303466 (SFD)DEPARTMENT OF BUILDING & SAFETY �" FIELD OFFICE
BUILDING PERMIT
-
PERMIT NO.
03
%.VVIVI L Or KI VCK31IJC3
DST1
�l
CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES
1 ST FL.
? p7
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. @ 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
SUPP. TO P ERMIT . I
VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD SIGN WASHER (AUTO)(DISH)
NO.
APPLIANCE (:1 DRYER GARBAGE DISPOSAL
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED LAUNDRY TRAY
AIR HANDLING UNIT CFM IDLE METER KITCHEN SINK
ABSORPTION SYSTEM B.T.U. TEMP USE PERM SVC WATER CLOSET
COMPRESSOR HP POLE, TEMP/PERM LAVATORY
HEATING SYSTEM ❑ FORCED ❑ GRAVITY AMPERES SERV ENT SHOWER
BOILER B.T.U. SQ.FT.• @ a BATH TUB
COPIES
SQ.FT. @ a WATER HEATER
SQ.FT.RESID @ 11/4a SEWAGE DISPOSAL
LEGAL DESCRI T N
SQ.FT.GAR @ 3/4a HOUSE SEWER
GAS PIPING
PERMIT FEE
PERMIT FEE. PERMIT FEE
-
DBL.
I TOTAL FEES
MOB.HM.FEE
MICRO FEE - MECH. FEE PL. CK. FEE CONST. FEE ELECT. FEE SMI FEE
J
FEE PLUMB. FEE
J F M A M J J A S O N D
JOB ADDRESS SP NO
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OWNER
'
G ee5ts
76
77
COMMUNITY
tV.,/
VALUATION
DATE
7
DST OFFICE
J
78
M H PERMIT FEE
$
USE OF PERMIT y F.C.
L
SUPP. TO P ERMIT . I
PERMIT
NO.
-
303466
MICROFILM FEE
COPIES
$
BOOK -PAGE' PARCEL
LEGAL DESCRI T N
;MECHANICAL FEE
DBL
$
USE NO.
ZONE
SET BACK
LOT SIZE
GRP
TYPE
CBY
I
��4
ICK
r
1
S
S
R
/a-
I IV
PLAN CHECK FEE
$
BOND AMT.
PLAN NO. PLAN CHECKER -
NSPECTOR
j /}
SIP
rrJA�LDA.TE;)
CONSTRUCTION FEE
DBL
$
NAME OF CONST. LENDER
BRANCH OFFICE
NO LENDER IN LVED
ELECTRICAL FEE
DBL
$
ADDRESS
CITY
STATE
STRONG MOTION
$
OWNE U'ENrs SIGNATURE..
CONTRACTOR
"INSTRUMENTATION FEE
'SPECIALINSP
$
AD R SS
ADDRESS,
DEMOLITION ffFEE
REGISTRATION
PLUMBING FEE
DBL
$
�' Y ZIP CODE
CITY ZIP CODE
TOTAL FEES 0 $
TEL. NO. AREA
CODE
TEL. NO.,
AREA CODE
LICENSE u
CASH❑CHECK
i
�/�
.O.❑N.C.❑/10
,:RECEIVED BY • TREES REQUIRED
HAI
HI MIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF
r
120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
SEWAGE SYSTEM /
""
AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE
T/'f'j� LL
jL H LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, I ALSO AGREE TO CARRY
wIf A T—
-
-I1 —I CrvIr LVTCC a. COMPUANCE WiTh THE LAWS OF THE JIAIC Or
CALIFORNIA INFE6N11
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 (REV. 6.761 OF CALIFORNIA. -