2903332 (SFD)FIELD OFFICE
DEPARTMENT OF BUILDING & SAFETY
BUILDIFJG PERMIT —
I
PERMIT NO.
290332
OWNER
Lkowuv 1 1 Vr RI Y GR71NC -.11111W'
77
COMMUNITY
D(`SST
✓!
CONSTRUCTION ESTIMATE
DST
NO. ELECTRICAL FEES
IVO. PLUMBING FEES
`M H PERMIT FEE
1ST FL. SQ.
2ND FL.
FOR.
GAR.
CAR P.
WALL SQ.
ESTIMATED CONSTRUCTION
FT. @
UNITS
E
SQ. FT. @ YARD SPKLR SYSTEM
SQ. FT. @ MOBILEHOME SVC. BAR SINK
MICROFILM FEE
SQ. FT. @ POWER OUTLET ROOF DRAINS
$
SQ. FT. @ g4oDRAINAGE PIPING
131
FT. @ DRINKING FOUNTAIN
SQ. FT. @ URINAL
VALUATION$ WATER PIPING
t�Q
NOTE: Not to be used as property tax valuation
$
SWIM POOL, PVT
FLOOR DRAIN
ZONE
SET BACK
MECHANICAL FEES
SWIM POOL, COMM
WATER SOFTENER
VENT SYSTEM WAN ❑ EVAP. COOL XHOOD
SIGN
WASHER(AUTO H)
ff—.S
APPLIANCE RYER
OQ
GARBAGE DISPOSAL
pA
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
"r.."""
LAUNDRY TRAY
1
S
AIR HANDLING UNIT CFM
R
IDLE METER
KITCHEN SINK
4
PLAN CHECK FEE
ABSORPTION SYSTEM B.T.U.
$
TEMP USE PERM SVC
WATER CLOSET
¢f3
PLAN CHECKER
COMPRESSOR HP
OD
POLE, TEMP/PERM
LAVATORY
(yb
HEATING SYSTEM ORCED ❑ GRAVITY
MPERES SERV ENT
SHOWER
dt
CONSTRUCTION FEE
BOILER B.T.U.
$
SQ.FT. @ a
BATH TUB
t7c�
NO LENDER INVOLVED
SQ. FT. @ a
WATER HEATER
ELECTRICAL FEE
Q.FT.RESID @ 11/4a JS M
SEWAGE DISPOSAL
"J
ADDRESS
CITY
STATE
Q.FT.GAR @ 3/4a
HOUSE SEWER
$
OWNER/AYaE SIGNATURE N./
£:
�'�
CONTRACTOR
FEE
GAS PIPING
cy
,,,
PERMIT FEE
PERMIT FEE
PERMIT FEE
c
DBL.
TOTAL FEES
D
MOB.HM.FEE
/
MICRO FEE
9�
MEC H. FEE
ae
L. CK. FEE
-�--
CONST. FEE ELECT. FEE
/�S: o
SMI FEE
�`I
FEE
PLUMB. FEE
39,2a
I
JOB ADDRESS SP NO
Ae �,.• o I
OWNER
76
77
COMMUNITY
VALUATION
$
DATE - -
DST
OFFICE
78
`M H PERMIT FEE
$
O.
'USE QW P15FIMIT F.C. S PP O PERMIT PERMIT N1290332
E
BOOK PAGE PARCEL LEGA DESC RIP ION
MICROFILM FEE
COPIES
$
131
if
.MECHANICAL FEE
DBL
$
USE O.
ZONE
SET BACK
LO�TJS�IZE GRP
TYPE C/K��ByY
�/''��
% 60
X
ff—.S
"r.."""
1
S
S
R
—0 1
4
PLAN CHECK FEE
$
BOND AMT.
PLAN NO. %
PLAN CHECKER
FINAL DATE
JINSPECTOR
CONSTRUCTION FEE
DBL
$
NAME OF CONST. LENDER
BRANCH OFFICE
NO LENDER INVOLVED
l
04
ELECTRICAL FEE
DBL
$
ADDRESS
CITY
STATE
,STRONG MOTION
'INSTRUMENTATION
$
OWNER/AYaE SIGNATURE N./
£:
�'�
CONTRACTOR
FEE
,,,
.�
'SPECIAL
FEE
$
TEL. NO.
AREA CODE
LICENSE u
RECEIVED BY TREES REQUIRED
T SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF
{
20 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
W.1
AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE
WI HE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, I ALSO AGREE TO CARRY
Di MDFNGATI(lAl IAICI IDAwI(C IID lw . v Cuo lvcce 1c
SEWAGE SYSTEM
T
LL
f
p. �i/
CALIFORNIA COVERING CONTRACTORS IS ALSO GUARANTEED.
I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE
FORM 284.208 (REV. 6-76) SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE
OF CALIFORNIA.