303524 (SFD). DEPARTMENT OF BUILDING & SAFETY FIELD. OFFICE
BUILDING PERMIT
J F M A M J J A S O N D
PERMIT NO.
IRMPF -
VVVIYI I Vr-RIYCRJIVC
77
77
COMMUNITY
VALUATION
DST
CONSTRUCTION. ESTIMATE
OFFICE
NO. ELECTRICAL FEES
LA . QUIM7-11-77
NO. PLUMBING FEES
1ST FL.e^'
b,""
2ND FL.,
FOR. �i
GAR.
CAR P.
WALL
ESTIMATED CONSTRUCTION
SQ. FT. @ $ f1t4
UNITS -
M H PERMIT FEE
$
SQ. FT. @ YARD SPKLR SYSTEM
USE OF PERMIT
SQ. FT. @ u= MOBILEHOME SVC. BAR SINK
SUPP. TO PERMIT PERMIT
'1303524
SQ. FT. @ =tet' t� POWER OUTLET ROOF DRAINS
NO.
SQ. FT. @ s DRAINAGE PIPING
COPIES
SQ. FT. @ DRINKING FOUNTAIN
SQ. FT. @ URINAL
LEA774GAL DESCRIPTION
VALUATION $�"` WATER PIPING
`J
NOTE:.Not to be used as property tax valuation
SWIM POOL, PVT `
�z a. ,
FLOOR DRAIN
DBL
$
MECHANICAL FEES
USE NO.
SWIM POOL, COMM
SET BACKI LOT SIZE GRP
WATER SOFTENER
TYPE
BY
VENT SYSTEM# AN ❑ EVAP. COOL . ,,HOOD
kj i't,
SIGN
WASHER AUTO DI
I. q
APPLIANCE Q DRYER
r ,
ICK
PLAN CHECK FEE
GARBAGE DISPOSAL
$
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR '❑ SUSPENDED
PLAN. NO.
PLAN CHECKERFINAL
DA IN PECTOR
LAUNDRY TRAY
AIR HANDLING UNIT CFM
IDLE METER
KITCHEN SINK
Ca a
ABSORPTION SYSTEM B.T.U.
TEMP USE PERM SVC
w WATER CLOSET
!
CONSTRUCTION FEE
COMPRESSOR ^"C;. 0 HP
�'z,
POLE, TEMP/PERM
NAME OF CONST. LENDER
;,LAVATORY
' 4r -
HEATING
HEATING SYSTEM ORCED ❑ GRAVITY
•,
w AMPERES SERV ENT
"�
SHOWER
ELECTRICAL FEE
BOILER B.T.U.
$
< SQ.FT. @ a
ADDRESS
''BATH TUB
STATE
SQ.FT. @
JIWATER HEATER
r C,.vl
STRONG MOTION
�
$
f E5Q.FT.RESID @ MAI:
� r :mfr
s SEWAGE DISPOSAL
INSTRUMENTATION FEE
4z7 ,A,
w" : SQ.FT.GAR @ 3/4a
r
HOUSE SEWER
e
'SPECIALINSP
GAS PIPING
O
$
PERMIT FEE
tt
ADDRESS
PERMIT FEE
"r ,c.)c
PERMIT FEE
DBL. I
TOTAL FEES
111013,HII,FEEI
MICRO FEE
MECH. FEE
PL CK. FEE
CONST. FEE
ELECT. FEE
'SMI FEE
}
FEE
PLUMB. FEE
J F M A M J J A S O N D
JOB ADDRESS SP NO
I
54-400 Avenida b.. '
OWNER
CORP
76
77
77
COMMUNITY
VALUATION
-
DATE
DST
OFFICE
LA . QUIM7-11-77
I
78
M H PERMIT FEE
$
USE OF PERMIT
F.C.
Ml
SUPP. TO PERMIT PERMIT
'1303524
NO.
MICROFILM FEE
COPIES
$
BOOK PAGE PARCEL
LEA774GAL DESCRIPTION
�z a. ,
MECHANICAL FEE
DBL
$
USE NO.
ZONE
SET BACKI LOT SIZE GRP
TYPE
BY
I. q
ICK
PLAN CHECK FEE
$
BOND AMT.
PLAN. NO.
PLAN CHECKERFINAL
DA IN PECTOR
k_/�% 77�Ca
!
CONSTRUCTION FEE
DBL
$
NAME OF CONST. LENDER
BRANCH OFFICE
NO LENDER VOLVED
F
ELECTRICAL FEE
DBL
$
ADDRESS
CITY
STATE
STRONG MOTION
�
$
OWNER/AGENTS SIGNATURE -
CONTRACTOR y
,Y
INSTRUMENTATION FEE
4z7 ,A,
e
'SPECIALINSP
$
ADDRESS
ADDRESS
DEMOLITION
FEE
REGISTRATIO
PLUMBING FEE
DBL
$
CITY ZIP CODE
CITY — - ZIP caDE
-A 011713
TOTAL FEESTEL.
MAP
NO. AREA
CODE
TEL. NO.
1tE C
IGEN5E
a 1 -:31
F�
. v �
CASH ❑CHECK>.O.❑N.C.$
#"if)'��i �
Y IS
1 i4
RECEIVED BY TREES REQUIRED
I MIT SHALL BECOME V01D IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF -
R 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
I E Y AGREE THATALL WORK IN CONNECTION THIS PERMIT WILL BE DONE IN ACCORDANCE„
SEWAGE SYSTEMWITH
c
k'
T °' vr^ LL
p
H THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA,.I ALSO AGREE TO CARRY
(IAA DC AIC ATIlIw
11—um—CL UPON M7 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. e-76) SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE
OF CALIFORNIA.