297398 (AR)MENT OF BUILDING & SAFETY FIELD OFFICE
BUILDING PERMIT
J F M Aim J J A S O N D
PERMIT NO.
9739
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COMMUNITY
VALUATION
DST
CONSTRUCTION ESTIMATE
NO ELECTRICAL -FEES
NO. PLUMBING FEES
1ST FL.
2ND FL.
FOR.
GAR.
CAR P.
WALL
ESTIMATED CONSTRUCTION
SQ. FT. @ + O $ :
% i UNITS
78
M H PERMIT FEE
SQ. FT. @ YARD SPKLR SYSTEM
SQ. FT. @ _00r G� MOBILEHOME SVC. BAR SINK
SUPP. TOPERMIT
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 as property tax-voluation
SWIM POOL, PVT
MICROFILM FEE
FLOOR DRAIN
$.
.MECHANICAL FEES
SWIM POOL, COMM
WATER SOFTENER
VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD
SIGN
MECHANICAL FEE
WASHER (AUTO) (DISH)
$
APPLIANCE ❑ DRYER
:ONE
SET BACK LOT SIZE
GARBAGE DISPOSAL
TYPE
ICK B'
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
IDLE METER
KITCHEN SINK
ABSORPTION SYSTEM L� B.T.U.
TEMP USE PERM SVC
WATER CLOSET
COMPRESSOR HP
POLE, TEMP/PERM
PLAN CHECK FEE
LAVATORY
$
HEATING SYSTEM Cl FORCED ❑ GRAVITY
AMPERES SERV ENT
PLAN CHECKER
SHOWER ,
BOILER B.T.U.
SQ.FT. @ a
Q-
BATH TUB
J`
SQ.FT. @ a
CONSTRUCTION FEE
WATER HEATER
$
NAME OF CONST. LENDER
Q.FT.RESID @ 1 Vk
NO'CEN,R INVOLVED
SEWAGE DISPOSAL
SQ.FT.GAR @ 1/aa
HOUSE SEWER
ELECTRICAL FEE
DBL
$
ADDRESS
CITY
GAS PIPING
PERMIT FEE
ff
�I
PERMIT FEE
f
PERMIT FEE
STRONG MOTION
INSTRUMENTATION FEE
DBL.
TOTAL FEES
IMOB.HM.FEEI
MICRO FEE
MECH. FEE PL. CK. FEE
I CONST. FEE
ELECT. FEE
SMI FEE
FEE
PLUMB. FEE
J F M Aim J J A S O N D
JOB ADDRESS - SP NO
�} I
/-V-Z20
OWNER
A9e&,'
76
77
COMMUNITY
VALUATION
DATE
DST I OFFICE,
�Z7
78
M H PERMIT FEE
$
USE'OFOffiERMIT�. F.C.
SUPP. TOPERMIT
PERMIT NO,
MICROFILM FEE
COPIES
$.
BOOK PAGE PAR/CEL
DESCRIPTION
—moi
ItGAL
AL
✓� /'
MECHANICAL FEE
DBL
$
USE NO.
:ONE
SET BACK LOT SIZE
GRP
TYPE
ICK B'
(/
PLAN CHECK FEE
$
BOND AMT.
PLAN YO.
PLAN CHECKER
FINAL DATE INSPECTOR
j
Q-
J`
CONSTRUCTION FEE
DBL
$
NAME OF CONST. LENDER
BRANCH OFFICE
NO'CEN,R INVOLVED
ELECTRICAL FEE
DBL
$
ADDRESS
CITY
STATE
ff
�I
STRONG MOTION
INSTRUMENTATION FEE
$
OWNS ENTS SI A7JR /' -
f{
CONTRACTOR `
,F
'SPECIAL INSP
$
AXR
ADDRESS
�]
DEMOLITON
FEE
REGISTRATION
+
PLUMBING FEE
DBL
$
CITY nP CODE
CITY ZIP COD=
{ ie
TOTAL FEES $ -
EL.NO. AREA
CODE
TEL. NO.
AREA CODE
LICENSE 4
CASH ❑CHECK .O.❑N.C.❑
�"""%
!
-RECEIVED BY TREES REQUIRED
THIS'PERMIT SHA L BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF
WORK FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
`SEWAGE SYSTEM
I HEREBY AGREE T -IAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE
T LL P
-
WITH THE LAWS Or RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, I ALSO AGREE TO CARRY
r'(1MDCAIf ATIll l lw •C I'iDAwl/'c I
Vr VI�IV\I CIv1rLVICCJ. l- IVrLIANCE YYlln Inc LAVY a OF ME a IHICUr
CALIFORNIA COVEtINC°, CONTRACTORS IS ALSO GUARANTEED.
I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE
SO IN ACCORDANCE WITH SECTION 5541 ORTHE BUSINESS AND PROFESSIONS CODE OF THE STATE
FORM -284.208 IREV. 6-76I OF CALIFORNIA.