297430 (SFD)FIELD OFFICE
DEPARTMENT OF BUILDING & SAFETY
BUILDING PERMIT ' ,..— — n,vr nr, nr
J F M A M J J A S O N D
PERMIT NO.
9743
now
Cwtorw1 I Vr RI YCR>t1UC
77
COMMUNITY
1,
VALUATION
$/<�
DST
CONSTRUCTION ESTIMATE
OFFICE
�,
NO. ELECTRICAL FEES
M H PERMIT FEE
NO. PLUMBING FEES
$
1 ST FL.
2ND FL.
FOR.
GAR.2f4
CAR P.
WALL SQ.
ESTIMATED CONSTRUCTION
SQ. FT. @ $
,
UNITS
NO.
SQ. FT. @ YARD SPKLR SYSTEM
SQ. FT. @ �.-- i MOBILEHOME SVC. BAR SINK
SQ. FT. @ i POWER OUTLET ROOF DRAINS
%ERM
SQ. FT. @ DRAINAGE PIPING
FT. @ DRINKING FOUNTAIN
SQ. FT. @ URINAL
VALUATION $ " WATER PIPING
COPIES
NOTE: Not to be used as property tax valuation
SWIM POOL, PVT
LEG L DESCRI ION
FLOOR DRAIN
,$
MECHANICAL FEES
AS 11 .
SWIM POOL, COMM
MECHANICAL FEE
WATER SOFTENER
$
VENT SYSTEM FAN ❑ EVAP. COOL OOD
SIGN
LOT SIZE
WASHER(AUTO H)
400
APPLIANCE RYER
GARBAGE DISPOSAL
d�
o
FURNACE ❑ UNIT (:)WALL ❑ FLOOR ❑ SUSPENDED
PLAN CHECK FEE
LAUNDRY TRAY
BOND AMT.
AIR HANDLING UNIT CFM
FINAL DATE Iry(�e1�E\\CTOR
IDLE .METER
KITCHEN SINK
QQ
ABSORPTION SYSTEM B.T.U.
TEMP USE PERM SVC
2,.WATER CLOSET
d
$
COMPRESSOR HP
*_
POLE, TEMP/PERM
NO LEND INVOLVED
LAVATORY
4d
Pst
HEATING SYSTEM ORCED ❑ GRAVITY
0
&2yjjAMPERES SERV ENT
SHOWER
do
$
BOILER T. U.
ADDRESS CITY
SQ.FT. @ a
STATE
j BATH TUB
SQ.FT. @ a
WATER HEATER
$
'77
OWNER/AGGEEN•TS SIGNATURE CONTRACTOR
Q.FT.RESID @ 11/4a
SEWAGE DISPOSAL
100
x,7/7
SQ.FT.GAR @ 3/44
HOUSE SEWER
GAS PIPING
$
PERMIT FEE
ADORE S y ADDRESS
PERMIT FEEPERMIT
REGISTRATION
FEE
400
DBL.
I TOTAL FEES)jj
JMOB.H FEE
MICRO FEE
MECH.FEE
PL. CK. FEE
I CONST, FEE6 ELECT. FEE
SMIFFOIEEEEE
FEEI
PLUMB. FEE
J F M A M J J A S O N D
JOB ADDRESS SP NO
../ 3 '" pu—b <
OWNER
/ f/ Y
76
77
COMMUNITY
1,
VALUATION
$/<�
DA' E
b /7 ^7
/PERMIT
DST
//
OFFICE
�,
76
M H PERMIT FEE
$
USE OF
F.C.
SUPP. O PERMIT
NO.
%ERM
100
MICROFILM FEE
COPIES
BOOK PAGE PARCEL
LEG L DESCRI ION
,$
AS 11 .
- a?caz� Nrf
MECHANICAL FEE
DBL
$
USE N .ZONiryEi�{y
BACK
LOT SIZE
GRP TYPE CK BY
q
o
SSEETT
PLAN CHECK FEE
$
BOND AMT.
PLAN NO./ PLAN CHECKER
FINAL DATE Iry(�e1�E\\CTOR
CONSTRUCTION FEE
DBL
$
NAME OF CONST. LENDER BRANCH
OFFICE
NO LEND INVOLVED
Pst
ELECTRICAL FEE
DBL
$
ADDRESS CITY
STATE
STRONG MOTION
INSTRUMENTATION FEE
$
'77
OWNER/AGGEEN•TS SIGNATURE CONTRACTOR
x,7/7
SPECIALINSP
DEMOLITON
FEE
$
ADORE S y ADDRESS
REGISTRATION
. Q
PLUMBING FEE
DBL
$
CITY ZIP CODE CITY
ZIP CODE
TOTAL FEES.AREA
CODE TEL.
NO.
AREA CODE
LICENSE u
CASH ❑ ❑CHECK .O.❑N.C.,i^+G*
,
RECEIVED BY TEES REQUIRED
THIS IT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF
120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE
SEWAGE SYSTEM
T LL
P
T LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, I ALSO AGREE TO CARRY
�� AA DCAIC ATI -111
Crv-LVT CCJ. I. MrUANCE W11 r1 IHc LAWS OF IHE JI NIC Vr
CALIFORNIA COVERING CONTRACTORS IS ALSO GUARANTEED.
I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE
FORM 284-208 (REV. 6-78) - SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE
OF CALIFORNIA.