290233 (RPL)FIELD OFFICE
- DEPARTMENT OF BUILDING & SAFETY S
BUILDING PERMIT _ .__ _ __
•
J F M A M J J A S O N D
. PERMIT NO.
2-90233
OWNER
Ire
%.VUIVI T VF KIVCKbIUt'I
77
t
COMMM,UNNITYY
I VALUATION
DST
t
CONSTRUCTION ESTIMATE
NO. I ELECTRICAL FEES
78
NO. PLUMBING FEES
1 ST FL.
2ND FL.
POR.
GAR.
CAR P.
WALL SQ.
ESTIMATED CONSTRUCTION
SQ. FT. @ $
JUNITS
F.C.
SUP . TO PERMIT , PE
MIT
SQ. FT. @ YARD SPKLR SYSTEM
SQ. FT. @ MOBILEHOME SVC. BAR SINK
COPIES
SQ. FT. @ POWER OUTLET ROOF DRAINS
SQ. FT. @ DRAINAGE PIPING
LEGAL DESCRIPTION
1064 rlaltz' v 00 --
FT. @ DRINKING FOUNTAIN
DBL
SQ. FT.- @ f � URINAL
VALUATION $ WATER PIPING
ZONE
NOTE: Not to be used as property tax valuation
SWIM POOL, PVT
190
1 FLOOR DRAIN
MECHANICAL FEES
SWIM POOL, COMM
WATER SOFTENER
VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD
SIGN
WASHER (AUTO)(DISH)
PLAN CHECK FEE
APPLIANCE ❑ DRYER
$
GARBAGE DISPOSAL
PLAN NO.
FURNACE ❑ UNIT ❑ WALL [:)FLOOR ❑SUSPENDED
FINAL DATE INSPECTOR
LAUNDRY TRAY
AIR HANDLING UNIT
IDLE METER
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERM SVC
$
WATER CLOSET
NAME OF CONST. LENDER
COMPRESSOR HP
POLE, TEMP/PERM
LAVATORY
HEATING SYSTEM ❑ FORCED (:]GRAVITY
AMPERES SERV ENT
SHOWER
ELECTRICAL FEE
BOILER B.T.U.
SQ.FT. @ a
BATH TUB
CITY
STATE
SQ.FT. @ a
WATER HEATER
t�
SQ.FT.RESID @ 11/4a
I
SEWAGE DISPOSAL
$
SQ.FT.GAR @ 3/4a
OWNER/AGENTS SIGNATURE
HOUSE SEWER
GAS PIPING
00
PERMIT FEE
PERMIT FEE
PERMIT FEE
SPECIAL NSP
DBL.
TOTAL FEES
.
MOB.HM.FEE
MIG RO FEE
MECH. FEE PL. CK. FEE
ear
CONST. FEE
mo -
..311.1��
ELECT. FEE
����
SMI FEE
it�
FEE
PLUMB. FEE
•
J F M A M J J A S O N D
JOB ADDRESS SP NO
I
/f"�iar� 7 _ . �?/ti%1i�7~,p I
OWNER
Ire
76—_
77
t
COMMM,UNNITYY
I VALUATION
DATE
OST
OFFICE
78
M H PERMIT FEE
$
USE OF PERMIT
F.C.
SUP . TO PERMIT , PE
MIT
NO.
MICROFILM FEE
COPIES
$
BOOK PAGE PARCEL
107- 3541-
LEGAL DESCRIPTION
1064 rlaltz' v 00 --
MECHANICAL FEE
DBL
$
USE NO.
ZONE
SET BACK LO�TyJJS��IZJJ//E%%
A
GRP
TYPE
Cf�K�pyBY
/
s'
PLAN CHECK FEE
$
BOND AMT.
PLAN NO.
PLAN CHECKER
FINAL DATE INSPECTOR
CONSTRUCTION FEE
DBL
$
00
NAME OF CONST. LENDER
BRANCH OFFICE
NO LENDER INVOLVED
ELECTRICAL FEE
DBL
$
ADDRESS
CITY
STATE
STRONG MOTION
INSTRUMENTATION FEE,
$
OWNER/AGENTS SIGNATURE
CONT -T R
r
SPECIAL NSP
$
ADDRESS
ADDRESS
DEMOLITION
REGISTRATION
FEES
'
�li
PLUMBING -FEE
DBL
$
O�
CITY ZIP CODE
CITY ZIP CODE
.�
��!
TOTAL FEES IsJ
TEL. NO. AREA
CODE
TEL.
AREA CODE
LICENSE`u
CASH ❑CHECK.O.❑N.C.❑
,N,O/.�
RECEIVED BY TREES REQUIRE
0or THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF
ORK FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME, VOID.
SEWAGE SYSTEMV
I HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE
T LL P
WITH THE LAWS'OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, I ALSO AGREE TO CARRY
—vmr�rv�r nvry I'zw"" It UVULA MY tMPLUTttS. 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.