280528 (SFD) BFIELD OFFICEUILDING PERMIT DEPARTMENT OF BUILDING&SAFETY
COUNTY OF RIVERSIDE IIIIIIIIIIIIIIIIIIIIII
22
f - - I E LF
��jjCONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES
I ST FL. sS 3,-:2SQ.FT. @/!.yVIP, 5 7'31m UNITS
2ND FL. SQ.FT. @ j YARD SPKLR SYSTEM
POR. SQ.FT. @ 3�- _ 1 , p""` MOBILEHOMESVC. BAR SINK
GAR. SQ.FT. @,57, Uc POWER OUTLET ROOF DRAINS
CARP. SOFT. @ DRAINAGE PIPING
WALL 42Du�( SQ.FT. DRINKING FOUNTAIN
SQ FT @ URINAL
ESTIMATED CONSTRUCTION VALUATION $ WATER PIPING
NOTE:Not to be used os property tax valuation SWIM POOL,PVT FLOOR DRAIN
MECHANICAL FEES SWIM POOL.COMM WATER SOFTENER
VENT SYSTEM Q4 FAN ❑ EVAP. COOL TKHOOD SIGN WASHER(AUT04DISHI
APPLIANCE DjevtR ... GARBAGE DISPOSAL
FURNACE ❑UNIT ❑WALL ❑FLOOR ❑SUSPENDED LAUNDRY TRAY
AIR HANDLING UNIT CFM IDLE METER KITCHEN SINK
ABSORPTION SYSTEM B.T.U. TEMP USE PERM SVC 3 WATER CLOSET
COMPRESSOR 0A.) � HP POLE,TEMP/PERM LAVATORY
HEATING SYSTEM FORCED ❑ GRAVITY ;00 AMPERES SERV ENT 7 SHOWER
BOILER�B.T.U. SQ FT @ ¢ BATH TUB
SQ FT @ a WATER HEATER �'( '
SQ FT RESID @ XDBLSMI
E DISPOSAL
39 SQ FT GARAGE @ a OSEWER
PERMIT FEE INGMOBILE HOME PERMIT FEE $ PERMIT FEE FEETOTAL FEES OB.HM.FEE MICRO FEE MECH.FEE DBL. nP11.LR.FEE CONST.FEE DBL. ELECT.FE FEE PLUMB.FEE DBL.
2�� 2 3/x,3 o'�7,.sv s a.: ,f ro #3o
JOB ADDRESS - SP NO OWNER
J F M A M J J A 5 O N D
74 -70 t3 �/ 4i t 50lyltJ7e4t $$e
[[11/
76 75 �SEOFP�RMIT�hf /��� �`-� JDATE� I /R/ PE,)IV00528
M H PERMIT FEE $ COMMUNIT L4
DST UNITS ROOMS 14ZTION ISUPP.TOPERMIT QFFICE
MICROFILM FEE COPIES $ LEGAL DESCRIPTION
MECHANICAL FEE DBL $ o SETBACK LOTS12Ey/- / F,IyO. GRP TYPE Iksy
S R/U ✓�•Sf f/p b D f�3..i . i
PLAN CHECK FEE $ Oo BOND AMT, PLAN No. PLAN CHECKER 4 FINAL DATE IPECTOT
CONSTRUCTION FEE DBL. $ /7
^D NAME OF CONST.LENDER BRANCH OFFICE NO LENDER INVOLVED
ELECTRICAL FEE DBL $ / ADDRESS CITY STATE
�3
STRONG MOTION $ OWNSRYQCENRSIONAT R J CONTRACTOR
INSTRUMENTATION FEE 3 �,...� ' 71;1I�,�lhn1ke 4 f �
$ ADDRESS t� J ADDRESS
FEE
PLUMBING FEE DBL cITY ZIP CODE CITY ZIP CODE
J F
I/ TEL.NO. TEL.NO. LICENSE
TOTAL FEES $ 3/ 16 y03,5
CASH ❑ CHECK M.O. ❑ N.C. ❑Q9 JAPIN
,? V
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS.CESSA-
RECEIVED BY r TREES REQUIRE OF WORK FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
I HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN AC-
CORDANCE WITH THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, I ALSO
LL P6X� AGREE TO CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLIANCE WITH THE
FT/4%0 E
LAWS OF THE STATE OF CALIFORNIA COVERING CONTRACTORS IS ALSO GUARANTEED.
I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS
FORM 284-208 (Rev. 10-74)@L HAS DONE SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE
OF THE STATE OF CALIFORNIA.