301840 (SFD)DEPARTMENT OF BUILDING & SAFETY
BUILDING PERMIT a J^n11&Iry ^e Dlvesclne I
FIELD OFFICE
J F M A M J J A S O N D
PERMIT NO.
1. 84 01
OWNER
vVV1�11 Vr RI vcnal VC
Now,
COMMUNITY VALUATION
410
La Ak $ g 7;L �—
DST
i
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
-i l �
1ST FL. SQ.
2ND FL. SQ.
POR. SQ.
GAR.
CAR P. EE]SQ.
WALL SQ.
ESTIMATED CONSTRUCTION
FT. @ $
$
UNITS
USE OF PERMIT
F.C.
FT. @ * ! YARD SPKLR SYSTEM
FT. @ MOBILEHOME SVC. BAR SINK
SQ. FT. @ g qv- �.�-- POWER OUTLET ROOF DRAINS
FT. @ J DRAINAGE PIPING
-
FT. @ DRINKING FOUNTAIN
/e
SQ. FT. @ URINAL
VALUATION $ •f+ WATER PIPING
NOTE: Not to be used as property tax valuation
SWIM POOL, PVT
FLOOR DRAIN
$
MECHANICAL FEES
LEGAL DESCRIPTION
SWIM POOL, COMM
WATER SOFTENER
VENT SYSTEM XFAN ❑ EVAP. COOL HOOD
04
SIGN
WASHER (AUTO)(QSId)
$
APPLIANCE DRYER
ZOJNyE/�
SET BAC Kr�v��
GARBAGE DISPOSAL
GJRjRPP]
TyY/PE ICK
FURNACE ❑ UNIT Cl WALL ❑ FLOOR ❑ SUSPENDED
LAUNDRY TRAY
'may
AIR HANDLING UNIT CFM
IDLE METER
KITCHEN SINK
%
,a •
/�
ABSORPTION SYSTEM B.T.U.
TEMP USE PERM SVC
WATER CLOSET
` m
COMPRESSOR HP
POLE, TEMP/PERM
LAVATORY
HEATING SYSTEM FORCED ❑ GRAVITY
1 iJ
ISC.AMPERES SERV ENT
60 SHOWER
R 1•i+
BOILER B.T.U.f!
@
BATH TUB
$
BOND AMT.
SQ.FT. @ a
WATER HEATER
FINAL'DAAT/E INSPf�G1;OR
SQ.FT.RESID @ 11/4a
SEWAGE DISPOSAL
AQ 60
��+�j
G SQ.FT.GAR @ s/4a
HOUSE SEWER
DBL
$
NAME OF CONST. LENDER BRANCH
OFFICE
GAS PIPING
420
PERMIT FEE
PERMIT PERMIT FEE
PERMIT FEE
ELECTRICAL FEE
DBL.
I TOTAL FEES
MOB.HM.FEE
MICRO FEE
FEE
PL. CK. FEE
I CONST. FEE I
ELEZT.FEE SMI FEE
97
• ./I
FEE
PLUMB. FEE
J F M A M J J A S O N D
JOB ADDRESS SP NO
le
OWNER
76
COMMUNITY VALUATION
410
La Ak $ g 7;L �—
J4 del <1A 4
JOFFICE /
O* -T / • � DS` `
-•I
6 `/6
77
78
u/ttv .t
-i l �
MH PERMIT FEE
$
USE OF PERMIT
F.C.
SUPP. TO PERMIT PERMIT
NO.
/e
00/301840
MICROFILM FEE
COPIES
$
'IMOK PAGE P EL
LEGAL DESCRIPTION
—.. / l
�y r iJ
T 1` + / IV % 7' f
MECHANICAL FEE
DBL
$
USE NO.
ZOJNyE/�
SET BAC Kr�v��
LOT SIZE
�?-/
GJRjRPP]
TyY/PE ICK
BY
'may
%
,a •
/�
�
S-1
` m
t �
/
1 iJ
5
S .M
R 1•i+
• `
PLAN CHECK FEE
$
BOND AMT.
PLAN NO,
{
PLAN CHECKER
FINAL'DAAT/E INSPf�G1;OR
��+�j
CONSTRUCTION FEE
DBL
$
NAME OF CONST. LENDER BRANCH
OFFICE
NO LE ER INVOLVED
j
ELECTRICAL FEE
DBL
$
ADDRESS CITY
STATE
21
x-7
STRONG MOTION
INSTRUMENTATION FEE
$
40'
OWNER/AGENTS SIGNATURE CONTRACTOR
., )
P2
-c-
SPECIALI
SPECIALNSP
$
ADDRESS ADDRESS
DEMOLITON
FEE
ti•, {
P
REGISTRATION
PLUMBING FEE
DBL
$
CITY ZIP ZIP CODE CITYZIP
CODE
y
4.4 �7�V/ti% T,9
TOTAL FEES $
TEL. NO.AREA
CODE TEL.
NO,
AREA CODE
LI/CENSE�ya
CASHOCHEC O.ON.C.❑
".+""'fig
"3t 4?
1 f 4.
! �d•✓ a
RECEIVED BY 7 TREES REQUIREDIT
SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF
/
O �kt120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
R BY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE
TH COMPENSATIOTHE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, I ALSO AGREE TO CARRY
N INS
SEWAGE SYSTEM
T Z
LL
pj }C f
FORM 284-208 (REV. 6-76)
URANCE 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
SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE
OF CALIFORNIA.