302224 (SFD)DEPARTMENT OF BUILDING &SAFETY FIELD OFFICE
BUILDING PERMIT
7 _
J F I �M A M J J A S O N D
PE30 RMIT NO.
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COMMUNITY
j
VAI A% r �y
$ f �.✓ ice.
DST
DST
224
78
M H PERMIT FEE
$
USE OF*ERMIr F.C.
RNAT
CONSTRUCTION ESTIMAt�T�nE,
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1 ST FL. SQ. FT. @ `T�< $
UNITS
MICROFILM FEE
COPIES
2ND FL. SQ. FT. @
BOOK AGE PARCEL
LEGAL DE RIPTION
YARD SPKLR SYSTEM
POR. SQ. FT. @
MOBILEHOME SVC.
BAR SINK
DBL
GAR. SQ. FT. @
vO
POWER OUTLET
ZO E
ROOF DRAINS
LOT SIZE
CAR P. SQ. FT. @
CK BY
DRAINAGE PIPING
e+n�`
WALL SQ. FT. @
it
y�
DRINKING FOUNTAIN
I
SQ. FT. @
S
PLAN CHECK FEE
URINAL
$
ESTIMATED CONSTRUCTION VALUATION $ 24
ao'60
PLAN NO.
PLAN CHECKER
WATER PIPING
4149
NOTE: Not to be used as property tax voluation
SWIM POOL, PVT
FLOOR DRAIN
MECHANICAL FEES
SWIM POOL, COMM
WATER SOFTENER
VENT SYSTEM ❑ FAN ❑ EVAP. COOL VHOOD
SIGN
WASHER (AUTO)(W"k
4:%t9
$
APPLIANCE DRYER
ei0
BRANCH OFFICE
NO LE, DER INVOLVED
GARBAGE DISPOSAL
d7«
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
LAUNDRY TRAY
DBL
$
AIR HANDLING UNIT CFM
ADDRESS
IDLE METER
STATE
KITCHEN SINK
el—)
ABSORPTION SYSTEM B.T.U.
TEMP USE PERM SVC
WATER CLOSETLAC?!5
$
COMPRESSOR HP
.�
OWNER/AGENTS SIGNATURE
POLE, TEMP/PERM
INSTRUMENTATION FEE
LAVATORY
(at?
HEATING SYSTEM ORCED ❑ GRAVITYAMPERES
SERV ENT
GC3
SHOWER
$
BOILER T. U.
ADDRESS
SQ.FT. @ a
DEMOLITON
BATH TUBj
FEE
SQ.FT. @ a
WATER HEATER
fk'7
SQ.FT.RESID @ I V44
Idl
SEWAGE DISPOSAL
PLUMBING FEE
DBI
$
SQ.FT.GAR @ 3/4a✓j
CITY ZIP CODE
HOUSE SEWER
tY�j/��j�� t ire+
"` h
TOTAL FEES $
GAS PIPING
TEL. NO. AREA
CODE
PERMIT FEEp
AREA CODE
PERMIT FEE
[�O
PERMIT FEE
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1
DBL.
TOTAL FEES
MOB.HM.FEE
MICRO FEE
M . FEE
FL. CK. FEE
CONST. FEE
EL FEE
SMI FEE
FEE
PL MB. FEE
-+
J
.�.....
04
g3
0
,,....,
r
7 _
J F I �M A M J J A S O N D
JOB ADDRESS SP NO
OWNERI ('^
76
77
COMMUNITY
j
VAI A% r �y
$ f �.✓ ice.
DATE
DST
OFFICE
78
M H PERMIT FEE
$
USE OF*ERMIr F.C.
RNAT
PERMIT NO.
,' rx�
MICROFILM FEE
COPIES
$'
BOOK AGE PARCEL
LEGAL DE RIPTION
MECHANICAL FEE
DBL
$
USE NO.
ZO E
SET BACK
LOT SIZE
GRP TYPE
CK BY
e+n�`
it
y�
I
S
S
PLAN CHECK FEE
$
BOND AMT.
PLAN NO.
PLAN CHECKER
FINAL DATE IjJSPECTOR
CONSTRUCTION FEE
DBL
$
NAME OF CONST. LENDER
BRANCH OFFICE
NO LE, DER INVOLVED
ELECTRICAL FEE
DBL
$
ADDRESS
CITY
STATE
STRONG MOTION
$
OWNER/AGENTS SIGNATURE
CONTRACTOR
INSTRUMENTATION FEE
w.
SPECIALINSP
$
ADDRESS
ADDRESS
DEMOLITON
FEE
REGISTRATION
,
PLUMBING FEE
DBI
$
CIT ZIP CODE
CITY ZIP CODE
tY�j/��j�� t ire+
"` h
TOTAL FEES $
TEL. NO. AREA
CODE
TEL. NO.
AREA CODE
LICENSE 4
CASH ❑CHECK .O.❑N.C.❑ e:? d!5
�
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1
RECEIVED BY TREES REQUIRED®RR
IT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF
120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
SEWAGE SYSTEM
GREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE
T Ll p
AWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, I ALSO AGREE TO CARRY
LCJ. lR-lyAr LIAIVI..0 VVIIM Inc LA"a Vr IrIC JIAIC Vr
CALIFORNIA COVERING CONTRACTORS IS ALSO GUARANTEED.
I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE
FORM Zea -toe (REV. 6-76) SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE
OF CALIFORNIA.