296805 (SFD)DEPARTMENT OF BUILDING & SAFETY FIELD OFFICE
BUILDING PERMIT • NT F . dbI
-' J F I M A M J J A S O
PERMIT NO.COU
9680
JOB ADDRESS I SP NO
/
419�sem/( I
Y O RIVERSIDE
76
77
lr
CONSTRUCTION ESTIMATE
VALUATION
NO. ELECTRICAL FEES
DST
NO. PLUMBING FEES
1 ST FL.
- 2ND FL.
FOR.
GAR.
CAR P. SQ.
WALL SQ.
ESTIMATED CONSTRUCTION
SQ. FT. @
SQ. FT. @
490
UNITS
YARD SPKLR SYSTEM
7800
SQ. FT. @ MOBILEHOME SVC. BAR SINK
M H PERMIT FEE
SQ. FT. POWER OUTLET ROOF DRAINS
$
.@
FT. @ DRAINAGE PIPING
USE P MIT
FT. .@ DRINKING FOUNTAIN
SUPP. O PER
SQ. FT. @ URINAL
VALUATION $ d pQ WATER PIPING
NOTE: Not to be used as property tax valuation
SWIM POOL, PVT
..
FLOOR DRAIN
MECHANICAL FEES
SWIM POOL, COMM
COPIES
WATER SOFTENER
1360K AAGE PARCEL
O
VENT SYSTEM [J FAN ❑ EVAP. COOL AHOOD
SIGN
WASHER (AUTOSH)C`ydo
�^ ,f, `,
'0 ' �'�`ci} l�J b14?
APPLIANCE ❑ DRYER
DBL
$
I GARBAGE DISPOSAL
o441>
SET BACK
FURNACE ❑ UNIT, ❑ WALL ❑ FLOOR ❑ SUSPENDED
1
LAUNDRY TRAY
AIR HANDLING UNIT, CFM
IDLE METER
KITCHEN SINK
mC+
ABSORPTION SYSTEM B.T.U.
TEMP USE PERM SVC
PLA N NOLr
WATER. CLOSET
G'
COMPRESSOR HP
POLE, TEMP/PERM
LAVATORY
LOC
gCHECKER
` t
HEATING SYSTEM ORCED ❑ GRAVITY
G7„f�.
6 AMPERES SERV ENT
SHOWER
BOILER T. U.
SQ.FT. @ 4
BATH TUB
C"
$
NAME OF CONST. LENDER BRANCH
SQ.FT. @ 4 '
NOLE4DERINVOLVED
WATER HEATER
Gz5
/j
4'Q.FT.RESID @ 11/44
46C>
SEWAGE DISPOSAL
DBL
$
ADDRESS CITY
SQ.FT.GAR @ s/44
lea
HOUSE SEWER
GAS PIPING
G0
$
PERMIT FEE
tars
PERMIT FEE
eel
� PERMIT FEE
a
DBL.
I TOTAL FEES
Zza 3y
MOB.H M.FEE
MICRO FEE
MEC M. FEE
jljt �e
PL'. CK. FEE
.�.....
CONST. FEE
-��
ELECT. FEE
�
SMI FEE
'it
FEE
PLUMB. E
-�
-' J F I M A M J J A S O
N D
JOB ADDRESS I SP NO
/
419�sem/( I
OWNER -
76
77
COMMUNITY
VALUATION
DATE-�^
DST
OFFICE
/pzt- 40f
$ +
J
7800
M H PERMIT FEE
$
USE P MIT
F.C.
SUPP. O PER
PE IT
..
�
MICROFILM.FEE
COPIES
$
1360K AAGE PARCEL
O
LEGAL DESCR PTION
�^ ,f, `,
'0 ' �'�`ci} l�J b14?
MECHANICAL FEE
DBL
$
USE NO.
ZONE
SET BACK
LO..T�(SIZE GRP PE CK BY
1
PLAN CHECK FEE
$
BOND AMT.
PLA N NOLr
PLAN
FINAL
gCHECKER
` t
.DATE JINSPECTOR
CONSTRUCTION FEE
DBL
$
NAME OF CONST. LENDER BRANCH
OFFICE
NOLE4DERINVOLVED
/j
ELECTRICAL FEE
DBL
$
ADDRESS CITY
STATE
STRONG MOTION
INSTRUMENTATION FEE
$
OWNER/AGE N SIGNATURE CONTRACTOR
SPECIAL INSPADDRESS
$
ADDRESS
-
PFEE
DEMOLITION
°
REGISTRATION
PLUMBING FEE
DBL
$
CITY ZIP CODE CITY
ZIP CODE
TOTAL FEES $
TEL. NOeF AREA
CODE TEL.
NO.
AREA CODE
LICENSE 4
CASH❑CHECK O.❑N.C.❑ J'
RECEIVED BY ; TREES REQUIRED,
IS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATIOri OF
K FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
tSEWAGE SYSTEM
I HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE
T
LL
P
WITH THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, I ALSO AGREE TO CARRY
---- - _ - COMI'tNSAIION INSURANCE UPON MY EMPLOYEES. COMPLIANCE WITH THE LAWS OF THE STALE OF
CALIFORNIA COVERING CONTRACTORS IS ALSO GUARANTEED.
I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE
FORM 284-208 (REV. 6-76) SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE
OF CALIFORNIA.