286076 (SATT)DEPARTMENT OF.BUILDING & ,SAFETY -FIELD OFFICE
BUILDING PERMIT -
J F M A M J J A S O N -D
PERMIT NO.
141W\.VVI`i1 I Vr RI Ycmmic
4.
`76
77
COMMUNITY ^Y
VALUATION ,i �q
CONSTRUCTION ESTIMATE . ,
DST
NO. ELECTRICAL FEES
+ NO.
-PLUMBING FEES
'
`
',• ST Fl:�
2ND FL:
y POR.
GAR.
,CAR P. SQ.
•/WtA._LL�- SQ.
.?iaK346
• ESTIMA ED CONSTRUCTION
SG.IFT. @
, P
UNITS
SU PP.. O P MIT
PERMIT NO.
SQ. FT. @ YARD'SPKLR SYSTEM
SO. -FT. @ MOBILEHOME SVC. BAR SINK
SQ. FT.' @ POWER OUTLET ROOF DRAINS
FT. @' 1 I IDRAINAGE L PIPING
FT.''@ - DRINKING FOUNTAIN .
SQ.'FT. @ 1� j2071 42ja URINAL.. .
VALUATION $ Q;: WATER PIPING
,. NOTE: Not to be used as property tax valuation
: SWIM POOL,.PVT
MICROFILM FEE ^
FLOOR DRAIN
$O
MECHANICAL FEES
SWIM POOL,,COMM
F
WATER SOFTENER
77 012 40 /a of A A W'
MECHANICAL FEE
VENT SYSTEM XFAN ❑; EVAP. COOL OOD
�,,�;
SIGN -
USE NO.
-
-
WASHER(AUTO)(DkW)
SET BACK
LOT
APPLIANCE, WRYER
TYPE CK BYS/
GARBAGE DISPOSAL
FURNACE ❑ UNIT .❑ WALL ❑ FLOOR ❑ SUSPENDED
,
LAUNDRY TRAY
j/�
15'1.1
AIR HANDLING UNIT. j CFM
IDLE METER
,
KITCHEN SINK
•:
ABSORPTION SYSTEM '. 0 B.T.U. ,
TEMP USE PERM SVC
WATER CLOSET
ate
^
COMPRESSOR HP ,
HEATING SYSTEM • ORCED '❑.GRAVITY -
®;;
r POLE, TEMP/PERM
MPERES SERV ENT.A
It
LAVATORY
SHOWER•
Oe
U*
.BOILER
B.T.U.
BOND AMT.
SQ.FT. @ a
PECT R
BATHTUB
psi.
'
SO. FT.' @ a
WATER HEATER
o0
$
NAM OF 9ONST. LENDER / fT^ BRANCH
/;! SQ.FT.RESID @ 11/4a
NO LENDER INVOLVED
SEWAGE DISPOSAL
6i C1
SQ.FT.GAR @ 3/4a
-
HOUSE SEWER
DBL,t
$
ADDRESS • CITY,
STATE: Y
GAS PIPING
PERMIT FEE I
-
PERMIT FEE
PERMIT FEE
>
7
DBL.
• TOTAL FEES
MOB.HM.FEE
MICRO FEE'
MECH. FEE
PL. CK. FEE
CONST. FEE
ELECT: JF SMI FEE
FEE
PLUMB. FEE
J F M A M J J A S O N -D
JOB -ADDRESS SP NO
''� I
OWNER,- '
`76
77
COMMUNITY ^Y
VALUATION ,i �q
DATE'
76-
DST
OFFICE..
78
M H PERMIT FEE
$'
USE OF PER IT
SU PP.. O P MIT
PERMIT NO.
�]
kA
j�FF,G.
MICROFILM FEE ^
COPIES.
$O
BOOK PAGE PARCEL LEGAL DESCRIPTION
77 012 40 /a of A A W'
MECHANICAL FEE
DBL•
$ /�/
USE NO.
-
-
ZONE
•.
SET BACK
LOT
GRPPj�''
TYPE CK BYS/
,
j/�
15'1.1
]SIIZ�E/
f
,
/'•12
I Ilii.+.
S
R
L/ �6
'�@�!..
It
PLAN CHECK FEE ;
$
BOND AMT.
PLAN NO. PLAN CHECKER FINAL DATE I.P
PECT R
,CONSTRUCTION FEE
DBL
$
NAM OF 9ONST. LENDER / fT^ BRANCH
OFFICE
NO LENDER INVOLVED
'ELECTRICAL FEE
DBL,t
$
ADDRESS • CITY,
STATE: Y
-
STRONG MOTION
7
OWNER/AGENTS SIGNATURE
CONTRACTOR -
:INSTRUMENTATION FEE
SPECIAL INSP
DEMOLITON
-
$
-
ADDRESS - ADDRESS
�I�i,-
-- - -
PFEET
REGISTRATION
Y /I Vi
PLUMBING FEE
DBL$
CITY ZIP CODE CITY'
- r ZIP CODE
+
TOTAL FEES 0'& $
'1Qy
TEL. NO. (�Q AREA
CODE TEL,
NO,
AREA CODE
LICENSE U
CASH ❑CHECK .O.❑N.C.❑ !
G 3
RECEIVED-BY1 TREES REQUIRED
PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF
FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BEZOME VOID. '
RIAGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE',
SEWAGE SYSTEM
T LL
P
HE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, I ALSO AGREE TO CARRY.
ATI(>AI IwICI I
4C Yv rl Ir1C LM YYJ V( IIIC JI/11C Vr.
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.