286671 (PAT)- DEPARTMENT OF BUILDING & SAFETY FIELD OFFICE.
i BUILDING PERMIT
-F M. A M J, J A S O N -D
PERMITNO.
6 6
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DST
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CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES
1 ST FL.
' 2ND FL.
: 'POR.
GAR.
CAR P.
' WALL
"
ESTIMATED CONSTRUCTION
SQ. FT. @ $ UNITS
SQ. FT. @ YARD SPKLR SYSTEM
SQ. FT. O� O MOBILEHOME SVC. BAR SINK
@
SQ. FT. @ POWER OUTLET ROOF DRAINS
SQ. FT: @ DRAINAGE PIPING
SQ. FT. @ DRINKING FOUNTAIN
SQ. FT. @ URINAL
VALUATION $ WATER PIPING
NOTE: Not to be used as property tax valuation SWIM POOL, PVT FLOOR DRAIN
� `�' �/�_ V •
MECHANICAL FEES SWIM POOL, COMM WATER SOFTENER
/!/
VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD SIGN WASHER (AUTO) (DISH)
,M H PERMIT FEE
APPLIANCE ❑ DRYER GARBAGE DISPOSAL
$
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑SUSPENDED LAUNDRY TRAY
USE OF PERMIT
m� L 9 z
AIR HANDLING UNIT CFM IDLE METER KITCHEN SINK
SUPP. T PERMIT-
ABSORPTION SYSTEM O B.T.U. TEMP USE PERM SVC WATER CLOSET
7
COMPRESSOR • HP POLE, TEMP/PERM LAVATORY
.MICROFILM FEE
HEATING SYSTEM ❑ FORCED ❑ GRAVITY AMPERES SERV ENT SHOWER
$
BOILER B.T.U. SQ.FT. @ a BATHTUB
BOOK PAGE
PAGE PARCEL
SQ.FT. @ -a WATER HEATER
-
SQ.FT.RESID:-@ 11/4a SEWAGE DISPOSAL
SQ.FT:GAR @ 1/4a HOUSE SEWER
40/
GAS PIPING
DBL
PERMIT FEE
PERMIT FEE PERMIT FEE
USE NO.
DBL.
I TOTAL FEESA
1"1121,111,F]
MICRO FEE MECH. FEE PL. CK. FEE
�� "
CONST. FEE ELECT. FEE 'SMI FEE
FEE PLUMB. FEE
-F M. A M J, J A S O N -D
J�O,B�A/DDRE/SS/ (:
OWNER
76
77
COMMUNITY
VALUATION
$
DATEDST
OFFICE
'78
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f f�_BI I f7
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..iw
,M H PERMIT FEE
$
USE OF PERMIT
m� L 9 z
F.C.
01/6
SUPP. T PERMIT-
PE MIT NO
7
.MICROFILM FEE
COPIES
$
BOOK PAGE
PAGE PARCEL
LEGA LL DESCRIPTIOONN
40/
FEE
DBL
$
USE NO.
SET BACK
LOT SIZE
GRP
TYPE
BY
,MECHANICAL
IZONE
ICK
+q�
1
_/p�
R. 1
IRS
PLAN CHECK FEE
$
BOND AMT.
PLAN NO,
PLAN CHECKER
FINAL DATE INSP
CTOR
CONSTRUCTION FEE
DBL
$
NAME. OF CONST. LENDER BRANCH
OFFICE
NO LENDER INVOLVED
itLECTRICAL FEE
r
DBL
$
ADDRESS CITY
,
. -'
STATE
STRONG MOTION
$
'
OWNER G TS SIGNATIUCONTRACTOR R
/ r"- .
-
•INSTRUMENTATION FEE
�.,,.Firr
'SPECIAL)NSP$
DEMOLITION
FEE
D R ADDRESS
REGISTRATION
:!>f✓ ! s✓ f , Zd
'.PLUMBING FEE
DBL
$
CITY
�j' ZIP CODE CITY
ZIP CODE
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TOTAL FEES$
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div/
TEL. N6. AREA
CODE TEL.
J
NO.
_
AREA CODE
LICENSE F
.CASH ❑CHECK O.006
y�
,RECEIVED BYTREES REQUIRED r:
IS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120AAY5. CESSATION OF
W RK FOR 120. DAYS SHALL ALSO CAUSE PERMIT TO BECOME. VOID.
(SEWAGE SYSTEM
K, T I LL
P
I HEREBY AGREE THAT -ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE
WITH THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, I ALSO AGREE TO CARRY
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•a Vn/v��-� IJ I- I� II IZ 11LVTttJ. l-VMVI-
YLIAIt VV.. I'1 I'r1C LAI Z, Vr Irlt JI A It UrCALIFORNIA 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 ACCORDANCE WITH. SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE
.OF CALIFORNIA.