290199 (RER)FIELD OFFICE
. DEPARTMENT OF BUILDING E`I SAFETY
BUILDING PERMIT ,, l lklvw ,r r 1 ,
_
PERMIT NO.
901
I
Ujulm1 I Vr RIYCR.�IUC
-6
5��]
CONSTRUCTION ESTIMATE
VALUATION
NO. ELECTRICAL FEES
DST
1I
NO. PLUMBING FEES
.7B
1 ST FL.
2ND FL
GAR.
CAR P.
WALL SQ.
ESTIMATED CONSTRUCTION
SQ. FT. @ $
4�
UNITS
USE OF PERMIT f� Dai ¢ to
F.C.
SUPP. TO PERMIT
SQ. FT. @ YARD SPKLR SYSTEM
NO.
SQ. FT. @ MOBILEHOME SVC. BAR SINK
SQ. FT. @ POWER OUTLET ROOF DRAINS
SQ. FT. @ DRAINAGE PIPING
FT. @ DRINKING FOUNTAIN
SQ. FT. @ URINAL
a
VALUATION $ g WATER PIPING
9
NOTE: Not to be used as property tax valuation
SWIM POOL, PVT
.,MICROFILM FEE
'�
FLOOR DRAIN
$
MECHANICAL FEES
LEGAL DESCRIPTION
,� or.. f, � - .5L3
SWIM POOL, COMM
DBL
WATER SOFTENER
USE NO.
VENT SYSTEM ❑ FAN ❑ EVAP. COOL OOD
SET BACK
SIGN
f WASHER ((DISH)
'
APPLIANCE ❑ DRYER
GARBAGE DISPOSAL
;wQ
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
/�4'
LAUNDRY TRAY
AIR HANDLING UNIT CFM
I S
IDLE METER
R
/ KITCHEN SINK
PLAN CHECK FEE
ABSORPTION SYSTEM B.T.U.
TEMP USE PERM SVC
PLAN NO.
WATER CLOSET
FINAL DATE
INSPE OR
COMPRESSOR HP
QG
POLE, TEMP/PERM
LAVATORY
'
HEATING SYSTEM ❑ FORCED ❑ GRAVITY
AMPERES SERV ENT
DBL
SHOWER
NAME OF CONST. LENDER BRANCH
BOILER B.T.U.
6 LENDER NVOLVED
SQ.FT. .@ a
BATH TUB
SQ.FT. @ a
DBL
WATER HEATER
;t!r
�.�
ADDRESS CITY
STATE
Q.FT.RESID @ 11/4a
SEWAGE DISPOSAL
OWNER AGENT SIGNATURE CONTRACTOR
INSTRUMENTATION FEE
SQ.FT.GAR @ 3/4a
HOUSE SEWER
,
`S117 PECIALINSP
DEMOLITION
FEE
$
GAS PIPING
A RESS ADDRESS
"40.3�,F'7F"I/P 43elelll(4
PERMIT FEE
3
PERMIT FEE1
PERMIT FEE
DBL.
TOTAL FEES
MOB.HM.FEE
MICRO FEE
MEECH. FEE
. CK. FEE
C'OON/S�T. FEE
ELECT. FFEE
SMI EE
FEE
PLUMB. �FEE
�
J F I M A M 1 J A S O N D_t
e wmr�rvaranvry mw ��
JOB ADDRESS I SP NO
// _•� I
OWNER
.76
-6
—
77
COMMUNITY
.�` Vit,! -
VALUATION
DATE
15 %*7
DST
1I
I OFFICE
.7B
M H PERMIT FEE
$
USE OF PERMIT f� Dai ¢ to
F.C.
SUPP. TO PERMIT
PE MIT
NO.
f e�
a
9
.,MICROFILM FEE
'�
COPIES
$
BOOK PAGE PARCEL
7 i3. r�r�
LEGAL DESCRIPTION
,� or.. f, � - .5L3
MECHANICAL FEE
DBL
$
USE NO.
ZONNEE
A?
SET BACK
LOT SIIZyE�J1 GRP I TYPE CKJ`B�Yt
z.
�
/�4'
I S
S
R
./'1
PLAN CHECK FEE
$
BOND AMT.
PLAN NO.
PLAN CHECKER
FINAL DATE
INSPE OR
w
CONSTRUCTION FEE
DBL
$
NAME OF CONST. LENDER BRANCH
OFFICE
6 LENDER NVOLVED
`� %
✓ 9
ELECTRICAL FEE
DBL
$
;t!r
�.�
ADDRESS CITY
STATE
STRONG MOTION
$
OWNER AGENT SIGNATURE CONTRACTOR
INSTRUMENTATION FEE
/
`S117 PECIALINSP
DEMOLITION
FEE
$
A RESS ADDRESS
"40.3�,F'7F"I/P 43elelll(4
REGISTRATION
PLUMBING FEE
DBL
$
CI Y ZIP CODE CITY
ZIP CODE
TOTAL FEES'
TEL. N
CODE TEL.
NO.
AREA CODE
LICENSE a
CASH❑CHECK O.❑N.C.❑ !
]AREA
RECEIVED BYTREES 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.
SEWAGE SYSTEM
I HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE
T LL P
WITH THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, I ALSO AGREE TO CARRY
�.
IN mi cmrLvT rCO.�.vmru'+1��-c YYI 1 n ITU Irl rvo yr mU a 1 n 1 L v
CALIFORNIA COYER' TORS IS ALSO GUARANTEED.
QUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE
FORM 284-208 IREV. a-781 `'"' TN 5541 OF THE BUSINESS AND PROFESSIONS- CODE OF THE STATE