUILDING PERMIT . DEPARTMENT OF BUILDING & SAFETY FIELD OFFICE-
J F M A M J J A S O N D
PERMIT NO.
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VALUATION DATE
DST
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
J'
$ fP
NO. PLUMBING FEES
1 ST FL.
2ND FL.
POR.,
GAR.
CAR P.
WALL
ESTIMATED CONSTRUCTION
SQ. FT. @
w
UNITS
M H PERMIT FEE
SQ. FT. @ YARD SPKLR SYSTEM
$
SQ. FT. @ MOBILEHOME SVC. BAR SINK
USE OF.4PEjRjIM
SQ. FT. @ POWER OUTLET ROOF DRAINS
SQ. FT. @ DRAINAGE PIPING
SQ. FT. @ DRINKING FOUNTAIN
SQ. FT. @ URINAL
VALUATION $ _ WATER PIPING
414�
NOTE: Not to be used os property tax valuation
SWIM POOL, PVT
0354
FLOOR DRAIN
MECHANICAL FEES
COPIES
ISWIM POOL, COMM
WATER SOFTENER
LEGAL DESC RIP ION
VENT SYSTEM AN ❑ EVAP. COOL OOD
BO
SIGNWASHER
(AUTO _ H)
MECHANICAL FEE
DBL
APPLIANCE RYER
`.
USE NO.
ZONE
GARBAGE DISP SAL
t
TYPE
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
IDLE METER
KITCHEN SINK
d
ABSORPTION SYSTEM B.T.U.
TEMP USE PERM SVC
WATER CLOSET
1?G7
I
COMPRESSOR HP
A,
POLE, TEMP/PERM
LAVATORY
PLAN CHECK FEE
HEATING SYSTEMORCED ❑ GRAVITY
, e�
MPERES SERV ENT
Q
SHOWER
CJti
FINAL DATE IN�5PF1Tfy'TOR
BOILER B.T.U.
SQ.FT. @ a
BATH TUB
�'
CONSTRUCTION FEE
SQ.FT. @, a
WATER HEATER
OF CONST. LENDER BRANCH
OFFICE
NO DER INVOLVED
ELECTRICAL FEE
Q.FT.RESID @ 11/4a
�f
SEWAGE DISPOSAL,
GiCi
STATE
SQ.FT.GAR @/4¢
HOUSE SEWER
STRONG MOTION
$
GAS PIPING
�Q
PERMIT FEE
C!ri
PERMIT FEE?
PERMIT FEE
c91;7
'SPECIAL
DBL.
TOOT�AL FEES MOB.H M.FEE
MICRO FEE
MECH. FEE
L.CK. FEE
CONST. FEE
ELEn. FEE
SMI FEE
FEE PL
FEE
J F M A M J J A S O N D
JOB ADDRESS SP NO OWNER
I
p e
76
77
COMMUNITY
VALUATION DATE
D
OFFICE
>J
J'
$ fP
78
w
M H PERMIT FEE
$
USE OF.4PEjRjIM
F.C. SUP . TO PE MIT . PE$MIT
NO.
L[
/(
! Jdl
0354
MICROFILM FEE
COPIES
$
BOOK AGE PARCEL
LEGAL DESC RIP ION
MECHANICAL FEE
DBL
$
`.
USE NO.
ZONE
SET BACKLOT
SIZE GRP
TYPE
CK BY
`+"
I
5
5
R
PLAN CHECK FEE
$ .
BOND AMT.
PLAN NO.
LAN CHECKER
FINAL DATE IN�5PF1Tfy'TOR
�'
CONSTRUCTION FEE
DBLNAME
OF CONST. LENDER BRANCH
OFFICE
NO DER INVOLVED
ELECTRICAL FEE
DBL
$
ADDRESS CITY
STATE
STRONG MOTION
$
<74c
WN�Eb_ SIGNATURE f CONTRACTOR
INSTRUMENTATION FEE
I
r'
'SPECIAL
$
Ap E ADDRESS
INSP
DEMOLITON
FEE
�f
�f
2'
REGISTRATION
'f I.,tll
PLUMBING FEE
DBL
$
CITY e . ZIP CO E CITY
ZIP CODE
TOTAL FEES lb. $
TEL. NO. AREA
CODE TEL.
NO,
AREA CODE
LICENSE c
CASH❑CHECK O.❑N.C.❑
RECEIVED BY TREES REQUIRED
H SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF
120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID
SEWAGE SYSTEM
/` lel
EBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE
T
L
P (r') 7l (f
H 7HE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, I ALSO AGREE TO CARRY
yr viv 11 uv1rwl CCJ. I1V 14.1 I1 C WIIt1 Ih[LAW. VY Itir.I A It Vr
CALIFORNIA COVERING CONTRACTORS IS ALSO GUARANTEED.
I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE
FORM 284-208 (REV. 6-78) _ SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE
OF CALIFORNIA.