286879 (AR)FIELD OFFICE.
- DEPARTMENT OF BUILDING & SAFETY
R1111niNGPERMIT
J F M A M J J A S O
PERMIT NO.
66
JOB ADDRESS SP NO
/� I
�+VV1�1 I Vr 9%1♦GRJIV16
p
76
DST
CONSTRUCTION ESTIMATE
' /�.l�
NO. ELECTRICAL FEES
NO. PLUMBING FEES
VALUATION
$ ;°=
v i SQ.
FOR.
'
' GAR.
t CAR P. SQ.
WALL SQ.
ESTIMATED CONSTRUCTION
FT. @ $
OFFICE
UNITS
M H PERMIT FEE$
SQ. FT. @ �d YARD SPKLR SYSTEM
SQ. FT. @ f 00 MOBILEHOME SVC. BAR SINK
POWER OUTLET ROOF DRAINS
SQ. FT. @
F.C.
FT. @ DRAINAGE PIPING
PE MI NO.
FT. @ DRINKING FOUNTAIN
SQ. FT.. @ URINAL
VALUATION $ OQ WATER PIPING
t3.
NOTE: Not -to be used as property tax valuation
6879
SWIM POOL, PVT
COPIES
FLOOR DRAIN -
BOOK PAGE PARCEL
MECHANICAL FEES
SWIM POOL, COMM
WATER SOFTENER
??3- O/S'
.SDA � ��,+� � � +ct JU Avlf �
VENT SYSTEM • XFAN ❑ EVAP. COOL ❑ HOOD
DBL
SIGN
WASHER (AUTO )(DISH)
ZONE
SET BACK LOT SIZE
APPLIANCE ❑ DRYER
TYPE CK BY
GARBAGE DISPOSAL
�--=
•
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
�,QX
'
LAUNDRY TRAY
AIR HANDLING UNIT CFM
IDLE METER
S 5 R
KITCHEN SINK
PLAN CHECK FEE
ABSORPTION SYSTEM B.T.U.
$
TEMP USE PERM SVC
BOND AMT-
WATER CLOSET
OP
COMPRESSOR 'Y" � HP
Q1
POLE, TEMP/PERM
LAVATORY
�f9
•
HEATING SYSTEM FORCED ❑ GRAVITY
CiE"f
AMPERES SERV ENT
$
SHOWER
NAME OF CONST. LENDER
BRANCH'OFFICE
BOILER B.T.U.
SQ.FT. @ ¢
BATH TUB
Q
:ELECTRICAL FEE
SQ.FT. @ a
$
WATER HEATER
ADDRESS
CITY
STATE
STRONG MOTION
SQ.FT.RESID @ 11/4a
$�'
SEWAGE DISPOSAL
O .AGENTS SIGNATURE
J
CONTRACTOR
INSTRUMENTATION FEE
SQ.FT.GAR '@ 1/4a
,,....�
HOUSE SEWER
�►
'SPECIALINSP
DEMOLITION
FEE
$
GAS PIPING -
ADDRESS
'
PERMIT FEE
O
PERMIT FEE
PERMIT FEE
+T illy
OBL.
I TOTAL FEES
IMOB.HM.FEEI
MICRO FEE
MECH. FEE
PL. CK. FEE
00
CONST. FEE
2-0,
ELECT. FEE
- SMI FEE
457
FEE
PLUMB. FEE
J F M A M J J A S O
N D
JOB ADDRESS SP NO
/� I
OWNER
76
'7 O'1 P Irdf .%
' /�.l�
77
COMMUNITY
� Ott
VALUATION
$ ;°=
DATA
I a
DST
11,._4
OFFICE
78
M H PERMIT FEE$
USE CIF PER I' y�
F.C.
SUP .. TO PERMIT
PE MI NO.
6879
MICROFILM FEE
COPIES
$
BOOK PAGE PARCEL
LEGAL DESCRIPTIO
??3- O/S'
.SDA � ��,+� � � +ct JU Avlf �
MECHANICAL FEE
DBL
$
USE NO.
ZONE
SET BACK LOT SIZE
GRP
TYPE CK BY
1.
�--=
�,QX
'
-1
S 5 R
PLAN CHECK FEE
$
�y
BOND AMT-
PLAN NO.
PLAN CHECKER FINAL D E ^. .. 1 1!4 �/P�jCTOR
39
-7av�AVC.L�...4
CONSTRUCTION FEE
DBL
$
Q�
NAME OF CONST. LENDER
BRANCH'OFFICE
NOLEND £RINVOLVED
:ELECTRICAL FEE
DBL
$
ADDRESS
CITY
STATE
STRONG MOTION
$�'
O .AGENTS SIGNATURE
J
CONTRACTOR
INSTRUMENTATION FEE
,,....�
vo t&.A
- -
'SPECIALINSP
DEMOLITION
FEE
$
ADDRESS R
�j., A
ADDRESS
REGISTRATION
+T illy
PLUMBING FEE
DBL
$
CITY ZIP CODE
CITY ZIP CODE'
/
ousir
TOTAL FEES $
TEL. N AREA
CODE
_j
TEL. NO.
AREA CODE
LICENSE tt
/
CASH ❑CHE O.❑N.C.❑ 1
41"'•O 7-3
;RECEIVED BY REES REQUIREDIS'PERMIT
SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF
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 '
-SEWAGE SYSTEM
s
T
Li
PP r
WITH THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, I ALSO AGREE TO CARRY
a....._. __.'l . •..._•-..-IN-G....__ _. _...... _'S"' --•--- __-... -••...__ ........._ ..._ _. ..._ _...._ _.
CALIFORNIA COVERING CONTRACTORS IS ALSO GUARANTEED.
1 HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE
FORM 284-208 (REV. 6.76) SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE
OF CALIFORNIA.