301956 (SFD)DEPARTMENT OF BUILDING •81 SAFETY FIELD OFFICE
BUILDING PERMIT r-^#m,T„ „r•,,,",1e,ne
PERMIT NO.
13019W
N D
%Ajul\11 Vr KI Y rnbllu .
77
DST
CONSTRUCTION ESTIMATE
NO.
ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL.
2ND FL.
POR.
GAR.
CAR P.
WALL
ESTIMATED CONSTRUCTION
SQ. FT. s
LC
UNITS
M H PERMIT FEE
$
SQ. FT. @ YARD SPKLR SYSTEM
US5'OFfPERMIT F.C.SUPP. 11 PERM
SQ. FT. @ MOBILEHOME SVC. BAR SINK
SQ. FT. @ POWER OUTLET ROOF DRAINS
SQ. FT. @ DRAINAGE PIPING
SQ. FT. @ DRINKING FOUNTAIN
SQ. FT. @ URINAL
i.
VALUATION $ - WATER PIPING
NOTE: Not to be used as property tax valuation
SWIM POOL, PVT
FLOOR DRAIN
MECHANICAL FEES
SWIM POOL, COMM
WATER SOFTENER
VENT SYSTEM [J FAN ❑ EVAP.,000L OOD
42&
SIGN
$
WASHER(AUT LSH)
3TJ
APPLIANCE ❑ DRYER
GARBAGE DISPOSAL
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
MECHANICAL FEE
DBL
$ •
LAUNDRY TRAY
USE NO.
AIR HANDLING UNIT CFM
SET BACK
IDLE METER
GRP I TYPE
KITCHEN SINK
C?
ABSORPTION SYSTEM B.T.U.
TEMP USE PERM SVC
WATER CLOSET
ex—
COMPRESSOR HP
rl
POLE, TEMP/PERM
t LAVATORY;41y,
4N2
HEATING SYSTEM ORCED ❑ GRAVITY
„�
AMPERES SERV ENT
SHOWER
V
BOILER B.T.U.
R
SOFT. @ ¢
-
BATH TUB
00
$
SQ. FT. . @ ¢
BOND AMT.
WATER HEATER
t
Q.FT.RESID @ 11/4¢
SQ.FT.GAR @ 3/k
SEWAGE DISPOSAL
HOUSE SEWER'
GAS PIPING
0
PERMIT FEE
Ol
PERMIT. FEE
PERMIT. FEE
er—
DBL.
TOTAL FEES MOB.HM.FEE
MICRO FEE
ME . FEeEv�,y,y L. CK. FEE
CONST. FEE —,E/qL
Ff/EEpj�
SMI FEE
FEE
PLCMB.
L,F,Ep+E��y,
J F M A M J J A O
S
N D
JOB ADDRESS SP NO OWNER
I
77
COMMUNITY - VAffUVlrlIffN DATE
DST OFFICE
I
78
M H PERMIT FEE
$
US5'OFfPERMIT F.C.SUPP. 11 PERM
ERMIT
NO.
i.
301951
MICROFILM FEE
COPIES
$
BOOK AGE PARCEL
LEGAL DESCRIPTION
MECHANICAL FEE
DBL
$ •
USE NO.
ZONE
SET BACK
LOT SIZEyw.
GRP I TYPE
ICKBY
.}y}
VV�.r
rl
I55
R
f -'SI
-
PLAN CHECK FEE
$
BOND AMT.
PLAN NO,
PLAN CHECKER FINAL DATE SPECTOR
CONSTRUCTION FEE
DBL
$
NAME OF CONST. LENDER
BRANCH OFFICE
NO LENDER INVOLVED
ELECTRICAL FEE
DBL
$
ADDRESS
CITY -
STATE
40
STRONG MOTION
$
OWNER/AGENT4A*URE
OINSTRUMENTATION
CONTRACTOR
FEE�
'SPECIAL
$
ADDRESS" _
ADDRESS
INSP
DEMOLITON
~ -
�j
REGISTRATIONl
-FEE
f '
PLUMBING FEE
DBL
$
CITY ZIP CODE
CITY ZIP CODE
TOTAL FEES $
TEL. N
AREA CODE
TEL. NO.
AREA CODE
LICENSE z
Y.
CASH ❑CHECK O.❑N.C.❑ j
44-42242
RECEIVED BY TREES REQUIRED
T IS&'PIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF -
120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
H GREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE
SEWAGE SYSTEMI
T L
P
THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, I ALSO AGREE TO CARRY '
AADCwIC ATIlIwI Iwlfl •lil-c
- - - LIV-LVICCJ. I, VIV\r LIHIV LC VVllrl THE LAWS OF Irl[JIAtrur
CALIFORNIA COVERING CONTRACTORS IS ALSO GUARANTEED.
I HEREBY CERTIFY THATTHEINDIVIDUAL WHO. PREPARED THE PLANS AND SPECIFICATIONS HAS DONE
SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE
FORM 284.208 (REV. 6-761 OF CALIFORNIA.