286704 (BLCK)BUILDING PERMIT DEPARTMENT OF BUILDING & SAFETY FIELD OFFICE
J F I M A M J J A S O N D
PERMIT NO.
286704
OWNER
t 7-
COUNTY OF RIVERSIDE
77
COMMUNITY -
DST
CONSTRUCTION ESTIMATE
OFFICE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
$ A? V W leeJIAI
1ST FL.
2ND FL.
POR.
GAR.
CAR P.
WALL f�
ESTIMATED CONSTRUCTION
SQ. FT. @ $
78
UNITS
$
SQ. FT. @ YARD SPKLR SYSTEM
USE OF P MIT61
SQ. FT. @ MOBILEHOME SVC. BAR SINK
SUPP. TO PERMIT
SQ. FT. @ POWER OUTLET ROOF DRAINS
SQ. FT. @ DRAINAGE PIPING
SQ. FT. @ aDt�. ' DRINKING FOUNTAIN
j %
&Xvwo Ll1r !7286704
SQ. FT. @ URINAL
VALUATION $ VAI 0,0 ... WATER PIPING
MICROFILM FEE
NOTE: Not to be used os property tax valuation
$
SWIM POOL, PVT
FLOOR DRAIN
LEGAL DESCRIPTIION
MECHANICAL FEES
SWIM POOL, COMM
WATER SOFTENER
10 'A, Jc*v 7"R -
MECHANICAL FEE
VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD
$
SIGN
WASHER (AUTO) (DISH)
ZONE
SET BACK LOT SIZE
APPLIANCE ❑ DRYER
TYPE
BY
GARBAGE DISPOSAL
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
µ
LAUNDRY TRAY
I
AIR HANDLING UNIT CFM
PLAN CHECK FEE
IDLE METER
KITCHEN SINK
BOND AMT.
ABSORPTION SYSTEM B.T.U.
PLAN CHECKER
TEMP USE PERM SVC
WATER CLOSET
COMPRESSOR HP
POLE, TEMP/PERM
LAVATORY
10
J
HEATING SYSTEM ❑ FORCED ❑ GRAVITY
CONSTRUCTION FEE
AMPERES SERV ENT
SHOWER
NAME OF CONST. LENDER
BOILER B.T.U.
NO LENDER INVOLVED
SQ.FT. @ a
BATH TUB
SQ. FT. @ a
WATER HEATER
DBL
$
ADDRESS
SQ.FT.RESID @ 1l/4a
SEWAGE DISPOSAL
SQ.FT.GAR @ 3/4a
HOUSE SEWER
r
STRONG MOTION
$
OWNER/AGENTS SIGNATURE
GAS PIPING
INSTRUMENTATION FEE
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL.
I TOTAL FEES
X/ A+.
IMOB.HM.FEEI
MICRO FEE
MECH. FEEPL.
CK. FEE
t
CONST. FEE ELECT. FEE
w
/Vy
SMI FEE
FEE F
PLUMB. FEE
J F I M A M J J A S O N D
JOB ADDRESS ) I SP NO
j f' g /LfV CAI
OWNER
t 7-
76
77
COMMUNITY -
VALUUAATIIOOONf
DATE DST
OFFICE
$ A? V W leeJIAI
M$
78
M H PERMIT FEE
$
USE OF P MIT61
F.C.
SUPP. TO PERMIT
PERMIT NO.
j %
&Xvwo Ll1r !7286704
MICROFILM FEE
COPIES
$
BOOK PAGE PARCEL
LEGAL DESCRIPTIION
(IP�— — li7
10 'A, Jc*v 7"R -
MECHANICAL FEE
DBL
$
USE NO.
ZONE
SET BACK LOT SIZE
GRP
TYPE
BY
µ
I 1 S S R
I
ICK
yl
PLAN CHECK FEE
$
BOND AMT.
PLAN NO.
PLAN CHECKER
FINAL DATE INSPECTOR
I
10
J
n
CONSTRUCTION FEE
DBL
$
NAME OF CONST. LENDER
BRANCH OFFICE
NO LENDER INVOLVED
ELECTRICAL FEE
DBL
$
ADDRESS
CITY
STATE
r
STRONG MOTION
$
OWNER/AGENTS SIGNATURE
CONTRACTOR
INSTRUMENTATION FEE
'SPECIALINSP
$
ADDRESS
ADDRESS
DEMOLITIONPFEE
REGISTRATION
tJ t &A � Rlz4
PLUMBING FEE
DBL
$
CITY ZIP CODE
CITY ZIP CODE
1AIMs 'PA. .
TOTAL FEES
$
TEL. NO. AREA
CODE
TEL. NO. AREA CODE
LICENSE p
CASH❑CHECK O.❑N.C.❑Q
r
0,0414
+
3t
RECEIVED BY "
TREES REQUIREDl\
IS PERMIT SHAVOIDIF WOERK IS NOT 120 DAYS. CESSATION OF
DALYS SHOO
O FOR TO BECOME VO WITHIN
I HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE
.SEWAGE SYSTEM
"�
T LL
p
WITH THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, I ALSO AGREE TO CARRY
ihAADCkICAT—li i
�/• m1 C/v1rLVICCJ. I.VMI'LIAIV LC WIIr1 Irtt LAWS OF THES ATE 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
FORM 284-206 (REV. 6-761 OF CALIFORNIA.