290612 (SATT)DEPARTMENT OF BUILDING & SAFETY- &, FIELD OFFICE
BUILDING PERMIT __.._.__. __ _.•.___.__
A M N D
F N1 A S Q
PERMIT NO.
906121
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COMMUNITY
VALUATION
F;�
I- CONSTRUCTION ESTIMATE
I OFFICE
NO. ELECTRICAL FEES
M H PERMIT FEE$
NO. PLUMBING•FEES
1ST FL.ot2!Vg'
2ND FL.
FOR.
GAR.
CAR P.
WALL
ESTIMATED CONSTRUCTION
SQ. FT. @
+fid'
UNITS
PERMIT NO.
SQ. FT. @ YARD SPKLR SYSTEM.
COPIES
SQ. FT. @ MOBILEHOME SVC. BAR SINK
SQ. FT. @ S'@� „® POWER OUTLET ROOF DRAINS
LEGAL DESCRIPTION
SQ. FT. @ DRAINAGE PIPING
DBL
SQ. FT. @ DRINKING FOUNTAIN
SQ. FT. @ URINAL
ZONE
VALUATION $ < 4f0 WATER PIPING
C?C?
- NOTE: Not to be used as property tax valuation
TYPE CK BY
✓
SWIM POOL, PVT
FLOOR DRAIN
Rail
;PLAN CHECK FEE
MECHANICAL FEES
$
SWIM POOL, COMM
BOND AMT.
WATER SOFTENER
'PLAN CHECKER
- FIN L DATE INS
VENT SYSTEM Ej FA_ N ❑ EVAP. COOL. XHOOD
4Ca
SIGN,.
$ [[
WASHER(AUTO SH)
qc,6
OFFICE
APPLIANCE RYER
'ELECTRICAL FEE
DBL
$
GARBAGE DISPOSAL+
ADDRESS CITY
"
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
STRONG MOTION
'INSTRUMENTATION FEE
$
LAUNDRY TRAY
cOWNER/AGENlT'SSfSSIIGNATURE CONTRACTOR
, *; s!
AIR HANDLING UNIT CFM:
IDLE METER
KITCHEN SINK
ADDRESS 'ADDRESS
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P� r G'.%' ( `{�"
ABSORPTION SYSTEM B.T.U.
TEMP USE PERM SVC
PLUMBING FEE
.'
ga WATER CLOSET
$
9
'
COMPRESSOR3 irFV HP
00
POLE, TEMP/PERM
CE,
LAVATORY
�fJ
NO. -
HEATING SYSTEM WORCED ❑ GRAVITY0
LICENSE tt
AMPERES SERV ENT
00
SHOWERlei
C�4
LL
BOILER B.T.U.
SQ.FT. @ a
BATH TUB
SQ.FT. @ 4
WATER HEATER
p_O
Q.FT.RESID @ 11/4c
,OOSQ.FT.GAR @ 1/4¢
6
X69
SEWAGE DISPOSAL
HOUSE SEWER
tpC
`
GAS PIPING
.12
PERMIT FEE
PERMIT FEE
PERMIT FEE
ey0
DBL.
TOTAL FEES
JMOB.HM.FEEI
M_ICR�O EE
MECH. FEE
PUCK. FEE
I CONST. FEE I
ELECT. FEE
SMI FEE
FEE
PLUMB. FEE
A M N D
F N1 A S Q
JO,�B�^ADDrDRESS/ . ? ,I,v /� SP NO
57
OWNER
77 -
COMMUNITY
VALUATION
DATE
All
DST
I OFFICE
M H PERMIT FEE$
USE OFF PERMIT
F.C.
SUPP. TO PERMIT
PERMIT NO.
MICROFILM FEE
COPIES
$
BOOK PAGE PARCEL
LEGAL DESCRIPTION
MECHANICAL FEE
DBL
$
USE NO.
ZONE
SET BACK�J
LOyT++/SIyZE
GRP -
TYPE CK BY
✓
f�
S
Rail
;PLAN CHECK FEE
$
BOND AMT.
PLAN NO.
'PLAN CHECKER
- FIN L DATE INS
OR
:CONSTRUCTION- FEE.
DBL
$ [[
-�
NAME OF CONST. LENDER BRANCH
OFFICE
NO LENDER INVOLVED
'ELECTRICAL FEE
DBL
$
ADDRESS CITY
STATE
STRONG MOTION
'INSTRUMENTATION FEE
$
P
/
cOWNER/AGENlT'SSfSSIIGNATURE CONTRACTOR
, *; s!
SPECIAL INSP
DEMOLITION
REGISTRATION
FEE
$
ADDRESS 'ADDRESS
'. jr �j,
P� r G'.%' ( `{�"
-
PLUMBING FEE
.'
DBL
$
9
�
CITY ZIP CODE CITY
f�.� 'Cwt-C�C.1'��� ���.�
ZIP CODE
TOTAL FEES $ sj
CASH OCHECK .O.0N.C.❑ C.�p
CE,
TEL.,NO. AREA
ODE TEL.
NO. -
AREA CODE
LICENSE tt
RECEIVED BY�: TREES REQUIRED .
TH ISP_ERfAIT SHALL BECOME VOID IRWORKIS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF
WOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
y,�I�. GREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE i
(n AWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, I ALSO AGREE TO CARRY
n uC n-11 Lica
SEWAGE SYSTEM
T ��
LL
p ��-
CALIFORNIA COVERING CONTRACTORS IS ALSO GUARANTEED.
I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE
FORM
SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE
284-208 (REV. 6-76) SO
CALIFORNIA. -