301849 (SFD). DEPARTMENT OF BUILDING & SAFETY FIELD OFFICE
BUILDING PERMIT
J F M A M J J A S O ND
PERMIT NO4 91.
3 01
-
VVVIYI t. Vr RIYCR7IYC
77
COMMUNITY - ALUAI N
DA - O ICE
CONSTRUCTION ESTIMATE
/ �-
NO. ELECTRICAL FEES
M H PERMIT FEE
NO. PLUMBING FEES
$
1ST FL.
2ND FL.
FOR.
GAR.
CAR P.
WALL
ESTIMATED CONSTRUCTION
SQ. FT. @ $
d
UNITS
IT NO.
SQ. FT. @ YARD SPKLR SYSTEM
SQ. FT. @ ' d MOBILEHOME SVC. BAR SINK
SQ. FT. @4 a -0 POWER OUTLET ROOF DRAINS
SQ. FT. '@ DRAINAGE PIPING
SQ. FT. @ DRINKING FOUNTAIN
SQ. FT. @ URINAL
COPIES
VALUATION $ WATER PIPING
fJD
NOTE: Not to be used os property tax valuation
LEGAL DESCRIPT N
SWIM POOL, PVT
FLOOR DRAIN
MECHANICAL FEES
MECHANICAL FEE
SWIM POOL, COMM
$
WATER SOFTENER -
USE NO.
ZONE
VENT SYSTEM AN ❑ EVAP. COOL OOD
LOT SIZES
SIGN
TYPE CK BY
WASHER (AUTO)(Q1AW
" DC7
2-
APPLIANCE RYER
C$t�
/s)—
4014910I
GARBAGE DISPOSAL .
13
I• C
FURNACE ❑ UNIT [:]WALL ❑ FLOOR ❑ SUSPENDED
S
x,�Myy ry
R!'Yi
PLAN CHECK FEE
LAUNDRY TRAY
$
AIR HANDLING UNIT CFM
PLAN NO.
IDLE METER
FINAL DATE INS
KITCHEN SINK
�t9
ABSORPTION SYSTEM B.T.U.
TEMP USE PERM SVC
WATER -CLOSET .,
�Q
COMPRESSOR p/ HP
DBL
POLE, TEMP/PERM
LAVATORY
ri�t3
NOL DER INVOLVED
HEATING SYSTEM ORCED ❑ GRAVITY
BOILER T. U.
ALJ
AMPERES SERV ENT
AaZJ
SQ.FT. @ a
SQ.FT. @ a
�00
SHOWER
BATH TUB
WATER HEATER
ELECTRICAL FEE
.DBL
SQ.FT.RESID @ 11/4a
SEWAGE DISPOSAL
d�C)
STATE
We7jSQ.FT.GAR @ ?/4a
HOUSE SEWER
A
STRONG MOTION
$
GAS PIPING
G>tv
INSTRUMENTATION FEE
PERMIT FEEp
PERMIT FEE
;n
PERMIT FEE
31 i0
DBL.
TOTAL FEES
IMOB.HM.FEEI
MICRO FEE
M H. FEE
L. CK. FEE
I CONST. FEE EL
. FEE/�
SMI FEE
FEE
PLUMB. FEES}
J F M A M J J A S O ND
JOB ADDRESS SP NO
I
OWNER
f
a
76
77
COMMUNITY - ALUAI N
DA - O ICE
41
/ �-
78
M H PERMIT FEE
$
OSE PERMIT F.C.
SIPP.IrO PERMIT
PE$3
IT NO.
w av01841
MICROFILM FEE
COPIES
$
BOOK GE PARCEL
LEGAL DESCRIPT N
MECHANICAL FEE
DBL
$
USE NO.
ZONE
SET BACK
LOT SIZES
PP
TYPE CK BY
2-
/s)—
4014910I
a
I• C
'S
S
x,�Myy ry
R!'Yi
PLAN CHECK FEE
$
BOND AMT.
PLAN NO.
PLAN CHECKER
FINAL DATE INS
P TOR
CONSTRUCTION FEE
DBL
$
NAME OF CONST. LENDER
BRANCH OFFICE
NOL DER INVOLVED
110
ELECTRICAL FEE
.DBL
$
ADDRESS
CITY
STATE
A
STRONG MOTION
$
OWNER/AGENT S SIGNATURE
CONTRAC70R
A' he y D
INSTRUMENTATION FEE
'SPECIAL INSP
$
ADDRESS
ADD SS �^
DEMOLITION
FEE
REGISTRATION
PLUMBING FEE
DBL
$
CITY ZIP CODE
C ITY ZIP cooE
TOTAL FEES $
TEL. NO.
AREA CODE
L.O.
A EA CODE
LICENSE
CASH❑CHEC .O.❑N.C.❑,_�
�y
RECEIVED BY. TREES REQUIRED
T SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF
*K20 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
HGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE
SEWAGE SYSTEM
f
T �lj
LP
WS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, I ALSO AGREE TO CARRY
FORM 284-208 (REV. 6-76)
® CQMrtNJAIIUN INJURANLE 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
SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE
OF CALIFORNIA.