286471 (ELEC)FIELD OFFICE
DEPARTMENT OF BUILDING & SAFETY
BUILDING PERMIT -6_, ., — -
' F M A M ) A S O N D
PERMIT NO.
' 8
OWNER p
f4�1rIG .
�+VVIV 1 1 Vr RIYCRJIVC
COMMUNITY' - V LUATION
if $ •/"
DATE
M `Y ��"
D/)S1
i f
- CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
'M H PERMIT FEE
NO. PLUMBING FEES
$
I.ST FL.
2ND FL.
- • POR.
GAR.
CAR P.
WALL
ESTIMATED CONSTRUCTION
SQ. FT. @ $
UNITS
SUPP. T PERMIT
PE MIT NO
6 4
SQ. FT. @ YARD SPKLR SYSTEM
SQ. FT.. @ MOBILEHOME SVC. BAR SINK
COPIES
SQ. FT. @ POWER OUTLET ROOF DRAINS
SQ. FT. @ DRAINAGE PIPING
LEGAL DESCRIPTION ..y- j ✓j
SQ. FT. @ DRINKING FOUNTAIN
DBL .
SQ. FT. @ URINAL
VALUATION' $ _ WATER PIPING
ZONE /r
NOTE: Not to be used as property tax valuation
SWIM POOL, PVT
GRP
FLOOR DRAIN
�IlyS
MECHANICAL FEES
SWIM POOL, COMM
R..✓
WATER SOFTENER
$
VENT SYSTEM [I FAN ❑ EVAP. COOL ❑ HOOD
SIGN
PLAN NO.
WASHER (A.UTO)(DISH)
FINAL DATE INS
CTOR
APPLIANCE ❑ DRYER
DBL
$
GARBAGE DISPOSAL
NAME OF CONST. LENDER BRANCH
OFFICE
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
ELECTRICAL FEE
!J!
LAUNDRY TRAY
ADDRESS CITY
AIR HANDLING UNIT CFM
IDLE METER
STRONG MOTION
!INSTRUMENTATION FEE
KITCHEN SINK
.D
'
ABSORPTION SYSTEM B.T.U.
TEMP USE PERM SVC.
' ION
DEMOLITION
DEMOLITION
REGISTRATION
WATER CLOSET
FEE
COMPRESSOR HP
POLE, TEMP/PERM
ADDRESS = I ADDRESS
LAVATORY
HEATING SYSTEM ❑ FORCED ❑, GRAVITY
AMPERES SERV ENT
$
SHOWER
arr I ZIP CODE CITY
ZIP CODE
BOILER B.T.U.
SQ.FT. @ ¢
TEL. NO. -
6
BATH TUB
NO. _
IAIEA.11,DE
LICENSE tt
SQ.FT. @
aWATER
HEATER
SEWAGE SYSTEM
'.'• T'
LL
{
P
SQ.FT.RESID @ 1)/a¢
/
EWAGE D SPOSAL
SQ.FT.GAR @ t/4¢
E SEWER
[HOUS
AS PIPINGPERMIT
FEE
PERMIT FEE
.30s
ERMIT FEE
DBL.
TOTAL FEES -
./r
IMOB,HM.FEEI
MICRO FEE
MECH. FEE PL.CK. FEECO
NST. FEE
ELECT. FEE
/3r o
SMI FEE
,
FEE
PLUMB. FEF,
' F M A M ) A S O N D
JOB ADDRESS SP NO
i_ i��f�L9 I
OWNER p
f4�1rIG .
7644
77
COMMUNITY' - V LUATION
if $ •/"
DATE
M `Y ��"
DST OFFICE
f/
78
'M H PERMIT FEE
$
USE PER
e,c,
F.C.
SUPP. T PERMIT
PE MIT NO
6 4
71
MICROFILM FEE
COPIES
$
BOOK PPAAGGE PARCEL
LEGAL DESCRIPTION ..y- j ✓j
MECHANICAL FEE
DBL .
$
USE NO.
ZONE /r
- SET BACK
LOT SIZE
GRP
TYPE
�IlyS
S
R..✓
PLAN CHECK FEE
$
BOND AMT.
PLAN NO.
PLAN CHECKER
FINAL DATE INS
CTOR
CONSTRUCTION FEE
DBL
$
NAME OF CONST. LENDER BRANCH
OFFICE
NO LENDER IN/VOLVED
Y
ELECTRICAL FEE
DBL
$
ADDRESS CITY
STATE
STRONG MOTION
!INSTRUMENTATION FEE
.D
OWNER/ACi PS SI NATURE CONTRACTOR
,
' ION
DEMOLITION
DEMOLITION
REGISTRATION
FEE
$
ADDRESS = I ADDRESS
.
PLUMBING FEE
DBL
$
arr I ZIP CODE CITY
ZIP CODE
' TOTAL FEES _16.$
CASH ECK[�M.O.❑N.C.❑ l �
CXR
TEL. NO. -
6
AREACODE TEL.
NO. _
IAIEA.11,DE
LICENSE tt
:RECEIVED BY TREES REQUIRED '
THIS'PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF
WORK FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME. VOID.
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
SEWAGE SYSTEM
'.'• T'
LL
{
P
U!.', ..
FORM 284-208 (REV. 6-76)
k_UrnlrtrvaA I IUN INSUKANCE UPUN MY EMPLOYEES. COMPLIANCE WITH THE LAWS OF THE STATE 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
OF CALIFORNIA.