296797 (BLCK)BUILDING PERMIT DEPARTMENT OF BUILDING & SAFETYFIELD OFFICE.
-
PERMIT NO.
�
\.VUIV I T Vi KI V CKWUC 'flowI
DST
CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES
1ST FL.
2ND FL.
POR.
GAR.
CAR P.
WALL
ESTIMATED CONSTRUCTION
SQ. FT. @ $ UNITS
SQ. FT. @ YARD SPKLR SYSTEM
SQ. FT. @ MOBILEHOME SVC. BAR SINK
SQ. FT. @ POWER OUTLET ROOF DRAINS
SQ. FT. @ DRAINAGE PIPING
SQ. FT. @ DRINKING FOUNTAIN
SQ. FT. @ URINAL
VALUATION $ WATER PIPING
NOTE: Not to be used as property tax valuation SWIM POOL, PVT FLOOR DRAIN
USE O PER IT F.C.
MECHANICAL FEES SWIM POOL, COMM WATER SOFTENER
PEZgNO
VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD SIGN WASHER (AUTO) (DISH)
APPLIANCE ❑ DRYER 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 WATER CLOSET
COMPRESSOR HP POLE, TEMP/PERM LAVATORY
MICROFILM FEE
HEATING SYSTEM ❑ FORCED ❑ GRAVITY AMPERES SERV ENT SHOWER
$
BOILER B.T.U. SQ.FT. @ a BATH TUB
BOOK PAGE P/AI LEGAAL/L��DESCRIPTION
SQ. FT. @ ¢ WATER HEATER
SQ.FT.RESID @ 1l/44 SEWAGE DISPOSAL
SQ.FT.GAR @ 3/4¢ HOUSE SEWER
MECHANICAL
MECHANICAL FEE
DBL
GAS PIPING
PERMIT FEE
PERMIT FEE PERMIT FEE
SET BACK
DBL.
I TQ+TyyAL7FEES
MOB.M M.FEE
J
MICRO FEE MECH. FEE PL, CK, FEE
CONST. FEE ELECT. FEE SMI FEE
FEE PLUMB. FEE
J F M A M J J A S O N D
JOB ADDRESS SP NO
OWNERI
,77
COMMUNITY
VALUAMIION ,i
DATTEE
77
DST
OFFICE
M H PERMIT FEE
$
USE O PER IT F.C.
SUPP. TO PERMIT
PEZgNO
a •IQ Olaf / S X
MICROFILM FEE
COPIES
$
BOOK PAGE P/AI LEGAAL/L��DESCRIPTION
�RCCEL
ft /[� J/�� 54
YNI
MECHANICAL
MECHANICAL FEE
DBL
$
USE NO.
ZONE
SET BACK
LOT SIZE
GRP
TYPE jcK BY
I
s
s {ate
PLAN CHECK FEE
$
BOND AMT.
PLAN NO.
PLAN CHECKER
-
FINA`o,4
JINSPECOR
� P
;CONSTRUCTION FEE
DBL
$
NAME OF CONST. LENDER
BRANCH OFFICE
NO LENDERI VOLVED
�r-
G't3
d
ELECTRICAL FEE
DBL
$
ADDRESS
CITY
STATE
,STRONG MOTION
$
OWN R/AGENTS SIGNATURE
CONTRACTOR
INSTRUMENTATION FEE
(rf
.'SPECIALINSP
$
AD RESS
AODRF,f
DEMOLITON
'REGISTRATION
FEE
a %
PLUMBING FEE
DBL
$
CITY ZIP CODE
CITY ZIP CODE
LI
TOTAL FEES $
TEL. NO. AREA
CODE
TEL. O. \ AREA CODE
(CENSE tt
CASH❑CHECK .O.❑N.C.❑jj
�s
,RECEIVED BY TREES REQUIREDAITHIS
PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF
ORK FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
!SEWAGE SYSTEM
I
I HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE
T LL
P
WITH THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, I ALSO AGREE TO CARRY
COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLIANCE WITH THE LAWS OF THE STATE OF
CALIFORNIA COVERING CONTRACTORS IS ALSO GUARANTEED.
I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE
FORM 284-208 (REV. 6-76) 50 IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE
OF CALIFORNIA.
FIELD OFFICE-'
BUILDING PERMIT DEPARTMENT OF BUILDING & SAFETY `
AML COUNTY OF RIVERSIDE
CONSTRUCTION ESTIMATE
. 1ST FL. 14is SQ.FT. @
2ND FL. SO. FT. @
POR. V-00 SO. FT. @
GAR. Q' SO. FT. @ S
CAR P. SOFT. @
WALLSQ. FT. @
__dSQ. FT. @
ESTIMATED CONSTRUCTION VALUATION $
NOTE: Not to be used as property tox voluation
MECHANICAL FEES
VENT SYSTEM16 FAN ❑ EVAP. COOL I
NO. I ELECTRICAL FEES
UNITS
4)4 MOBILEHOME SVC.
174049 Z POWER OUTLET
SWIM POOL, PVT -
SWIM POOL, -COMM
SIGN
NO. PLUMBING FEES t
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL •
WATER PIPING
FLOOR DRAIN
WATER SOFTENER
WASHFR (Ai ITn11flt1MT
APPLIANCE
JOB ADDRESS - 1 SP NO
A
OWNER
74
-rl?-,2oo r eAlTeZV im
GARBAGE DISPOSAL
Q�
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
PEBM8
2 I _t•!00 1 8 0
76
I? ,
LAUNDRY TRAY
'
AIR HANDLING UNIT
CFM
IDLE METER
COMMUNI
KITCHEN SINK
pp
ABSORPTION SYSTEM
B.T.U.
SUPP. TO PERMIT
TEMP USE PERM SVC
a
WATER CLOSET
04
COMPRESSOR S
HP
POLE, TEMP/PERM
LAVATORY
� Q
HEATING SYSTEM FORCED ❑ GRAVITY
MICROFILM FEE
SQ AMPERES SERV ENT
Q
16
SHOWER
04.
BOILER � B.T.U.
$
SO FT @ ¢
LOT SIZE
/ '
BATH TUB
0
CK BY
SO FT @ ¢
WATER HEATER.1
(fid
a� /�
R.;L 40
SQ FT RESID @/
O
$
�
SEWAGE DISPOSAL
,Q t7o
PLAN NO.
PLAN CHECKER
FINAL DATE
L-1- a, ► -
, OSO FT GARAGE @
CONSTRUCTION FEE
DBL
HOUSE SEWER
PERMIT FEE
NO LENDER INVOLVED
f
/+
00
GAS PIPING
MOBILE HOME PERMIT FEE
$
$
PERMIT FEE
Q
/
PERMIT FEE
d
2 8E ROT
8
�AL FEE
M08. HM.FEE
MItBO FEE
/C27 E
DBL.
�QC �FE�'
CONST. FEE
DBL.
EL �T.fEE
DBL.
SMIFEE
FEE
PLUMB.
DBL.
F M A M J J A $ O N D
JOB ADDRESS - 1 SP NO
A
OWNER
74
-rl?-,2oo r eAlTeZV im
75
USE O RMIT
JDATE
PEBM8
2 I _t•!00 1 8 0
76
I? ,
'
M H PERMIT FEE
$
COMMUNI
DST
UNITS
ROOMS
VALUATION
SUPP. TO PERMIT
OFFICE
Al 'A
91
MICROFILM FEE
COPIES
.3
$
16
LEGAL DESCRIPTION
PIV- !7 7y- 03/-po 2- 'A/oT-, - ?3j -%? Nps; &Ao2M �IA �
MECHANICAL FEE
DBL
$
SETBACK
LOT SIZE
ZONE
USE NO. GRP
TYPE
CK BY
1
Y 4 ^ /
�j
h 5A #3'f
a� /�
R.;L 40
PLAN CHECK FEE
Apo
$
�
.sv
BOND AMT.
Ing
PLAN NO.
PLAN CHECKER
FINAL DATE
L-1- a, ► -
IN CTOR
��
CONSTRUCTION FEE
DBL
$
NAME OF CON51. LENDER BRANCH OFFICE
NO LENDER INVOLVED
/+
00
ELECTRICAL FEE
DBL
$
ADDRESS CITY
STATE
STRONG MOTION
$
OWNER/AGENT'S SIGNATURE
CONTRACTOR
INSTRUMENTATION FEE
%
T/4,rr
FEE
$
ADDRESSr
7 A �p7'f ��r/E �/QOfZ
ADDRESS
c
PLUMBING FEE
DBL
$
{
CITY ZIP CODE
CITY ZIP CODE
TOTAL,FEE$
$
n /
TEL. NO. TEL.
�t�! ,,,Q��/�
NO. LICENSE
CASH fCl M.O. ❑ , N.C• ❑
{
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSA
EON OF WORK FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
RECEIVED BY
TREES TREES REQUIRED
I HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN AC
WITH THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, I ALSC
SEWAGE SYSTEMCORDANCE
TI&A
LL
p
AGREE TO CARRY, COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLIANCE WITH THE
I I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPAREDTHEPLANS 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.