286892 (SFD)DEPARTMENT OF BUILDING & SAFETY FIELD OFFICE
BUILDING PERMIT ~
J F M A M J J A S O
PER NO.
'Raw
Lwin\11 Vr RI Y CR>t1YC
76
77
DST
CONSTRUCTION ESTIMATE
VALUATION
NO. ELECTRICAL FEES
OFFICE
NO. PLUMBING FEES
' 1 ST FL. SQ.
2ND FL.
POR.
GAR.
CAR P. SQ.
WALL SQ.
ESTIMATED CONSTRUCTION
FT. @ R% $
UNITS
USfJEO PER IT ¢
F.C.
SUPP. TO PERMIT
SQ. FT. @ YARD SPKLR SYSTEM
O.
N28
_ MOBILEHOME SVC. BAR SINK
SQ. FT. @00
4�C�
SQ. FT. @ 4o POWER POWER OUTLET ROOF DRAINS
FT. @ DRAINAGE PIPING
FT. @ DRINKING FOUNTAIN
SQ. FT. @ URINAL
VALUATION $ Cd WATER PIPING
+
' NOTE: Not to be used as property tax valuation
$
SWIM POOL; PVT
BOOrKy PAGE
�� PARCEL
FLOOR DRAIN
MECHANICAL FEE
MECHANICAL FEES
$
SWIM POOL, COMM
USE NO.
WATER SOFTENER
SET BACK LOTSIIE GRP
VENT SYSTEM FAN ❑ EVAP. COOL 5eOOD
CK BY
SIGN
WASHER (AUT ISH)
44 wl
APPLIANCE WRYER
p¢3
IRyS SIR �r
GARBAGE DISPOSAL
ClCi
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
v/7
LAUNDRY TRAY
1 S V jftA
AIR HANDLING UNIT CFM
I
IDLE METER
KITCHEN SINK
►�
. ABSORPTION SYSTEM 0 B.T.U.
PLAN NO.
TEMP USE PERM SVC
FINAL CD—ATE' I I�rg/q��C
WATER CLOSET
COMPRESSOR HP
J4 4W
POLE, TEMP/PERM
LAVATORY
;
HEATING SYSTEM ORCED ❑ GRAVITY
0£
AMPERES SERV ENT
22
3SHOWER
BRANCH OFFICE NO
BOILER B.T.U.
SQ.FT. @ a
BATH TUB
QO
SQ.FT. @ a
DBL
WATER HEATER
caCD
ADDRESS
CITY STATE
W�FQQ.FT.RE50 @ 11/aa
SEWAGE DISPOSAL
0
SQ.FT.GAR @ 3/aa
f
HOUSE SEWER
GAS PIPING
f
PERMIT FEE
3
$
PERMIT FEE
C7i�
PERMIT FEE
tyC3
DBL.
TOTAL FEE�S]MOB.HM.FEEI
MICRO EE
�MyE�C�yHy. FEE/✓�
L. CK. FEE
CONST. FEE
ELECT. FEE
SMI FEE
FEE
PLUMB. FEEree
J F M A M J J A S O
N D
JOB ADDRESS SP NO
I
50A2%.
OWNER
76
77
COMMUNITY
VALUATION
DAT DST
OFFICE
M H PERMIT FEE$
USfJEO PER IT ¢
F.C.
SUPP. TO PERMIT
PERMIT
O.
N28
MICROFILM FEE
COPIES
$
BOOrKy PAGE
�� PARCEL
LEGAL, DESCRIPTIOlq
MECHANICAL FEE
DBL
$
USE NO.
[ZONE
SET BACK LOTSIIE GRP
TYPE
CK BY
IRyS SIR �r
v/7
1 S V jftA
I
PLAN CHECK FEE
$
BONDAMT. .
PLAN NO.
PLAN CHECKER
FINAL CD—ATE' I I�rg/q��C
;CONSTRUCTION FEE
DBL
$
NAME OF'CONST. LENDER
BRANCH OFFICE NO
LENDER INVOLVED
:ELECTRICAL FEE
DBL
$
ADDRESS
CITY STATE
"
J`
4 S
:STRONG MOTION
$
OWNER/AGENTS SIGNATURE
CONTRACT!/`•t
'INSTRUMENTATION FEE
SPECIALINSP$
ADDRESS
ADDRESS
DEMOLITION
REGISTRATION
FEE
r3- 740
PLUMBING FEE
DBL
$
00
CITY ZIP CODE
CITY ZIP CODE
TOTAL FEES$
TEL. NO. AREA
CODE
TEL. AREA CODE
LICENSE ate,/
CASH ❑CHEC .O.❑�❑
jNO.. /�j /
73`J'i~3— / g, it
RECEIVED BY TREES REQUIREDI
SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF
O 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
I - B AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE.
THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, I ALSO AGREE TO CARRY
MPENSATION INSUR
;SEWAGE SYSTEM
T �
LL
P �y
yS
ANLE 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
SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE
FORM 284.208 (REV. 6-761 OF CALIFORNIA.