296806 (SFD)DEPARTMENT OF BUILDING & SAFETY
BUILDING PERMIT
FIELD OFFICE
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J F M A M' J J A S O N D
PERMIT NO.
9680
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VV V1�11 Vr RIYGIli11OF.
77
COMMUNITY.(�1
-
DST
CONSTRUCTION ESTIMATE
OFFICE
NO. ELECTRICAL FEES
'M H PERMIT FEE *.
NO. PLUMBING FEES
$
1ST FL.
2ND FL.
' POR.
GAR.
CARP.
WALL
ESTIMATED CONSTRUCTION
SQ. FT. $
F.CC,
UNITS
PERMIT
NO.
SQ. FT. @ YARD SPKLR SYSTEM
°MICROFILM FEE
SQ. FT. .@ MOBILEHOME SVC. BAR SINK
$
SQ. FT. @A, 'fd' ,50, le POWER OUTLET ROOF DRAINS .
BOOK ARG E PARCEL
SQ. FT. @ DRAINAGE PIPING
MECHANICAL FEE
SQ. FT: @ DRINKING FOUNTAIN
$I
SQ. FT. @ ' URINAL
USE NO.
VALUATION $ , , WATER PIPING
_
NOTE: Not to be used as property tax valuation
GRP TYPE GK V
SWIM POOL, PVT
FLOOR DRAIN'
PLAN CHECK FEE
., ..-'MECHANICAL FEES"
1
SWIM POOL, COMM
PLAN
�y
WATER SOFTENER
FIN�jAL DATE INSe.ECT/OR/j
-VENT SYSTEM [) FAN ❑ 'EVAP. COOL OOD
a +
SIGN
0451,
WASHER (AUT ISH)
OO
NO LENDER INVOLVED
APPLIANCE ❑DRYER
DBL
$
GARBAGE DISPOSAL
�.a
STATE
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑,SUSPENDED
$lQ
i
LAUNDRY TRAY -
'SPECIAL INSP
DEMOLITON
REGISTRATION
AIR HANDLING UNIT CFM
IDLE METER
$
KITCHEN SINK,
POD ESS ADDRESS
!/ l� p ♦ G`�7
ABSORPTION SYSTEM 0 B.T.U.
TEMP USE PERM SVC
DBL
I
WATER CLOSET
,Z49
Y ZIP CODE CITY
.
ltA 4 2S
COMPRESSOR .0 HP
1AV0
POLE, TEMP PERM
TEL. NO. AREAjCO/
j X�
LAVATORY
NO.
AREA CODE
HEATING SYSTEM 5ZFORCED ❑ GRAVITY
RECEIVED B TREES REQUIREDHIS
AMPERES SERV ENT
SEWAGE SYSTEM
S
-
SHOWER
P
BOILER B.T.U.
SQ. FT. @ a
BATH TUBS
SQ.FT.' @ a
WATER HEATER
Q.FT.RESID @ 1%c
126-60SEWAGE
DISPOSAL
SQ.FT.GAR @ 3/aa
4046
HOUSE SEWER,
GAS PIPING
PERMIT FEE
PERMIT FEE
-3
PERMIT FEE
� •
DBL.
TOTAL FEES
MOB.HM.FEE
MICRO FEE
F MEC H. FEE
L. CK. FEE
CONST. FEE
ELECT. FEE
SMI FEE
FEE PLUMB. FEE
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J F M A M' J J A S O N D
ADDRESS. SP'NO
fpi A;Orejpj *z
OWN ,
76
77
COMMUNITY.(�1
VALUAT /tet w
DATE
DST
1
OFFICE
7804
'M H PERMIT FEE *.
$
USE OF`PER HITT (�/F�
F.CC,
SUPP. O PERMIT
PERMIT
NO.
°MICROFILM FEE
COPIES
$
BOOK ARG E PARCEL
LEGAL DESCRIPTION'
I,01l k " lam vl? 5 +i . .
MECHANICAL FEE
DBL
$I
��Iqq
USE NO.
ZONE
SET BACK
LOT SIZE ,(
/!
GRP TYPE GK V
FF
PLAN CHECK FEE
$
1
BOND
BOND AMT.
PLAN
�y
PLAN/C�HjEC/KER �)
FIN�jAL DATE INSe.ECT/OR/j
CONSTRUCTION FEE
DBL
$ "tt..
& J
0451,
NAME OF CONST. LENDER BRANCH
OFFICE
NO LENDER INVOLVED
ELECTRICAL FEE
DBL
$
ADDRESS CITY
STATE
STRONG MOTION
INSTRUMENTATION FEE
$lQ
i
OW AGENTS SIGNATURE CONTRACTOR
���
'SPECIAL INSP
DEMOLITON
REGISTRATION
$
POD ESS ADDRESS
!/ l� p ♦ G`�7
PFEE
PLUMBING FEE
DBL
I
$
l'3 s
Y ZIP CODE CITY
.
ltA 4 2S
. ZIP CODE
- TOTAL FEES $ '
CASH ❑CHECK `O.❑�❑
TEL. NO. AREAjCO/
j X�
DE TEL
/1
NO.
AREA CODE
LICENSE F
RECEIVED B TREES REQUIREDHIS
PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF
ORK FOR -120 DAYS SHAH ALSO CAUSE PERMIT TO BECOME VOID.
I HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE
WITH THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, I ALSO AGREE TO CARRY
C'CIMPFMCATIrN.M IMCI IDAM! C I I.—I I V Cw1Dl r•VCCC l-��wn, l w • �wilru ruc , w.�w, c ruc crwrc flc
SEWAGE SYSTEM
S
-
T LL
P
CALIFORNIA COVERING CONTRACTORS IS. ALSO GUARANTEED.
I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE
FORM 280-208 (REV, 6-76)SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE
OF CALIFORNIA.