303507 (SFD)FIELD OFFICE
DEPARTMENT OF BUILDING & SAFETY
BUILDING PERMIT • — r &
F M A M J J A S O N D
PERMIT NO.
3 03 50 7
mew �.vv1� 1 yr n� Gn.7� VG
DST
CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES
1ST Fl. SQ.
2ND FL. SQ.
POR. 41A SO.
GAR.
CAR P. SQ.
WALL SO.
ESTIMATED CONSTRUCTION
FT. Is UNITS
FT. @_ YARD SPKLR SYSTEM
FT. @ MOBILEHOME SVC. BAR SINK
SO. FT. @ POWER OUTLET ROOF DRAINS
FT. @ DRAINAGE PIPING
FT. @ DRINKING FOUNTAIN
SQ. FT. @ URINAL
VALUATION $ WATER PIPING
NOTE: Not to be used as property tax valuation SWIM POOL, PVT FLOOR DRAIN
MICROFILM FEE
MECHANICAL FEES SWIM POOL, COMM WATER SOFTENER
$
VENT SYSTEM Q<FAN (] EVAP. COOL OOD SIGN WASHER (AUTO) (01,161,4
BOOK PAGEAL DESCRIPTIOM
44 RCEL L &I- Z_ --m
71'/- 1414;:;L
APPLIANCE DRYER GARBAGE DISPOSAL
DBL
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED LAUNDRY TRAY
AIR HANDLING UNIT CFM IDLE METER KITCHEN SINK
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ABSORPTION SYSTEM B.T.U. TEMP USE PERM SVC WATER CLOSET
GRP TYPE
COMPRESSOR HP POLE, TEMP/PERM LAVATORY
PLAN CHECK FEE
HEATING SYSTEM ORCED ❑ GRAVITY AMPERES SERV ENT SHOWER
$
BOILER B.T.U. SQ.FT. @ ¢ BATH TUB
BOND AMT.
SQ.FT. @ ¢ WATER HEATER
PLAN CKER
Q.FT.RESID @ 11/4a SEWAGE DISPOSAL
SQ.FT.GAR @ 3/4a HOUSE SEWER
OR
GAS PIPING
DBL
PERMIT FEE PERMIT FEE PERMIT FEE
DBL.
TOTAL F+E�ES r
+1 `
MOB.H M.FEE
J
MICRO FEE .FEE PL. CK. FEE
Q
CONST. FEE EL FEE SMI FEE rE
Q� �/
FEE PL FE/Ey�
f✓V
F M A M J J A S O N D
JOB ADDRESS I SP NO
COMMUNITY19AELTAfidN-DAT
$..�
OWNER
051 DST OFFICE
.
76
77
78
M H PERMIT FEE
$
USE OF PERMIT
F.C.
040
SUPP, PER14T PE
MIT
N
MICROFILM FEE
COPIES
$
BOOK PAGEAL DESCRIPTIOM
44 RCEL L &I- Z_ --m
71'/- 1414;:;L
MECHANICAL FEE
DBL
$
USE NO.
�]���SETObACK
LOTSIZE
GRP TYPE
K
CK BY
PLAN CHECK FEE
$
BOND AMT.
PLAN NO.
PLAN CKER
FINAL DATE INSP
OR
CONSTRUCTION FEE
DBL
$
NAME OF CONST. LENDER
BRANCH OFFICE
NO LE R INVOLVEO
ELECTRICAL FEE
DBL
$
ADDRESS
CITY
STATE
STRONG MOTION
INSTRUMENTATION FEE
$
OWNER/AGENTS SIGNATURE
CONTRAC OR
., .�
SPECIAL INSP$
DEMOLITION
REGISTRATION
FEE
ADDRESS
A D S
r
PLUMBING FEE
DBL
$
7
a6
CITY ZIP CODE
CITY . ZIP CODE
TOTAL FEES $
CASH OCHECK[XA.O.0N.C. �
TEL. NO.
AREA CODE
T . NO.
'3
AREA C E
/il
LICE/NSE a
2,q& I
RECEIVED BYTREES REQUIRED
T SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF
PK 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOIDSEWAGE
I AGREE THATALLWORK IN CONNECTION WITH THIS PERMITWILLBE DONE INACCORDANCE
E LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, I ALSO AGREE TO CARRY
SYSTEM
T 1A LL
P��
avmmiv� c urvim mr cmrLvrcca. CtDmruArvL.c vvnn THE LAvva Or Inc a1Hlc yr
RING CONTRACTORS IS ALSO GUARANTEED.
THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE
=E WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE