286714 (PLBG)DEPARTMENT OF BUILDING & SAFETY FIELD OFFICE
BUILDING PERMIT .......
'.
J F M A M, J J A S O N D
- PERMIT NO,
286714�.
- �< t %juim 1 i Vr. RI V CR.11IIJC
^76
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. @ MOBILEHOME SVC. BAR -SINK
SO. 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
MECHANICAL FEES SWIM POOL, COMM WATER SOFTENER
'-
VENT SYSTEM ❑ FAN ❑ `EVAP. COOL ❑ HOOD SIGN WASHER (AUTO) (DISH)
$
APPLIANCE ❑ DRYER GARBAGE -DISPOSAL
USE 6F PEF6AIT C
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED LAUNDRY TRAY
SUUPP. TO PERMIT
AIR HANDLING UNIT CFM IDLE METER KITCHEN SINK
ABSORPTION SYSTEM 0 B.T.U. TEMP USE PERM SVC WATER CLOSET
'
COMPRESSOR 0 HP POLE, TEMP/PERM LAVATORY,
HEATING SYSTEM ❑ FORCED ❑ GRAVITY. AMPERES -SERV ENT SHOWER
BOILER B.T.U. SQ.FT. @ a BATH TUB '
SQ.FT.• @ ¢ WATER HEATER /
MICROFILM FEE
SQ.FT.RESID @ I'Aa SEWAGE DISPOSAL
$
SQ:FT.GAR "@ 3/a¢ HOUSE SEWER
BOOK PAGE PARCEL�JLEGAL
_28G714
DESCRIPTION
GPERMIT
FEE
EGAS�FEE
PERMIT FEE Del?
DBL.
I TOTAL FEES
lMqB.HM.FEEFMICRO
FEE. MECH. FEE PL. CK; FEE
CONST. FEE -'ELECT. FEE SMI FEE
FEE PLUMB. FEE
j
'.
J F M A M, J J A S O N D
JOB ADDRESS SP NO_
I
OWNER
^76
77
UNITY
VALUATION
DATE -
DST
OFFICE
,_M H PERMIT FEE
$
USE 6F PEF6AIT C
F -C.
SUUPP. TO PERMIT
PERMIT NO.
Apor 6A J PlAt6
MICROFILM FEE
COPIES
$
BOOK PAGE PARCEL�JLEGAL
_28G714
DESCRIPTION
•MECHANICAL FEE
DBL
$
USE NO.
ZONE SET BACK
LOT SIZE
GRP
TYPE
CK BY
-
S S R
o
:PLAN CHECK FEE -
$
BOND AMT. .
PLAN NO.
PLAN CHECKER
FINAL DATE IN
`ECTOR
?7
/71
'CONSTRUCTION FEE
DBL
$
NAME OF CONST. LENDER
BRANCH OFFICE NO LENDER INVOLVED
ELECTRICAL FEE
DBL
$
-ADDRESS
CITY' STATE
STRONG MOTION
OWNER/AGENTS SIGNATURE
CONT•R'� R - t , lot
.INSTRUMENTATION FEE
41 /r �.
i 00 A
'SPECIAL ION
$
ADDRESS
ADDRESS
DEMOLITION
FEE
.REGISTRATION -
PLUMBING FEE
DBL
$
CITY ZIP COOL
CI ZIP CODE
lAlos
TOTAL FEES $
TEL. NO,
AREA CODE
TEL. NO.
REA CODE
LICENSE C
CASH❑CHECK .O.❑N.C.❑
RECEIVED B TREES REQUIRED
IS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED ITHIN 120 DAYS. CESSATION OF
Oft'
RK FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
'SEWAGE SYSTEM
I HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE
u:. T LL p
'
WITH THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, i ALSO AGREE TO CARRY
r'ne�oowle LAWS use„�,..�.-r �.,,-......, �...,. ....__.. ..._.. _.....__ .... _.. _.
CALIFORNIA COVERING CONTRACTORS IS ALSO GUARANTEED.
I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE
FORM zea -toe (REV. a -gel SO IN ACCORDANCE W!TH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE
OF CALIFORNIA,