301848 (SATT)BUILDING PERMIT DEPARTMENT „ „ OF BUILDING & SAFETY_ A
�„
FIELD OFFICE, •
•
J F M A' M J J A S O N D
PERMIT NO.
71mv
i
L.VVIYI I Or RIYCR�IUC
/ LJ
DST
CONSTRUCTION ESTIMATE
V LU TION
NO. ELECTRICAL FEES
OFFICE
NO'. PLUMBING FEES
M H PERMIT FEE
1ST FL. SQ. FT. @ $
$
UNITS
u E OF PERMIT
F.C.
SU P. TO PERMIT
2ND FL. SQ. FT. @
NO.
YARD SPKLR SYSTEM
POR. SQ. FT. @
MOBILEHOME SVC.
BAR SINK
301848
GAR. Q. FT. @
POWER OUTLET
MICROFILM FEE
ROOF DRAINS
$
CAR P. SQ. FT: @
allOK PAGE P EJ LEGAL DE51301PTION
DRAINAGE PIPING
WALL SQ. FT: @
MECHANICAL FEE
DBL
$
DRINKING FOUNTAIN
USE NO.
SQ. FT. @
BACK I LOISIZE
GR
TYPE
URINAL
ESTIMATED CONSTRUCTION VALUATION $
6th
WATER PIPING
7X.�
NOTE: Not to be used as property tax valuation - f
p
SWIM POOL,. PVT
FLOOR DRAIN
MECHANICAL FEES
•fin.- O
SWIM POOL; COMM
WATER SOFTENER
Gr
PLAN CHECK FEE
VENT SYSTEM FAN ❑ EVAP. COOL HOOD
{j
SIGN
BOND AMT.
WASHER (AUTO)(
042
FINAL DATE INSPE
APPLIANCE DRYER
GARBAGE DISPOSAL
-5
FURNACE ❑ UNIT ❑ WALL ❑ FL OR ❑ SUSPENDED
2 ;Y r
�
CONSTRUCTION FEE
LAUNDRY TRAY
$
AIR HANDLING UNIT CFM
BRANCH OFFICE
IDLE METER
KITCHEN SINK
ABSORPTION SYSTEM �•B.T.U.
TEMP USE PERM SVC
ELECTRICAL FEE
WATER CLOSET
s;}�
COMPRESSOR HPPOLE,
4{FORCED
CITY
TEMP/PERM
p LAVATORY
37.
HEATING SYSTEM •. ❑ GRAVITY
AMPERES SERV ENT
STRONG MOTION
INSTRUMENTATION FEE
SHOWER
$
BOILER B.T.U.
CONTRACTOR'e%� ,�? -" . • •.•; „_
K,e
SQ.FT. @ a
BATH TUB
1
'SPECIAL
SQ.FT. @ a
WATER HEATER
406
ADDRESS
ADDRESS
d 'Q.FT.RESID• @ 1l/4a
'
SEWAGE DISPOSAL
r•, SQ.FT.GAR @ ¢/4¢
d�
HOUSE SEWER .
DBL
$
CITY ZIP CODE
CITY ZIP CODE
GAS PIPING
PERMIT FEE
�y
PERMIT FEE
$
PERMIT FEE
TEL. NO. AREA
CODE
DBL.
TOTAL FEES
MOB.HM.FEE
- MICRO FEE
-MEG H. FEE
L. CK. FEE
CONST. FEE
ELE T. FEE
ASMI FEE
FEE
PLUMB. FEE
SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF
.4r
R 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID:
I MEBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE
THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, I ALSO AGREE TO CARRY
YL DCAIC ATI/lw
SEWAGE SYSTEM
T
LL
P%
l 7
l t-
F
•
J F M A' M J J A S O N D
JOB ADDRESS , SP NO
-
OWNER
76
/ LJ
77
COMMUNITY
V LU TION
DSTs
OFFICE
78
M H PERMIT FEE
$
u E OF PERMIT
F.C.
SU P. TO PERMIT
PERMIT
NO.
4-4-1"1�141AXAKr
301848
MICROFILM FEE
COPIES
$
allOK PAGE P EJ LEGAL DE51301PTION
- 60, a
MECHANICAL FEE
DBL
$
USE NO.
ZONE
BACK I LOISIZE
GR
TYPE
CK BY
I
^� �SET
. e AL.•
I
-
p
L�
•fin.- O
IfT✓ S i
_
Gr
PLAN CHECK FEE
$
BOND AMT.
PLAN NO.
PLAN CHECKER
FINAL DATE INSPE
OR
-5
y
2 ;Y r
�
CONSTRUCTION FEE
DBL
$
NAME OF CONST. LENDER
BRANCH OFFICE
NO LENDER INVOLVED
ELECTRICAL FEE
DBL
$
ADDRESS
CITY
STATE
37.
STRONG MOTION
INSTRUMENTATION FEE
$
OWNER/AGENTS SIGNATURE
CONTRACTOR'e%� ,�? -" . • •.•; „_
K,e
1
'SPECIAL
$
ADDRESS
ADDRESS
INSP
DEMOLITON
REGISTRATION
FEE
PLUMBING FEE
DBL
$
CITY ZIP CODE
CITY ZIP CODE
�y
TOTAL FEES
$
{
TEL. NO. AREA
CODE
TEL. NO.- AREA CODE
LICENSE/n
{ASH❑CHECK .O.❑N.C.❑
RECEIVED BY r9
TREES REQUIREDIT
SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF
.4r
R 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID:
I MEBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE
THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, I ALSO AGREE TO CARRY
YL DCAIC ATI/lw
SEWAGE SYSTEM
T
LL
P%
FORM 284-208 (REV. 6-76)
vrvl� Mf CMrLLJI CCJ. COMPUANCE 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
SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE
OF CALIFORNIA.