301834 (SFD)FIELD OFFICE
DEPARTMENT OF BUILDING .& SAFETY
RlinnitUP DFRMIT .__
J F I M A M J J A S O N D
PERMIT NO.
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t
DST
CONSTRUCTION ESTIMATE
COMMUNITY
NO. ELECTRICAL FEES
NO. PLUMBING FEES
DST
1ST FL.
2ND FL.
POR.
GAR. r
CAR P.
WALL
ESTIMATED CONSTRUCTION
SQ. FT.
UNITS
/l+
SQ. FT. @ i YARD SPKLR SYSTEM
78
SQ. FT. @ MOBILEHOME SVC. BAR SINK
SQ. FT. @ .� 1 " POWER OUTLET ROOF DRAINS
SQ. FT. @ DRAINAGE PIPING
M H PERMIT FEE
SQ. FT. @ DRINKING FOUNTAIN
$
URINAL
USE OF PERMIT
VALUATION $ •" WATER PIPING
SUPP. TO PERMIT
NOTE: Not to be used as property tax valuation
NO.
SWIM POOL, PVT
FLOOR DRAIN
MECHANICAL FEES
SWIM POOL, COMM
WATER SOFTENER
301
VENT SYSTEM FAN ❑ EVAP. COOL NVHOOD
t)A0
SIGN
WASHER (AUTO)
COPIES
$
APPLIANCE VIDWYER
BOOK PAGE PA L LE AL DESC io
GARBAGE DISPOSAL
FURNACE ❑ UNIT ❑ WALL ❑ FL OR ❑ SUSPENDED
MECHANICAL FEE
DBL
LAUNDRY TRAY
USE O.
AIR HANDLING UNIT CFM
SET BACK
IDLE METER
KITCHEN SINK
;�CK
BY
ABSORPTION SYSTEM B.T.U.
TEMP USE PERM SVC
WATER CLOSET
COMPRESSOR HP
5,0
POLE, TEMP/PERM
LAVATORY
HEATING SYSTE FORCED ❑ GRAVITY
00
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
1 3
SQ.FT. @ a
BATH TUB
SQ.FT. @ ¢
WATER HEATER
LAO
BOND AMT.
PLAN NO.
T Q.FT.RESID @ ll/,4
SEWAGE DISPOSAL
0
SQ.FT.GAR @ 3/4a
HOUSE SEWER
ti
IIISP
3
CONSTRUCTION FEE
GAS PIPING
71 04
PERMIT FEE
OFFICE
1 PERMIT FEE
%PERMIT FEE
DBL.
TOTAL FEES JMOB.H M.FEE
MICRO FEE
M H. FEE
PL. CK. FEE
CONST. FEE
ELECT. FEE SMIJFEE
�7 f,
FEE
PLUMB. FEE
-174
J F I M A M J J A S O N D
JOB ADDRESS SP NO
OWNER
76
t
H
77
COMMUNITY
VALUXTrDN
DA
DST
OFFICE
/l+
78
Aj
M H PERMIT FEE
$
USE OF PERMIT
F.C.
SUPP. TO PERMIT
PERMIT
NO.
1001
301
834
MICROFILM FEE
COPIES
$
BOOK PAGE PA L LE AL DESC io
f
—. t -'5'16 AI
MECHANICAL FEE
DBL
$
USE O.
ZONE
SET BACK
LOT SIZE
GRP
;�CK
BY
E/'
1 3
1 _jj5
S R
PLAN CHECK FEE
$
BOND AMT.
PLAN NO.
PLAN CHECKER
FINAL DATE
TOR.
ti
IIISP
3
CONSTRUCTION FEE
DBL
$
NAME OF CON 5T. LENDER BRANCH
OFFICE
--NOL
OLEN R INVOLVED
-
ELECTRICAL FEE
DBL
$
ADDRESS CITY
STATE
STRONG MOTION
$
OWNER/AGENTS SIGNATURE CONTRACTOR
INSTRUMENTATION FEE
f
SPECIAL
$
ADDRESS A
RESS
INSP
DEMOLITON
FEE
!'� J
P.
REGISTRATION
_i 1-k/
PLUMBING FEE
DBL
$
CITY ZIP CODE CITY
ZIP CODE
�/-
TOTAL FEES $
TEL. NO. AREA
CODE TEL.
NO.
AREAColl
LICENSEE I
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CASH❑CHECK O.❑N.C.❑ V
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�J".13 2
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RECEIVED BY TREES REQUIRED
R SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF
F DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
H REE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE
SEWAGE SYSTE
rT-
LL
p
E AWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, I ALSO AGREE TO CARRY
MPFA1C ATIr—lk 1I
FORM 284-208 IREV. 6.76)
CALIFORNIA 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
OF CALIFORNIA.