296940 (SFD)- DEPARTMENT OF BUILDING & SAFETY FIEID OFFICE
BUILDING PERMIT
J F M A M J J A S O N D
PERMIT NO.
OWNER
G .
t-wwry l i yr KI V CK311JC
�I
COMMONITYV
DST
CONSTRUCTION ESTIMATE
D
NO.. ELECTRICAL FEES'
NO. PLUMBING FEES
1 ST FL.
2ND FL.
POR. _
GAR.
CAR P. SQ.
WALL SQ.
ESTIMATED CONSTRUCTION
SQ. FT. @ $
UNITS
M H PERMIT FEE
$
SQ. FT. @ YARD SPKLR SYSTEM
"F-SUPP.
SQ. FT. @ �Q MOBILEHOME SVC. BAR SINK
PERMIT
SQ. FT. @ ' a� POWER OUTLET ROOF DRAINS
FT. @ DRAINAGE PIPING
FT. @ %/ DRINKING FOUNTAIN
SQ. FT. @ URINAL
VALUATION $ ®s> WATER PIPING
lJi9
NOTE: Not to be used as property tax valuation
SWIM POOL, PVT
MICROFILM FEE
FLOOR DRAIN
$
BOOK PAGE FfARCEL
MECHANICAL FEES
SWIM POOL, COMM
WATER SOFTENER
'
VENT SYSTEM FAN ❑ EVAP. COOL HOOD
$
ISIGN,
ZONE
WASHER(AUTO H)
X10
GRP TYPE CK BY
APPLIANCE RYER
c
GARBAGE DISPOSAL
00,
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
LAUNDRY TRAY .
AIR HANDLING UNIT CFM
IDLE METER
KITCHEN SINK
PLAN CHECK FEE
ABSORPTION SYSTEM B.T.U.
$ ti
TEMP USE PERM SVC
PLAN N
WATER CLOSET
Qri
OR
COMPRESSOR �i HP
Q
POLE, TEMP/PERM
LAVATORY
HEATING SYSTEMRCED ❑ GRAVITY
O
,
6 AMPERES SERV ENT
CTC3
SHOWER
?
NO LENDER INVOLVED
BOILER T. U.
SQ.FT. @ ¢
jr
BATH TUB
ELECTRICAL FEE
DBL
$
SQ.FT. @ ¢
WATER HEATER
p0
[u�,
SQ.FT.RESID @ 11/4a
SEWAGE DISPOSAL ^
SQ. FT. GAR @ 3/4¢
"STRONG MOTION
HOUSE SEWER
•
$
OWNER/AGENTS SIGNATURE CO
11ACTOR •`
ONSTRUMENTATION FEE
A1J� "ii
r�Mr
GAS PIPING
dL>
SPECIAL
PERMIT FEE
00
PERMIT FEE
$
PERMIT FEE •
INSP
DEMOLITON
DBL.
I TOTAL FEES
MOB.HM.FEE
MICRO FEE
M . FE�Er/y/y
)L. CK. FEE
CONST". FLEE yp
ELECT. FEE
SMI FEE
FEE PL
B. FEE33
J F M A M J J A S O N D
JOB ADDR SP NO
I
ltP. Jt
OWNER
G .
76ESS
77
COMMONITYV
ALUATION
DATE
D
FFICE
78
M H PERMIT FEE
$
sE O E T
"F-SUPP.
` PERM
PERMIT
NO.
r296940
MICROFILM FEE
COPIES
$
BOOK PAGE FfARCEL
LEGALDESCRIP 0 N
MECHANICAL FEE
DBL
$
USE NO.
ZONE
SET BACK
LOT SIZE
GRP TYPE CK BY
PLAN CHECK FEE
$ ti
.BOND AMT.
PLAN N
PLAN CHECKER
FINAL DATE INS
OR
CONSTRUCTION FEE
DBL
$
NAME OF CONST. LENDER BRANCH
OFFICE
NO LENDER INVOLVED
r
ELECTRICAL FEE
DBL
$
ADDRESS CITY
STATE ..
[u�,
"STRONG MOTION
•
$
OWNER/AGENTS SIGNATURE CO
11ACTOR •`
ONSTRUMENTATION FEE
A1J� "ii
r�Mr
J70
SPECIAL
$
ADDRESS "- - ADDRESS
INSP
DEMOLITON
REGISTRATION
`"
d
'PLUMBING FEE
DBL
$
CITY ZIP CODE CITY
ZIP CODE
eno
or
TOTAL FEES is
r t7A
TEL. NO. AREA
CODE• TEL.
NO.
AREA
LICENSE a
=ASH❑CHECK 0.❑N.C.❑
jCODE
DECEIVED BY T ES REQUIRED
IS'PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION'OF
RK FOR 120 DAYSSHALLALSO CAUSE PERMIT TO BECOME VOID.
REBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE
SEWAGE SYSTEM
/ 1'
T .. LL
P �y ':
WITH THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, I ALSO AGREE TO CARRY
.i(IAA DF AIC ATIlIwI Iwlcl le w— „n— ..'v c...., i....•-.- -....._.•....._.......... ...:.._-
_�. _.... ..,_ ...... ..
..� ..... .. v. ...r v....� v.
CALIFORNIA COVERING CONTRACTORS IS A150 GUARANTEED.
I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE
SO IN•ACCORDANCE WITH SECTION 5541 OF, THE BUSINESS AND PROFESSIONS CODE OF THE STATE
=ORM 284-208 (REV. 6.76) OF CALIFORNIA.