297055 (SFD)• DEPARTMENT OF BUILDING & SAFETY FIELD OFFICE
.
BUILDING PERMIT �,,,��1„�� ,
J F M A M J J A S O N D
.
PERMIT NO55
297
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COMMUNITY
VTION
$ aC1
DST
CONSTRUCTION ESTIMATE
OFFICE
NO. ELECTRICAL FEES
LT
NO. PLUMBING FEES
1 ST Fl.
2ND FL.
POR.
GAR.
CAR P.
WALL
ESTIMATED CONSTRUCTION
SQ. FT. @
aCJ
UNITS
SUPP. O PERM PE
MIT N
SQ. FT. @ YARD SPKLR SYSTEM
SQ. FT. @ MOBILEHOME SVC. BAR SINK
SQ. FT. @]AM as POWER OUTLET ROOF DRAINS
SQ. FT. @ DRAINAGE PIPING
SQ. FT. @ DRINKING FOUNTAIN
7
SQ. FT. @ URINAL
MICROFILM FEE
VALUATION Is �! WATER PIPING
Qfi
NOTE: Not to be used as property tax valuation
BOOK AGE PARCEL
SWIM POOL, PVT
FLOOR DRAIN
MECHANICAL FEES
SWIM POOL, COMM
DBL-
WATER SOFTENER
USE O.
VENT SYSTEM (-j FAN;& EVAP. COOL UOHOOD
SET BACK
SIGN
RP
WASHER (AUT SH)
CK BY
APPLIANCE RYERG►
GARBAGE DISPOSAL
4
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
S
LAUNDRY TRAY
R
PLAN CHECK FEE
AIR HANDLING UNIT
$
IDLE METER
BOND AMT.
KITCHEN SINK
PLAN CHECKER
FINAL DATEINSPECTOR
ABSORPTION SYSTEM B.T.U.
TEMP USE PERM SVC
WATER CLOSET
4:21-510A-)�v
COMPRESSOR HP
#07 6 Q
POLE, TEMP/PERM
$
LAVATORY
r�G►
OFFICE
HEATING SYSTEM ORCED C] GRAVITY
ZOO
MPERES SERV ENT
424
SHOWER
BOILER B.T.U.
ELECTRICAL FEE
SQ.FT. @ ¢
$
BATH TUB
40
STAT
SQ. FT. @ ¢
WATER HEATER
Cil
SQ.FT.RESID @ 11/a¢ 1
SEWAGE DISPOSAL
STRONG MOTION
SQ.FT.GAR @ 1/a¢
$
HOUSE SEWER
OWNE GENTS SIG TUR CONTRACTOR
,�
INSTRUMENTATION FEE
GAS PIPING
SPECIALINSP
PERMIT FEE
PERMIT FEE
$
PERMIT FEE
31 0--S
DBL.
I TOTAL FEES MOB.HM.FEE
MICRO FEE
MEUR. FEE
0L. CK. FEE
.r,...r
I CONST. FEE EL
!%a
FEE
oik
SMI FEE
i
FEE
PLUXrB. FEE
s pd
J F M A M J J A S O N D
JOB ADDRESS I SP NO
0I I
OWNER
76
77
COMMUNITY
VTION
$ aC1
DATE Q�
G7
DST
//
OFFICE
78
LT
M H PERMIT FEE
$
S O ER T
F.C.
SUPP. O PERM PE
MIT N
7
0a
MICROFILM FEE
COPIES
$
BOOK AGE PARCEL
LEGAL DESCRIP ION
MECHANICAL FEE
DBL-
$
USE O.
ZONE
SET BACK
LOT SIZE
RP
TYPE
CK BY
4
S
5
R
PLAN CHECK FEE
$
BOND AMT.
PLAN NO.
PLAN CHECKER
FINAL DATEINSPECTOR
4:21-510A-)�v
CONSTRUCTION FEE
DBL
$
NAME OF CONST. LENDER BRANCH
OFFICE
NO LENpER INVOLVED
424
ELECTRICAL FEE
DBL
$
ADDRESS CITY
STAT
STRONG MOTION
$
OWNE GENTS SIG TUR CONTRACTOR
,�
INSTRUMENTATION FEE
SPECIALINSP
$
ADD s ADDRESS
DEMOLITON
FEE
REGISTRATION
PLUMBING FEE
DBL
$
CITY ZIP CODE CITY
ZIP CODE
TOTAL FEES 0)0. $
RECEIVED B .` TREES REQUIRED
IS PERMIT SHALL BECOME VOID IF WORK 15 NOT COMMENCED WITHIN 120 DAYS. CESSATION OF
FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
3
SEWAGE SYSTEM
jEBY AGREE THATALL WORK IN CONNECTION WITH THIS PERMITWILL BE DONE IN ACCORDANCE
T
LL
WITTHE.LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, I ALSO AGREE TO CARRY
CUMPtINSA I ION INSURANCE UPON MY EMPLOYEES. COMPLIANCE WITH THE LAW5 OF THE STATE OF
CALIFORNIA COVERING CONTRACTORS IS ALSO GUARANTEED.
I HEREBY CERTIFY THAT THEINDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE
FORM 284-206 (REV. 6-76) SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE
OF CALIFORNIA.