286893 (ELEC)i
FIELD OFFICE
•
BUILDING PERMIT DEPARTMENT OF BUILDING & SAFETY A.
'
J F M A M J J A S O 1 N I D�
PERMIT NO.
286 8�
K-
%.VVIV 1 i Vi RI V CRMuc
76
_ -
DST
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
DATE
'.LI I
NO. PLUMBING FEES
OFFICE
' 1 ST FL.
2ND FL.
POR.
GAR.
' CAR P.
WALL SQ.
ESTIMATED CONSTRUCTION
SQ. FT. @ $
UNITS
$
USE 49F PERMIT
,&A sw�
SQ. FT. @ YARD SPKLR SYSTEM
SUPP. TO PERMIT
SQ. FT. @ MOBILEHOME SVC. BAR SINK
G893
SQ. FT. @ POWER OUTLET. ROOF DRAINS
MICROFILM FEE
SQ. FT. @ DRAINAGE PIPING
$
FT. @ DRINKING FOUNTAIN
BOOK PAGE PARCEL
SQ. FT. @ URINAL
VALUATION Is WATER PIPING
` NOTE: Not to be used as property tax valuation
SWIM POOL, PVT
FLOOR DRAIN
DBL
'
MECHANICAL FEES
SWIM POOL, COMM
ZONE
WATER SOFTENER
LOT SIZE
•
VENT SYSTEM [j FAN ❑ EVAP. COOL ❑ HOOD
SIGN
WASHER(AUTO)(DISH)
'
APPLIANCE ❑ DRYER
s
I
GARBAGE DISPOSAL
S
R
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
]CK
LAUNDRY TRAY
PLAN CHECK FEE$
AIR HANDLING UNIT CFM-
•IDLE METER
BOND AMT.
KITCHEN SINK
FLAN CHECKER
FIIJAI DATEINSPECTOR
ABSORPTION SYSTEM B.T.U.
TEMP USE PERM SVC
WATER CLOSET
COMPRESSOR O HP
POLE, TEMP/PERM
LAVATORY
:CONSTRUCTION FEE
DBL
HEATING SYSTEM ❑ FORCED ❑ GRAVITY
.,AMPERE -SERV ENT
I
SHOWER
NO LENDER INVOLVED
BOILER B.T.-U.
SQ.FT. @ ¢
BATH TUB
ELECTRICAL FEE
SQ.FT. @ ¢
$
WATER HEATER
ADDRESS CITY
'
STATE
SQ.FT.RESID @ 11/4¢
SEWAGE DISPOSAL
C3� 0
r°
SQ.FT.GAR @ 3/4¢
-
STRONG MOTION'
HOUSE SEWER
$
OWNERIAGENTS SIGNATURE CONTRAC
INSTRUMENTATION FEE
GAS PIPING
PERMIT FEE
SPECIALINSP
PERMIT FEE
i?
PERMIT FEE
$
•
DBL. I
TOTAL
,,FEES
yy
'cap
L
IMOB.HM.FEEI
MICRO FEE
:M7ECHt.FEEEPL'CK. FEE
CONST. FEE
ELECT. FEE
f�A
SMI FEE
FEE
PLUMB. FEE
J F M A M J J A S O 1 N I D�
JOB ADDRESS SP NO
OWNER -
76
.77
COMMUNITY
ul0
VALUATION
DATE
'.LI I
DST
iI
OFFICE
78
TLA
:M H PERMIT FEE
$
USE 49F PERMIT
,&A sw�
SUPP. TO PERMIT
PE
�Ml�O
G893
MICROFILM FEE
COPIES'
$
BOOK PAGE PARCEL
LEG DESCRIPTION
- d- 429r'a.
MECHANICAL FEE
DBL
$
USE NO. '
ZONE
SET BACK
LOT SIZE
GRP
TYPE
BY
s
I
S
S
R
]CK
•. 41i
PLAN CHECK FEE$
BOND AMT.
PLAN NO.
FLAN CHECKER
FIIJAI DATEINSPECTOR
:CONSTRUCTION FEE
DBL
$
NAME OF CONST. LENDER BRANCH
OFFICE
NO LENDER INVOLVED
ELECTRICAL FEE
DBL
$
ADDRESS CITY
STATE
C3� 0
r°
-
STRONG MOTION'
$
OWNERIAGENTS SIGNATURE CONTRAC
INSTRUMENTATION FEE
05 s Z
SPECIALINSP
$
ADDRESS ADDRESS.
DEMOLITION
;REGISTRATION
FEE
;
PLUMBING FEE
DBL
$
CITY ZIP CODE CITY
ZIP CODE
vmf
• TOTAL FEES $
�
TEL. NO. AREA
CODE TEL.
NO.
AREA CODE
LICENSE tt
J
CASH ❑CHEC .O.❑N.C.❑ J
134-47/9'
1
:RECEIVED BY go, TREES REQUIREDTHIS
PERMIT SHALL BECOME VOID IF WORK 15 NOT COMMENCED WITHIN 120 DAYS. CESSATION OF
AWITH
WORK FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME. VOID.
SEWAGE SYSTEM
I HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE
T LL P
THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, I ALSO AGREE TO CARRY
tUMVtINJA I IUN INOUKANLt UPUN MY tMPLUYttS. 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 CAI IFORNIA- -