286276 (SATT)DEPARTMENT OF BUILDING & SAFETY
BUILDING PERMIT
FIELD OFFICE
'
\ PERMIT NO.
'ROW<.VVIYI
I Vr KIVCRJI{JC
77
VALUATION
$ I'
DST
J
/
CONSTRUCTION ESTIMATE
78
NO. ELECTRICAL FEES,
NO. PLUMBING FEES
" 1ST FL.
2ND FL.
POR. 64
GAR.
CAR P.
WALL
-,
'ESTIMATED CONSTRUCTION
SQ. FT. @ $ 10
♦
UNITS
SQ. FT. @ YARD SPKLR SYSTEM
SQ. FT. @ 4110 MOBILEHOME SVC. BAR SINK
d4286276
SQ. FT. @ Gd POWER OUTLET ROOF DRAINS
SQ. FT. @ DRAINAGE PIPING
SQ. FT. @ DRINKING FOUNTAIN
SQ. FT. @ URINAL
VALUATION $ WATER PIPING
NOTE: Not to be used as property tax valuation
SWIM POOL, PVT
COPIES
FLOOR DRAIN
•
MECHANICAL FEES
MECHANICAL FEE
SWIM POOL, COMM
$
WATER SOFTENER
USE NO. ZONE
SET BACK
VENT SYSTEMAN ❑ EVAP. COOL HOOD
GRP
SIGN
WKBY
WASHER (AUTO)#)ISH)
>"
APPLIANCE DRYER
GARBAGE DISPOSAL
r`7
:I.
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
LAUNDRY TRAY
`
AIR HANDLING UNIT CFM
1 S S
IDLE METER
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERM SVC
WATER CLOSET
PL�A/N�NNO.
PLA�N,+CHECKER
COMPRESSOR 3.TjWEU HP
POLE, TEMP/PERM
LAVATORY
00
HEATING SYSTEM ORCED ❑ GRAVITY
00AMPERES
SERV ENT
00
SHOWER
OQ
$
BOILER B.T.U.
NAME OF CO' ST. LENDER/^
SQ.FT. @ a
NO LENDER INVOLVED
BATH TUB
SQ.FT. @a
WATER HEATER
Op
$
At B'
Q.FT.RESID @ ll/k0.$,SEWAGE
STATE
DISPOSAL
`qgZQ.FT.GAR
TA -
r;
@ l/aa
HOUSE SEWER
$
M
OWNER/AGENTS SIGNATURE
r�
CONTRACTOR
GAS PIPING
.
PERMIT FEE
—300
PERMIT FEE
PERMIT FEE
QCT
$
DBL.
I TOTAL FEES
jMOB.HM.FEEj
MICRO EE
M`ECCH.. FEE
PL. CK. FEE
COONNSSTT..FFE'E
IV Pt
ELECT.FEE
SMI FEE
00:
. FEE
PLUMS. FEE
CIA
J F M A M J J A S O N D
JOB ADDRESS - SP NO
I
OWNER
��, • �'} V
76
77
COMMUNITY
1,4 .
VALUATION
$ I'
DATE ST/
OFFICE
78
.M H PERMIT FEE
$
USE PER IT
F.G.
SUPP. O PERMIT
PERMIT NO.
t
d4286276
MICROFILM FEE
COPIES
$,BOOK
PAGE PARCEL
i ate= O 1
LEGAL DESCRIPTION
'4 ► gf
MECHANICAL FEE
DBL
$
USE NO. ZONE
SET BACK
LOT SIZE
GRP
I TYPE
WKBY
r`7
1 S S
R p�,
PLAN CHECK FEE
$
BOND AMT.
PL�A/N�NNO.
PLA�N,+CHECKER
FINAL DATE INSPECTOR
CONSTRUCTION FEE
DBL
$
NAME OF CO' ST. LENDER/^
BRANCH OFFICE
NO LENDER INVOLVED
ELECTRICAL FEE
DBL
$
At B'
CITY
STATE
TA -
r;
STRONG MOTION
INSTRUMENTATION FEE
$
M
OWNER/AGENTS SIGNATURE
r�
CONTRACTOR
SPECIAL INSP
$
ADDRESS
ADDRESS
DEMOLITION
REGISTRATION
FEE/
PLUMBING FEE
DBL
$
CITY,r� ZIP CODE
CITY ZIP CODE
TOTAL FEES
is
TEL. go. A
E.A CODE
TEL. NO.
AREA CODE
LICENSE
CASH 0CHECK .0.0N.C.❑
/ /
C,L-
L% +
'RECEIVED BY
TREES REQUIRED,
MIT SHALUBECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF
R 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE
�rRTE�B
SEW SYSTEM
;
T 49740 LL
P ,
LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, I ALSO AGREE TO CARRY
A Tlllwi i
CALIFORNIA COVERING CONTRACTORS�15 ALSO GUARANTEED. CE
UARANTEED`t wnn THE wwavr THE STATE cJr
I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE
FORM Zea -toe (REV. e-�sl SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE
OF CALIFORNIA.