296935 (SFD)DEPARTMENT OF BUILDING & SAFETY FIELD OFFICE
BUILDING PERMIT -- ,.,�„
J F M A M J J A S O N D
PERMIT NO.
1 2969351
OWNER
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77
COMMUNITY
VALUATION
DATE
CONSTRUCTION ESTIMATE
OFFICE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST Fl. SQ.
2ND FL.
POR.
GAR. ��%dSQ.
CAR P. SQ.
WALL SQ.
ESTIMATED CONSTRUCTION
FT. @ $
�C>
UNITS
$
SQ. FT. @ YARD SPKLR SYSTEM
F.C.
SQ. FT. @ t 0 C MOBILEHOME SVC. BAR SINK
PE MIT N
FT. @ POWER OUTLET ROOF DRAINS
FT. @ DRAINAGE PIPING
FT. @ DRINKING FOUNTAIN
SQ. FT. @ URINAL
VALUATION $ WATER PIPING
DL%
NOTE: Not to be used as property tax valuation
COPIES
SWIM POOL, PVT
FLOOR DRAIN
DESCR TION
MECHANICAL FEES
SWIM POOL, COMM
1442 P;A;�LEGAL
WATER SOFTENER
MECHANICAL FEE
DBL
VENT SYSTEM D<FAN ❑ EVAP. COOL jjaeHOOD
00
SIGN
ZONE
WASHER(AUTO)WH)
LO�Try/S��IZ�E GRP TYPE CK BY
APPLIANCE RYER
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1�
GARBAGE DISPOSAL
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FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
I
IDLE METER
R
KITCHEN SINK
G�
ABSORPTION SYSTEM B.T.U.
TEMP USE PERM SVC
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PLAN NO.
WATER CLOSET
INSPECTOR
COMPRESSOR HP
POLE, TEMP/PERM
LAVATORY
HEATING SYSTEM&J-FORCED ❑ GRAVITYf?
/� AMPERES SERV ENT
�
/ SHOWER
BOILER B.T.U.
CONSTRUCTION FEE
SQ.FT. @ a
$
BATH TUB
e-->
BRANCH OFFICE
NO LENDER INVOLVED
SQ. FT. @ a
WATER HEATER
f�
ELECTRICAL FEE
Q.FT.RESID @ 11/4a
(,
SEWAGE DISPOSAL
ADDRESS
CITY
STATE
SQ.FT.GAR @ 3/4a
HOUSE SEWER
STRONG MOTION
$
GAS PIPING
OWNER/ N sI$ Gy ): 1
�-Ki'ri V
CONTRACTOR
PERMIT FEEPERMIT
FEE
�...+�
PERMIT FEE
SPECIAL INSP
DBL.
TOTAL FEES
4A
MOB.WM.FEE
1
MICRO FEE
M H. FEE
PL. CK. FEE
I CONST. FEE
ELEZ7.FEE
SMI FEEFEE
'51
PLUMB. FEE
J F M A M J J A S O N D
JOB ADDRESS SP NO
I
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OWNER
t/.
76
77
COMMUNITY
VALUATION
DATE
DST
OFFICE
r�
I
78
M H PERMIT FEE
$
USE O PERMIT
F.C.
SUPP. TO PERMIT
PE MIT N
8 935
MICROFILM FEE
COPIES
$
BOOK PAGE
DESCR TION
1442 P;A;�LEGAL
MECHANICAL FEE
DBL
$
USE NO.
ZONE
SET BACK
LO�Try/S��IZ�E GRP TYPE CK BY
/J
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1�
4
//g
I
S
R
W-�'V C/
PLAN CHECK FEE
$
BOND AMT.
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PLAN NO.
PLAN CHECKERFINAL DATE
INSPECTOR
I
CONSTRUCTION FEE
DBL
$
NAME OF CONST. LENDER
BRANCH OFFICE
NO LENDER INVOLVED
c?c1
ELECTRICAL FEE
DBL
$
ADDRESS
CITY
STATE
STRONG MOTION
$
J
OWNER/ N sI$ Gy ): 1
�-Ki'ri V
CONTRACTOR
INSTRUMENTATION FEE
�...+�
SPECIAL INSP
$
ADDRESS
ADDRESS
DEMOLITION
FEE
�!7,
REGISTRATION
PLUMBING FEE
DBL
$
CITY CODE
CITY ZIP CODE
3
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�q �jZIP
f %�1r1 sp 4�AAq
TOTAL FEES $
TEL. NO. AREA
CODE
TEL, NO.
AREA CODE
LICENSE o
CASH ❑CHEC .O.❑N.C.❑
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RECEIVED BY TREES REQUIREDWAIl
HIS 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
'�
f
HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE
T �� LL
P
ITH THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, I ALSO AGREE TO CARRY
\-vrvr O`Jf\IIVIV—aumAiNLc ur%.A`I mT cmrLVI CCa. l.VmrLI A r`iCr YYIIn Inc LAYYa Vr Inc aIAIC Vr
CALIFORNIA COVERING CONTRACTORS IS ALSO GUARANTEED.
I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE
FORM zea -208 IREV. 6-76) SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE
OF CALIFORNIA.