290214 (SFD)BUILDING PERMIT
PERMIT NO.
CONSTRUCTION ESTIMATE
1 ST Fl.
SQ. FT. @ $
2ND FL.
SQ. FT. @
FOR.
SQ. FT. _@
t•@
GAR.
SQ. FT.
CAR P.
SQ. FT. @
WALL
SQ. FT. @
cls
SQ. FT. @
ESTIMATED CONSTRUCTION
VALUATION $
NOTE: Not to be used Os Drooertv tax valuation
0 DEPARTMENT OF BUILDING & SAFETY
COUNTY OF'RIVERSIDE '
NO. I ELECTRICAL FEES
UNITS
MOBILEHOME SVC.
POWER OUTLET
SWIM Pnnl PVT
FIELD OFFICE
NO. PLUMBING FEES
ARD SPKLR SYSTEM
AR SINK
OOF DRAINS
RAINAGE PIPING
RINKING FOUNTAIN
WATER PIPING
PInnD nDAIAI
J F M AIM J J A S 1 O N D
MECHANICAL FEES
SWIM POOL, COMM
..7 av YC l—€� la.,W lam' i/4� j
WATER SOFTENER
COMMUNITY
VALUATION j DATE
VENT SYSTEM ❑ FAN ❑ EVAP. COOL. OOD
x
SIGN
M H PERMIT FEE
WASHER (AUTO SH)
cls
APPLIANCE ❑ DRYER
F.C. SP.'TO PERMIT PERMIT
NO.
GARBAGE DISPOSAL
pq
FURNACE (:)UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
el .1
LAUNDRY TRAY
pC�
AIR HANDLING UNIT CFM
COPIES
IDLE METER
KITCHEN SINK
s
ABSORPTION SYSTEM E::� B.T.U.
TEMP USE PERM SVC
MECHANICAL FEE
WATER CLOSET
do
COMPRESSOR HP Ck
J
POLE, TEMP/PERM
LOT/SlZ/
LAVATORY
tJa
HEATING SYSTEM ORCED ❑ GRAVITY
MPERES SERV ENT
00
SHOWER
cyta
BOILER B.T.U.
SQ.FT. @ a
BATH TUB
q
j,
SQ.FT. @ a
WATER HEATER
eJC3
AWT.RESID @ 11/4a
/
SEWAGE DISPOSAL
tme
$
Q•FT.GAR @ 3/4a
PLAN NO.
/9v/
HOUSE SEWER
FINAL DATE JINSPECTOR
GAS PIPING
sa
� )_LI-�I
PERMIT FEE
f?Gi
DBL
PERMIT FEE
G14i
PERMIT FEE
OFFICE
NO LENDER INVOLVED
DBL,
TOTAL FEES
MOB.HM.FEE
MICRO EE
MEC H. FEE
PL. CK. FEE
CONST. FEE
ELE T. FEE
SMI FEE
FEE
PL B. FEE
J F M AIM J J A S 1 O N D
JOB ADDRESS SP NO OWNE ,
I
p� r� /� or,'76
..7 av YC l—€� la.,W lam' i/4� j
77
COMMUNITY
VALUATION j DATE
ST
OFFFIE''
.78
M H PERMIT FEE
$
USE IF PER IT�y
F.C. SP.'TO PERMIT PERMIT
NO.
el .1
2 90214
MICROFILM FEE
COPIES
$
BOOK P E PARCEL LEGAL DESCCRRIPTI N
MECHANICAL FEE
D L
$
USE N6.
ZO/JNNE'��'fj
SET BACK
LOT/SlZ/
GRP
TYPE ICK BY
��,w►E
q
PLAN CHECK FEE
$
BOND AMT.
PLAN NO.
/9v/
PLAN CHECKER
FINAL DATE JINSPECTOR
sa
� )_LI-�I
CONSTRUCTION FEE
DBL
$
NAME OF CONST, LENDER BRANCH
OFFICE
NO LENDER INVOLVED
ELECTRICAL FEE
DBL
$
ADDRESS CITY
STATE
STRONG MOTION
INSTRUMENTATION FEE
$
+ry
r
OWNER! NTS SIG ,' UR{_ J j ( CONTRACTOR
* (iji
t
.SPECIAL INSP
•DEMOLITION.
FEE
$
ADDRESS ADDRESS
REGISTRATION
:PLUMBING FEE
DBL
$
CITY ZIP CODE CITY
ZIP CODE
04�
TOTAL FEES is
TEL. NO, AREA
CODE TEL.
NO.
AREA CODE
. LICENSE F
CASH❑(CHECK .❑N.C.❑
5zt I/—. i ��
OD
RECEIVED BY,r REES REQUIRED
KWIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF
120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE
THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, I ALSO AGREE TO CARRY
(1AADCwIC ATlllw
SEWAGE SYSTEM
T L
P I
CALIFORNIA COVERING CONTRACTORS�IS ALSO GUARANTEED�� ... .,I IIIA I .I�.,I
I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE
FORM 284-208 (REV. 6.76) SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE
OF CALIFORNIA.
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