302088 (SFD)® DEPARTMENT OF BUILDING & SAFETY FIELD OFFICE
BUILDING PERMIT
J F M A M J J A S O N D
PERMIT NO. 881
30
R
VVVIYI t Vr RIYCRJIVC
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COMM NITY
DST
l
CONSTRUCTION ESTIMATE
DST
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1 ST FL.
2ND FL.
POR.
GAR.
CAR P. SQ.
WALL SQ.
ESTIMATED CONSTRUCTION
SQ. FT. @ 4/ $
L
UNITS
78
M H PERMIT FEE
SQ. FT. @ r YARD SPKLR SYSTEM
$
SQ. FT. @ MOBILEHOME SVC. BAR SINK
USE OF PERMIT .40
SQ. FT. @ '� 0, POWER OUTLET ROOF DRAINS
SUPP. TO PERMIT
FT. @ DRAINAGE PIPING
NO.
FT. @ DRINKING FOUNTAIN
SQ. FT. @ URINAL
VALUATION $ 44 WATER PIPING
NOTE: Not to be used as property tax valuation
00
SWIM POOL, PVT
FLOOR DRAIN
.MECHANICAL FEES
MICROFILM FEE
SWIM POOL, COMM
WATER SOFTENER
BOOK PIVE PARCEL
VENT SYSTEM FAN [] EVAP. COOL HOOD
00
SIGN
WASHER(AUTO)(Q"
40
APPLIANCE 9. DRY R
O�
DBL
GARBAGE DISPOSAL
USE NO.
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
SET BACK
LOT SIZE
LAUNDRY TRAY °
T�YIPE CK BY
AIR HANDLING UNIT , CFM
IDLE METER
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERM SVC
WATER CLOSET
COMPRESSOR � HP
POLE, TEMP/PERM
LAVATORY
HEATING SYSTEM FORGED El GRAVITY
S QO
2^kMPERES SERV ENTSHOWER
R
BOILER B.T.U.
PLAN CHECK FEE
SQ.FT. @ rt
BATH TUB
BOND AMT.
PLAN NO. PLAN CHECK FINAL DATE INS CTOR
SQ.FT. @ a
WATER HEATER
CONSTRUCTION FEE
Q.FT.RESID @. 11/44
SEWAGE DISPOSAL
Q
NAME OF CONST. LENDER
ANCH OFFICE
NO LENDER INVOLVED
L SQ.FT.GAR @ 3/aa
HOUSE SEWER
GAS PIPING
DBL
$
PERMIT FEE
ADDRESS CITY
PERMIT FEE
PERMIT FEE
db
DBL.
I TOTAL FE'EES'
I....FIM.FEErICRO
FEE
ME H. FEE
i �>
. CK. FEE
CONST. FEE
so-tv
ELECT. FEE SMI FEE
O �2 I *-
FEE
PLUMB. FEE
J F M A M J J A S O N D
JOB ADDRESS/• �/ ' I SP NO
� le le C. //.,
OWN'EER''� %'
-4 . j Lam.. L.' xis
76
77
COMM NITY
VALUATION
DATE
DST
OFFICE
I
78
M H PERMIT FEE
$
USE OF PERMIT .40
F.C.
SUPP. TO PERMIT
IERMIT
NO.
f +
00
-302081
MICROFILM FEE
COPIES
$
BOOK PIVE PARCEL
LEGAL DESCRIPTION
40
MECHANICAL FEE
DBL
$
USE NO.
ZONE
SET BACK
LOT SIZE
GRP
T�YIPE CK BY
1
S
S
R
PLAN CHECK FEE
$
BOND AMT.
PLAN NO. PLAN CHECK FINAL DATE INS CTOR
CONSTRUCTION FEE
DBL
$
NAME OF CONST. LENDER
ANCH OFFICE
NO LENDER INVOLVED
ELECTRICAL FEE
DBL
$
ADDRESS CITY
STATE
xr
r .
STRONG MOTION
$
OWNER/AGENr5odNXTURE
CONTRACTOR
INSTRUMENTATION FEE
1
�.
w C Q ^j �" T
SPECIAL INSP
$
ADDRESS ADDRESS
DEMOLITION
FEE
,/";
q
REGISTRATION
Cry (SIL•+
PLUMBING FEE
DBL
$
CITYZIP CODE Cm
ZIP CODE
TOTAL FEES $
TEL. NO. AREA
CODE TEL.
NO.
AREA CODE
LICENSE a
CASH OCHEC .O.0N.C.❑
7-
RECEIVED BY TREES REQUIRED
SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF
20DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
FT
THATALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE
VHELAWS OF RIVERSIDE
iSEWAGE SYSTEM
6
iGREE
T
L
P �j
COUNTY AND THE STATE OF CALIFORNIA, I ALSO AGREE TO CARRY
SATI CiN INCL IRAN( -F I IPfIIJ AAV FAADI IIYFFG ('/IAA DI IAAIrC \A/ITLI TIJF I AU/C !1C T4lC CTATF (]L
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 284.206 (REV. 6-761 OF CALIFORNIA.