286154 (SATT)DEPARTMENT OF BUILDING & SAFETY FIELD OFFICE.
BUILDING PERMIT ,.,�, ,.,T„ — ,,,,,r „I
J F M A M 1 J A S O N D
PERMIT NO..
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t. VVIVI RIY
Or CRJIVC
76
DST
CONSTRUCTION ESTIMATE
VALUATION
rq
49
NO. ELECTRICAL FEES
DST
NO. PLUMBING FEES
78
1ST FL.
2ND FL.
POR.
GAR.
CAR P.
WALL
ESTIMATED CONSTRUCTION
SQ. FT. @.X � $.L2 Ij
t&rA !t
UNITS,
USE Off PE IT®
F.C.
SUP TO P RMIT
SQ. FT. @ YARD SPKLR SYSTEM
NO,
SQ. FT.. @ MOBILEHOME SVC. BAR SINK
POWER OUTLET ROOF DRAINS
SQ. FT. @,:I:
SQ. FT. @ DRAINAGE PIPING
0 f1p, #� C
4�-' e
SQ. FT. @ DRINKING FOUNTAIN
SQ. FT. @ URINAL
VALUATION $ WATER PIPING
MICROFILM FEE
NOTE: Not to be used as property tax valuation
$
SWIM POOL, PVT
BOOK flAGE PARCEL
FLOOR DRAIN
MECHANICAL FEES
SWIM POOL, COMM
I plc3,F
WATER SOFTENER
DBL
$
VENT SYSTEM ❑ FAN ❑ EVAP. COOL XHOOD
14—
SIGN
SET BACK LOTSSlZff
WASHER(AUT ISH)
C3
APPLIANCE DRYER
/y
GARBAGE DISPOSAL
r
FURNACE ❑ UNIT. ❑ WALL ❑ FLOOR ❑ SUSPENDED
'PLAN CHECK FEE
$
LAUNDRY TRAY
BOND AMT.
PLAN NO.
AIR HANDLING UNIT CFM
FINAL DATE INSPECTOR
IDLE METER
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERM SVC
�5
J
111WATER CLOSET01>
CONSTRUCTION FEE
DBL
COMPRESSOR HP
POLE, TEMP/PERM
BRANCH OFFICE
LAVATORY
*a
HEATING SYSTEM JXFORCED ❑ GRAVITY
d
��. AMPERES SERV ENT
C3
SHOWER
ELECTRICAL FEE
DBL
BOILER B.T.U.
SQ.FT. @ a
CITY
% BATH TUB
SQ.FT. @ a
WATER HEATER
a*
$
Q
IJOQ. @ 11/4a
62
J.SEWAGE DISPOSAL
!e
iv
SQ.FT.GAR @ 3/4a
910
HOUSE SEWER
FEE
$
ADDRESS
�f
ADDRESS
GAS PIPING
11119
REGISTRATION
PERMIT FEEPERMIT
FEE
PERMIT FEE
0a
PLUMBING FEE
DBL.
TOTAL FEES
jMOB.HM.FEEj
MICRO FEE
MECH. FEEF.L.
CK. FEE
CONST. FEE
ELECT. FEE
SMI FEE
FEE
PL B. FEE
J F M A M 1 J A S O N D
JOB ADDRESS SP NO
/ �✓ �f I
OWNER
76
77
COMMUNITY
A
VALUATION
rq
49
DATE
} /�
DST
OFFICE
78
M H PERMIT FEE
$
USE Off PE IT®
F.C.
SUP TO P RMIT
PERMIT
NO,
0 f1p, #� C
4�-' e
2861
MICROFILM FEE
COPIES
$
BOOK flAGE PARCEL
LEGAL//DESCRIPTION
-
I plc3,F
'MECHANICAL FEE
DBL
$
}
USE NO.
ZONE
SET BACK LOTSSlZff
GRP TYPE
ICK BY
/y
11. S 5—Is
S R `V ✓i��7 N
r
'PLAN CHECK FEE
$
BOND AMT.
PLAN NO.
PLAN CHECKER
FINAL DATE INSPECTOR
Awe
/'r
�5
J
CONSTRUCTION FEE
DBL
$
NAME OF CONST. LENDER
BRANCH OFFICE
NO LENDER INVOLVED
ELECTRICAL FEE
DBL
$/1
ADDRESS
CITY
STATE
STRONG MOTION
FEEc'
$
Q
OWNER/AGENTS SIGNATURE
CONTRACTOR
.INSTRUMENTATION
iv
'SPECIALINSP.
DEMOLITION
FEE
$
ADDRESS
�f
ADDRESS
REGISTRATION
' 4O �T {j
PLUMBING FEE
DBL
$
CITY ZIP CODE
CITY ZIP CODE
all
(Ai/� li/4) OM
TOTAL FEES
TEL. -O. f AREA
CODE
TEL. NO.
AREA CODE
LICENSE tt
(CASH ❑CHECK .O.❑N. C.❑$
RECEIVED BY REES REQUIRED
HIS IT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF
OR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
,.1 4 EB AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE
THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, I ALSO AGREE TO CARRY
� hAADCAIC ATI/lnll
SEWAGE SYSTEM T A(%�
K
LL
P s py
S;d' {�+
CIv1rLVICCJ. LVMrL1A1VLC Wi IH IHE LAV,/.) Or 1 H JI AIC Or
c CALIFORNIA COVERING CONTRACTORS IS ALSO GUARANTEED.
I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE
FORM 284.208 IREV. 8-761 SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE
OF CALIFORNIA.