302186 (SATT)FIELD OFFICE
db DEPARTMENT OF BUILDING & SAFETY
BUILDING PERMIT COUNTY OF RIVERSIDE
S
J F M A M J J A O N D
PERMIT NO. -
OWNER
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77
COMMUNITY
DST
CONSTRUCTION ESTIMATE
DST
NO. ELECTRICAL FEES
78
NO. PLUMBING FEES
1 ST FL.
2ND FL.
POR.
GAR. 4&10
CAR P.
WALL SQ.
'
ESTIMATED CONSTRUCTION
SQ. FT. @ $
USE OF P MIT y
UNITS
SUP P. TO PERMIT
PERMIT
NO.
SQ. FT. @ YARD SPKLR SYSTEM
SQ. FT. @ MOBILEHOME SVC. BAR SINK
SO. FT. @ POWER OUTLET ROOF DRAINS
SQ., FT. @ DRAINAGE PIPING
FT. @ DRINKING FOUNTAIN
SQ. FT. @ URINAL
VALUATION $ e -w. WATER PIPING
NOTE: Not to be used as property tax,voluation
MICROFILM FEE
SWIM POOL, PVT
$
FLOOR DRAIN. .
OK P PARCEL LEGAL DE RI PTION
MECHANICAL FEES
SWIM POOL, COMM
WATER SOFTENER
MECHANICAL FEE
VENT SYSTEM [J FAN ❑ EVAP. COOL HOOD
O!l
SIGN
USE NO.
WASHER (AUTO H)
p0
APPLIANCE RYER
d
TY E CKBV
GARBAGE DISP SAL
FURNACE' ❑UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
+�
.PLAN CHECK FEE
LAUNDRY TRAY
AIR HANDLING UNIT CFM
PLAN NO. //
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IDLE METER
�FI/NAL�D�ATE JINSPgCTOR
7- //_DATE
KITCHEN SINK
CONSTRUCTION FEE
ABSORPTION SYSTEM B.T.U.TEMP
$
USE PERM SVC
NAME OF CONST. LENDER BRANCH
WATER CLOSET
NO INVOLVED
• COMPRESSOR_ HP
POLE, TEMP/PERM
o
LAVATORY
HEATING SYSTEM ORCED ❑ GRAVITY�>i
ELECTRICAL FEE
MPERES SERV ENT
4'k
SHOWER
ADDRESS CITY
BOILER B.T.U.
STATE
SQ.FT. @ a
BATH TUB
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OWNER/Ap EN;$ SIGNATU E �CONTRACTOR
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DDRE$ ADDRESS
SQ.FT. @ ¢
j WATER HEATER
$
, SQ.FT.RESID @ 11/4¢
j
SEWAGE DISPOSAL60
SQ.FT.GAR @ 3/4¢
HOUSE SEWER
Q;
GAS PIPING
PLUMBING FEE
PERMIT FEE
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PERMIT FEE
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PERMIT FEE -21
DBL,
TOTAL FEES
MOB-HM.FEE
MICRO FEE
M EE
PL. CK. FEE
CONST. FEE
Joe
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SMI FE(EyJp
FEE PL
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LICENSE u
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J F M A M J J A O N D
JOB ADDRESS SP NO
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OWNER
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77
COMMUNITY
VALUA N
DATE
DST
OFFICE
78
M H PERMIT FEE
$
USE OF P MIT y
F.C.
SUP P. TO PERMIT
PERMIT
NO.
MICROFILM FEE
COPIES
$
OK P PARCEL LEGAL DE RI PTION
G L 0 .2
MECHANICAL FEE
DBL
$ /
USE NO.
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SET BACK
LOT SIZE
GRP
TY E CKBV
y�
+�
.PLAN CHECK FEE
$
BOND AMT.
PLAN NO. //
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PLAN CHECKER
/
�FI/NAL�D�ATE JINSPgCTOR
7- //_DATE
CONSTRUCTION FEE
D
$
NAME OF CONST. LENDER BRANCH
OFFICE
NO INVOLVED
o
ELECTRICAL FEE
DBL
$
ADDRESS CITY
STATE
,,STRONG MOTION
,INSTRUMENTATION FEES+
$-
/
OWNER/Ap EN;$ SIGNATU E �CONTRACTOR
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DDRE$ ADDRESS
'SPECIALINSP
$
DEMOLITION
FEE
REGISTRATION
Q;
PLUMBING FEE
DBL
$
ZIP CODE Cm
ZIP CODE
FEES $
CASH ❑CHEC M.O.❑N.C.❑ L✓�
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L. N AREA
JTOTAL
— ,
C TEL.
NO.
AREA CODE
J
LICENSE u
.RECEIVED BY TREES REQUIRED
THIS P IT SHlill BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF
WORK 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
I H REE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE
S OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, I ALSO AGREE TO CARRY
AAD (IAIIAIcII
SEWAGE SYSTEM
w
T LL
/
P O i �G
-'Wl Ivli CIvlrLVIrCJ. COMPLIANCE WITH 1190 LAVVJ LJr 119E JIAIC Vr
CALIFORNIA COVERING CONTRACTORS IS ALSO GUARANTEED.
I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE
FORM 284-208 (REV. 6-78) - SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE
OF CALIFORNIA.