302226 (SFD)DEPARTMENT OF BUILDING & :SAFETY � FIELD OFFICE
BUILDING PERMIT _--
J F M A M J 1 A S O. TJ D
PERMIT NO.
..302226-1
#
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77 -
CONSTRUCTION ESTIMATE-
DATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
$ ,
1ST FL.
2ND FL.
- POR.
GAR.
CAR P.
WALL
ESTIMATED CONSTRUCTION
SQ. FT. @ $
tc�.'i
UNITS '
M H PERMIT FEE
$
SQ. FT. @ YARD SPUR SYSTEM
USE OF27
ERM
SQ. FT. @ C?� MOBILEHOME SVC. BAR SINK
SUPP TO P.E PERMITO.
SQ. FT. POWER OUTLET ROOF DRAINS
SQ. FT. @ DRAINAGE PIPING
SQ. FT. @ DRINKING FOUNTAIN
SQ. FT. @ URINAL
VALUATION $ GSe:7 WATER PIPING
�3
NOTE: Not to be used as property tax valuation
$
SWIM POOL, PVT
BOOK VAGE PARCEL
FLOOR DRAIN
MECHANICAL FEES
SWIM POOL, COMM
WATER SOFTENER
DBL
$
VENT SYSTEM ❑ FAN ❑ EVAP. COOL HOOD
USE N6.
SIGN
SET BACK
WASHER (AUTO)(at.*
GRP TYPE-
CK BY
APPLIANCE DRYER
srr
GARBAGE DISPOSAL
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la
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
I
S
LAUNDRY TRAY
R
PLAN CHECK FEE
AIR HANDLING UNIT. CFM
$
IDLE METER
BOND AMT.
KITCHEN SINKQ
PLAN CHECKER
FINAL DATE 1 PECTOR
ABSORPTION SYSTEMIF
0 B.T.U.
TEMP USE PERM SVC
WATER CLOSET
Gjp
COMPRESSOR �,HPI
1POLE, TEMP/PERM
LAVATORY
tjl9
HEATING SYSTEM ORCED ❑ GRAVITY
A01AMPERES SERV ENT
1f 00
SHOWER
"
BOILER B.T.U.
NO LE DER INVOLVED
SQ. FT. @ a
BATH TUB
•
SQ. FT. @ a
DBL
WATER HEATER
ADDRESS CITY
STATE
SQ.FT.RESID @ .11/aa
SEWAGE DISPOSAL
06? .
SQ. FT. GAR .@, 3/aa
HOUSE SEWER
OWNER/AGENTS SIGNATURE CONTRACTOR
INSTRUMENTATION FEE
GAS PIPING
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9
PERMIT FEE
PERMIT FEE
042
PERMIT FEE
'SPECIALINS
DBL. I
TOTAL FEES MOB.HM.FEE
MICRO FEE
-WECH. FEE
PL. CK. FEE
NNST:FEE
CONST.-FEE
I
ELEe FEE
SMI FEE
FEE
PL
J F M A M J 1 A S O. TJ D
JOB ADDRESS L O SP NO
O , I
OWNER -" - -
�
a
77 -
C NIT VA ATIO
DATE
DST .OFFICE'
$ ,
78
M H PERMIT FEE
$
USE OF27
ERM
F.C.
SUPP TO P.E PERMITO.
302226
MICROFILM FEE
COPIES
$
BOOK VAGE PARCEL
LE AL DESCRIPTON
MECHANICAL FEE
DBL
$
USE N6.
ZONE
SET BACK
LOT SIZE
GRP TYPE-
CK BY
srr
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la
I
S
S
R
PLAN CHECK FEE
$
BOND AMT.
PLAN NO. •
PLAN CHECKER
FINAL DATE 1 PECTOR
(-(JIf
CONSTRUCTION FEE
DBL
$
NAME OF CONST, LENDER BRANCH
OFFICE
NO LE DER INVOLVED
•
ELECTRICAL FEE
DBL
$
ADDRESS CITY
STATE
STRONG MOTION
$.
OWNER/AGENTS SIGNATURE CONTRACTOR
INSTRUMENTATION FEE
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9
'SPECIALINS
$
ADDRESS d' Y ADDRESS
DEMOLITON
FEE
'
f
REGISTRATION
/
PLUMBING FEE
DBL
$
CITY zIP c DE CITY
ZIP CODE
-
TOTAL FEES -� $
TEL. NO.
AREA CTEL.
NO.
AREA CODE
LICENSE #'
CASH ❑CHECK .O.❑N.C.❑
14.—F
RECEIVED BY TREES REQUIRED
THI P M T SHALL BECOME VOID If WORK IS NOT COMMENCED WITHIN 1.20'DAYS. CESSATION OF
20 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID,
I AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE
SEWAGE SYSTEM
/
T LL
If
p
TH LAWS Of RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, I ALSO AGREE TO CARRY
ATT: A --
-6
�.-......�.�,.�� •. I I� ir'..•J vl Il ll JII•'. I,L VI
CALIFORNIA COVERING CONTRACTORS IS ALSO GUARANTEED.
I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HASDONE,
FORM zea-zoa IaEv. a•�sl SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE
OF CALIFORNIA.