286803 (PAT)DEPARTMENT OF BUILDING 8r SAFETY FIELD OFFICE
BUILDING PERMIT ,
J F M AJOB
J J S O
M A N D
PERMIT NO.
868Q
%-wviA i W Vr RI YCRJINC
1%
CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES
1 ST FL. SQ. FT. @ $- UNITS
- 2ND FL. SQ. FT. @ YARD SPKLR SYSTEM
POR. FT. C.— / d. MOBILEHOME SVC. BAR SINK
GAR. SQ. FT. @ POWER OUTLET ROOF DRAINS
CAR P. SQ. FT. @ DRAINAGE PIPING
WALL SQ -FT. @ DRINKING FOUNTAIN
SQ. FT: @ URINAL
ESTIMATED CONSTRUCTION VALUATION $ WATER PIPING
NOTE: Not to be used as property tax valuotion SWIM POOL, PVT FLOOR DRAIN
DATE 11117
+ j
MECHANICAL FEES SWIM POOL, COMM WATER SOFTENER
VENT SYSTEM [-j FAN ❑ EVAP. COOL ❑ HOOD SIGN WASHER (AUTO)(DISH)
APPLIANCE ❑ DRYER GARBAGE DISPOSAL
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED LAUNDRY TRAY
AIR HANDLING UNIT CFM IDLE METER KITCHEN SINK
M H PERMIT FEE'
ABSORPTION SYSTEM B.T.U. TEMP USE PERM SVC WATER CLOSET
$
COMPRESSOR HP POLE, TEMP/PERM LAVATORY
USEOPPPERRMIT/
HEATING SYSTEM ❑ FORCED ❑ GRAVITY AMPERES SERV ENT SHOWER
SUP . TO PERMIT
BOILER B.T.U. SQ.FT. @ a BATH TUB
SQ.FT. @ a WATER HEATER
COPIES
SQ.FT.RESID @ 11/4a SEWAGE DISPOSAL
SQ.FT.GAR @ 3/4a HOUSE SEWER
LEGAL DESCRIPTION '
,.007�/�
MECHANICAL FEE
GAS PIPING
$
PERMIT FEE
PERMIT FEE PERMIT FEE
-
DBL. I
�TOTALFEES
MOB.HM. FEE
I.
MICRO FEE MECH. FEE PL. CK. FEE
CON/ST. FEE ELECT. FEE SfMi FEE,
FEE PLUMB. FEE
J F M AJOB
J J S O
M A N D
ADDRESS - SP NO
,/ n
- �P 4/G.r 1
OWNER
` � ��
/�
76
77
COMMUNITY
VALUATION
DATE 11117
+ j
DSTOFFICE
M H PERMIT FEE'
$
USEOPPPERRMIT/
F.G.
SUP . TO PERMIT
PES06
MICROFILM FEE
COPIES
$
BOOK PAGE PARCEL
773 —15a- -0/0
LEGAL DESCRIPTION '
,.007�/�
MECHANICAL FEE
DBL
$
USE NO.
ZjO/�N%�/E-
SET BACK �OT SIZE
GRP
TYPE
BY
'
40
�7CKKK
elL
� •
I S/J S R /
PLAN CHECK FEE
$
®
°---
BOND AMT.
PLAN NO.
PLAN CHECKER
FINAL DATE I
PECTOR
9
a- ro
.CONSTRUCTION FEE
DBL
$
-
NAME OF CONST. LENDER
BRANCH OFFICE
NO LENDER INVOLVED
ELECTRICAL FEE
DBL
$
ADDRESS
CITY
STATE
STRONG MOTION
$
OW^N�E-R/AGENTS SIGNATURE
CONTRACTOR
INSTRUMENTATION FEE
'SPECIALINSP
DEMOLITION
FEE
$
ADDRESS
'It --7 y `1 A
ADDRESS
'
REGISTRATION
�.J d� *'� q
PLUMBING FEE
DBL
$
CITY ZIP CODE
CITY ZIP CODE
ey
TOTAL FEES $
TEL. N
TEL. NO.
AREA CODE
LICENSE a
CASH ❑CHECK .O.❑N.C.❑
54 1A]Av,C�ODE
RECEIVED BY TREES REQUIRD
THIS 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
I HERESY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE
T LL P
WITH THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, I ALSO AGREE TO CARRY
v LUm1'tNJA I IUN INJUKANLt UPUN MY tMPLUYttS. COMPLIANCE WITH THE LAWS OF THE STATE OF
• CALIFORNIA COVERING CONTRACTORS IS ALSO GUARANTEED.
I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HASDONE
FORM 284-208 (REV. 6-7e1 SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE
OF CALIFORNIA.