296792 (SATT)DEPARTMENT OF BUILDING & SAFETY FIELD OFFICE
BUILDING PERMIT
'
PERMIT NO.
MGM
COUNTY OF RIVERSIDE
FiDST
ll
CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES
1 ST FL.
2ND FL.
POR.
GAR.
CAR P.
WALL
ESTIMATED CONSTRUCTION
SQ. FT. @ $ UNITS
SQ. FT. @ YARD SPKLR SYSTEM
SQ. FT. @. MOBILEHOME SVC. BAR SINK
SQ. FT. @ POWER OUTLET ROOF DRAINS
SQ. FT. @ DRAINAGE PIPING
SQ. FT. @ DRINKING FOUNTAIN
SQ. FT. @ URINAL
VALUATION $ WATER PIPING
NOTE:, Not to be used os property tax valuation SWIM POOL, PVT FLOOR DRAIN
MECHANICAL FEES SWIM POOL, COMM WATER SOFTENER
M H PERMIT FEE
VENT SYSTEM ❑ FAN ❑ E.VAP. COOL ❑ HOOD SIGN WASHER (AUTO) (DISH)
$
APPLIANCE ❑ DRYER GARBAGE DISPOSAL
USE Or PERMIT f pe
�j
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED LAUNDRY TRAY
PP. TO PERMIT
AIR HANDLING UNIT CFM IDLE METER KITCHEN SINK
ABSORPTION SYSTEM B.T.U. TEMP USE PERM SVC WATER CLOSET
COMPRESSOR HP POLE, TEMP/PERM LAVATORY
•
HEATING SYSTEM ❑ FORCED ❑ GRAVITY AMPERES SERV ENT SHOWER
t 1' / it :,�'-
BOILER B.T.U. SQ.FT. @ ¢ BATH TUB .
;PERMIT
SQ.FT. @ a WATER HEATER
SQ.FT.RESID @ 11/aa SEWAGE DISPOSAL
MICROFILM FEE
SQ.FT.GAR @ 1/a¢ HOUSE SEWER
$
GAS PIPING
BOOK AGE PARCEL LEGAL DESCRIPTION
PERMIT FEE PERMIT FEE ' PERMIT FEE
4WAl-
I TOTAL FEES
IMOB.HM.FEEI
MICRO FEE- MECH. FEE PL. CK. FEE
CONST. FEE ELECT. PEE SMI FEE -
FEE PLUMB. FEE
I F M A M J J A S O N D
JOB ADDRESS SP NO
_?V I
Ire Ile /As,
OWNER
76
77
COMMUNITY
VALUATION
DATE
DST
OFFICE
� >
141 [ � zl� ;41Aq ,
�ry
$ 23 /�
�f
1 I�
/
/!
78
M H PERMIT FEE
$
USE Or PERMIT f pe
�j
PP. TO PERMIT
NO.
•
t 1' / it :,�'-
;PERMIT
MICROFILM FEE
COPIES
$
BOOK AGE PARCEL LEGAL DESCRIPTION
MECHANICAL FEE
Wi .
$
USE NO.
ZONE
SET BACK
LOT SIZE
GRP
TYPE CK BY
PLAN CHECK FEE
$
BOND AMT.
PLAN NO.1
PLANK CHECKER
FINAL DATE INSI
TOR
CONSTRUCTION FEE
ABL„_
$
NAME OF CONST. LENDER BRANCH
OFFICE
NO LENDER INVOLVED
J
w
ELECTRICAL FEE,
$
ADDRESS CITY
STATE
STRONG MOTION
$
OWNER/AGENTS SIGNATURE - CONTRACTOR
INSTRUMENTATION FEE/
A04:1
'SPECIALINSP
$
ADDRESS ADDRESS
DEMOLITON
FEE
REGISTRATION
w"
PLUMBING FEE
$
CITY/ ZIP CODE CITY
ZIP CODE
/
f4a
TOTAL FEES
$
TEL. NO. AREA
CODE TEL.
NO.
AREA CODE
LICENSE 4
CASH❑CHECK-O.❑N.C.❑
g44 -11S-9
RECEIVED BY l
TREES REQUIRED
HIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF
ORK FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE
WITH
SEWAGE SYSTEM1
T LL
P if .
THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, I ALSO AGREE TO CARRY
('-n AADCKIC ATII
�-� Ur VIN N%l CNAr LlJTEES. 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 264-206 (REV. 6-76) SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE
OF CALIFORNIA.