280789 (SATT)BUILDING PERMIT
CONSTRUCTION: ESTIMATE
S7 FL. SQ.FT.
zqlu
2ND FL. SQ..FT. @
POR. 5Q. FT. @
GAR. �� SQ. FT. @%
CAR P. SOFT. @
. WALLSQ. FT. @
SO. FT. @
ESTIMATED CONSTRUCTION VALUATION $
NOTE: Not to be used os property tox voluotion
MECHANICAL FEE`.
VENT -SYSTEM XFAN ❑ EVAP. COOL
DEPARTMENT OF BUILDING & SAFETY
COUNTY OF RIVERSIDE
FIELD OFFICE
32.
NO. ELECTRICAL FEES
NO. PLUMBING FEES
f Q.
UNITS
USE OF PERMIT
U �'h'�: `�
FURNACE ❑'UNIT O WALL ❑ FLOOR ❑ SUSPENDED
DATE
1Q !
YARD SPKLR SYSTEM
76
MOBILEHOME SVC.
BAR SINK
4 5z
POWER OUTLET
ROOF DRAINS
IDLE METER
$
DRAINAGE PIPING
COMMUNITY 1
IT
DRINKING FOUNTAIN
ROOMS
TEMP USE PERM SVC
URINAL
WATER CLOSET
� �.....
WATER PIPING
COMPRESSORHP
SWIM POOL, PVT
FLOOR DRAIN
"
SWIM POOL. COMM
WATER SOFTENER
,OD
SIGN
WASHER (AUTO) MIMII
DST
J F M A M{' J J A S O N D
APPLIANCE
32.
74
J l �%� / l7b5_C6
GARBAGE DISPOSAL
75
USE OF PERMIT
U �'h'�: `�
FURNACE ❑'UNIT O WALL ❑ FLOOR ❑ SUSPENDED
DATE
1Q !
PE MIT O
0 789
76
LAUNDRY TRAY
AIR HANDLING UNIT CFM
M H. PERMIT FEE
IDLE METER
$
KITCHEN SINK
COMMUNITY 1
IT
ABSORPTION SYSTEM j B.T.U.
ROOMS
TEMP USE PERM SVC
SUPP. TO PERMIT
WATER CLOSET
COMPRESSORHP
POLE, TEMP/PERM
LAVATORY
HEATING SYSTEM OFORCED ❑ GRAVITY
AMPERES SERV ENT
MICROFILM FEE
SHOWER
$
�
BOILER 0 B.T.U.
SQ FT @, a
BATH TUB
✓
MECHANICAL FEE
DBL
$�'gj
SQ FT @ : a
J
WATER HEATER
USE NO.
GRP
TYPE
SK
SOFT RESID @
i
SEWAGE DISPOSAL
r� /�
F;26 I
J
SQ FT GARAGE @
07
HOUSE SEWER
PLAN CHECK FEE
PERMIT FEE
BOND AMT.
PLAN NO. PLAN CHECKER
GAS PIPING
CTOR
MOBILE HOME PERMIT FEE $
PERMIT FEE
Q
PERMIT FEE
--
ER IT
TOTAL FEES
MOB. HM.FEE
MICRO FEE
MECH. FEE
DBL.
PL. CK. FEE
CONST. FEE
DBL.
ELECT. FEE DBL.
SMI FEE
FEE
PLUMB. FEE
DBL.ft
I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS
FORM 284-208 (Rei. 10-74) OIL HAS DONE SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE
I OF THE STATE OF CALIFORNIA.
JOB ADDRESS -/ �+ —SP NO—
OWNE.7 —
GDe<16
74
J l �%� / l7b5_C6
A.% C✓!
75
USE OF PERMIT
U �'h'�: `�
F.C.
/
DATE
1Q !
PE MIT O
0 789
76
M H. PERMIT FEE
$
COMMUNITY 1
IT
UNITS
ROOMS
VALUATION
SUPP. TO PERMIT
OF C
MICROFILM FEE
COPIES
$
�
LEG7L DESCRIPTION
��
77 -/ -62-2-oz /a /5 /a .5,4.( A).e
MECHANICAL FEE
DBL
$�'gj
SET BACKLO^TJS�IZE ZONE
USE NO.
GRP
TYPE
SK
r� /�
F;26 I
J
PLAN CHECK FEE
$
BOND AMT.
PLAN NO. PLAN CHECKER
FINAL DATEIN
CTOR
CONSTRUCTION FEE
DBL'
$�0
CAMEO F- ENDER }' BRANCH
OFFICE
NO LENDER INVOLVED
r
ELECTRICAL FEE
DBL
$
ADDRESS CITY
STATE
STRONG MOTION
INSTRUMENTATION FEE
$
r.+�
OWNER/AGENT'S SIGNATURE
CONTRACTOR
/
s
e, -f•- ,0&rkjo
a FEE
$
ADDRESS ,? /
Pdi '30)( �l
ADDRESS
PLUMBING FEE
DBL$
CITY ZIP CODE
CITY ZIP CODE
TOTAL FEES
$
�
TEL. N7
/j ._ 00
TEL. NO. LICENSE
CASH ❑ . CHECK M.O. O N -CO,
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSA-
TION OF WORK FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
RECEIVED By
TREES REQUIRED
I HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN AC -
DANCE WITH THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, I'ALSC
AGREE TO CARRY COMPENSATION
SEWAGE SYSTEM
�L✓1
�1
LL
Pte`
INSURANCE UPON MY EMPLOYEES. COMPLIANCE WITH THE
1 nLAIC! CTUC CTA -TE- /-•AI IEl1Dn11A /f1V LDln1I•`!'lI n IT A(TI C IC AIC! l`1 IA — nITEEM
I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS
FORM 284-208 (Rei. 10-74) OIL HAS DONE SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE
I OF THE STATE OF CALIFORNIA.