290067 (SFD)BUILDING PERMIT DEPARTMENT OF BUILDING & SAFETY
FIELD OFFICE
'JOB
J F I M A M J J A S O 1 N I D
PERMIT NO.
r 76
\.VVI�I I Vf RIv 1% IV&
-low'
DST
OFFICE
DST
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
La Uinta � °� _ �� -77
1ST FL. SQ.
2ND FL.
POR.
GAR.
CAR P. SQ.
WALL SQ.
ESTIMATED CONSTRUCTION
FT. @ r- {. $ 1Q2
4,V4-:24"
UNITS
$
USE OF PERMITF.C.
SQ. FT. @ YARD SPKLR SYSTEM
PE MIT
SQ. FT. @ r j>� . MOBILEHOME SVC. BAR SINK
C)40
SQ. FT. @ POWER OUTLET ROOF DRAINS
FT. @ DRAINAGE PIPING
FT. @ DRINKING FOUNTAIN
{^
SQ. FT. @ URINAL
90067
VALUATION $ WATER PIPING
'KJ
NOTE: Not to be used as property tax Valuation
!MICROFILM FEE
SWIM POOL, PVT
$
FLOOR DRAIN
BOOK .AGE PARCEL
LEGAL DESC PTIO.N
MECHANICAL FEES
SWIM POOL, COMM
WATER SOFTENER
Tot 12- T.A Outnts Cal
I MECHANICAL FEE
VENT SYSTEM "FAN ❑ EVAP. COOL '. HOOD
$
SIGN
USE NO. ZONE SET BACK
WASHER (AUTO*ISH)
A �+
TYPE CK BY
APPLIANCE aORYER
GARBAGE DISPOSAL
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
LAUNDRY TRAY
w I 30` S 1 S R 'i
AIR HANDLING UNIT CFM
IDLE METER
KITCHEN SINK
BOND AMT,
ABSORPTION SYSTEM O B.T.U.
PLAN CHECKER
TEMP USE PERM SVC
^ WATER CLOSET?+
COMPRESSOR ;—;3 P
POLE, TEMP/PERM
LAVATORY
I:CONSTRUCTION FEE
HEATING SYSTEMS FORCED E] GRAVITY
$
« f, AMPERES SERV ENT
NAME OF CONST. LENDER
�d SHOWERS
NO LENDER INVOLVED
BOILER B.T.U.j
SQ.FT. @ ¢
BATH TUB
c (�
ELECTRICAL FEE
DBL
$
SQ. FT. @ a
ADDRESS
WATER HEATER
STATE
'e SQ.FT.RESID @ 11/aa
SEWAGE DISPOSAL
r*4'SQ.FT.GAR @ 1/4a
S/
HOUSE SEWER
STRONG MOTION
$
OWNER/AGENTS SIGNATURE
f GAS PIPING
,y p
PERMIT FEE
cis.
PERMIT FEE
!.L- Q
PERMIT FEE
i
DBL.
TOTAL FEES
I C/----
MOB.HM.FEE
MICRO FEt
MECH. FEE
�=f� f"��
Pit. CK. FEE
�'' ''`" (r�'
CONST. FEE
'"��fP Glr
ELECT. FEE
� [��i
SMI FEE
✓"'• _a�.-l'
FEE
PL B. FEE
,r„"'�...
'JOB
J F I M A M J J A S O 1 N I D
ADDRESS I SP NO OWNER
,I
-731 Sam VimenteI ELDRIDM, Jack
r 76
COMMUNITY VALUATION DATE
DST
OFFICE
$
`ice
La Uinta � °� _ �� -77
11
IrAit
M H PERMIT FEE
$
USE OF PERMITF.C.
SUPP. TO PERMIT
PE MIT
NO.
{^
90067
!MICROFILM FEE
COPIES
$
BOOK .AGE PARCEL
LEGAL DESC PTIO.N
61'7-30r-007
Tot 12- T.A Outnts Cal
I MECHANICAL FEE
DBL
$
USE NO. ZONE SET BACK
LOT SIZE
GRP
TYPE CK BY
rw�•�
w I 30` S 1 S R 'i
if—
PLAN CHECK FEE
'$
BOND AMT,
PLAN NO.
PLAN CHECKER
DATE INSPECTOR
103
[FINAL
I:CONSTRUCTION FEE
DBL
$
NAME OF CONST. LENDER
BRANCH OFFICE
NO LENDER INVOLVED
ELECTRICAL FEE
DBL
$
ADDRESS
CITY
STATE
p
f7
STRONG MOTION
$
OWNER/AGENTS SIGNATURE
CONT Cd'OR+"`,
'INSTRUMENTATION FEE
`4�t
IAD
i}t
SPECIAL INSP
$
ADDRESS
DRESS
DEMOLITION
FEE
' :REGISTRATION
If
PLUMBING FEE
DBL
$
CITY ZIP CODE
CIT o ZIP CODE
F
yid
�t
*9 lAgA
. TOTAL FEES $
TEL. NO.
AREA CODE
TEL. NO.
AR'Elk'CODETcTrme
3,
CASH ❑CHECK .O.❑N.C.❑
63
A
/.�
i a I 412qq,
.RECEIVED BY r TREES REQUIRED
THIS PERMIT SHALL BECOME VOID IF WORK ISNOT COMMENCED WITHIN 120 DAYS. CESSATION OF
ORK FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
SEWAGE SYSTEM r
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
r- - I.VIv\r Cl`\JMI 1-11 1111rl`1 L Vf VI`1 /Y\1 Uv\rLVICCJ. l.V/Y\r IINIV \.0 YYlin InC L/1 YYJ Vf Inc JIfi1C Vr
CALIFORNIA COVERING CONTRACTORS IS ALSO GUARANTEED.
I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE'
FORM 264-208 (REV. 6-76) SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE
OF CALIFORNIA.