296526 (SFD)DEPARTMENT OF BUILDING & SAFETY
BUILDING PERMIT a ^ —
FIELD OFFICE
J F M A M J J A 5 O N D
PERMIT NO.
129652-6
mow
1
Cwtm I i Or RI V CR3IUC
f'- [
DST
CONSTRUCTION ESTIMATE
COMMUNITY
NO. ELECTRICAL FEES
NO. PLUMBING FEES
DST
I ST FL. 3-2-37
2ND FL.
POR. %J�
GAR.
CAR P.
WALL
ESTIMATED CONSTRUCTION
SQ. FT. @ & r $
} b
UNITS
$
SQ. FT. @ YARD SPKLR SYSTEM
F.C.
/
SQ. FT. @ �[_ MOBILEHOME SVC. BAR SINK'
PERMIT NO.
SQ. FT. @ , . Owl POWER OUTLET ROOF DRAINS
SQ. FT. @ DRAINAGE PIPING
SQ. FT. @ Y� DRINKING FOUNTAIN
�(�+r;ry- `�
TT;
SQ. FT. @ URINAL
VALUATIONWATER $ +� PIPING
1!v
NOTE: Not to be used as property tax valuation
COPIES
SWIM POOL, PVT
FLOOR DRAIN
BOOK PAGE PARCEL
LEGAL DESCRIPTION
MECHANICAL FEES
SWIM POOL, COMM
WATER SOFTENER
VENT SYSTEM 2XFAN ❑ EVAP. COOL EJHOOD�
DBL
SIGN
WASHER (AUTO)f)ISH)
pie
ZONESET
APPLIANCE DRYER
C
GRP
GARBAGE DISPOSAL
cs0
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
IDLE METER
f KITCHEN SINK
e�
ABSORPTION SYSTEM 0 B.T.U.
TEMP USE PERM SVC
WATER CLOSET
G
$
COMPRESSOR 6-7HP
BOND AMT.
POLE, TEMP/PERM
/57 LAVATORY
Gt0
ECTOR
HEATING SYSTEM FORCED GRAVITY
( ❑
�—� :?e AMPERES SERV ENT
�? SHOWER
NAME OF CONST. LENDER BRANCH
BOILER B.T.U.
NO LENDER INVOLVED
SQ.FT. @ a
i'" BATH TUB
e. e>
00
SQ.FT. @
IWATER HEATER
0E7
$
ADDRESS CITY
_?d . Q.FT.RESID @ I I/4a
` SEWAGE DISPOSAL
-y SQ.FT.GAR @ 3/4(1
HOUSE SEWER
STRONG MOTION
INSTRUMENTATION FEE�4«
$
GAS PIPING
00
PERMIT FEE
G5
_
PERMIT FEES
PERMIT FEE
L�n
'SPECIALINSP
DEMOLITION
DBL.
TOTAL FEES
../�I �/ . "
MOB.H M.FEE
"
MICRO FEE
�• -
M•�ECCH..yFEE
.. -rte 1
PL. CK. FEE
CONST. FEE
Q% l d7
ELECT. FEEE� 'SMI FEE
�`, / g
FEE
PLUMB.
V4/
J F M A M J J A 5 O N D
JOB ADDRESS SP NO
�j`jfI
OWNER -
76'57
f'- [
I 5 i
77
COMMUNITY
VALUATION
DATE -
DST
OFFICE
M H PERMIT FEE
$
USE OF PERMITIf (^�
F.C.
SUPP. TO PERMIT
PERMIT NO.
�(�+r;ry- `�
TT;
MICROFILM FEE
COPIES
$
BOOK PAGE PARCEL
LEGAL DESCRIPTION
MECHANICAL FEE
DBL
$
37
USE NO.
ZONESET
BACK
LOT SIZE
GRP
TYPE CK fB^Y�7
L-6�1
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
00
ELECTRICAL FEE
DBL
$
ADDRESS CITY
STATE
STRONG MOTION
INSTRUMENTATION FEE�4«
$
OWNER/AGENTS SIGNATURE
ONTRACTOR
L�n
'SPECIALINSP
DEMOLITION
FEE
$
ADDRESS ADDRESS
REGISTRATION '
PLUMBING FEE
DBL
$
CITY ZIP CODE CITY
ZIP CODE
TOTAL FEES$
%
TEL. NO, JAREACODE,
TEL.
NO. AREA CODE
�
LICENSE R
CASH❑CHEC M.O.❑N.C.❑—+-►
.] f Y %
01
11Vii' ""
RECEIVED BL,. TREES REQUIRED
T 'IT SHALL BECOME VOID IF WORK 15 NOT COMMENCED WITHIN 120 DAYS. CESSATION OF
RK . 20 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
� H GREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE
W HE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, I ALSO AGREE TO CARRY
MPENSATIO
SEWAGE SYSTEM
dd�
LL
j
P i
N INSURANCE UPON MY EMPLOYEES. 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. 6-76) SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE
OF CALIFORNIA.