286650 (SFD)s DEPARTMENT OF BUILDING & SAFETY FIELD OFFICE
BUILDING PERMIT`
J F M A M J - J A S Q N D
PERMITNO.S
6,
OWNER
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DST
r
CONSTRUCTION. ESTIMATE
VALUATIckw
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NO. ELECTRICAL FEES
DST
NO. I PLUMBING FEES
1ST FL.
2ND FL.
POR.
GAR.
CAR P. -,,,,SQ.
WALL
ESTIMATED CONSTRUCTION
SQ. FT. @ - 0 $
Q
UNITS
USE OF PERMIT
F.C.
SUPP. TO PERMIT
SQ. FT. @ YARD SPKLR SYSTEM
SQ. FT. @_11 Z �. MOBILEHOME SVC. BAR SINK
SQ. FT. @ <` POWER OUTLET ROOF DRAINS
' Q. .0
FT. @ DRAINAGE PIPING
SQ. FT. @ DRINKING FOUNTAIN
SQ. FT. @ URINAL
VALUATION $ i ''?' GM WATER PIPING'
NOTE: Not to be used os property tax valuation
SWIM POOL, PVT
•MICROFILM FEE
FLOOR DRAIN
$
e)BOOK
MECHANICAL FEES
LEGAL DE IPTION
SWIM POOL, COMM'
DBL
WATER SOFTENER
USE NO.
VENT SYSTEM [j FAN
❑ EVAP. COOL HOOD
LOT SIZE y�
SIGN
TYPE
WASHER (AUTO)(G4
APPLIANCE
OrDRYER
GARBAGE DISPOSAL
FURNACE ❑ UNIT ❑ WALL [:]FLOOR ❑ SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
`PLAN CHECK FEE$
IDLE METER
KITCHEN SINK
BOND AMT.
PLAN NO.
ABSORPTION SYSTEM :
B.T.U.
R
TEMP USE PERM SVC
WATER CLOSET
COMPRESSOR
HP
POLE, TEMP/PERM
CONSTRUCTION FEE
LAVATORY
.4•
HEATING SYSTEM .FORCED GRAVITY
OFFICE
AMPERES SERV ENT'
!}
SHOWER
BOILER B.T.U.
SQ.FT. @ a
ELECTRICAL FEE
F BATH TUB
$
ADDRESS CITY
STATE
SQ. FT. @ a
WATER HEATER
c p
SQ.FT.RESID @ 11/44
j '
SEWAGE DISPOSAL
0f)
:STRONG MOTION
,INSTRUMENTATION FEE
'1 :4 SQ.FT.GAR @ 3/44
HOUSE SEWER
€SPECIAL INSP
DEMOLITION
FEE
$
GAS PIPING
PERMIT FEE
REGISTRATIONi-/C/
.79
PERMIT FEE
f3
PERMIT FEE
DBL.
I TOTAL AF'JEES
MOB.HM.FEE++.M{�ICRO
FsE�E
MECH/. FEE
PL. CK. FEE
CONST.'1FEE
ELECT.FEE
SMI FEE
FEE
PLUMB. FEE
J F M A M J - J A S Q N D
JOB ADDRESS SP NO
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OWNER
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176
J
�
.77
COMMUNITY
VALUATIckw
�y f�
DATE
,r r t+
DST
OFFICE
M H PERMIT FEE
$
USE OF PERMIT
F.C.
SUPP. TO PERMIT
PERMIT NO.
' Q. .0
int/
286650
•MICROFILM FEE
COPIES
$
e)BOOK
PAGE PARCEL
LEGAL DE IPTION
MECHANICAL FEE
DBL
$
USE NO.
ZONE
SET BACK
LOT SIZE y�
GRP
TYPE
ICK BY
`PLAN CHECK FEE$
BOND AMT.
PLAN NO.
PLAN CHECKER
10
FINAL DATE INSP
R
CONSTRUCTION FEE
DBL
NAME OF CONST. LENDER BRANCH
OFFICE
NO LENDER INVOLVED
ELECTRICAL FEE
DBL
$
ADDRESS CITY
STATE
:STRONG MOTION
,INSTRUMENTATION FEE
$
OWNER I ENT SIGNATOR ! ♦ CONTRACTOR
€SPECIAL INSP
DEMOLITION
FEE
$
ADDRESS ADDRESS
REGISTRATIONi-/C/
PLUMBING FEE
DBL
$
O
CITY f }�+ G� ,yZIIPP CODE CITY
ZIP CODE
TOTAL FEES $
91r
TEL. NO.. AREA
CODE TEL.
NO.
AREA CODE
LICENSE v
fj j
CASH (DCHECK .O.QN.C.❑
RECEIVED BY �! _ TREES REQUIRED
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HI SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF
ORk ` 20 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
B AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE
tT
DC AHEIC LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, I ALSO AGREE TO CARRY
(IAA ATIlI�
SEWAGE SYSTEM
T �4pA! LL
p
_
CALIFORNIA COVER_NG .C.ONfRACT.O.R.S -II.S ..A'LvS'OrrGvU. AA. RA"N T,EED.�.,. ♦�,I, I�,.n �J vl IIII JIn IL VI
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.