290616 (SFD)• '`' ` -'1: '� -
DEPARTMENT OF BUILDING 8L SAFETY FIELD OFFICE
BUILDING PERMIT T:^�
/^AI I\ITV Ar I�I�IrI�f`II�r
r-2.9
PERMIT NO.
0,61U
�'
�-
<eVVIV 1 I %jr KI V CR3ILJC
.. - ., -
77 _ 4
COMMUNITY
,
VALUATI
lCjj �\
$ �5 i�®
4,
DST
rl
'4
CONSTRUCTION ESTIMATE
78
NO. ELECTRICAL FEES
NO. PLUMBING FEES
"1ST FL..
le
2ND FL.
POR.
GAR.'
CAR P.
r ,WALL
r.. ESTIMATED CONSTRUCTION
SQ. FT. @
UNITS,-
PERMIT
NO.
SQ. FT. @ YARD SPKLR SYSTEM
SQ. FT. @ MOBILEHOME SVC. BAR SINK
POWER OUTLET ._ ROOF DRAINS
SQ. FT. @• s—.,a -
SQ. FT. @ - DRAINAGE PIPING
SQ.. FT. @ e DRINKING FOUNTAIN
SQ. FT: @ ° URINAL
VALUATION $ WATER PIPING
COPIES
^NOTE:
Not to be used as property tax valuation
"
SWIM POOL; PVT
DBL
FLOOR DRAIN
USE NO.
MECHANICAL FEES
•
SWIM POOL, COMM
GRP i TYPE CK BY
WATER SOFTENER '
`w
VENT SYSTEM ❑ FAN ❑ EVAP. COOL DjOOOD
047
SIGN
w•Sl;( �[
V/N'�V
WASHER(AUTO)#aSH)
I .�
wSSE+T..BACK
5 w/
APPLIANCE RYER
Cl0 �. M -
PLAN CHECK FEE
GARBAGE DISPOSAL
$
FURNACE ❑ UNIT .❑ WALL ❑ FLOOR ❑ SUSPENDED
,
f
LAUNDRY TRAY
/
AIR HANDLING UNIT CFM
IDLE METER
CONSTRUCTION FEE
KITCHEN SINK
$
F'
ABSORPTION SYSTEM B.T.U.
OFFICE t
TEMP USE PERM SVC
t• WATER CLOSET
COMPRESSOR HP
d!J
r: POLE, TEMP/PERM ,F
ELECTRICAL,FEE
LAVATORY
fCYS%
HEATING SYSTEM ORCED, ❑ GRAVITY.
GCi
AMPERES SERV ENT
STRONG MOTION
FEESPECIAL
SHOWER
C7G�
BOILER B.T.U.
SQ.FT. @, a
BATH TUB
INSP
DEMOLITION
SQ.FT. @ -r a
EE -
FEE-
WATER HEATER
$
r• :
t�
ADDRES ADDRESS
. .FT.RESID @ 1 I/aa
4:154
SEWAGE DISPOSAL
dO
-
"
Q.FT.GAR' @ 3/aa
OC
HOUSE SEWER
DBL
$
-,.
CITYZIP CODE CITY
I „ ZIP CODE
GAS PIPING
E_7
PERMIT FEE
CC>
PERMIT FEEilll
; EE FEE
�
�,.
DBL.
I TOTAL FEES
/!� j
MOB.H M.FEE
MICRO FEE
/�
MECH. FEE
L.,CK.. FEE
arlr�•
CONST. FEE
ELECT. FEE .
i��
SMI FEE. 'i
Jt •`/,.,,.may
FEE
PLUMB. FEE
9
J F• M A M J J A 5 O' N D
JOB ADDRESS SP NO
� I
OWNER
,�j p `
77 _ 4
COMMUNITY
,
VALUATI
lCjj �\
$ �5 i�®
4,
DATE
DST
Z //`/(///f'''
1 O�
78
,MH PERMIT FEE$•
sE o PER IT'
F.C.
SU . TO RMIT
PERMIT
NO.
2906MICROFILM
FEE
COPIES
$
eBO)pOyK� P)A'G%E P�ApRCEL LEGA�L�DyESC TION{/�
MECHANICAL FEE
DBL
$
USE NO.
ZONE
•
LOT
GRP i TYPE CK BY
'I'!'•
11.er
w•Sl;( �[
V/N'�V
•S reel
I .�
wSSE+T..BACK
5 w/
S
R
PLAN CHECK FEE
$
BOND AMT.
PLAN L40. PLAN PLAANN CCHECKER '.' FINAL DATE JINSPECTOR
f
�f{jy/j
CONSTRUCTION FEE
DBL'
$
NAME OF CONST. LENDER BRANCH
OFFICE t
NO LENDER INVOLVED
ELECTRICAL,FEE
DBL
$
ADDRESS CITY
STATE
STRONG MOTION
FEESPECIAL
$INSTRUMENTATION
OWNER%i1'O�7,.rIGNATURE�CONTRACTOR
INSP
DEMOLITION
EE -
FEE-
$
ADDRES ADDRESS
REGISTRATION
REGISTRATION)
PLUMBING FEE
DBL
$
e
CITYZIP CODE CITY
I „ ZIP CODE
<. TOTAL FEES $ '
TEL. Nd. 9- AREA
CODE • , TEL.
NO."-
AREA CODE
CENSE,
CASH❑.CHECK O.❑N.C.❑ QV`7`
�'ie' ,�
`.
RECEIVED -BY� TREES REQUIRED
THIS IT SHALL BECOME VOID IF.WORK IS NOT COMMENCED WITHIN 120 DAYS.- CESSATION OF
WO R 120 DAYS SHALL ALSO CAUSE PERMIT .TO BECOME VOID.
Y AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE. '
T LAWS OF RIVERSIDE COUNTY AND THE STATE,OF CALIFORNIA, I ALSO AGREE TO CARRY,
SEWAGE SYSTEM
t=>
/�/Y�
T LL
P �//]
A �G ATII ll lwlcl 1
L UP—MI EMFLVI CCJ. COMPLIANCE WITH THE LAWS OF THESTATE OF
CALIFORNIA COVERING CONTRACTORS IS -ALSO GUARANTEED.
I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE I
SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE -OF THE STATE, -
FORM 264-208 (REV. 6-76) OF CALIFORNIA. - -
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