286151 (SFD)DEPARTMENT OF BUILDING & SAFETY FIELD OFFICE
BUILDING PERMIT ^• l u1Tv ♦ter nlvrn1-
J F M A M J A S O N D
PERMIT NO.
OWNER
\.,VV1�1 1 Vr RI•Grt71VG
76
""/S L. R f Ti!
DST
CONSTRUCTION ESTIMATE
VALUATION
NO. ELECTRICAL FEES
DSSTL
NO. PLUMBING FEES
1ST FL. SQ.
2ND FL.
POR.
GAR.
CAR P. SQ.
WALL SQ.
ESTIMATED CONSTRUCTION
FT. @ $
SQ. FT. @
n
UNITS
YARD SPKLR SYSTEM
M H PERMIT FEE
SQ. FT. @ MOBILEHOME SVC. BAR SINK
$
SQ. FT. @ POWER OUTLET ROOF DRAINS
USE PER IT
FT. @ DRAINAGE PIPING
SUPP. TO PER IT
FT. @ 00, DRINKING FOUNTAIN
8 15
SQ. FT. @ URINAL
VALUATION$ A WATER PIPING
NOTE: Not to be used as property tax voluotion
SWIM POOL, PVT
de
FLOOR DRAIN
MECHANICAL FEES
SWIM POOL, COMM
COPIES
WATER SOFTENER
BOOK PAGE PARCEL LEGAL DESCRIPTION
VENT SYSTEM FAN ❑ EVAP. COOL CWHOOD
q-0—
SIGN
I WASHER (AUT ISH)
0-9
DBL
APPLIANCE XDRYER
�'
SE O.
ZONE
%
GARBAGE DISPOSAL
SI E
GRP
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
CK BY
LAUNDRY TRAY
AIR HANDLING UNIT
IDLE METER
KITCHEN SINK
I.�S5
ABSORPTION SYSTEM B.T.U.
R4a/�'
TEMP USE PERM SVC
WATER CLOSET
Com$
PLAN CHECK FEE
COMPRESSOR ie 0 HP
,�Ga
POLE, TEMP/PERMLAVATORY<12
BOND AMT.
PLAN
QNO.
PLAN CHECKER
FINAL DATE 1',PECTOR
HEATING SYSTEM FORCED ❑ GRAVITYQGi
AMPERES SERV ENT
SHOWER
.04P
BOILER B.T.U.
SQ.FT. @ ¢
BATH TUB
ao
SQ. FT. @ ¢
WATER HEATER
D
DBL
$
Q.FT.RESID @ 11/4¢
OFFICE
SEWAGE DISPOSAL
AO
SQ.FT.GAR @ 3/a¢
HOUSE SEWER
ELECTRICAL FEE
DBL
$
ADDRESS CITY
GAS PIPING
PERMIT FEE
G
PERMIT FEE
PERMIT FEEp—
STRONG MOTION
INSTRUMENTATION FEE
DBL.
F TOTAL F6E5
IMOB.HM.FEEI
MICRO FEE
MECH. FEE
P12 f'''C�K. FEE
CONST. FEE
eEELLECT. FEEF_��//'
SM�:ff:F
FEE
PLUMB. FEE
J F M A M J A S O N D
JOB ADDRESS/r f/�� / L I SP NO
F
OWNER
76
""/S L. R f Ti!
d i,
77
COMMUNITY
VALUATION
DATE �
j
DSSTL
OFFICE
78
M H PERMIT FEE
$
USE PER IT
F.C.
SUPP. TO PER IT
PE MI N
8 15
1
MICROFILM FEE
COPIES
$
BOOK PAGE PARCEL LEGAL DESCRIPTION
MECHANICAL FEE
DBL
$
�'
SE O.
ZONE
%
SET BACKLOT
SI E
GRP
TYPE
CK BY
I.�S5
SA
R4a/�'
�..
PLAN CHECK FEE
�J�
$
BOND AMT.
PLAN
QNO.
PLAN CHECKER
FINAL DATE 1',PECTOR
h
f.
CONSTRUCTION FEE
DBL
$
NAME OF CONST. LENDER BRANCH
OFFICE
NO LENDER INVOLVED
ELECTRICAL FEE
DBL
$
ADDRESS CITY
STATE
STRONG MOTION
INSTRUMENTATION FEE
$
ON9NE�/AGEN, I AT RE CONTRACTOR
f
-.y✓f �y�C� t�
p, ;;' /� . ♦ NC ♦
SPECIAL INSP
$
ADD E S ADDRESS
DEMOLITON
FEE
i��/�
REGISTRATION
♦ `!
PLUMBING FEE
DBL
$
c' Y ZIP CODE CITY
ZIP CODE
TOTAL FEES$
TEL. NO AREA
TEL,
NO,
AREA CODE
LICENSE u
CASH ❑CHK .O.❑�❑ A 33,
ICODE
f�I
RECEIVED BY TREES REQUIRED
is KIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF
120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
I EBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE
SEWAGE SYSTEM
y
T diCi
LL
P /�
H THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, I ALSO AGREE TO CARRY
-�-EOMPtNSA I ION INSUKANLt UPON 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
FORM 264-206 IRE V. 6-761 SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE
OF CALIFORNIA. r