290770 (AR)FIELD OFFICE
BUILDING PERMIT DEPARTMENT OF BUILDING & SAFETY
J F M A M 1 J' A S O N D
PERMIT NO.
OWNER •
VUUN-1 T Ur K1VCK�IUC �I
77
COMMUNITY
DSTs
�i
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
78
1ST FL.
2ND FL.
POR.
GAR.
CAR P.
WALL
`ESTI%v1ATED CONSTRUCTION
SQ. FT. @ $
UNITS
USE OF PERMIT ./Vy �.
SQ, FT. @ YARD SPKLR SYSTEM
SUPP. TO[/P�yEI�M�jIT[T'�
SQ. FT. @ MOBILEHOME SVC. BAR SINK
SQ. FT. @ POWER OUTLET ROOF DRAINS
SQ. FT. @ DRAINAGE PIPING
SQ. FT. @ DRINKING FOUNTAIN
SQ. FT. @ C3 URINAL
VALUATION $ WATER PIPING
NOTE: Not to be used as property tax valuation
SWIM POOL, PVT
FLOOR DRAIN
MICROFILM FEE
- MECHANICAL FEES
SWIM POOL, COMM
WATER SOFTENER
ITOOR -PAGE PARCEL
VENT SYSTEM [( FAN ❑ EVAP. COOL p HOOD
SIGN
WASHER (AUTO) (DISH)
APPLIANCE ❑ DRYER
GARBAGE DISPOSAL
MECHANICAL FEE
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
$
LAUNDRY TRAY
USE NO.
AIR HANDLING UNIT CFM
IDLE METER
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERM SVC
WATER CLOSET
COMPRESSOR r� HIP
POLE, TEMP/PERM
LAVATORY
HEATING SYSTEM ❑ FORCED ❑ GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SQ. FT. @ ¢
BATH TUB
SQ. FT. @ ¢
WATER HEATER
PLAN CHECK FEE-
SQ.FT.RESID @ 11/4¢
SEWAGE DISPOSAL
'
SQ.FT.GAR @ 3/4¢
HOUSE SEWER
FINAL DATE INSPECT
R
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE.
DBL.
TOTAL FEES
MOB.HM.FEE
MICRO FEE
MECH. FEE PL. CK. FEE
I CONST. FEE ELECT. FEE
SMI FEE
FEE
PLUMB. FEE
J F M A M 1 J' A S O N D
JOB ADDRESS SP NO
I
OWNER •
76
T
77
COMMUNITY
VALUATION
DATE
FF
OICE
78
M H PERMIT FEE
$
USE OF PERMIT ./Vy �.
F.C.
SUPP. TO[/P�yEI�M�jIT[T'�
PERMIT NO.
2
70
MICROFILM FEE
COPIES
ITOOR -PAGE PARCEL
LEGAL DESCRIPTION
MECHANICAL FEE
DBL
$
USE NO.
ZONE
SET BACK
LOT SIZEGRP
TYPE CKf^(yBY
PLAN CHECK FEE-
$
BOND AMT.
PLAN NO.
PLAN'CHECKER
FINAL DATE INSPECT
R
CONSTRUCTION FEE
DBL
$
NAME OF CONST. LENDER BRANCH
OFFICE
NO LENDER INVOLVED
ELECTRICAL FEE
DBL
$,
ADDRESS CITY
STATE
STRONG MOTION
$
OWNER/AGENTS SIGNATURE CONTRACTOR
j
INSTRUMENTATION FEE
SPECIAL INSP
$
ADDRESS ADDRESS
DEMOLITION
REGISTRATION
FEE
/f
PLUMBING FEE
DBL
$
CITY ZIP CODE CITY
ZIP CODE
bl
TOTAL FEES
$
TEL. NO. AREA
CODE TEL.
NO.
AREA CODE
LICENSE v
:ASH❑CHECK .O.❑N.C•❑
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,
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RECEIVED BY �' ~ TREES REQUIRED
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.
�eIHEREBY
kEWAGE SYSTEM
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
rn_D[wlc4n
- COMPLIANCE WITH THE LAWS OF IYIt JIA EOF
CALIFORNIA COVERING CONTRACTORS IS ALSO GUARANTEED.
I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE
FORM 284-208 (REV. 6.761 SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE
OF CALIFORNIA.