AR (286657)FIELD OFFICE
• DEPARTMENT OF BUILDING & SAFETY
BUILDING PERMIT
J F M A M J J A S O N D
PERMIT NO.
866
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76
CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES
1 ST FL.
2ND FL.
FOR.
GAR.
CAR P. SQ.
WALL
ESTIMATED CONSTRUCTION
SQ. FT. @ $ UNITS
SQ. FT. @ YARD SPKLR SYSTEM
SQ. FT. @ MOBILEHOME SVC. BAR SINK
SQ. FT. @ POWER OUTLET ROOF DRAINS
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 PERMIT
"A
MECHANICAL FEES SWIM POOL, COMM WATER SOFTENER -
SUPP. TO PERMIT
VENT SYSTEM [j FAN ❑ EVAP. COOL ❑ HOOD SIGN WASHER (AUTO)(DISH)
APPLIANCE ❑ DRYER GARBAGE DISPOSAL
COPIES
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED LAUNDRY TRAY
AIR HANDLING UNIT CFM IDLE METER KITCHEN SINK
LEGAL DESCRIPTION
ABSORPTION SYSTEM O B.T.U. TEMP USE PERM SVC WATER CLOSET
COMPRESSOR HP POLE, TEMP/PERM LAVATORY
HEATING SYSTEM ❑ FORCED ❑ GRAVITY AMPERES SERV ENT SHOWER
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- -Ato All"
ST
BOILER B.T.U. SQ. FT. @ a BATH TUB
DBL
SQ.FT. @ a WATER HEATER
SQ.FT.RESID @ 11/44 SEWAGE DISPOSAL
ZONE
SQ.FT.GAR @ 3/4a HOUSE SEWER
LOT SIZE
GRP
GAS PIPING
CK BY
PERMIT FEE
PERMIT fEE PERMIT FEE
-9616.
TOT FEES
MOB.HM.FEE
MICRO FEE MECH. FEE PL. CK. FEE
CONST. FEE ELECT. FEE SMI FEE__T
FEE PLUMB. FEE
J F M A M J J A S O N D
JOB ADDRESS SP NO
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IS
76
77
COMMUNITY
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VALUA ION
DATE
ST
OFFICE
78
M H PERMIT FEE
$
USE O PERMIT
"A
F.C.
SUPP. TO PERMIT
PE MIT NO
86657
MICROFILM FEE
COPIES
$
BOOK PAGE PARCEL
LEGAL DESCRIPTION
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ST
MECHANICAL FEE
DBL
$
USE NO.
ZONE
SET BACK
LOT SIZE
GRP
TYPE
CK BY
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PLAN CHECK FEE
$
BOND AMT.
PLAN NO.
PLAN CHECKER
FINAL DATE IN
ECTOR
CONSTRUCTION FEE o
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$
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NAME OF CONST. LENDER
BRANCH OFFICE
NO LENDER INVOLVED
77
ELECTRICAL FEE
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$
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ADDRESS
CITY
STATE
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STRONG MOTION
$
OWNER/AG ' IGNATURE
CONTRACTOR
INSTRUMENTATION FEE
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DEMOLITION
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FEE
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ADDRESS
REGISTRATION
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PLUMBING FEE
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12TOTAL
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CITY ZIP CODE
FEES $
AREA
CODE
TEL. NO.
AREA CODE
LICENSE u
CASH ❑CHECK .O.❑N.C.❑
RECEIVED BY
TREES REQUIRED rg
IS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF
W RK FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME. VOID.
SEWAGE SYSTEMI
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
(`OMrtNv ,A I ION 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) SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE
OF CALIFORNIA.