286823 (SATT). DEPARTMENT OF BUILDING & SAFETY �,
BUILDING PERMIT ,. l ,,,*`; ;1 � �,�,�I
FIELD OFFICE -
J F I M A M J J A S O N D
PERMIT NO.
86823
-low
Ujuvi1 ► Or Rjvcrt�lvc
COMMUNITY -
VALUATION
DST
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. @ $
2ND FL. SQ. FT. @
POR. 86 SQ. FT. @
GAR. SQ. FT. @ SSP
CAR P. SQ. FT. @
WALL SQ. FT. @
SQ. FT. @
ESTIMATED CONSTRUCTION VALUATION$
�_ >�2lJ
4t
UNITS
MOBILEHOME SVC.
POWER OUTLET
PE MI�NO
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
CIO;
NOTE: Not to be used as property tax valuation
SWIM POOL, PVT
iI`f V.cG vg
FLOOR DRAIN
MECHANICAL FEES
,MICROFILM FEE
SWIM POOL, COMM
$
WATER SOFTENER
BOOK PAGE PARfy�CMEJL
LEGAALLj�DESCRIPTION
VENT SYSTEM KFAN ❑ EVAP. COOL HOODS
SIGN
WASHER (AUTO ISH)
.
MECHANICAL FEE
APPLIANCE WRYER
$
USE NO..
GARBAGE DISPOSAL
ASO
SIZE
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
TYPE IC"Y
LAUNDRY TRAY
AIR HANDLING UNIT CFM
IDLE METER
KITCHEN SINK.
I. d�1«
/SyET
ABSORPTION SYSTEM B.T.U.
TEMP USE PERM SVC
WATER CLOSET
0_,e
COMPRESSOR T,6 � HP
POLE, TEMP/PERM
LAVATORY
HEATING SYSTEM ORCED ❑GRAVITY
AMPERES SERV ENT
SHOWER
$
BOILER B.T.U.
BOND AMT.
SQ.FT. @ a
PLAN CHECKER
BATH TUB
q,
SQ.FT: @ a
WATER HEATER
0
.a7'7�
CONSTRUCTION FEE
.FT.RESID @ M/4a
$
SEWAGE DISPOSAL
OF CONST. LENDER BRANCH
OFFICE
NO LENDER INVOLVED
'SQ.FT.GAR @ 3/4a
jNAME
`
HOUSE SEWER
.sem
• ELECTRICAL FEE
DBL
$
GAS PIPING
ADDRESS CITY
PERMIT FEE
PERMIT FEES,
47Ss'1
PERMIT FEE
,
�A
DBL.
TOTAL FEES
MOB.HM.FEE
MICRO FEE
J
MECH. FEE
PL. CK. FEE
CONST. FEE
ELECT. FEE
- SMI FEE
FEE
PLUMB. FEE
J F I M A M J J A S O N D
JOB ADDRESS - SP NO
I
OWNER
,76
77
COMMUNITY -
VALUATION
DATE
DST I OFFICE
M H PERMIT FEE
$
USE OF PERMIT //�� %% �♦��y.
F.C.
SUPP. TO PE MIT
PE MI�NO
6
iI`f V.cG vg
00
,MICROFILM FEE
COPIES
$
BOOK PAGE PARfy�CMEJL
LEGAALLj�DESCRIPTION
��I ��rl /
/(yy��f [t dfy
AXs 31-11 134, 2qi � '1 6/!
�I
MECHANICAL FEE
DBL
$
USE NO..
ZONE
BBACKt LOT
SIZE
GRP,*�
TYPE IC"Y
I. d�1«
/SyET
PLAN CHECK FEE
$
BOND AMT.
PLAN NO,
�`ivSP
PLAN CHECKER
FINAL DATE INSPECTOR
.a7'7�
CONSTRUCTION FEE
DBL
$
(:) a
OF CONST. LENDER BRANCH
OFFICE
NO LENDER INVOLVED
jNAME
`
.sem
• ELECTRICAL FEE
DBL
$
ADDRESS CITY
STATE
47Ss'1
,
�A
: STRONG MOTION
$
OWNER/ 6N 5 SI UR CONTRACTOR
G % �g � "
:INSTRUMENTATION FEE
t�
ISPECIAL INSP
$
ADDRESS ADDRESS
DEMOLITION
''REGISTRATION
FEE
f i �
;PLUMBING FEE
DBL
$
e0
CITY ZIP CODE CITY
ZIP CODE
TOTAL FEES is
EL. N AREA
CODE TEL.
NO.
AREA CODE
LICENSE a
,.CASH❑CHEC .O.❑N.C.❑ PTC..'
/./
3 �1
/
c RECEIVED BY TREES REQUIRED
k
IT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF
F R 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME. VOID.
SEWAGE SYSTEM
1�,
REBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE '
T Q� LL
P iil
ITH THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, I ALSO AGREE TO CARRY "
(_UfAI'ENJA I IUN INJURANCE 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. 6-76) SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE
OF CALIFORNIA.