290768 (SPIN). DEPARTMENT OF BUILDING & SAFETY FIELD OFFICE
BUILDING PERMIT
J F I M A M J J A S O
.M
CO
PERMIT NO 8
9076
1 1 Vr RI Y CR71UC ''
DST
f
CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES
1 ST FL.
2ND FL.
POR.
GAR.
CAR P. SQ.
WALL SQ.
ESTIMATED CONSTRUCTION
SQ. FT. @ $ UNITS
SQ. FT. @ YARD SPKLR SYSTEM
SQ. FT. @ MOBILEHOME SVC. BAR SINK
SQ. FT. @ POWER OUTLET ROOF DRAINS
FT. @ 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
M H PERMIT FEE$
MECHANICAL FEES SWIM POOL, COMM WATER SOFTENER
VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD SIGN WASHER (AUTO) (DISH)
USE OF PERMIT
APPLIANCE ❑ DRYER GARBAGE DISPOSAL
S+U�PPP.lTTO PERMIT PERMIT
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED LAUNDRY TRAY
AIR HANDLING UNIT IDLE METER KITCHEN SINK
i
ABSORPTION SYSTEM B.T.U. TEMP USE PERM SVC WATER CLOSET
COMPRESSOR HP POLE, TEMP/PERM LAVATORY
/ F/Av�
HEATING SYSTEM ❑ FORCED ❑ GRAVITY AMPERES SERV ENT SHOWER
290768
BOILER B.T.U. SQ.FT. @ a BATH TUB
SQ. FT. @ a WATER HEATER
SQ.FT.RESID @ 11/4a SEWAGE DISPOSAL
SQ.FT.GAR @ 3/4a HOUSE SEWER
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GAS PIPING
PERMIT FEE
PERMIT FEE PERMIT FEE
MICROFILM FEE
DBL.
TOTAL FEES
MOB.HM.FEE
MICRO FEE MECH. FEE PL. CK, FEE
CONST. FEE ELECT. FEE SMI FEE
I ) FEE PLUMB. FEE
J F I M A M J J A S O
.M
CO
N D
JOB ADDRESS SP NO
4�l ,,
OWNE
I77 +4
COMMUNITY
VALUATION
DATE %
DSSTf
OFF
M H PERMIT FEE$
USE OF PERMIT
F.C.
S+U�PPP.lTTO PERMIT PERMIT
NO.
i
/ F/Av�
290768
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trE A•
MICROFILM FEE
COPIES
$
LEGAL DESCt6!
((/B/�O°OK IAGGGE�E PA;;�
_ i MZ.,tp
/-
,,MECHANICAL FEE
DBL
$
USE NO. ZONE SET BACK LOT SIZE GRP TYPE CK BY
t
'PLAN CHECK FEE
$
I S S R
BOND AMT. PLAN NO. PLAN CHECKER FINAL DATE I PECTOR
,CONSTRUCTION FEE
DBL
$
NAME OF CONST. LENDER
BRANCH OFFICE
NO LENDER INVOLVED
k
!ELECTRICAL' FEE
.
DBL
$
ADDRESS
•I
CITY
STATE
'STRONG MOTION
$
OWNER/AGEL47S SIGNATURE
CONTRACTOR
INSTRUMENTATION FEE
SPECIALINSP
:DEMOLITON
EE
$
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�/�
4'
ADDRESS '
Fb �b
ADDRESS
EGISTRATION
/ GGA/
s/'�j •
'PLUMBING FEE
DBL
$
CITYj t ZfP CODE
CITY ZIP CODE
TOTAL FEES
TEL. NO.
.
AR
J/v E�A^CCODE
TEL, NO,
AREA CODE
LICENSE tt
CASH HECK❑M.O.❑N.C.❑$
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:RECEIVED BY TREES REQUIRE
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.
LEWAGE SYSTEM
T I LL p
I HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE
WITH THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, I ALSO AGREE TO CARRY
COMPENSATION INSURANCE UPON MY EMPLOY EES PLIAWITH THEL AWS OF THE STATE OF
NCE
CALIFORNIA COVERING CONTRACTORS IS ALSO GUARANTEED.
I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE
FORM 284-208IREv. s -TBI SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE
OF CALIFORNIA.