301832 (SFD)r DEPARTMENT OF BUILDING & SAFETY FIELD OFFICE
BUILDING PERMIT a „—
'
J F M A M J J A S O N
- PERMIT NO.
301 am
OWNER
%.VVI\1 i Vr RI Y 6R.;:IIYC
COMMUNITY„�.0
GL,✓r
VA,L/UjATIO
g tS.
DST
CONSTRUCTION ESTIMATE.
78
NO.
ELECTRICAL FEES
$
NO. PLUMBING FEES
USE OFr PERMIT
1 ST FL.
2ND FL.
POR.
GAR.
CARP.
WALL
ESTIMATED CONSTRUCTION
SQ. FT. @,1e, -4,4T$
PERMIT
NO.
UNITS
SQ. FT. @ ( YARD SPKLR SYSTEM
>� 'r ✓' 64E C
10
SQ. FT. @ >G MOBILEHOME SVC. BAR SINK
SQ. FT. @ Jr�a4O POWER OUTLET ROOF DRAINS
SQ. FT. • @ DRAINAGE PIPING
MICROFILM FEE
SQ. FT. @ DRINKING FOUNTAIN
$
SQ. FT. @ URINAL
'BOOK Ar GE PARCEL
VALUATION $ / - WATER PIPING
+.
NOTE: Not to be used as property tax valuation
SWIM_POOL, PVT
f
FLOOR DRAIN
DBL
$
MECHANICAL FEES
USE NO.,
ZONE
SWIM POOL, COMM
GRP
WATER SOFTENER
CK BY
VENT SYSTEM WAN ❑ EVAP. COOL 5j&OOD
rad
SIGN
WASHER (AUTO) (DISM)
APPLIANCE J>VRYERJ
PLAN CHECK FEE
$
GARBAGE DISPOSAL
PLAN NO.
PLAN CHECKER
FURNACE ❑ UNIT Cl WALL ❑ FLOOR ❑ SUSPENDED
/C70R
LAUNDRY TRAY
AIR HANDLING UNIT r—� CFM
IDLE METER"
DBL
KITCHEN SINK
e
NAME OF CONST, LENDER
ABSORPTION SYSTEM 0 B.T.U.
NO D R INVOLVED
TEMP USE PERM SVC
WATER CLOSET '
COMPRESSOR . HP.
p,,
DBL. •
POLE, TEMP/PERM
LAVATORY
CITY
STATE
HEATING SYSTEM ORCED ❑ GRAVITY.MPERES
SERV ENTf3
SHOWER
BOILER B.T.U.
SQ.FT. @ a
BATH TUB
STRONG MOTION
-
$
-
OWNER/AGENTS SIGNATURE
SQ.FT: @ a .
INSTRUMENTATION FEE
WATER ,HEATER
CX7
gT1
G7f:y
�w•�'
SPECIAL INSP.$.
Q.FT.RESID @ 11/44
%�
SEWAGE DISPO$A'L
ADDRESS - -
AD RESS -
1
SQ.FT.GAR ' @ 3/4a
�-s�
HOUSE SEWER
17�yA
4/
PFEE
PLUMBING FEE
DBL
GAS PIPING
CITY ZIP CODE
PERMIT FEE
GC?
PERMIT FEE
XPERMIT FEE
...
TOTAL FEES $
DBL.
TOTAL FEES //�
MOB.HM.FEE
MICRO FEE
MECH. FEE
PL. CK, FEE
CONST: FEE
y�
EL FEEAi�
SMIFEE
FEE
PLUMB. FEE,
'
J F M A M J J A S O N
JOB ADDRESS SP NO
OWNER
76
77
COMMUNITY„�.0
GL,✓r
VA,L/UjATIO
g tS.
DATEd
v,`",+'`
DSTf FICE
78
M H PERMIT FEE
$
USE OFr PERMIT
F.C.
SUPP TO PERMIT
PERMIT
NO.
>� 'r ✓' 64E C
G'.t.Y?
301
832
MICROFILM FEE
COPIES
$
'BOOK Ar GE PARCEL
LEGALJDESCRIPTION
f
MECHANICAL FEE
DBL
$
USE NO.,
ZONE
SET BACK LOT SIZE
GRP
TYPE
CK BY
+. e�
S 8 .3 .R.;Z
PLAN CHECK FEE
$
BOND AMT.
PLAN NO.
PLAN CHECKER
FINAL DATE IN/SP
/C70R
CONSTRUCTION FEE
DBL
NAME OF CONST, LENDER
BRANCH OFFICE
NO D R INVOLVED
ELECTRICAL FEE
DBL. •
$
ADDRESS
CITY
STATE
STRONG MOTION
-
$
-
OWNER/AGENTS SIGNATURE
CONTRA_ CT '14 .• � V,�.`;”' /'-
r/
INSTRUMENTATION FEE
gT1
G7f:y
�w•�'
SPECIAL INSP.$.
ADDRESS - -
AD RESS -
DEMOLITION
REGISTRATION
17�yA
4/
PFEE
PLUMBING FEE
DBL
$
CITY ZIP CODE
Cm ZIP CODE
TOTAL FEES $
TEL. NO.
flEL. NOf
AREA CODE
LICENSE/>s
CASH❑CHE-5!k- O.bN.C.❑
j G
RECEIVED BY TREES REQUIRED
T SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF
20 DAYS SHALL ALSO'CAUSE PERMIT -TO BECOME VOID. -
H B AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE ;
THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, I ALSO AGREE TO CARRY
AADCwIC ATI/lwl Iw lc• in♦ w�,-r „n.-�..... �..... �...��.. .. i.. _.....__ . .._.. _.._
SEWAGE SYSTEM
T
LL
j
P a/ .
-11— Ur Il m I= ILV TCCJ. 1111AYLIANC-t WI 111 1 M LAWJ UY IHt JIAIt Vh
CALIFORNIA COVERING CONTRACTORS 1S 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
FORM 284-208 (REV. 6.76) OF CALIFORNIA. -