302230 (SFD)DEPARTMENT OF BUILDING & SAFETY 1 FIELD OFFICE
BUILDING PERMIT
J F M A M J J A S O N D
PERMIT NO.
2-3 ol
,. �W
VVIJIVI Vr RIYCR.DIYC
�'
COMMUNITY
VALUATION
DST
CONSTRUCTION ESTIMATE
OFFICE
NO. ELECTRICAL FEES
1
NO. PLUMBING FEES
1ST FL.
2ND FL.
POR. i
GAR.
CAR P.
WALL
ESTIMATED CONSTRUCTION
SQ. FT. @
78
UNITS
VE.. /
SQ. FT. @ YARD SPKLR SYSTEM
SQ. FT. Crx ge Q2 MOBILEHOME SVC. BAR SINK
SQ. FT. @6,'-U POWER OUTLET ROOF DRAINS
SQ. FT. @ DRAINAGE PIPING
SQ. FT. @ DRINKING FOUNTAIN
SQ. FT. @ URINAL
PERMIT
VALUATION $ WATER PIPING
.
NOTE: Not to be used as property tax valuation
SWIM POOL, PVT
FLOOR DRAIN
/)
lv 0
MECHANICAL FEES
SWIM POOL, COMM
MICROFILM FEE
WATER SOFTENER
$
'
VENT SYSTEM [I FAN ❑ EVAP. COOL HOOD
SIGN
WASHER(AUTO)Qft
MECHANICAL FEE
APPLIANCE DRYER
^.�5
USE NO.
GARBAGE DISPOSAL
�y
LOT SIZE
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
I TYPE KK BY
LAUNDRY TRAY
�
AIR HANDLING UNIT CFM
IDLE METER
KITCHEN SINK
ABSORPTION SYSTEM O B.T.U.
TEMP USE PERM SVC
07 WATER CLOSET
PLAN NO.
CHECKER
COMPRESSOR ' 0 HP
6 TOR
POLE, TEMP/PERM
LAVATORY
G�3
HEATING SYSTEM XORCED ❑ GRAVITY
410
MPERES SERV ENT
p CST
SHOWER
�
$
BOILER B.T.U.
NAME OF CONST. LENDER BRANCH
SQ. FT. @ 'a
NO LEN R INVOLVED
BATH TUB
S
do
SQ. FT. @ a
WATER HEATER
400
$
ADDRESS CITY
/AIJSQ.FT.RESID @ 11/k
/
SEWAGE DISPOSAL
SQ.FT.GAR @ 3/a¢
HOUSE SEWER
$
OWNER/ GENTS SIGNATURE CONTRACTOR
'.INSTRUMENTATION FEE
GAS PIPING
PERMIT FEE
G1CJ
PERMIT FEE
rxi
PERMIT fEE4>0
$
DBL.
TOTAL FEES
i✓ao
MOB.HM.FEE
MICRO FEE
MECH. FEE
PL. CK. FEE
CONST. FEE
EL T. FEE
SMI FEE
FEE
PLL' FEE
J F M A M J J A S O N D
JOB ADDRESS SP NO
� I
OWNER
�.77
COMMUNITY
VALUATION
DATE
- DST
OFFICE
1
$
78
VE.. /
/N/
M H PERMIT FEE
$
USE OF PERMIT�F�.C.
SUP . TO PE I
PERMIT
/)
lv 0
30223A
MICROFILM FEE
COPIES
$
BOOK PAGE qr PARC LLEGAL DESC RIP 10
MECHANICAL FEE
DBL
$
USE NO.
SET BACK,y[y
LOT SIZE
'GRFF
I TYPE KK BY
�
17,0'NE
PLAN CHEC5 FEE
$
BOND AMT.
PLAN NO.
CHECKER
FINAL DATE INS
6 TOR
[PLAN
CONSTRUCTION FEE
DBL
$
NAME OF CONST. LENDER BRANCH
OFFICE
NO LEN R INVOLVED
do
ELECTRICAL FEE
DBL
$
ADDRESS CITY
STATE
'STRONG MOTION
$
OWNER/ GENTS SIGNATURE CONTRACTOR
'.INSTRUMENTATION FEE
.n °off
'SPECIALINSP
$
ADDRESS ADDRESS
DEMOLITION I
FEE
-REGISTRATION
PLUMBING FEE
DBL
$
CITY ZIP CODE CITY
ZIP CODE
ol
y C
TOTAL FEES
$
TEL. O. AREA
CODE TEL.
NO.
AREA CODE
LICENSE a
/
AZ
CASH .O.❑N.C.❑
AowQ
6-469-112!21
RECEIVED BY
TREES REQUIRED
j \ IT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION Of
TP`'W R R 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
I EBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE
SEWAGE SYSTEM
T LL
p
H THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, I ALSO AGREE TO CARRY
OMPENS T
A ION INSURANCE UPON MY EMPLOYEES. 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 HAS DONE
FORM 284.208 (REV. 6-7el SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE
OF CALIFORNIA.