303527 (SATT)FIELD OFFICE
DEPARTMENT OF BUILDING & SAFETY
BUILDING PERMIT a � r%i mivw �r nwLne.— I
J F M A M J J A S. O N D
PERMIT NO.
5t
OWNER -
Wvvi 1 I %jr RI cKallJC
77
COMMUNITY
DS7
CONSTRUCTION ESTIMATE
DST
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. 91
2ND FL:
POR.
GAR.
CAR P.
WALL
ESTIMATED CONSTRUCTION
SQ. FT. @ $
a...
UNITS
78
M H PERMIT FEE
SQ. FT. @ YARD SPKLR SYSTEM
$.
SQ. FT. @-� MOBILE HOME SVC. BAR SINK
USE OF PERMIT
SQ. FT. @ POWER OUTLET ROOF DRAINS
SUPP, TO PERMIT rE�IITIT
SQ. FT. @ DRAINAGE PIPING
NO.
SQ. FT. @ DRINKING FOUNTAIN .
MICROFILM FEE
SQ. FT. @ URINAL
$
VALUATION $ WATER PIPING
BOOK PAGE PARCEL
NOTE: Not to be used as property tax valuation
SWIM POOL, PVT
FLOOR DRAIN
7 - 21 Ca!b?
MECHANICAL FEES
MECHANICAL FEE
swim POOL, COMM
WATER SOFTENER
USE NO.
VENT SYSTEM AN ❑ EVAP. COOL OOD
SET BACK
SIGN
WASHER(AUTO)(D"
O
CK BY
APPLIANCE [DRYER
72,
GARBAGE, DISPOSAL
{j
Imo` I
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
.fi'�
LAUNDRY TRAY • -'
I -741
S S
AIR HANDLING UNIT CFM
RQ�t�
IDLE METER
KITCHEN SINK
$
ABSORPTION SYSTEM 0 B.T.U.
PLAN NO.
TEMP USE PERM SVC
WATER .CLOSET
p
COMPRESSOR HP
POLE, TEMP/PERM
7,1AVATORY
HEATING SYSTEM ❑ FORCED ❑ GRAVITY
AMPERES SERV ENT
da SHOWER
$
BOILER B. T. U.
OFFICE
SQ.FT. @ ¢
BATH TUB
.t
SQ.FT. @ ¢
WATER HEATER
A�
DBL
$
Q.FT.RESID @ 11/4¢
SEWAGE DISPOSAL
STATE
SQ.FT.GAR @ 3/4¢
HOUSE SEWER
GAS PIPING
PERMIT FEE
`jam
PERMIT FEE
d PERMIT FEE
v
OWNER/AGENTS SIGNATURE CONTRACTOR
OBL..'
TOTAL FEES
MOB.HM.FEE
MICRO FEE
MECH. FEE
PL: CK. FEE
CONST. FEE
ELECT. FEE MI 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
VALUATION
DATE
DST
OFFICE
$ �. {/p�
1 /
j
78
M H PERMIT FEE
$.
USE OF PERMIT
F.C.
SUPP, TO PERMIT rE�IITIT
NO.
5,
MICROFILM FEE
COPIES
$
BOOK PAGE PARCEL
LE AL 1EICRIPT109
7 - 21 Ca!b?
..- ,e9� T4s
MECHANICAL FEE
DBL
$
USE NO.
ZONjE���je
SET BACK
LOT SIZE/
GRP TY�P�Efj
CK BY
72,
�YV
{j
Imo` I
q
1 4
.fi'�
&b
I -741
S S
im
S y��
RQ�t�
PLAN CHECK FEE
$
BOND AMT.
PLAN NO.
PLAN CHECKER
.
FINAL DATES '7' ` INSP/EC
R
CONSTRUCTION FEE
DBL
$
NAME OF CONST. LENDER 'BRANCH
OFFICE
NO L R INVOLVED
ELECTRICAL FEE
DBL
$
ADDRESS CITY
`
STATE
STRONG MOTION
$
OWNER/AGENTS SIGNATURE CONTRACTOR
S 7�
?t 1
INSTRUMENTATION FEE
N S
'SPECIALINSP
$
.ADDRESS ADDRESS.
DEMOLITION
FEE
REGISTRATION
40', s'
PLUMBING FEE
DBL
$
CITY ZIP CODE CITY
ZIP CODE
TOTAL FEES $
TEL. NO. AREA
CODE TEL.
NO.
AREA CODE
LICEN F
CASH ❑CHECK .O.❑W.C.
1T
-.:sem '
°7W
-244 �
RECEIVED BY' TREES REQUIRED
MIT SHALL BECOME VOID IF WORK ISNOT COMMENCED WITHIN 120 DAYS. CESSATION OF
j�R R 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
SEWAGE SYSTEM
E Y AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE .
T}� LL P
H THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, I ALSO AGREE' TO CARRY
COMPENSATION INSURANCE 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. 8-78) - SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE
OF CALIFORNIA.