286900 (SFD)DEPARTMENT OF BUILDING & SAFETY a FIELD OFFICE
BUILDING PERMIT I
J F M A M 1 J A S O N D
PERMIT NO.
001
OWNER
jam%
A� V 01
COUNTY OF RIVERSIDE
77
COMMUNITY
DBT
CONSTRUCTION ESTIMATE
DST
NO. ELECTRICAL FEES
NO. PLUMBING FEES
� /
1 ST FL.
' 2ND FL.
POR.
GAR.
CAR P.
WALL SQ.
ESTIMATED CONSTRUCTION
SQ. FT. @
e'er
UNITS
78
M H PERMIT FEE
SQ. FT. @ YARD SPKLR SYSTEM
$
SQ. FT. @ MOBILEHOME SVC. BAR SINK
USE PE MIT
SQ. FT. @ ez POWER OUTLET ROOF DRAINS
SQ. FT. @ DRAINAGE PIPING
SU . TO PE IT
FT. @ DRINKING FOUNTAIN
O.
SQ. FT. @ URINAL
WATER PIPING
VALUATION $az
NOTE: Not to be used as property tax valuation
SWIM POOL, PVT
FLOOR DRAIN
MECHANICAL FEES
MICROFILM FEE
SWIM POOL, COMM
WATER SOFTENER
BOOK PAGE PARCEL
VENT SYSTEM UFAN ❑ EVAP. COOL XHOOD
SIGN
WASHER (AUTO)j;USH)
APPLIANCE RYER,,
MECHANICAL FEE
D L
GARBAGE DISPOSAL
USE NO.
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
SS'E`T� BACK LOT SIZE{/��f�qJ
GRP TYPE CK BY
LAUNDRY TRAY
AIR HANDLING UNIT CFM
IDLE METER
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERM SVC
WATER CLOSET
4z
COMPRESSOR HP
PLAN CHECK FEE
POLE, TEMP/PERM
LAVATORY
'fid.
BOND AMT.
HEATING SYSTEM - ORCED ❑ GRAVITY
�£
MPERES SERV ENT
05 SHOWER
pG+
BOILER T. U.
SQ.FT. @ a
BATH TUB
p
—
^% aVQQ._�
"�
SQ.FT. @ a
WATER HEATER
I is
.FT.RESID @ I lAa
SEWAGE DISPOSAL
CONSTRUCTION FEE
DBL
$
SQ.FT.GAR @ s/a¢dr
HOUSE SEWER
NO LENDER INVOLVED
GAS PIPING
PERMIT FEE!
DBL
PERMIT FEE
pawPERMIT FEE
ADDRESS
/71
CITY
DBL.
TlO�TAL FEES
111,1 11,1111
REZEfl
,M/(� H. FEE
PL. CK. FEECON(�ST.
FEE
ELECT. FEE SMII FFiETE/
FEE
PLUMB. FE
EE�
J F M A M 1 J A S O N D
JOB ADDRESS I SP NO
I
..� - i
OWNER
jam%
A� V 01
76
77
COMMUNITY
VALUATION
DATE
DST
OFFw�E
� /
$ apa
17 .., i
.vy /
was/ , 77
78
M H PERMIT FEE
$
USE PE MIT
F.C. j
SU . TO PE IT
PERMIT
O.
MICROFILM FEE
COPIES
$
BOOK PAGE PARCEL
LEG/AL�DEES,CRIPTON
MECHANICAL FEE
D L
$
USE NO.
ZO�N(�E]
SS'E`T� BACK LOT SIZE{/��f�qJ
GRP TYPE CK BY
PLAN CHECK FEE
$
BOND AMT.
PLAN NO.
PLAN CHECKER
FINAL DATE INSPECTOR
1
—
^% aVQQ._�
"�
/
I is
G '
CONSTRUCTION FEE
DBL
$
NAME OF CONST, LENDER
BRANCH OFFICE
NO LENDER INVOLVED
ELECTRICAL FEE
DBL
$
ADDRESS
/71
CITY
STATE'
STRONG MOTION
INSTRUMENTATION
$
OWNER/AGENTS SIG'ATUR t •
nd , w
CONTRACTOR
FEE
SPECIALINSP
$
ADDRESS J
ADDRESS
DEMOLITION
FEE
REGISTRATION
PLUMBING FEE
DBL
$
TY ZIP CODE
CITY ZIP CODE
390992,53
TOTAL FEES .-
$
'TEL. Pie. 4F AREA
CODE
.TEL. NO.
AREA CODE
LICENSE 4
CASH❑CHECKw. O.❑N.C.❑
4X/
_ y
7_1! V�
RECEIVED BY -
T ES REQUIRED
-o/;?
SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 1.20 DAYS. CESSATION OF
X,,IT
120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
GREE THATALLWORK INCONNECTION WITH THIS PERMITWILL BE DONE IN ACCORDANCE
SEWAGE SYSTEM
T
LL
P
WS OF RIVERSIDE COUNTY AND'THE STATE OF CALIFORNIA, 1 ALSO AGREE TO CARRY
Illw
- I..0 A PU, MT 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
FORM zea-ZOB (REV. 6-76) SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE
i OF CALIFORNIA.