SFD (297204)DEPARTMENT OF BUILDING & SAFETY
BUILDING PERMIT
FIELD OFFICE
J F M A 'M J 1 A S O N D
PERMIT NO.
��
- ,�.VVIV I. I Or RI Y ERSIUE2972041
77
COMMUNITY
ALLUUATIONN
DST
CONSTRUCTION .ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1 ST FL.
2ND FL.
POR.
GAR.
CAR P.
WALL SQ.
ESTIMATED CONSTRUCTION
SQ. FT. $ 27
j,'**
UNITS
USE PE IT
F.C.
SQ. FT. @ YARD-SPKLR SYSTEM
PERMIT
SQ. FT. @ tea: MOBILEHOME SVC. BAR SINK
SQ. FT. @ 519 POWER OUTLET ROOF DRAINS
SQ. FT. @ DRAINAGE PIPING
FT. @ DRINKING FOUNTAIN
SQ. FT. @ URINAL
00/1
VALUATION$ Cd0 WATER PIPING
` NOTE: Not to be used as property tax valuation
SWIM POOL, PVT
COPIES
FLOOR DRAIN
BOOK 'PAGE PARCEL
ECHANICAL FEES
SWIM POOL,- COMM
WATER SOFTENER
Alc-_ y
VENT SYSTEM [] EVAP. COOL HOODI
DBL
SIGN
WASHER (AUTO) (DISH).
SET BACK;
LOT SIZE
APPLIANCE DRYER
GARBAGE DISPOSAL
'00
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
q
LAUNDRY TRAY
AIR HANDLING UNIT CFM
IDLE METER
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERM SVC
WATER -CLOSET
O0
-PLAN CHECK FEE
COMPRESSOR HP
14;—n
POLE, TEMP/PERM
BOND AMT.
LAVATORY
PLAN CHECKER
FINAL DAT!/Et. INSPECTOR
HEATING SYSTEM -[,3,—
FORCED ❑GRAVITY
pGY'.
AMPERES SERV ENT
SHOWER
GY8
BOILERB.T.U.'
SQ. FT.•@ aj
CONSTRUCTION FEE
BATHTUB
$.,
NAME OF CONST. LENDER BRANCH
OFFICE
SQ.FT. @' a
WATER HEATER
Q.FT.RESID @ . 111/aa
ELECTRICAL FEE
SEWAGE DISPOSAL
$
ADDRESS CITY
SQ.FT.GAR @ 3/4a
HOUSE SEWER
77
OE
-STRONG MOTION
GAS PIPING
e o
OWNER/AGENT'S SIGNATURE - CONTRACT
PERMIT FEE
�
PERMIT FEE
PERMIT FEE
pe!i
'SPECIAL INSP
DBL.
TOTAL FEES
IMOB.RM.FEEI
MICRO FEE
MECH. FEE
PL. CK. FEE
CONST. FEE
Aq
EL CT. FEE
SMI FEE
FEE
PLUMB. FEE
J F M A 'M J 1 A S O N D
JOB ADDRESS SP NO
1
OWNER
'
77
COMMUNITY
ALLUUATIONN
DATE
DST OFFICE
M H PERMIT FEE
$
USE PE IT
F.C.
SURF. TO PERMIT
PERMIT
NO.
00/1
1297204'
MICROFILM FEE
COPIES
$
BOOK 'PAGE PARCEL
LEGAL DESCRIPTION
Alc-_ y
MECHANICAL FEE
DBL
$
US NO. ZO,rNEE�y//�
SET BACK;
LOT SIZE
GRP TYPE CK BY
q
-PLAN CHECK FEE
('
$
BOND AMT.
PLAN NO.
PLAN CHECKER
FINAL DAT!/Et. INSPECTOR
CONSTRUCTION FEE
DBL
$.,
NAME OF CONST. LENDER BRANCH
OFFICE
EN DER INVOLVED
ELECTRICAL FEE
DBL
$
ADDRESS CITY
STATE
77
OE
-STRONG MOTION
$
OWNER/AGENT'S SIGNATURE - CONTRACT
°-
INSTRUMENTATION FEE
r
'SPECIAL INSP
2
-
ADDRESS ADDRESS
'DEMOLITON
FEE
REGISTRATION-
_
PLUMBING FEE
DBL
$
CITY ZIP CODE CITY
ZIP CODE
TOTAL FEES $
TEL. NO. AREA
CODE TEL.
NO.
AREA CODE
LICENSE n
r, �+
CASH O.❑N.C.❑
:,RECEIVED BY TREES REQUIRED
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.
I HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE
aSEWAGE
.SYSTEMor
LAWS
WITH THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, I ALSO AGREE TO CARRY
_
T LL
p
r nAAPFNCATI IN[l IDAN!'C 110/ kl AAV CAADIl CCC` !'l1 AADI IA 11— %A/ITU TU1 I A/ -C TIIC -ATC ( C
FORM 284-208 (REV. 6-76)
�_.... �.-... ....... '........��....�
CALIFORNIA COVERING CONTRACTORS IS ALSO GUARANTEED.
1 HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE
SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE
OF CALIFORNIA.