302236 (SFD)• BUILDING PERMIT DEPARTMENT , OF BUILDING & SAFETY FIELD OFFICE
J F M A M J J A S O N D
PERMIT NO.
wow
:.VVIYI i Or RIYCR5IVC
COMMUNITY
VALUATI DATE
-
DST
CONSTRUCTION,ESTIMATE
I -A %
NO. ELECTRICAL FEES
1
NO. PLUMBING FEES
78
1ST FL.
2ND FL.
POR.
GAR.
CAR P.
WALL
ESTIMATED CONSTRUCTION
SQ. FT. @ $
$
UNITS
USE OF RMI
F.C. SUPP. O PERhCT PERMIT
SQ. FT. @ YARD SPKLR SYSTEM
SQ. FT. @pry MOBILEHOME SVC. BAR SINK
SQ. FT. @4,,22 4Q POWER OUTLET ROOF DRAINS
SQ. FT. @ DRAINAGE PIPING
SQ. FT. @ DRINKING FOUNTAIN
SQ. FT. @ URINAL
MICROFILM FEE
VALUATION $ �p�p WATER PIPING
6i2i
NOTE: Not to be used as property tax valuation
BOOK PA E PARCEL LEGAL DESCRIPTIO
SWIM POOL, PVT
FLOOR DRAIN
MECHANICAL FEES
DBL
1SWIM POOL, COMM
WATER SOFTENER
ZONE
SET BACK
VENT SYSTEM [f FAN ❑ EVAP. COOL &OHOOD
TYPE CK BY
SIGN
WASHER(AUTO)(a"
00
APPLIANCE RYER
�,4w
GARBAGE DISPOSAL
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
7
LAUNDRY TRAY
AIR HANDLING UNIT CFM
IDLE METER
KITCHEN SINK
PLAN CHECK FEE
ABSORPTION SYSTEM B.T.U.
TEMP USE PERM SVC
PLAN NO.
WATER CLOSET
00
COMPRESSOR HP�
POLE, TEMP/PERM
LAVATORY
�15�
% N- 4--7,7 .c
HEATING SYSTEM ORCED ❑ GRAVITY
24s
AMPERES SERV ENT
Al 4D
SHOWER
pp
NO LENDEINVOLVED
BOILER B.T.U.
SQ. FT. @ a
Qap
BATH TUB
pQ
ELECTRICAL FEE
DBL
SQ.FT. @ a
WATER HEATER—
C?
STATE
2JISQ.FT.RESID @ 111/4a
J
SEWAGE DISPOSAL
:A
STRONG MOTION
SQ.1' GAR @ s/44
Q
HOUSE SEWER
INSTRUMENTATION FEE/,4r,
�1
GAS PIPING
PERMIT FEE
pts
PERMIT FEE
7!X3
IPERMIT FEE
CJv
....-
DBL.
I TOTAL FEES
MOB.HM.FEE
MICRO FEE
J
M .FEE
L. CK. FEE
CONST. FEE
ELECT. FEE
SMI FEE
FEE
PLUMB. FEE1,93
J F M A M J J A S O N D
JOB ADDRESS SP NO OWNER
I t� L
e
-31 &Q
76
—_t
77
COMMUNITY
VALUATI DATE
DST
I OFFICE
I -A %
$
1
78
M H PERMIT FEE
$
USE OF RMI
F.C. SUPP. O PERhCT PERMIT
NO.
r
3022
MICROFILM FEE
COPIES
$
BOOK PA E PARCEL LEGAL DESCRIPTIO
MECHANICAL FEE
DBL
$
USE NO.
ZONE
SET BACK
LOT SIZE GRP
TYPE CK BY
00
7
4
PLAN CHECK FEE
$
BOND AMT.
PLAN NO.
PLAN CHECKER
FINAL DATE INS CsTCR
�15�
% N- 4--7,7 .c
CONSTRUCTION FEE
DBL
$
NAME OF CONST. LENDER BRANCH
OFFICE
NO LENDEINVOLVED
Qap
ELECTRICAL FEE
DBL
$
ADDRESS CITY
STATE
STRONG MOTION
$
OWNER/AGENTS SIGNATURE CONTRACTOR
INSTRUMENTATION FEE/,4r,
�1
SPECIALNSP
$
ADD ESSADDRESS
DEMOLITON
I
�l
FEE
REGISTRATION
1
PLUMBING FEE
DBL
$
CITY ZIP CODE CITY
ZIP CODE
410
42 92,2260.
TOTAL FEES is
TEL. NO. AREA
CODE TEL.
NO.
AREA CODE
LICENSE 4
CASHOCHECK O.ON.C.❑ 490017-7
RECEIVED BY, TREES REQUIRED
T SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF
20 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
WAGREE
SEWAGE SYSTEM �:✓ `
I THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE
T LL p
THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, I ALSO AGREE TO CARRY
MPENS
-TION 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. 6-76) SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE
OF CALIFORNIA.