303504 (SFD)DEPARTMENT OF BUILDING & SAFETY FIELD OFFICE
BUILDING PERMIT a - .,
S O
J F M A M J J A N D
PERMIT NO.
50 41
��
�.V V1�1 f Vr RIYGR�IYC w'
r I
DST
11
CONSTRUCTION ESTIMATE
COMMUNITY VALUATION
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ.
2ND FI,. - SQ.
POR. 4A SQ.
GAR. Of
CAR P. SQ.
WALL SQ.
ESTIMATED CONSTRUCTION
FT. @ $
7 !f 77
UNITS
78
FT. @ YARD SPKLR SYSTEM
FT. @ AtO� MOBILEHOME SVC. BAR SINK
SQ. FT. @ 4!i�O J� POWER OUTLET ROOF DRAINS
F.C.
FT. @ DRAINAGE PIPING
PERMIT
FT. @ DRINKING FOUNTAIN
NO.
SQ. FT. @ URINAL
VALUATION $ dpi WATER PIPING
NOTE: Not to be used as property tax valuation
SWIM POOL, PVT
FLOOR DRAIN
303504
MECHANICAL FEES
SWIM POOL, COMM
WATER SOFTENER
MICROFILM FEE
COPIES
VENT SYSTEM FAIL ❑ EVAP. COOL X HOOD
SIGN
WASHER(AUTO)(
APPLIANCE DRYER
t _
77 . 'G4P .i 7w'
MECHANICAL FEE
GARBAGE DISPOSAL
$
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
LOT SIZE
GRP TYPE
LAUNDRY TRAY
AIR HANDLING UNIT CFM
/�
�f
IDLE METER
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERM SVC
WATER CLOSET
I S S R
COMPRESSOR HP
POLE, TEMP/PERM
LAVATORY
$
HEATING SYSTEM ORCED ❑ GRAVITY
PLAN NO.
AMPERES SERV ENT
SHOWER
PECTOR
.
BOILER B.T.U.
SQ.FT. @
BATH TUB
moi' Zr
��,• (3' , I'^�-
SQ. FT. @ ¢
WATER HEATER
$
NAME OF CONST. LENDER
BRANCH OFFICE
Q.FT.RESID @ 11/4a
SEWAGE DISPOSAL
Ajjj SQ.FT.GAR @ 3/4a
HOUSE SEWER
ELECTRICAL FEE
DBL
$
ADDRESS
GAS PIPING
STATE
PERMIT FEE1
PERMIT FEE
PERMIT FEE
it
DBL,
TOTAL FEES
MOO.HM.FEE
MICRO FEE MMR.
FEE
PL. K. FEE
I CONST. FEE ELE . FEE
SMI FEE
',.j
FEE PLUM.
FEE.62
S O
J F M A M J J A N D
JOB ADDRESS SP NO
I
OWNER
76
r I
77
COMMUNITY VALUATION
DA E
DST OFFICE
N,".*t $res 7� 1w-
7 !f 77
78
M H PERMIT FEE
$
USE OF PERMIT
F.C.
SUPP. TO ERMI
PERMIT
NO.
fl46
303504
MICROFILM FEE
COPIES
$
BOK/ PA P EL GAL DESCRI .
t _
77 . 'G4P .i 7w'
MECHANICAL FEE
DBL
$
USE NO. ZONE StT BACK
LOT SIZE
GRP TYPE
CK BY
+y
�✓
/�
�f
's' �
�.i
�6�"
✓
I S S R
PLAN CHECK FEE
$
BOND AMT.
PLAN NO.
PLAN CHECKER
'AN
FINAL DATE
PECTOR
.
moi' Zr
��,• (3' , I'^�-
CONSTRUCTION FEE
DBL
$
NAME OF CONST. LENDER
BRANCH OFFICE
N ENDER INVOLVED
ELECTRICAL FEE
DBL
$
ADDRESS
CITY
STATE
STRONG MOTION
Q�
$
OWNER/AGENTS SIGNATURE
CONTRA TOR 0— ✓F'fi
i
INSTRUMENTATION FEE
SPECIAL NSP
$
ADDRESS
ADDRESS
DEMOLITION
FEE
,
�l
REGISTRATION
�Z-7-'6
PLUMBING FEE
DBL
$
CITY ZIP CODE
cTrV ZIP CODE
TOTAL FEES $
TEL. NO.
AREA CODE
T
ARE ODE
LICE S n
CASH❑CHECK .O.❑N,,C.❑
/
ZA1, l/
RECEIVED BY 1 TREES REQUIRED
P T SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF
RK 2Q DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
1 H AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE
SEWAGE SYSTEM
T �.fifi4 LL
P Y/
THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, I ALSO AGREE TO CARRY
ni/aFnc"TI(l IIwICIIDAnI C rCn[
CALIFORNIA COVERING CONTRACTORS IS ALSO GUARANTEED.
I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE
FORM 284.208 IREV. 5-761 SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE S'(ATE
OF CALIFORNIA.