290398 (AR)DEPARTMENT OF BUILDING 81 SAFETY FIELD OFFICE
.
BUILDING PERMIT — „ ,
J F M A M J J A• S O N D
PERMIT NO. 8
9039
OWNER
L.VVIVI T Or KIYCKJI{JC
COMMUNITY
VALUAATION
DST
1 //
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
M H PERMIT FEE
NO. PLUMBING FEES
$
1ST FL. m2
2ND FL.
POR.
GAR.
CAR P.
WALL SQ.
ESTIMATED CONSTRUCTION
SQ. FT. @ $
F.C.
UNITS
PERMIT NO.
SQ. FT. @ YARD SPKLR SYSTEM
SQ. FT. @ MOBILEHOME SVC. BAR SINK
SQ. FT. @ POWER OUTLET ROOF DRAINS
SQ. FT. @ DRAINAGE PIPING
290398
FT. @ DRINKING FOUNTAIN
SQ. FT. @ URINAL
COPIES
VALUATION $ WATER PIPING
•NOTE: Not to be used os property tax valuation
LEGAL DESCRIPTION
SWIM POOL, PVT
FLOOR DRAIN
MECHANICAL FEES
s
r
ISWIM POOL, COMM
DBL
WATER SOFTENER
. VENT SYSTEM AN p EVAP. COOL ❑ HOOD
txCr
SIGN
LO IZE
WASHER (AUTO) (DISH)
TYPE
APPLIANCE ❑ DRYER
GARBAGE DISPOSAL
FURNACE ❑ UNIT. ❑ WALL ❑ FLOOR ❑ SUSPENDED
LAUNDRY TRAY
I
AIR HANDLING UNIT CFM
S
IDLE METER
PLAN CHECK FEE
KITCHEN SINK
$
ABSORPTION SYSTEM B.T.U.
BOND AMT.
TEMP USE PERM SVC
PLAN CHECKER
WATER CLOSET
'00
COMPRESSOR E HP
POLE, TEMP/PERM
LAVATORY
Qin
HEATING SYSTEM ❑ FORCED ❑ GRAVITY
AMPERES SERV ENT
CONSTRUCTION FEE
SHOWER
$
BOILER B.T.U.
NAME OF CONST. LENDER BRANCH
SQ.FT. @ Q
NOLEN DERINVOLVED
BATH TUB
SQ.FT. @ a
WATER HEATER
ELECTRICAL FEE
DBL
$
SQ.FT.RESID @ l 1/4a
f
SEWAGE DISPOSAL
STATE
SQ.FT.GAR @ 3/4a
HOUSE SEWER
STRONG MOTION
$
GAS PIPING
ACTOR +!
PERMIT FEE
PERMIT FEEQ
PERMIT FEE
SPECIAL INSP
DBL.
TOTAL FEES
IMOB.HM.FEEI
MICRO FEE
MECH. FEE
PC CK. FEE
CONST. FEE
ELECT. FEESMI
FEE
FEE
PLUMB. FEE
J F M A M J J A• S O N D
JOB ADDRESS SP NO
OWNER
76
77
COMMUNITY
VALUAATION
DATE +
7-7
GIST/ OFFICE
71
M H PERMIT FEE
$
USE OF PERMIT
F.C.
S,UIP�P. TO PE IT
PERMIT NO.
mnc,
290398
MICROFILM FEE
COPIES
$
BOOK P GE PARCEL
LEGAL DESCRIPTION
«y
s
r
MECHANICAL FEE
DBL
$,
USE NO.
ZONE
ET BACK
LO IZE
GRP
TYPE
�-
le -1
JCKBY
I
5
S
R
PLAN CHECK FEE
$
BOND AMT.
PLAN NO.
PLAN CHECKER
FINAL DATE INSPECTOR
'
CONSTRUCTION FEE
DBL
$
NAME OF CONST. LENDER BRANCH
OFFICE
NOLEN DERINVOLVED
ELECTRICAL FEE
DBL
$
ADDRESS CITY
STATE
STRONG MOTION
$
OWNER/AGENTS SIGNATURE CONT�
ACTOR +!
INSTRUMENTATION FEE
�' ter`..
SPECIAL INSP
$
ADDRESS ADORES!;
DEMOLITION
REGISTRATION
FEE
/�Y f
/.�
PLUMBING FEE
DBL
$
CITY ZIP CODE CITY
ZIP CODE
TOTAL FEES
$
TEL. NO. AREA
CODE!!
AREA CODE
LICENSE a
-ASH❑CHECK .O.❑N.C.❑
7/'-f
2
RECEIVED BY `� TREES REQUIREf
a THIS -PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF
WORK FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
SEWAGE SYSTEMI
HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE
ccs T LL P
WITH THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, I ALSO AGREE TO CARRY
COMPENSATION
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 2e4-206 (REV. 6-76) SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OFTHE STATE
OF CALIFORNIA.