272675 (SFD)DST
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VENT SYSTEM ❑ FAN ❑ EVAP. COOL '❑ HOOD ,? -, <
, SIGN
FIELD OFFICE
BUILDING PERMIT
DEPARTMENT OF BUILDING & SAFETY
75
COUNTY OF RIVERSIDE
F. C.
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO-. PLUMBING FEES
I ST FL. �U 1U
SQ.FT. @/ 7 -^ Ae J �Cv `--� UNITS
LAUNDRY TRAY
SQ. FT. @
M H PERMIT FEE
YARD SPKLR SYSTEM
2ND FL.
ti
SO. FT. @^� ' �"' �
4— MOBILEHOME SVC.
�'✓+✓
BARSINK
POR. � �
_
SQ. FT. ®G..- POWER OUTLET
ROOF DRAINS
GAR. 41
ISO.Fl. @
WATER CLOSET
DRAINAGE PIPING
CAR P.
FT. @
POLE, TEMP/PERM
DRINKING FOUNTAIN
WALLSQ.
___dSQ
FT @
HEATING SYSTEM {[j FORCED ❑ GRAVITY
URINAL
ESTIMATED CONSTRUCTION VALUATION $ /
,)�� G i
WATER PIPING
NOTE: Not to be used as property tax voluotion
SWIM POOL, PVT
FLOOR DRAIN
MFCHANICAI FFFS
SWIM POOL. COMM
WATER SOFTENER
DST
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VENT SYSTEM ❑ FAN ❑ EVAP. COOL '❑ HOOD ,? -, <
, SIGN
OWNER
WASHER (AUTO) tDTSF1r J� j
APPLIANCE '4' r "a
75
GARBAGE DISPOSAL
F. C.
DATE
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR 0 SUSPENDED
76 76
-�
LAUNDRY TRAY
2M675
M H PERMIT FEE
AIR HANDLING UNIT CFM
$
IDLE METER
COMMUNITY
KITCHEN SINK
ABSORPTION SYSTEM 0 B.T.U.
VALUATION
TEMP USE PERM SVC
OFFICE
WATER CLOSET
COMPRESSOR HP
POLE, TEMP/PERM
LAVATORY
HEATING SYSTEM {[j FORCED ❑ GRAVITY
AMPERES SERV.ENT
SHOWER
BOILER O B.T.U.
SQ FT @ ¢
BATH TUB
�2 J
SQ FT @ C
/
WATER HEATER
$
LEGALDESCRIPTION
SQ FT RESID 7�j
�/ ter, f
SEWAGE DISPOSAL
��
7 :7j—
7 'MECHANICAL
41V,; SQ FT GARAGE @%1
HOUSE SEWER
�-"�
MECHANICALFEE
PERMIT FEE -a7 \>(i
$
%
GAS PIPING
LOT SIZE ZONEUSE
MOBILE HOME PERMIT FEE Is
I
I
f I PERMIT FEE
() I
PERMIT FEE
ER51gO� b
21
/ TOTAL FEES �
OB. HM.FEE
MICRQ FEE��
MECH.FEE
DBL
I PL CK. FEE
CONST. FEE
DBL.
E;ECT.FF�(
DBL.
SMIFE
FEE
PLUM B F�„
�
DBL.
J F M A M J J A S O N 0
�uB ADuaEss Srrv0
OWNER
`USE
75
OF PERMIT
F. C.
DATE
P
76 76
-�
2M675
M H PERMIT FEE
$
COMMUNITY
DSTU)i7
OOMS
VALUATION
SUPP, TO PERMIT
OFFICE
MICROFILM FEE
COPIES
$
LEGALDESCRIPTION
/
��
7 :7j—
7 'MECHANICAL
.
�-"�
MECHANICALFEE
DBL
$
SET BACK
LOT SIZE ZONEUSE
NO.
GRP
TYPE
CK BY
/
4
IJ3
¢ j
PLAN CHECK FEE
$
BOND AMT.PLAN
NO.
l
PLAN CHECKER
FINAL DATE
I
IN�pE TOR /
I
1G-L� �%
CONSTRUCTION FEE
DBL
$
NAME OF CONST. LENDER BRANCH
OFFICE
NO LENDER INVOLVED
ELECTRICAL FEE
DBL
$
ADDRESS CITY
STATE
�'
STRONG MOTION
$
OWNER/AGENT'S SIGNATURE
CON yt OR
INSTRUMENTATION FEE
$
ADDRESS
ADDRESS
FEEX
!
PLUMBING FEE
DBL
$
CITY ZIP CODE
CITY ZIP CODE
TOTAL FEES
$
7,
TEL. NO.
LICENSE
CASH ❑ CHECK Q/ M.O. ❑ N.C. Q j
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN/ 120 DAYS. CESSA
ION OF WORK FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
RECEIVED BY /
�^'�•
TREES REQUIRED i`�
I HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN AC
CORDANCE WITH THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, I ALSC
TO EMPLOYEES. COMPLIANCE WITH THI
i
SEWAGESYSTEM
{�„n
LL
F�/�G%,T
AGREE CARRY COMPENSATION INSURANCE UPON MY
1A\A/C ,C TUC CT A TC,1C!•A I I Cl DAll A !'ll\/COIAII`/' Kl ArT(ADC IC A I C!1(_I I A DA KITCCn
I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS
FORM 284-208 (Rev. 10-74) (DL HAS DONE SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE
OF'THE STATE OF CALIFORNIA.