286416 (SFD)FIELD OFFICE
DEPARTMENT- OF BUILDING & SAFETY . z
BUILDING PERMIT
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•• J F M A M J J A' S O N D'
PERMIT NO.
28641
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'•' CONSTRUCTION ESTIMATE
NO.
ELECTRICAL FEES
NO. PLUMBING FEES
'78
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r
'
1 ST FL.
2N6 FL.
FOR. `�
GAR.,
GAR.,
CAR P. _
WALL
ESTIMATED CONSTRUCTION
SQ. FT. @-0":$
���
S..
UNITS
M H PERMIT FEE
SQ. FT. @ YARD SPKLR SYSTEM
SQ. FT. @ MOBILEHOME SVC. BAR SINK
F.G.
SQ. FT. @.- d�q=. POWER OUTLET ROOF DRAINS
SQ. FT. em
PERMIT NO.
SQ. FT. @ + ' DRAINAGE PIPING
SQ. FT. @ DRINKING FOUNTAIN
SQ. FT. @ URINAL
VALUATION $ WATER PIPING
,
NOTE: Not to be used as property tax valuation
SWIM POOL, PVT
FLOOR DRAIN
'MICROFILM FEE '
MECHANICAL FEES
$
SWIM POOL, COMM' " '
�+B',OOOOK �GE
� PARCEL.
WATER SOFTENER
MECHANICAL FEE
DBL
VENT SYSTEM ❑ FAN ❑ EVAP. COOL ' HOOD
CO
SIGN
ZONE
WASHER (AUTO)(946W1
LOT /SIZ` w
GRP/j�R
APPLIANCE RYER
�Q
=
GARBAGE DISPOSAL
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
LAUNDRY, TRAY
SS
./
AIR HANDLING UNIT CFM
e74d(��
IDLE METER
KITCHEN SINK.
-
$ • i!_
ABSORPTION SYSTEM 0 B.T.U.
BOND AMT.-
TEMP USE PERM SVC
PLANNCHjECKER • -
WATER CLOSET
Q�
COMPRESSOR HP
# 0_2
POLE, TEMP/PERM
LAVATORY , '
00
•
HEATING SYSTEM, WORCEb ❑ GRAVITY'.
.' J4jTMPERES
SERV ENT''
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SHOWER
CFO
OFFICE
BOILER B.T.U.
f SOFT: @ a
BATH TUB V
ELECTRICAL FEE
' SQ.FT. @
$
WATER HEATER
ADDRESS CITY
•Q.FT.RESID
STATE
@ 11/4a
�(
SEWAGE DISPOSAL.
-
-STRONG MOTION
;INSTRUMENTATION FEE
Q.fT.GAR @ . 3/4(10
$
HOUSE SEWER
OWNERi DENTS SIGNA U CONTRACTOR
J,
-
GAS PIPING
.SPECIALINSP
DEMOLITON
'•REGISTRATION
PERMIT FEE
8Fi
PERMIT FEE
$
PERMIT:FEE -
oa
•-
DBL.
TOTAL FE
MOB.HM.FEE
MICRO FEE
MEC"HH.. 'FEE PL..
K FEE
CONST. FEE ELECT.FEE
SMI FEE
FEE
wPPL,..Uq�MB. FE{,EE
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•• J F M A M J J A' S O N D'
JOB. ADDRESS + - '� SP NO
n I
OWN,EERRf ;g "•
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76._ _
C+4 CJ.�J „ �/� �j I D
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,%7
COMMMUNITY ,,.I�1
VALUATION
$da tl
DATE
3
DST
A/r
OFFICEOFFICE
'78
f' u f i � F
M H PERMIT FEE
$ (
USE OF PERMIT
. 1a,
F.G.
SUPP. TO PERMIT
PERMIT NO.
!Z E'
golf..
'MICROFILM FEE '
COPIES
$
�+B',OOOOK �GE
� PARCEL.
LEG`AL_OESCR�pTION y yq
3A 40 SvJt4
MECHANICAL FEE
DBL
$_ y.,
1
USE NO.
ZONE
SET BACK
LOT /SIZ` w
GRP/j�R
TVP CK BY
,.f�
1
SS
./
RI�
e74d(��
••.ir'
PLAN CHECK FEE, "-
-
$ • i!_
BOND AMT.-
PLANNO.
PLANNCHjECKER • -
-FINAL DATE • I SP,(E'C�TOR
-
'CONSTRUCTION FEE
DBL$
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NAME`OF CONST, LENDER BRANCH
OFFICE
NOLENDERINVOLVED
ELECTRICAL FEE
DBL
$
ADDRESS CITY
STATE
�(
-STRONG MOTION
;INSTRUMENTATION FEE
$
OWNERi DENTS SIGNA U CONTRACTOR
J,
.SPECIALINSP
DEMOLITON
'•REGISTRATION
FEE-
$
A DRESS ADDRESS
�5#0v k.
J ,7
PLUMBING FEE
•�� ' •'
DBL
$x
�a7!.
�B •
CITY / ZIP CODE CITY
ZIP CODE
'
,,�6' 7 l•�c`.s� tom'
- TOTAL. FEES
$ JJ „ •
TEL. NO. .- AREA
CODE TEL.
NO,
AREA CODE
LICENSE n
;CASH ❑CHECK .O.❑N.C.❑-7111
.'
'
RECEIVED.BY ;
TREES REQUIRED
RMIT SHAAECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF
O OR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.,
BY AGREE.THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE
TH. '
SEWAGE SYSTEM
fI
�>•EWA -
T
LL
P
THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA,.I ALSO AGREE TO CARRY
inAADFI.I[AT1f 11 Iwlfl IDAwI/•c I t
FORM 284.208 (REV. 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.