302184 (SFD)DEPARTMENT OF BUILDING & SAFETY FIELD OFFICE
BUILDING PERMIT — ,
J F M A M J J A S O N' D
PERMIT N
F8 1084
'ROW
1
11-OuYI VP KIVCK31UC
77COMMUNITY
VALU TI N
CST
[AV,
CONSTRUCTION ESTIMATE
OFFICE
NO. ELECTRICAL -FEES
NO. PLUMBING FEES
6/z- -7'7
1ST FL.
2ND FL.
POR. L '
GAR.
CAR P.
WALL SQ.
ESTIMATED CONSTRUCTION
SQ. FT.
iB
UNITS
jD
3 ..
SQ. FT. @ YARD SPKLR-SYSTEM
SQ, FT. @ MOBILEHOME SVC. BAR SINK
SQ. FT. @ POWER OUTLET ROOF DRAINS
SQ. FT. @ t DRAINAGE PIPING
F.C.
FT. @ DRINKING FOUNTAIN
PERMIT
SQ. FT. @ URINAL
VALUATION $ (jp WATER PIPING
NOTE: Not to be used as property tax valuation
SWIM POOL, PVT
FLOOR DRAIN
d
MECHANICAL FEES
SWIM POOL, COMM
WATER SOFTENER
MICROFILM FEE
COPIES
VENT SYSTEM ❑ FAN ❑ EVAP. COOL HOOD
60
SIGN
WASHER( SH)
APPLIANCE RY
MECHANICAL FEE
DBL
$
GARBAGE
USE NO.
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FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
`f
TkY�PEE/
C[ BY
LAUNDRY TRAY
AIR HANDLING UNIT CFM
IDLE METER
/2[
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERM SVC
WATER CLOSET
COMPRESSOR 0 HP
POLE, TEMP/PERM
PLAN CHECK FEE
LAVATORY
,.
HEATING SYSTEA ORCED ❑ GRAVITY6
PLAN NO,
AMPERES SERV ENT
f31i
SHOWER
BOILER B.T. U. -
SQ.FT. @ a
BATH TUB
CONSTRUCTION FEE
DBL
SQ. FT. @ a
WATER HEATER
BRANCH OFFICE
NO l DER INVOLVED
'
% Q.FT.RESID @ MAc1,5
F40
SEWAGE DISPOSAL
ELECTRICAL FEE
DBL
Q.FT.GAR @.1/aa
—44
HOUSE SEWER
CITY
STATE
��IR75A(SENT`S
GAS PIPING
PERMIT FEEPERMIT
FEE
�
PERMIT FEE
r
INSTRUMENTATION FEE
DBL.
I TOTAL FEES `
L
MOB.HM.FEE
MICRO FEE
M H. FEE
.gid
L. CK. FEE
CONST. FEIE+,
EL . FEE
/9.
'SMIFEE
FEE
PL B. FE E
J F M A M J J A S O N' D
JOB ADDRESS - SP NO
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wr✓ e I
OWNER
Ile kS,
76
77COMMUNITY
VALU TI N
E
ST
OFFICE
$ &
6/z- -7'7
iB
jD
3 ..
M H PERMIT FEE
$
USE OF PERMIT
F.C.
SUPP. T PERMIT"
PERMIT
NO.
d
MICROFILM FEE
COPIES
$
OK PA fthCEt LEGAL DESCRIPTION
pS f / o -e' /L/ /FV // -ct
MECHANICAL FEE
DBL
$
USE NO.
ZONEjy:/'�
LOT SIZE
SET BACK LOT
GRP
TkY�PEE/
C[ BY
f)
/2[
PLAN CHECK FEE
$
BOND AMT.
PLAN NO,
PLANK CHECKER
FINAL DATE INSPECTOR
CONSTRUCTION FEE
DBL
$
NAME OF CONST. LENDER
BRANCH OFFICE
NO l DER INVOLVED
'
F40
ELECTRICAL FEE
DBL
$
ESS
CITY
STATE
��IR75A(SENT`S
STRONG MOTION'
$
�
SIGNAT E
Of lTRAt f�R
INSTRUMENTATION FEE
'SPECIALINSP
$
ADDRESS
ADDRESS
DEMOLITION
FEE
REGISTRATION
PLUMBING FEE
DBL
$
CITY ZIP CODE
CITY ZIPCDDE
TOTAL FEES $
TEL. NO. AREA
CODE
TEL. NO.
AREA CODE
LICENSE n
l
_
CASH❑CHECK .O.❑N.C.❑ 40dX
�'
-RECEIVED BY TREES, REQUIRED
THIS"PER IT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF
WORK FQO DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
IHE(� GREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE
SEWAGE SYSTEM
1
TLL
p
ee PP E LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, I ALSO AGREE TO CARRY
wlcerinwl IwlU lonwl�c no�wi .
CALIFORNIA COVERING -60N TRACTORS 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
FORM 284-209 IREv. s-�sl _ OF CALIFORNIA.