301851 (SFD)- DEPARTMENT OF BUILDING & SAFETY FIELD OFFICE
BUILDING PERMIT I
RVJUKAINI.t UrUN MT tMYLVTtt J. L.UMYLIANI-t WIIH INt LAWJ VY Irlt JIAIt 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. 6-76) SO IN ACCCIRDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE
OF CALIFO' A
MNO.
5"IT
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DST
CONSTRUCTION ESTIMATE
NI Y
NO. ELECTRICAL FEES
D
NO. PLUMBING FEES
O ICE
15T FL. 60 SQ.
2ND FL..
FOR.
GAR.
CAR P. SQ.
WALL SQ.
ESTIMATED CONSTRUCTION
FT. @ $UNITS
-
78
SQ. FT. @ YARD SPKLR SYSTEM
A2,
SQ. FT. @ MOBILEHOME SVC. BAR SINK
SQ. FT. @ ' POWER OUTLET ROOF DRAINS
FT. @ DRAINAGE PIPING
FT. @ DRINKING FOUNTAIN
SQ. FT. @ URINAL
.C.
VALUATION $ Qj WATER PIPING
00
NOTE.: Not to be used•as property tax valuation
SWIM POOL, PVT
MICROFILM FEE
or FLOOR DRAIN
$
MECHANICAL FEES
LEGAL DE5C TIO
SWIM POOL, COMM
WATER SOFTENER
F
VENT SYSTEM AN ❑ EVAP. COOL&. -HOOD
MECHANICAL FEE
SIGN
$
WASHER (AUTO)
450
TorTIE
APPLIANCE RYER
Q�3
GARBAGE DISPOSAL
0
FURNACE ❑ UNIT ❑ WALL Cl FLOOR ❑ SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
PLAN CHECK FEE
IDLE METER
$
KITCHEN SINK
�.
PLAN NO.
ABSORPTION SYSTEM B.T.U.
FINAL DATE
TEMP USE PERM SVC
WATER CLOSET
Cd7
COMPRESSOR HP
POLE, TEMP/PERM
�INSP
LAVATORY
CX:
HEATING SYSTEM RCED ❑GRAVITY]
MPERES SERV ENT
yrrXi
SHOWER
BOILER T. U.
L
SQ.FT. @ ¢
BATH TUB
f?C7
DERINVOLVED
01
SQ.FT. @ ¢
WATER HEATER
L3
ELECTRICAL FEE
DBL
J Q.FT.RESID @ 11/4¢
SEWAGE DISPOSAL
pIQ
SQ.FT.GAR @ 3/4¢
HOUSE SEWER
Ai.
STRONG MOTION
$
GAS PIPING
CONTR `BYO,`
�+-
PERMIT FEE
PERMIT FEE
G
PERMIT FEE
ESC?
DBL.
TOTAL FEES
MOB.HM.FEE
- MICRO FEE
MEeff. FEE�E+[y,/a
. CK. FEE
CONST. FEE ELEtr
FEE
SMI FEE
FEE PLUW.
FEE
RVJUKAINI.t UrUN MT tMYLVTtt J. L.UMYLIANI-t WIIH INt LAWJ VY Irlt JIAIt 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. 6-76) SO IN ACCCIRDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE
OF CALIFO' A
JOB ADDRESS SP NO
OWNER
S O
J F M A M J J A N D
� I
D.1.,
f
76
77
NI Y
VALUA N
D
DST
O ICE
78
A2,
M H PERMIT FEE
OSE OF ER' T
a»
.C.
SUPP. PERMIT
PE
1-301851
MIT N
MICROFILM FEE
COPIES
$
BOOK P GE PARCEL
LEGAL DE5C TIO
F
MECHANICAL FEE
DBL
$
Nbe —If
TorTIE
5 BACK I LO/I SIZE GF?h TYPE CK BY
ryyw/�
y�
PLAN CHECK FEE
$
BOND AMT.
PLAN NO.
PLAN CHECKER
FINAL DATE
TOR
�INSP
CONSTRUCTION FEE
L
$
NAME OFCONST.LtNDER JW
BRANCH OFFICE NOL
DERINVOLVED
01
ELECTRICAL FEE
DBL
$
ADDRESS
CITY STATE
Ai.
STRONG MOTION
$
OWNER/AGENTS SIGNATURE
CONTR `BYO,`
�+-
INSTRUMENTATION FEE
�
IADDR
042
SPECIAL INSP
$
ADDRESS
SS
DEMOLITION
FEE
REGISTRATION
PLUMBING FEE
DBL
$
CITY ZIP CODE
CITY ZIP CODE
TOTAL FEES $
TEL. NO. AREA
CODE
L. O. EA CODE
LI E E u
CASH ❑CHECK :O.❑N.C.❑
/
f
I - 4 W< 33;,�
RECEIVED BY . TREES REQUIREDT
T SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF
20 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID. 1
I H AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE
SEWAGE SYSTEM
T L
P
THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, I ALSO AGREE TO CARRY
RVJUKAINI.t UrUN MT tMYLVTtt J. L.UMYLIANI-t WIIH INt LAWJ VY Irlt JIAIt 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. 6-76) SO IN ACCCIRDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE
OF CALIFO' A