303395 (SATT)• BUILDING PERMIT DEPARTMENT OF BUILDING & SAFETY
FIELD OFFICE
CUMPtN�'A 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
ea-zoe (REV. 6-76) SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE
OF CALIFORNIA.
PERMIT NO.
JOB ADDRESS SP NO OWNER
bVV1911 Vi RIYCR7IUC
�''
I L
M-
76
DST
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
VALUATIO61.01 DATE DfSTf
NO. PLUMBING FEES
1ST FL.
2ND FL.
POR.
GAR.
' CAR P. SQ.
WALL SQ.
ESTIMATED CONSTRUCTION
SQ. FT. @ $
UNITS
M H PERMIT FEE
SQ. FT. @ YARD SPKLR SYSTEM
$
SQ. FT. @ MOBILEHOME SVC. BAR SINK
USE OF PERM F.C. SUPP. 710 PERMOr
SQ. FT. @ !I POWER OUTLET ROOF DRAINS
MIT
FT. @ DRAINAGE PIPING
FT. @ DRINKING FOUNTAIN
SQ. FT. @ URINAL
VALUATION$ QQ WATER PIPING
NOTE: Not to be used as property tax valuation
03395
SWIM POOL, PVT
FLOOR DRAIN
MICROFILM FEE
COPIES
MECHANICAL FEES
SWIM POOL, COMM
WATER SOFTENER
VENT SYSTEM [J FAN ❑ EVAP. COOL OOD
APPLIANCE RYER
04$
®(S
SIGN
$
WASHER (AUTO SH)
GARBAGE DISP SAL
E?:?
SET BACK
FURNACE ❑ UNIT Q WALL ❑ FLOOR ❑ SUSPENDED
TYPE CK BY
LAUNDRY TRAY
AIR HANDLING UNIT CFM
IDLE METER
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERM SVC
2. WATER CLOSET
S
COMPRESSOR � HP
POLE, TEMP/PERM
PLAN CHECK FEE
jill LAVATORY
$
HEATING SYSTEMORCED ❑ GRAVITY
3
MPERES SERV ENT
DATE
SHOWER
�!(3
BOILER T. U.
SQ.FT. @ a
BATH TUB
JINSPECTOR
/u '� o -
CONSTRUCTION FEE
DBL
SQ.FT. @ a
j WATER HEATER
ply
NO LE DER INVOLVED
Q.FT.RESID @ 11/4a
SEWAGE DISPOSAL
4ZS
ELECTRICAL FEE
DBL
SQ.FT.GAR @ 3/4a
��
HOUSE SEWER
CITY
STATE
GAS PIPING
O—'d
STRONG MOTION
PERMIT FEE
t
PERMIT FEE
ep
PERMIT FEE
�j17
DBL.
TOTAL FEES
MOB.HM.FEE
MICRO FEE ME
/Z
. F
o.'
PL. CK. FEE
—
CONST. FEE
/S a
EL .FEE
j
SMI FEE
FEE
PLUMB. FEE
CUMPtN�'A 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
ea-zoe (REV. 6-76) SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE
OF CALIFORNIA.
JOB ADDRESS SP NO OWNER
J F M A M J J A S O
N D
I L
M-
76
77
MMMUNITY
VALUATIO61.01 DATE DfSTf
IOFFICE._
M H PERMIT FEE
$
USE OF PERM F.C. SUPP. 710 PERMOr
PE
MIT
NO,
03395
MICROFILM FEE
COPIES
$
0140
OOK P GEPARCEL LEGAL DESC P 1
or
MECHANICAL FEE
DBL
$
'USEfqO.
SET BACK
LOT SIZEGRP
TYPE CK BY
S
R
PLAN CHECK FEE
$
BOND AMT.
PLAN NO,
1 LAN CHECKERFINAL
DATE
JINSPECTOR
/u '� o -
CONSTRUCTION FEE
DBL
$
NAME OF CONS LE D R of
BRANCH OFFICE
NO LE DER INVOLVED
ELECTRICAL FEE
DBL
$
ADDRESS
CITY
STATE
STRONG MOTION
$
OWNER/AGENTS SI ATURE
T'
CONTRACTbR
INSTRUMENTATION FEE
f
'SPECIAL INSP
$
IJORESS
ADDRESS
DEMOLITION
FEE
�j
REGISTRATION
PLUMBING FEE
DBL
$
CITY ZIP CODE
CITE zip CODE
9Z Z4�9
TOTAL FEES $
TEL. NO. AREA
CODE
TEL. NO.
AREA CODE
LICENSE #
CASH EICHECK O.ON.C.❑
-ff'
4300
_
RECEIVED BY TREES REQUIRED
HIS P IT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS!CESSATION OF
20 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
SEWAGE SYSTEM
! H AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE
T �"�^'f L P ! Y%1
NJ HE LAWS OF.RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, I ALSO AGREE TO CARRY
CUMPtN�'A 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
ea-zoe (REV. 6-76) SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE
OF CALIFORNIA.