285754 (PAT)DEPARTMENT OF BUILDING & SAFETY FIELD OFFICE
BUILDING PERMIT
J F M A M J J A S O
PERMIT NO.
lqww t.VV/Y I T Vi RI V CR3IUC
DST
CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES
1ST FL. SQ.
2ND FL.
POR.
GAR.
CAR P.
ALL SQ.
ESTIMATED CON TRUCTION
FT. @ $ UNITS
SQ. FT. @ YARD SPKLR SYSTEM
SQ. FT. @ MOBILEHOME SVC. BAR SINK
SQ. FT. @ POWER OUTLET ROOF DRAINS
SQ. FT. @ DRAINAGE PIPING
FT. @ DRINKING FOUNTAIN
SQ. FT. @ 1. URINAL
VALUATION $ WATER PIPING
NOTE: Not to be used as property tax valuation SWIM POOL, PVT FLOOR DRAIN
MECHANICAL FEES SWIM POOL, COMM WATER SOFTENER
VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD SIGN WASHER (AUTO) (DISH)
APPLIANCE ❑ DRYER GARBAGE DISPOSAL
F.C.
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED LAUNDRY TRAY
AIR HANDLING UNIT CFM IDLE METER KITCHEN SINK
ABSORPTION SYSTEM O B.T.U. TEMP USE PERM SVC WATER CLOSET
746
COMPRESSOR HP POLE, TEMP/PERM LAVATORY
54
HEATING SYSTEM ❑ FORCED ❑ GRAVITY AMPERES SERV ENT SHOWER
COPIES
BOILER B.T.U. SQ.FT. @ a BATH TUB
SQ. FT. @ a WATER HEATER
LEGAL ESCRIPTION
SQ.FT.RESID @ 11/4a SEWAGE DISPOSAL
SQ.FT.GAR- @ 1/4a HOUSE SEWER
-i
GAS PIPING
MECHANICAL FEE
PERMIT FEE
PERMIT FEE PERMIT FEE
DBL.
TOTAL FEES
F,/C:;t
MOB.HM.FEE
MICRO FEE MECH. FEE PL. CK. FEE
CONST. FEE ELECT. FEE SMI FEE..
FEE PLUMB. FEE
J F M A M J J A S O
JOB ADDRESS SP NO
N D n
44) n
OWNER '
A // -446"
efljg
76
77
OMM•W?JITY VALUATION
DATE
OSTf
OFFICE
M H PERMIT FEE
$
USE F PERMIT 1 1 �_
F.C.
5 PP. TO PERMIT PERMIT NO.
746
54
MICROFILM FEE
COPIES
$
BOOK PAGE PARCEL
LEGAL ESCRIPTION
AAA
MECHANICAL FEE
DBL
$
USE NO.
Z{OI Ef/
SET BACK
LOT SIZE GRP
/f
TYPE CKK BBy'.
(
[/�jyc
PLAN CHECK FEE
$
BOND AMT.
PLAN NO.
PLAN CHECKER
FI �(SA
INSTZ-
a'- 7
CONSTRUCTIONFEE
DBL
$
/
NAME OF CONST. LENDER BRANCH
OFFICE
NO LENDER INVOLV D
ELECTRICAL FEE
DBL
$
ADDRESS CITY
STATE
STRONG MOTION
$
.`1 k
OWNTAGENTS SIGNA •' RE CONTRACTO
/
INSTRUMENTATION FEE
(f V
SPECIAL INSP
$
AD 55 ADDRESS
J. 1
�'
DEMOLITION
FEE
r'
A/
REGISTRATION
,
G 'F+. to '^•_l
PLUMBING FEE
DBL
$
CITY ZIP CODE Cln
i ZIP CODE
TO FEES gjo, $
TEL. NO.
AREA CODE TEL.
NO.
AREA CODE
LICENSE a
CASH❑CHE .O '.C.❑�
RECEIVED BY S REQUIRED
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF
WORK FOR. 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
I HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE
SEWAGE SYSTEM
T LL
P
WITH THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, I ALSO AGREE TO CARRY
CC)MPFIJCATInM IIJCI IDAIJ('C lion AAV CAADInVCC[ !'nAADI IAA1(•C WITU TNF I AWC nF THF CTATF CIF
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
FORM 284-208 IREV. 6.761
OF CALIFORNIA.