286865 (BLCK)BUILDING PERMIT
• DEPARTMENT OF BUILD(NG & SAFETY .
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FIELD OFFICE
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I PERMIT NNO.
86865
I ROW COUNI 1 Vi RIYCR�IUC
1'
DST
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CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES
s. 1ST FL.
i 2ND FL.
i POR.
GAR.
CAR P.
WALL SQ
ESTIMATED CONSTRUCTION
SQ. FT. @ $ UNITS
SQ. FT. @ YARD SPKLR SYSTEM
SQ. FT. @ MOBILEHOME SVC. BAR SINK
SQ. FT. @ POWER OUTLET ROOF DRAINS
SQ. FT. @ DRAINAGE PIPING
FT. FT. @ DRINKING FOUNTAIN
SQ. FT. @ URINAL
VALUATION Is WATER PIPING
' NOTE: Not to be used as property tax valuation SWIM POOL, PVT FLOOR DRAIN
DST
/�
MECHANICAL FEES SWIM -POOL, COMM WATER SOFTENER
X78
VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD SIGN WASHER (AUTO) (DISH)
APPLIANCE ❑ DRYER GARBAGE DISPOSAL
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED LAUNDRY TRAY
AIR HANDLING UNIT CFM IDLE METER KITCHEN SINK
F.C.
ABSORPTION SYSTEM B.T.U. TEMP USE PERM SVC WATER CLOSET
MIT NO
COMPRESSOR HP POLE, TEMP/PERM I ILAVATORY
HEATING SYSTEM ❑ FORCED ❑ GRAVITY AMPERES SERV ENT SHOWER
COPIES
BOILER B.T.U. SQ.FT. @ a BATH TUB
SQ.FT. @ a WATER HEATER
LEGAL DESCRIPTION
SQ.FT.RESID @ 11/4a SEWAGE DISPOSAL
SQ.FT.GAR @ 3/4a HOUSE SEWER
GAS PIPING
PERMIT FEE
PERMIT FEE PERMIT FEE
DBL.
I TOTAL FEES
]MOB.HM.FEEI
MICRO FEE MECH. FEE PL. CK. FEE
1. CONSTA. FEE ELECT. FEE SMI FEE
4L01
I FEE PLUMB. FEE
'F M A M f A S Q
N D
JOB ADDRESSf I SP NO
OWNER
=77
COMMUNITY L
,vim e,-) .
VALUATION ^�
$ 1 �' �i � °
DATE -
/ -9' ,7
DST
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OFFICE
X78
M H PERMIT FEE
$
U/SEOF PERMIT
iEJ�/� Wil' f86865
F.C.
SU . TO PERMIT PE
MIT NO
'MICROFILM FEE
COPIES
$
BOOK PAGE PARCEL
LEGAL DESCRIPTION
MECHANICAL FEE
DBL
$
USE NO.
ZONE I
ET BACK
LOT SIZE
GRP
TYPE ICK BY
I
I
1
S
S
R
%
:PLAN CHECK FEE
$
BOND AMT.
PLAN NO.
PLAN CHECKER
FINAL DATE NSPECTOR
a- a -1.0
,
CONSTRUCTION FEE
DBL
$
NAME OF CONST. LENDER BRANCH
OFFICE
NO LENDER INVOLVED
C;,
:ELECTRICAL FEE
DBL
$
ADDRESS CITY
STATE
STRONG MOTION
Q
OWNER/AGENTS SIGNATURE CONTRAC
INSTRUMENTATION FEE
$
ADDRESS ADDRESS
..SPECIALINSP
DEMOLITION
FEE
H
REGISTRATION
7/— -
PLUMBING FEE
DBL
$
CITY ZIP CODE CITY
f ZIP CODE
TOTAL FEES$
TEL, NO. AREA
CODE TEL.
NO.
AREA CODE
LICENSE/ F
CASH ❑CHECK .O.❑N.C.❑%
='RECEIVED BY TREES REQUIRED
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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.
"SEWAGE SYSTEM
I HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE
fi T LL P
WITH THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, I ALSO AGREE TO CARRY
;f COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLIANCE WITH THE LAWS OF THE STATE OF
CALIFORNIA COVERING CONTRACTORS IS ALSO GUARANTEED.
I HEREBY CERTIFY THAT THEINDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE
FORM 284-208 IREV. 8-761 SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE
OF CALIFORNIA.