AR (296659)53595 Avenida Madero
296659
pp -
FIELD OFFICE'
DEPARTMENT OF BUILDING & SAFETY -
BUILDING PERMIT '
yJOB
J F M A M J J A S O N D
PERMIT NO-
296,62.1
- :.V V IV 1 T yr KI V CK31LJC ''
DST
CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES
1ST FL.
2ND FL.
POR.
GAR. -
• CAR P.
WALL
CST MATED CONSTRUCTION
SQ. FT. @ $ UNITS
SQ.`"FT. @" YARD SPKLR SYSTEM
SO. - 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
MECHANICAL FEES SWIM POOL, COMM WATER SOFTENER
VENT SYSTEM ❑ FAN' ❑ EVAP. COOL, ❑ HOOD SIGN WASHER (AUTO)(DISH)
APPLIANCE ❑ DRYER GARBAGE DISPOSAL
M H PERMIT FEE
'FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED, LAUNDRY TRAY -
$
AIR HANDLING UNIT CFM IDLE METER KITCHEN SINK
USE o ER IT _
' G65
ABSORPTION SYSTEM 0 B.T.U. TEMP USE PERM SVC' WATER CLOSET
SLIT. TO PERMIT
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 • PA L
SQ.FT. @ a WATER HEATER:
SQ.FT.RESID @'` IYAa SEWAGE DISPOSAL
SQ.FT.GAR @ 3/4a HOUSE SEWER
VA
/ j
GAS PIPING
DBL
PERMIT FEE
PERMIT, FEE' PERMIT FEE
USE NO.
DBL.
TOTAL FEES
MOB.HM.FEE
MICRO FEE MEC H. FEE - PL. CK. FEECONST.
FEE ELECT. FEE SMIFEE
FEE PLUMB. FEE
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J F M A M J J A S O N D
ADDRESS SP'NO
OWNER -
tovf.41 f.
76
7.
r.L✓
-77
.COMMUNITY -
VALUATION
TE
DST
OFFICE -
78
y
M H PERMIT FEE
$
USE o ER IT _
' G65
F.C.
SLIT. TO PERMIT
PESO
MICROFILM FEE
COPIES-
$
BOOK PAGE • PA L
LEGESCRIPTION
VA
/ j
MECHANICAL FEE.
DBL
$ '
USE NO.
101E
SET BACK
LOT SIZE
GRPTYPE
CK BY
PLAN CHECK FEE
BOND AMT.
PLAN NO.
PLAN CHECKER
'FINAL DATE I SPECTOR
11 • c L,
CONSTRUCTION FEE
DBL,
$
NAME OF CONST. LENDER I BRANCH
OFFICE
NO LENDER INVOLVED
,y
ELECTRICAL FEE
DBL
$
ADDRESS. CITY
STATE
STRONG MOTION
$ .,
''"
R/
OWNER/AGE S IG NATUR ,` CONTRACTOR
INSTRUMENTATION FEE
SPECIAL INSP
_ -. '
$
ADDRESS ''• ADDRESS
_ -
DEMOLITION
FEE
REGISTRATION
Pe`
PLUMBING FEE
DBL
$
CITY ZIP CODE CITY
ZIP CODE
' TOTAL .FEES $
77
. ." TEL. N - AREA
CODE TEL.
NO.
CODE
- LICENSE A
CASH❑CHECK .O.❑ ❑
... {
JAREA
RECEIVED BY TREES RECJUIR
00THIS'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
1 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
-M rtM C Ur VIN MT CMrLVTCCJ. L-VMYLIANI-t' VVI IN INt LAWJ VF IHt JIAIt Vh
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) . - SO IN ACCORDANCE WITH, SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE -OF THE STATE.
OF CALIFORNIA.