286420 (SFD)BUILDING PERMIT DEPARTMENT „ „ OF BUILDING & SAFETY
t„
W
FIELD OFFICE
1
J F M A M J J A S O N D
T
PERMIT NO.
86420
- NNW
1
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,�
DST
/f
CONSTRUCTION ESTIMATE
VALUATION
NO. ELECTRICAL FEES
DST OFFICE
61
NO. PLUMBING FEES
78
1ST FL. AtAl SQ.
2ND FL. SQ.
POR. /�`
GAR. SQ.
CAR P. 'SQ.
WALL SQ.
ESTIMATED CONSTRUCTION
FT. @ $ a,,.
UNITS
FT. @ YARD SPKLR SYSTEM
SQ. FT. @ �a , MOBILEHOME SVC. BAR SINK
FT. @ �� �� POWER OUTLET ROOF DRAINS
F.C.
FT. @ DRAINAGE PIPING
PERMIT
FT. @ DRINKING FOUNTAIN
SQ. FT. @ URINAL
VALUATION$ Lf WATER PIPING
NOTE: Not to be Used as property tax valuation
* 4m,286420
SWIM POOL, PVT
FLOOR DRAIN
MECHANICAL FEES
MICROFILM FEE
SWIM POOL, COMM
$
WATER SOFTENER
«BOOK PAGE PARCEL
LEGAL DESCRIPTION
f j
VENT SYSTEM [I FAN ❑ EVAP. COOL X HOOD
�„L7..
SIGNj
WASHER (AUTO)(
....
k'MECHANICAL FEE
APPLIANCE XDRYER
$
�-p
USE NO.
GARBAGE DISPOSAL
SET BACK LOT SIZE
GRP TYPE
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
LAUNDRY TRAY
iL w
�' 1b
AIR HANDLING UNIT CFM
IDLE METER
PLAN CHECK FEE
KITCHEN SINK
...
ABSORPTION SYSTEM B.T.U.
PLAN NO.
TEMP USE PERM SVC
FINAL DATE Il/y5�-pECTj/q(tI
WATER CLOSET
r.
COMPRESSOR _3-&XjIiiIIE�� HP¢
POLE, TEMP/PERM
LAVATORY
Csr
t
HEATING SYSTEM XORCED ❑ GRAVITY
/a5tAMPERES SERV ENT
0
SHOWER
BRANCH OFFICE
BOILER B.T.U.
.ELECTRICAL FEE
SQ. FT. @ a
$
�
BATH TUB
00
CITY
STATE
STRONG MOTION
SQ. FT. @ a
aa
D
WATER HEATER
tX?
CONTRACTOR
INSTRUMENTATION FEE
f 0.FT. RESID @ 11/4a
r
SEWAGE DISPOSAL
c�
'SPECIALINSP
SQ.FT.GAR @ 3/4 It
3
HOUSE SEWER
ADDRESS
ADDRESS
-
FEE
GAS PIPING
•
PERMIT FEE
06
PERMIT FEE
PERMIT FEE
co
-635 San Rafael #R
DBL.
I TOTAL FEES
IMOB.HM.IEEI
MICRO FEE
MEC H. FEE
PL. CK. FEE
CONST. FEE
ELECT. FEE
SMI FEE
FEE
PLUMB. FEE0-4
1
J F M A M J J A S O N D
T
JOB ADDRESS SP NO
,,,tea M�y� (Ae,# ��,4 1
�'
OWNER
�}
,�
r77
COMMUNITY
VALUATION
DATE
31
DST OFFICE
61
78
r M H PERMIT FEE
$
P/E IT -
USE GOFLL
F.C.
SUPP. TO PERMIT
PERMIT
NO.
* 4m,286420
MICROFILM FEE
COPIES
$
«BOOK PAGE PARCEL
LEGAL DESCRIPTION
f j
[meg
likht
o
k'MECHANICAL FEE
DBL
$
�-p
USE NO.
ZONE
SET BACK LOT SIZE
GRP TYPE
CK
Yt\
.,nws�
iL w
�' 1b
J
1 S S R I®f✓
4/
PLAN CHECK FEE
$
BOND AMT.
PLAN NO.
PLAN CNEFKKER
FINAL DATE Il/y5�-pECTj/q(tI
t
-.CONSTRUCTION FEE
DBLNAME
$�/
00
OF CONST. LENDER
BRANCH OFFICE
NO LENDER INVOLVED
.ELECTRICAL FEE
DBL
$
�
�g„�/
ADDRESS
CITY
STATE
STRONG MOTION
aa
D
OWN E GENTS SIGN TURE
CONTRACTOR
INSTRUMENTATION FEE
it
'SPECIALINSP
$
ADDRESS
ADDRESS
DEMOLITON
FEE
REGISTRATION
-635 San Rafael #R
PLUMBING FEE
DBL
$
CITY ZIP CODE
CITY ZIP CODE
3
TOTAL FEES $
TEL. NO, AREA
CODE
TEL. NO.
AREA CODE
LICENSE tt
CASH❑CHEC .O.❑N.C.❑ �
fig-10”
714
RECEIVED BY,,' REES REQUIRED
THIS*PT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF
WORK20 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.I
GREE 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
MPENSATION INSURANCE UPON MY E P O TE OF
SEWAGE SYSTEM
J
P��
M LOYEES. C MPLIANCE WITH THE LAWS OF HE STA
ALIFORNIA COVERING CONTRACTORS IS ALSO GUARANTEED.
I 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
FORM 204-208 (REV. 6-76) OF CALIFORNIA.