303500 (SATT)DEPARTMENT OF BUILDING & SAFETY FIELD OFFICE
BUILDING PERMIT
NSURANCE UPON MY EMPLOYEES. COMPLIANCE WITH THE LAWS OF THE STATE 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. 676) SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE
OF CALIFORNIA.
PERMIT NO.
OWNER
R. V. COP.
Vr RIYCRIIJ
VVV171 I �C
COMMUNITY
VALUATION
DST
CONSTRUCTION ESTIMATE
OFFICE
NO. ELECTRICAL FEES
La luinttt
NO. PLUMBING FEES
7-11-77
1ST FL. °"J
2ND FL. !
POR. 11
GAR. 'L
CAR P. EE]SQ.
WALL
ESTIMATED CONSTRUCTION
SQ. FT. @ 4E -r$
UNITS
M H PERMIT FEE
$
SQ. FT. @ YARD SPKLR SYSTEM
USE OF PERMIT
SQ. FT. @ ��� �'. �.,,;,,.f MOBILEHOME SVC. BAR SINK
SUPP. TO PERMITPERMIT
SQ. FT. @ POWER OUTLET ROOF DRAINS
FT. @ DRAINAGE PIPING
SQ. FT. @ DRINKING FOUNTAIN
SQ. FT. @ URINAL
DMIU114; SI Att. Garage
VALUATION $ WATER PIPING,'
I3
NOTE: Not to be used as property tax valuation
SWIM POOL, PVT
MICROFILM FEE
FLOOR DRAIN,
$
MECHANICAL FEES
LEGAL DESCRIPTION '
SWIM POOL, COMM
WATER SOFTENER
774 - 164- 022
VENT SYSTEM fFAN ❑ EVAP.000L [HOOD
r" +$,a
SIGN
$
F' WASHER (AUTO)(DIS1:1)
USE NO.
ZONE
APPLIANCE ['DRYER
LOT SIZE
GRP
TYPE CK
GARBAGE DISPOSAL
FURNACE ❑ UNIT ❑ WALL. ❑ FLOOR ❑ SUSPENDED
R-1
LAUNDRY TRAY
R-3
AIR HANDLING UNIT
�20
IDLE METER
S 5'
KITCHEN SINK
e lfl
ABSORPTION SYSTEM 0 B.T.U.
TEMP USE PERM SVC
PLAN NO.
WATER CLOSET
` tx .J
COMPRESSOR HP
J ;.
POLE, TEMP/PERM
!-,LAVATORY
}
_CHECKER
HEATING SYSTEM FORCED Cl GRAVITY
�;' f,
AMPERES SERV ENT
:e..
SHOWER
NAME OF CONST. LENDER BRANCH
BOILER T. U.
NO LEND RINVOLVED
SQ.FT. @ a
BATH TUB
SQ. FT. "@ a
DBL
WATER HEATER
ADDRESS CITY
STATE
F .."'?SQ.FT.RESID @ 11/44
�r _ t
SEWAGE DISPOSAL
SQ.FT.GAR @/4a
HOUSE SEWER
�
OWNER/AGENT'S SIGNATURE CONTRA
CTOR ,d.
.INSTRUMENTATION FEE
GAS PIPING
ti`
PERMIT FEE}hCG
PERMIT FEE
PERMIT FEE
��
ADDRESS ADDRESS
DBL.
TOTAL FEES
MOB.HM.FEE
MICRO FEE
MECH. FEE-
PL CK. FEE
CONST. FEE
ELECT. FEE
SMI FEE
FEE
PLUMB. FEE
NSURANCE UPON MY EMPLOYEES. COMPLIANCE WITH THE LAWS OF THE STATE 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. 676) SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE
OF CALIFORNIA.
JOB ADDRESSI SP NO
53.911 Avenida Velasco I
OWNER
R. V. COP.
76
77
COMMUNITY
VALUATION
DATE
DST
OFFICE
La luinttt
$
25,970.00
7-11-77
11
Trx!II
78
M H PERMIT FEE
$
USE OF PERMIT
F.C.
SUPP. TO PERMITPERMIT
NO.
DMIU114; SI Att. Garage
001
I3
03501
MICROFILM FEE
COPIES
$
BOOK PAGE PARCEL
LEGAL DESCRIPTION '
774 - 164- 022
3 Lot 30, B1-238, UnLt 22
MECHANICAL FEE
DBL
$
USE NO.
ZONE
SET BACK
LOT SIZE
GRP
TYPE CK
BY
R-1
+?z1i�
R-3
�20
S 5,'
S 5'
R ?3r r
PLAN CHECK FEE
$
BOND AMT.
PLAN NO.
PLAN
FINAL DATE INSPECTOR
}
_CHECKER
CONSTRUCTION FEE
DBL
$
NAME OF CONST. LENDER BRANCH
OFFICE
NO LEND RINVOLVED
ELECTRICAL FEE
DBL
$
ADDRESS CITY
STATE
STRONG MOTION
$
�
OWNER/AGENT'S SIGNATURE CONTRA
CTOR ,d.
.INSTRUMENTATION FEE
,.
_OYs
SPECIALINSP
$
ADDRESS ADDRESS
DEMREGISOTIION
FEE
TRAT
37-075 Palm View
PLUMBING FEE
DBL
$
CITY ZIP CODE CITY
ZIP CODE
Rancho Mirage CA, 92270
TOTAL FEES
$
TEL. NO. AREA
CODE TEL.
NO.
AREA CODELICENSE
a
CASH ❑CHECK .O.❑N.C.❑
q
�� ✓
�5
328-3368
I 714
246119
;RECEIVED BY
TREES REQUIRED
T.�i).SMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF
((�JRRIIff' 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
AGREE THAT ALL WORK IN COI NECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE
L$EWAGE SYSTEM
r
�p
T :%.:'rt.•i
LL
p , %'r
„/� THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, I ALSO AGREE TO CARRY,
MPENSATION I
NSURANCE UPON MY EMPLOYEES. COMPLIANCE WITH THE LAWS OF THE STATE 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. 676) SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE
OF CALIFORNIA.