290376 (RPL)DEPARTMENT OF BUILDING & SAFETY
BUILDING PERMIT e-^iury „r n%irnernr I
FIELD OFFICE
F M Aim i J I A S Q N D
PT
PERMIT NO.
903
�
%.%0%011`11 1 1 Vr n1 V
j77
COMMUNITY VAL(U/AATION/y
u i '4U
W ,100, „r+
ATE �% +yM
3 fy
OST
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
FM HPERMIT FEE
NO. PLUMBING FEES
$
1ST FL. SQ.
2ND FL. SQ.
POR. SQ.
GAR. SQ.
CAR P. SQ.
WALL SQ.
ESTIMATED CONSTRUCTION
FT. @ $
UNITS
SUPP. TO PERMIT.
PERMIT N
FT. @ YARD SPKLR SYSTEM
FT. @ MOBILEHOME SVC. BAR SINK
F , ' K%/*2z
FT. @ POWER OUTLET ROOF DRAINS
FT. @ DRAINAGE PIPING
MICROFILM FEE
FT. @ DRINKING FOUNTAIN
$
SQ. FT. @ URINAL
PAGE PARCEL
VALUATION Is .,w. WATER PIPING
' NOTE: Not to be used as property tax valuation
SWIM POOL, PVT
li4
FLOOR DRAIN
R �t f l
AAl e �./ - �g �l C
MECHANICAL FEES
SWIM POOL, COMM
WATER SOFTENER
/ L/�
MECHANICAL FEE
VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD
SIGN
WASHER (AUTO)(DISH)
ZONE
APPLIANCE ❑ DRYER
LOTSIZE
GARBAGE DISPOSAL
TYPE
CK BY
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
IDLE METER
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERM SVC
WATER CLOSET
.
COMPRESSOR HP
POLE, TEMP/PERM
LAVATORY
HEATING SYSTEM ❑ FORCED ❑ GRAVITY
AMPERES SERV ENT
!PLAN CHECK FEE
SHOWER
$
BOILER B.T.U.
SQ.FT. @ a
PLAN CHECKER
H TUB
CTOR
SQ.FT. @ a
TER HEATER
7 —�
SQ.FT.RESID @ 11/aa
:CONSTRUCTION FEE
WAGE DISPOSAL
[HOUSE
$
NAME OF CONST. LENDER BRANCH
SQ.FT.GAR @ 3/a¢
NO LENDER INVOLVED
SEWER
... o
./
S PIPING,
DBL
?
PERMIT FEE
ADDRESS Cm
PERMIT FEE
STATE
PERMIT FEE00
DBL.
I TOTAL FEES
1,41
MOB.HM.FEE
MICRO FEE
MECH. FEE PL. CK. FEE
CONST. FFEEEj
ELECT. FEE
SMI FEE
FEE
PLUMB. FEE
F M Aim i J I A S Q N D
PT
JOB ADD RESSt� f� I SP NO
�lT / � e-
OWNER i s
776
j77
COMMUNITY VAL(U/AATION/y
u i '4U
W ,100, „r+
ATE �% +yM
3 fy
DST
rFILE
78
FM HPERMIT FEE
$
F P RMIT
USE-6F
F.CC..
SUPP. TO PERMIT.
PERMIT N
F , ' K%/*2z
29h"376
MICROFILM FEE
COPIES
$
PAGE PARCEL
LEGAL DESCRIPTION
}BOOK
R �t f l
AAl e �./ - �g �l C
/ L/�
MECHANICAL FEE
DBL
$
USE NO.
ZONE
SET BACK
LOTSIZE
GRP
TYPE
CK BY
/y
!PLAN CHECK FEE
$
BOND AMT.
PLAN NO.
PLAN CHECKER
FINAL DATE I
CTOR
7 —�
:CONSTRUCTION FEE
DBL
$
NAME OF CONST. LENDER BRANCH
OFFICE
NO LENDER INVOLVED
_
... o
./
ELECTRICAL FEE
DBL
$
ADDRESS Cm
STATE
'STRONG MOTION
$
OWNER/AGENTS SIGNATURE CONTRA
r
'INSTRUMENTATION FEE
SPECIALINSP.
$
ADDRESS ADDRESS
DEMOLITION
FEE
:REGISTRATIONqffiq
=PLUMBING FEE
DBL
$
CITY ZIP CODE CI
� �ZIP CODE
TOTAL FEES $
TEL. NO.
gREA CODE TEL.
NO�.�
LICENSE u
ASH HECK❑M O.❑N.C.❑�
�AREACODE
" >
-3 .,,IG 7—,r
/
f r
+RECEIVED BY TREES REQUIRED
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF
WORK FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
I HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE
SWAGE SYSTEM
T LL
p
WITH THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, I ALSO AGREE TO CARRY
COMPENSATION INSURANCE UPONMY OF
E E OF
—1-1COMPLIANCE WITH HE LAWS OF THE STAT
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
FORM 284-208 (REV. 6.761 OF CALIFORNIA.