302183 (SATT)FIELD OFFICE
DEPARTMENT OF BUILDING & SAFETY
BUILDING PERMIT
J F M A M J J A S O N D
PERMIT NO.
3021-31-
OWNER -
Ciju1V 1 T Vr -RI V CRIIUC
x
77
CONSTRUCTION ESTIMATE
VAU ION
$
[}E`i
NO. ELECTRICAL FEES
OFFICE
NO. PLUMBING FEES
1ST FL. SQ. FT. @0" $
[ l/1J'-�
UNITS
M H PERMIT FEE
2ND FL. SQ. FT. @
$
USE OF RMI j
YARD SPKLR SYSTEM
S PP. O PERMIl
FOR. SQ. FT. @ *`3a
Qin
MOBILEHOME SVC.,
BAR SINK
GAR. SQ. FT. @'
t"i�
POWER OUTLET
J.PE
ROOF DRAINS
CAR P. 50. FT. @
MICROFILM FEE
COPIES
$
DRAINAGE PIPING
-BOOK PAGE PARCEL
WALL SQ. FT. @
DRINKING FOUNTAIN
SQ. FT. @
URINAL
ESTIMATED CONSTRUCTION VALUATION $ -,
Ca d-
DBL
$
WATER PIPING
(o
NOTE: Not to be used as property tax valuation
L�0-r IIZE
SWIM POOL, PVT
CK BY
FLOOR DRAIN
MECHANICAL FEES
..
SWIM POOL, COMM
J,:YPE
WATER SOFTENER
I G!S
VENT SYSTEM [I FAN ❑ EVAP. COOL HOOD
CHCS
SIGN
WASHER(AUT SH)
00
BOND AMT.
APPLIANCE RYER
PLAN CHECKER
FINAL DATE IN,SSTOR
GARBAGE DISP SAL
AL'S
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
LAUNDRY TRAY
CONSTRUCTION FEE
AIR HANDLING UNIT CFM
$
IDLE METER
NAME OF CONST. LENDER BRANCH
KITCHEN SINK?
NO DER INVOLVED
ABSORPTION SYSTEM 0 B.T.U.
TEMP USE PERM SVC
WATER CLOSETe
ELECTRICAL FEE.
COMPRESSOR j/ - HP
$
POLE, TEMP/PERM
ADDRESS CITY
LAVATORY
STATE
HEATING SYSTEM FORCED ❑ GRAVITYGGt
` MPERES SERV ENT
G7�T
SHOWER
STRONG MOTION
BOILER B.T.U.
$
SQ. FT. @ a
OWNER/AGE 3S SIGNATURE-- CONTRACTOR
BATH TUB,.v
INSTRUMENTATION FEE
50. FT. @ ¢
WATER HEATER
$
AD Z:� + }N� AUORESS
SQ.FT.RESID @ 11/a4jSEWAGE
DEMOLITION FEE
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DISPOSAL,
ef—
SQ.FT.GAR @ 3/4¢
f
HOUSE SEWER
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PLUMBING FEE
DBL
$
GAS PIPING
TTY ZIP CODE CITY
ZIP CODE
PERMIT FEE
pQ
PERMIT FEE
G32J
PERMIT FEE
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TOTAL FEES - $
DBL. TOTAL FEES MOB.HM.FEE MICRO FEE
CH. FEE
. CK. FEE CONST. FEE
EL . FEE
SMIFEE/ FEE
PLO . FEEE*
CASH ❑CHEC .O.❑N.C.❑
ge
J�
RECEIVED BY TREES REQUIRED
r
THIS PERWT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION -OF,
WORK F DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
I HE GREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE
�..
SEWAGE SYSTEM
`,.
T LL
J F M A M J J A S O N D
JOB ADDRESS SP NO
I
OWNER -
76
x
77
MUNIT "'
VAU ION
$
[}E`i
DA - DST
OFFICE
78
[ l/1J'-�
Mfr
M H PERMIT FEE
$
USE OF RMI j
F.C.
S PP. O PERMIl
MIT
NO.
J.PE
MICROFILM FEE
COPIES
$
-BOOK PAGE PARCEL
LEGAL DESCRIPTION
MECHANICAL FEE
DBL
$
USE O.ZO E
SET BACK
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GR
CK BY
..
J,:YPE
I G!S
S
RQ
PLAN CHECK FEE
$
BOND AMT.
PLAN NO.
PLAN CHECKER
FINAL DATE IN,SSTOR
CONSTRUCTION FEE
DBL
$
NAME OF CONST. LENDER BRANCH
OFFICE
NO DER INVOLVED
C?C%
ELECTRICAL FEE.
DBL
$
ADDRESS CITY
STATE
STRONG MOTION
$
OWNER/AGE 3S SIGNATURE-- CONTRACTOR
INSTRUMENTATION FEE
'SPECIAL INSP
$
AD Z:� + }N� AUORESS
DEMOLITION FEE
�]
ef—
REGISTRATION'
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PLUMBING FEE
DBL
$
TTY ZIP CODE CITY
ZIP CODE
TOTAL FEES - $
L. O. AREA
CODE TEL.
NO.
AREA CODE
LICENSE n
CASH ❑CHEC .O.❑N.C.❑
ge
RECEIVED BY TREES REQUIRED
r
THIS PERWT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION -OF,
WORK F DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
I HE GREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE
�..
SEWAGE SYSTEM
`,.
T LL
P
IE AWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, I ALSO AGREE TO CARRY
1Umrt11J11IIUrl INLUI(All L.t UYUN MT tMYLUTttb. L-UMPLIANLL VVI IH IHE 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 2e420e (REV. 6.76) SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE
OF CALIFORNIA.