290192 (SPIN)DEPARTMENT OF BUILDING 81 SAFETY FIELD OFFICE
BUILDING PERMIT ^r nivrnr�nr 1
!'
PERMIT NO.
9 0 19
JOB ADDRESS I SP NO
I
1.VVI\1 ► Vr KIYCRJIIJC/OE1SJ1
3 f
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
`
i
1 ST FL.
2ND FL.
POR.
GAR.
CAR P. EE]SQ.
WALL SQ.
ESTIMATED CONSTRUCTION
SQ. FT. @ $
UNITS
OFFICE
SQ. FT. @ YARD SPKLR SYSTEM
SQ. FT. @ MOBILEHOME SVC. BAR SINK
•^�
SQ. FT. @ POWER OUTLET ROOF DRAINS
IT, @ DRAINAGE PIPING
FT. @ DRINKING FOUNTAIN
SQ. FT. @ - 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
:.
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
LAUNDRY TRAY
COPIES
$
AIR HANDLING UNIT CFM
IDLE METER
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERM SVC
WATER CLOSET
/DESCRIPTION
fwL%l —
"
COMPRESSOR HP
POLE, TEMP/PERM
LAVATORY
USE NO.
i
HEATING SYSTEM ❑ FORCED ❑ GRAVITY
AMPERES SERV ENT
SHOWER
TYPE
BY
BOILER B.T.U.
SQ.FT. @ a
BATH TUB
I
SQ. FT. @ a
WATER HEATER
-
SQ.FT.RESID @ 11/4a
SEWAGE DISPOSAL
SQ.FT.GAR @ 1/4a
HOUSE SEWER
I
5
S
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
$
i'
DBL.
TOTAL FEES
I4
MOB.HM.FEEJ
MICRO FEE
MECH. FEE PL. CK. FEE
I CONST. FEE ELECT. FEE
SMI FEE
' QEE
f M� f�
PLUMB. FEE
J F M A M J J A S O
N D
JOB ADDRESS I SP NO
I
OWNER
76
Yi
77
COMMUNITY
VALUATION
DATE
OFFICE
•^�
'78
;h1 H PERMIT FEE
$
USE OP[RMI
F.C.
SUPP O PERMIT PERMIT
NO.
f C�
MICROFILM FEE
COPIES
$
BOOKAGE PARCEL
LEGAL
/ f oo
/DESCRIPTION
fwL%l —
yMECHANICAL FEE
DBL
$
USE NO.
ZONE I
SET BACK
I LOT SIZE
GRP
TYPE
BY
ICK
I
5
S
R
:'PLAN CHECK FEE
$
BOND AMT.
PLAN NO.
PLAN CHECKER
FINAL DATE INS
ECTOR
CONSTRUCTION FEE
DBL
$
NAME OF CONST. LENDER BRANCH
OFFICE
NO LENDER INVOLVED
ELECTRICAL FEE
DBL
$
ADDRESS CITY
STATE
STRONG MOTION
$
OWNER/AGENTS SIGNATURE CONTRACTOR
'
INSTRUMENTATION FEE
N�
'SPECIALINSPADDRESS
$
AD
E 5
'DEMOLITION
r!�EE
�?C3
'REGISTRATION7—S-,�49
ogee 14
.PLUMBING FEE
DBL
$
CITY ZIP CODE CITY
ZIP CODE
TOTAL FEES
$
TEL. NO. AREA
CODE TEL.
NO.
LIC N//
HECK❑ .O.❑N.C.❑—
��;CASH
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[RECEIVED BY TREES REQUIRED
THIS *PERMIT SHALL BECOME VOID IF WORK 15 NOT COMMENCED WITHIN .120 DAYS. CESSATION OF
flyy
ORK FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
(SS EWAGE SYSTEM �V'
I HEREBY AGREE THAT ALL'WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE
T LL
iP
WITH THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, I ALSO AGREE TO CARRY
inAAPFIJCATInM IKICI IDAAI!-C I ID/1Al AAV CAADl/ VCCC l'/1DI IA III/ %A ITU TUC I A%AIC 11 TUC CTATC /lC
�'6'V"..,v,'r�r.—'alr—C"TO'S'IS'�—SO"G''A-R—A�rr�Il-rr�w.��rrllr
CALIFORNIA COVERING CONTRACTORS IS A150 GUARANTEED.
I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE
FORM 264-206 (REV. 6-76) SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE
OF CALIFORNIA.