AR (290288)BUILDING PERMIT DEPARTMENT OF BUILDING & SAFETY FIELD OFFICE
,
'
J F M A M J J A S O N I D
PERMIT NO29 .
OWNER
ry
' 1
LVVIV 1 Ir Vi RIYCRSIVC
77
COMMUNITY
114
VALUATION
$
DST
CONSTRUCTION ESTIMATE
NO. ELECTRICAL.FEES
78
NO. PLUMBING FEES
a,I !
1ST FL.
2ND FL.
POR.
GAR.
CAR P.
WALL SQ.
ESTIMATED CONSTRUCTION
SQ. FT. @ $
UNITS
M H PERMIT FEE
SQ. FT. @ YARD SPKLR SYSTEM
SQ. FT. @ s%' se MOBILEHOME SVC. BAR SINK
F.C.
SQ. FT. @ i' POWER OUTLET ROOF DRAINS
PERMIT NO.
SQ. FT. @ DRAINAGE PIPING
FT. @ DRINKING FOUNTAIN
SQ. FT. @ URINAL
#4C
Aw 1� /�f ..bi
VALUATION $ qt9 WATER PIPING
4?t?
NOTE: Not to be used as property tax valuation
SWIM POOL, PVT
'MICROFILM FEE
FLOOR DRAIN
$
MECHANICAL FEES
SWIM POOL, COMM
..
WATER SOFTENER
VENT SYSTEM [-j FAN ❑ EVAP. COOL ❑ HOOD
SIGN
MECHANICAL FEE
WASHER (AUTO)([lLW
$
APPLIANCE ❑ DRYER
USE O.
NE
GARBAGE DISPOSAL
LOT SIZE
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
TYPECKBY
m9
LAUNDRY TRAY
5
AIR HANDLING UNIT —� CFM
IDLE MET R
KIT61w" SINK
4�?
ABSORPTION SYSTEM B.T.U.
TEMP USE PERM SVC
WATER CLOSET
C7c:F
COMPRESSOR HP
POLE, TEMP/PERM
ILAVATORY
p;7
HEATING SYSTEM ❑ FORCED ❑ GRAVITY
IAMPERES SERV ENT
SHOWER
BOILER B.T.U.
SQ.FT. @ a
BATH TUB
SQ.FT. @ a
WATER HEATER
SQ.FT.RESID @ 11/4a
SEWAGE DISPOSAL
f .FT.GAR @ s/4a
Od,
HOUSE SEWER
fX1
NAME OF CONST. LENDER BRANCH
OFFICE
ly
GAS PIPING
PERMIT FEE
PERMIT FEE
�Q
PERMIT FEE
Jr I
DBL.
TOTAL FEES
MOB.HM.FEE
MICRO FEE
MECH. FEE L. CKK. FEE
(C/jO�NySj�T�. FEE
ELE T. FEE
SMI FEE
IE
FEE
PLUMB. FEE
'
J F M A M J J A S O N I D
JOB ADDRESS SP NO
!//1
J la 441 i� a i
OWNER
ry
' 1
76
77
COMMUNITY
114
VALUATION
$
DAT
DST
J
OFFICE
78
a,I !
/ t3' fc?yU,
M H PERMIT FEE
$
USE OF PERMIT
F.C.
SUP . TO PERMIT
PERMIT NO.
#4C
Aw 1� /�f ..bi
290200
no
'MICROFILM FEE
COPIES
$
BOOK PAGE PARCEL EGAL DESCRIPTIO�,,�pN,
..
j�
Mr *t / �" 13 /-
-77-7—V
MECHANICAL FEE
DBL
$
USE O.
NE
SET BACK
LOT SIZE
TYPECKBY
5
�GRP,
PLAN CHECK FEE
$BOND
AMT.
PLAN NO,
PLAN CHECKER
FINAL DATE INSPECTOR
CONSTRUCTION FEE
DBL
$
NAME OF CONST. LENDER BRANCH
OFFICE
NO LEN ER INVOLVED
0—lz
ELECTRICAL FEE
DBL
$
ADDRESS CITY
STATE
STRONG MOTION
$
G N
OWNER/AT.9�SIGNATURE CONTRACTOR
-
INSTRUMENTATION FEE
1
IADDRE
SPECIAL INSP
$
S ADDRESS
DEMOLITION
iREGISTRATION
FEE
1
.s f
PLUMBING FEE
DBL
$
CIT�•-�
Y ZIP CODE Cm
ZIP CODE
4;0
TOTAL FEES Is
TEL. N AREA
CODE TEL,
NO,
AREA CODE
LICENSE a
GASH❑CHECK .O.❑N.C.❑ %
RECEIVED BY TREES REQUIRED
THIS 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 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
(-(I AA DCAIC A T -
n Vrvl, MI cMPLOYEES. COMPUANCE WITH THE LAWS OF IFIL STATE VY
CALIFORNIA COVERING CONTRACTORS IS ALSO GUARANTEED.
I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE
FORM 2e4-208 (REV. 6-76) SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE
OF CALIFORNIA.