286143 (BLCK)DEPARTMENT OF BUILDING & SAFETY FIELD OFFICE
BUILDING PERMIT.A.
-
' J F M A M J J A S O N I D
PERMIT No..
2861431rf
OWNER
COUNTY OF RIVERSIDE
I.77
COMMUNITY VALUATION
DST
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
$
1ST Fl.
2ND FL.
POR.
GAR.
CAR P.
WALL 1;eAl
ESTIMATED CONSTRUCTION
SQ. FT. @ $
UNITS
SQ. FT. @ YARD SPKLR SYSTEM
X1 RAj A),ql 6143
SQ. FT. @ MOBILEHOME SVC. BAR SINK
COPIES
SQ. FT. @ POWER OUTLET ROOF DRAINS
SQ. FT. @ DRAINAGE PIPING
SQ. FT. @ DRINKING FOUNTAIN
SQ. FT. @ URINAL
22-006 �k j G I
I tA
VALUATION $ WATER PIPING
DBL
NOTE: Not to be used os property tax valuation
SWIM POOL, PVT
FLOOR DRAIN
ZONE
MECHANICAL FEES
ISWIM POOL, COMM
WATER SOFTENER
TYPE
VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD
SIGN
WASHER (AUTO) (DISH)
APPLIANCE ❑ DRYER
GARBAGE DISPOSAL
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
I
LAUNDRY TRAY
I
AIR HANDLING UNIT CFM
IDLE METER
KITCHEN SINK
PLAN CHECK FEE
ABSORPTION SYSTEM B.T.U.
TEMP USE PERM SVC
WATER CLOSET
BOND AMT.
COMPRESSOR HP
POLE, TEMP/PERM
LAVATORY
HEATING SYSTEM ❑ FORCED ❑ GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SQ -FT. @ 4
BATH TUB
1
SQ.FT. @ 4
WATER HEATER
SQ.FT.RESID @ 11/44
SEWAGE DISPOSAL
'CONSTRUCTION FEE
DBL
SQ.FT.GAR @ 3/44
HOUSE SEWER
NAME OF CONST. LENDER
BRANCH OFFICE
NOLENDERINVOLVED
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
(:ELECTRICAL FEE
DBL.
I TOTAL FEES
MOB.H M,FEE
MICRO FEE
MECH. FEE PL. CK. FEE
CONST. FEE ELECT. FEE
/q Q
FOS <. 0
SMI FEE
FEE
PLUMB. FEE
-
' J F M A M J J A S O N I D
JOB ADDRESS SP NO
OWNER
76
I.77
COMMUNITY VALUATION
DATE DST O ICE
I-- E
M H PERMIT FEE
$
USE O ER IT F.C. SUPP. O PE IT PE MI NO.
'
X1 RAj A),ql 6143
MICROFILM FEE
COPIES
$
BOOK PAGE
PPAGE PARCEL LEGAL&DESCRIPTION
22-006 �k j G I
I tA
( MECHANICAL FEE
DBL
$
USE NO.
ZONE
SET BACK
LOT SIZE GRP
TYPE
CK BY
r
I
s�
I
S
S
R
PLAN CHECK FEE
$
BOND AMT.
PLAN NO. PLAN CHECKER
FINAL DATE777
CCTOrR
INE;
7 GIW
1
'CONSTRUCTION FEE
DBL
$
NAME OF CONST. LENDER
BRANCH OFFICE
NOLENDERINVOLVED
(:ELECTRICAL FEE
DBL
$
ADDRESS
CITY
STATE
t
�
s
f�
`STRONG MOTION
$
OWNER/AGENTS SIGNATURE
CONTRACTOR i 1 -,l ` tr!rJ.uel�Y
'INSTRUMENTATION FEE✓t
I
,'SPECIALINSP
$
ADDRESS
ADDRESS
6DEMOLITION
FEE
`.REGISTRATION
'PLUMBING FEE
DBL
$
CITY ZIP CODE
CITY ZIP CODE
9,226,0
TOTAL FEES $
TEL. NO.
TEL. NO.
AREA CODE
LICENSE a
•CASH HECK❑M.O.❑N.C.❑ �pl[
=ODE
jj»,o
7f
' RECEIVED BY TREES REQUIRED
IS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF
RK FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
OWEREBY
FSEWAGE SYSTEM
AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE
�. T
LL
P
H THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, I ALSO AGREE TO CARRY
s - aJ• CUMPtNaA I IUN INSUKANCt UPUN MY tMPLUYtE5. COMPLIANCE WITH THE LAWS OF THE STATE OF
CALIFORNIA COVERING CONTRACTORS IS ALSO GUARANTEED.
I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE
FORM 284-208 (REV. 8-76) SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE
OF CALIFORNIA.