297132 (SFD)s DEPARTMENT OF BUILDING &-SAFETY FIELD OFFICE
W
RLDINGPERMIT
J F M
PERMIT NO.
29713
A S O
.VVI\11 Vr RIvrr%jlJC
NOW
OWNER.
r
DST
CONSTRUCTION ESTIMATE-
NO. ELECTRICAL FEES
*
NO. PLUMBING FEES
77
1ST FL.
2ND FL.
POR.
GAR.
CAR P.
WALL
ESTIMATED CONSTRUCTION
SQ. FT. @ $
UNITS
VALUATIONS -
$ _ �
� �
DA .,rj OF
/
DS/T/
//
SQ. FT. @ YARD SPKLR'SYSTEM
78
SQ. FT. @ / MOBILEHOME SVC. BAR- SINK
SQ. FT. C. POWER OUTLET ROOF DRAINS
$
SQ. FT. @ DRAINAGE PIPING
USE OFA RMIT
SQ. FT. @ DRINKING FOUNTAIN
SU . TOP RMIT ' -PERMIT
SQ. FT. @ URINAL
NO.
VALUATION $ !i WATER PIPING
NOTE: Not to be used os property tax valuation
SWIM POOL, PVT
FLOOR DRAIN
—TanG
I2971
MECHANICAL FEES
SWIM POOL, COMM
32,
WATER SOFTENER
MICROFILM FEE
VENT SYSTEM FAN VAP. COOL OOD
9�� B
SIGN
BOOK AGE PARCEL'
WASHER(AUTO)(
o ®ter
APPLIANCE RYER
00
GARBAGE DISPOSAL
®Q
FURNACE ❑ UNIT ❑ WALL Cl FLOOR ❑ SUSPENDED
$
USE NO.
LAUNDRY TRAY
SET BACK
LOT SIZE)GRP
f
AIR HANDLING UNIT CFM
CK BY
IDLE METER
KITCHEN SINK
0
ABSORPTION SYSTEM B.T.U.
TEMP USE PERM SVC
WATER CLOSET
iA CJC7
COMPRESSOR 0 HP
POLE, TEMP/PERM
LAVATORY "
HEATING SYSTEM XORCED ❑ GRAVITY
AMPERES SERV ENTE°�
SHOWER
/
BOILER B.T.U.
SQ.FT. @ a
BATH TUB
PLAN CHECK FEE
SQ.FT. @ d
WATER HEATER
PLAN NO.
PLAN CCCHHE�CKERI
C
INSPECTOR'
Fr�AA % e
Q.FT.RESID @- 11/4a
SEWAGE_ DISPOSAL
dO"
14
i 1 .00"V
SQ.FT.GAR @ 1/4a
,r
HOUSE SEWER
"
$
NAME OF CONSI. LENDER BRANCH
OFFICE
NO LENDS VOLVED
GAS PIPING
PERMIT FEEs
SO
PERMIT FEE
G*27
PERMIT FEE
-ELECTRICAL.FEE
DBL.
TOTAL FEES fOB.K'M.FEEI
MICRO FEE
M
PL. CK. FEE
r
I CONST. FEE
s
ELECT. FEE
/ ..
SMI FEE
- FEE
PL FEE
J F M
A M' J J
A S O
N D
JOB ADDRESS SP NO
I
��
OWNER.
r
76
*
77
COMMUNITY -
r
�
VALUATIONS -
$ _ �
� �
DA .,rj OF
/
DS/T/
//
OFF+IJC�/Ew.._,
'^TT
78
M H PERMIT FEE
$
USE OFA RMIT
F.C.
SU . TOP RMIT ' -PERMIT
NO.
I2971
32,
MICROFILM FEE
COPIES
$
BOOK AGE PARCEL'
LEGALLDDESCRIPTION�"'
MECHANICAL FEE
DBL
$
USE NO.
JZONE
SET BACK
LOT SIZE)GRP
f
TYPE
CK BY
%
PLAN CHECK FEE
$
BOND AMT.
PLAN NO.
PLAN CCCHHE�CKERI
C
INSPECTOR'
Fr�AA % e
14
i 1 .00"V
j
CONSTRUCTION FEE
'DBL
$
NAME OF CONSI. LENDER BRANCH
OFFICE
NO LENDS VOLVED
-ELECTRICAL.FEE
DBL
$
ADDRESS CITY
STATE
STRONG MOTION
$ -
,OWNER/AGENTS SIGNATURE %� CONTRACTOR
'
INSTRUMENTATION FEE
''SPECIALINSP
$
+'ADDRESS p 7�" ADDRESS
DEMOLITION
FEE
�-
:REGISTRATION
PLUMBING FEE
DBL
$
CIT ZIP CODE CITY
ZIP CODE
TOTAL FEES $
���
TEL. °jNO.O.% ". AREA CODE TEL.
NO.
AREA CODE
LICENSE 4
CASH ❑CHEC
.O.❑N.C.❑
/�' Q► �;�,� I'
,RECEIVED.BY
TREES REQUIRED
*PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF.
FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
EtBYAGREE THAT ALL WORK IN CONNECTION WITH THIS.PERMIT WILL BE DONE IN ACCORDANCE "
;SEWAGE SYSTEM
Ll
P
WITH THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, I ALSO AGREE TO CARRY
rnAA"KMATInkl 1w 1
CALIFORNIA COVERING CONTRACTORS IS ALSO 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
FORM 284-208 (REV. s•�sl OF CALIFORNIA.