290503 (SFD)DEPARTMENT OF BUILDING 8 SAFETY FIELD OFFICE•
BUILDING PERMIT I
J F I M A M J J A S O N D
PERMIT NO.
OWNER
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COUNTY OF RIVERSIDE
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' CONSTRUCTION
ESTIMATE
VALUATION
NO. ELECTRICAL FEES
NO. PLUMBING FEES
FICE
1 ST FL.
2ND FL.
POR.
GAR.
CAR P.
WALL
ESTIMATED CONSTRUCTION
SQ. FT. @ i 44 $
_
UNITS
USE O PERMIT ��
F! a
SQ. FT. @ YARD SPKLR SYSTEM
SUPP. O PERMI
SQ. FT. @ W MOBILEHOME SVC. BAR SINK
SQ. FT. @ POWER OUTLET ROOF DRAINS
SQ. FT. @ DRAINAGE PIPING
COPIES
SQ. FT. @ DRINKING FOUNTAIN
SQ. FT. @ URINAL
VALUATION $ d� WATER PIPING
NOTE: Not to be used as property tax valuation
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SWIM POOL, PVT
FLOOR DRAIN
$ i
MECHANICAL FEES
ZONE
SWIM POOL, COMM
WATER SOFTENER
GRP TYPE
C BY
VENT SYSTEM C:j FAN ❑ EVAP. COOL ❑ HOOD
S10
SIGN
WASHER(AUTO)(DISH)
APPLIANCE ❑ DRYER
GARBAGE DISPOSAL
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FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
PLAN CHECK FEE
LAUNDRY TRAY
BOND AMT.
AIR HANDLING UNIT CFM
I PLAN CHECKER FINAL DATE INSPC�T
IDLE METER
KITCHEN SINK
�J
ABSORPTION SYSTEM B.T.U.
TEMP USE PERM SVC
WATER CLOSET
CONSTRUCTION FEE
COMPRESSOR HP
$
POLE, TEMP/PERM
LAVATORY
OFFICE,
NO LENDER IN OLVED
HEATING SYSTEM ❑ FORCED ❑ GRAVITY
AMPERES SERV ENT .
SHOWER
BOILER B.T.U.
SQ.FT. @ a
BATH TUB
SQ.FT. @ a
WATER HEATER
$
ADDRESS CITY"
SQ.FT.RESID @ 1114 a
SEWAGE DISPOSAL
SQ.FT.GAR @ 114a
HOUSE SEWER
STRONG MOTION
'
$
OWNER/AGENTS SIGNATURE CONTRACTORY_-^
GAS PIPING
PERMIT FEE
la
PERMIT FEE
PERMIT FEE
'
DBL.
TOTAL FEES
]MOB.HM.FEEI
MICRO FEE
MECH. FEE
PL. CK. FEE
CONST. FEE ELECT. FEF_
SMI FEE
FEE
PLUMB. FEE
J F I M A M J J A S O N D
JOB ADDRESS I SP NO
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OWNER
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77
EL
COMMUNITY
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VALUATION
DATE `
y DSST%
FICE
H1 H PERMIT FEE
_
$
USE O PERMIT ��
F! a
F.C.
SUPP. O PERMI
PE IT Na.
9
,MICROFILM FEE
COPIES
$
BOOK PAGE PARCEL LEGAL•DE CRIPTION`
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MECHANICAL FEE
DBL
$ i
USE NO.
ZONE
SET ell
LOT'S71ZE
GRP TYPE
C BY
1 a+..
S10
S
R
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PLAN CHECK FEE
$
BOND AMT.
PLAN NO.
I PLAN CHECKER FINAL DATE INSPC�T
R
�J
CONSTRUCTION FEE
DBL
$
NAME OF CONST. LENDER BRANCH
OFFICE,
NO LENDER IN OLVED
ELECTRICAL FEE
DBL
$
ADDRESS CITY"
-TATE
STRONG MOTION
$
OWNER/AGENTS SIGNATURE CONTRACTORY_-^
;INSTRUMENTATION FEE
la
;SPECIAL INSP
$
ADDRESS ADDRESS
DEMOLITION
FEE
J�
REGISTRATION
/3.--
PLUMBING FEE
DBL
$
CITY ZIP CODE CITY
ZIP CODE
- TOTAL FEES�,q
//���
TEL. NO. AREA
CODE TEL.
NO. COD
LICENSE a
CASH ❑CHECK .O.❑N.C.❑
j�
JAREA
-3V7
143 S
:RECEIVED BY. ' TREES REQUIRED.
P SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF
120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME. VOID.
?HE
SEWAGE SYSTEM
AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE
T
LL
P
HE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, I ALSO AGREE TO CARRY
-,-0MrtNSA I ION 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 284-208 (REV. 6-78) SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE
OF CALIFORNIA.