303510 (SFD)a DEPARTMENT OF BUILDING & SAFETY FIELD OFFICE
BUILDING PERMIT
J F M A M J J A S O N D
PERMIT NO. 01
low \..V1JIY11 Vr RIYCR.';iIUC
DST
CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES
1ST FL.
2ND FL.
POR.
GAR.
CAR P.
WALL SQ.
ESTIMATED CONSTRUCTION
SQ.FT. @ --lp $ UNITS
SQ. FT. @ YARD SPKLR SYSTEM
SQ. FT. MOBILEHOME SVC. BAR SINK
SQ. FT. @An p POWER OUTLET ROOF DRAINS
SQ. FT. @ DRAINAGE PIPING
FT. @ DRINKING FOUNTAIN
SQ. FT. @ URINAL
VALUATION Is 401@ WATER PIPING
NOTE: Not to be used as property tax valuation SWIM POOL, PVT FLOOR DRAIN
I
MECHANICAL FEES SWIM POOL, COMM WATER SOFTENER
M H PERMIT FEE
VENT SYSTEM WAN ❑ EVAP. COOL AHOOD SIGN WASHER (AUTO)(D 14)
$
APPLIANCE 9kpRYER GARBAGE DISPOSAL
USE OF PERMIT F.C. SUPP. TO PERMITPERMIT NO.
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
MICROFILM FEE
COMPRESSOR""� HP POLE, TEMP/PERM LAVATORY
$
HEATING SYSTEM FORCED ❑ GRAVITY AMPERES SERV ENT SHOWER
BOILER B.T.U. SQ.FT. @ a BATH TUB
SQ.FT. @ a WATER HEATER
�BOOK
_2
✓ -
Q.FT.RESID @ 1l/4a SEWAGE DISROSAL
SQ.FT.GAR @ 3/4a HOUSE SEWER
GAS PIPING
PERMIT FEE e PERMIT FEE PERMIT FEE
MECHANICAL FEE
DBL.
I TOTAL FEE i4
MOB.H M.FEE
MICRO FEE MECH. FEE PL. CK. FEE
�ORQ
CONST. FEE ELE=. FEE SMI FEE
2 S 2.
FEE PL E
J F M A M J J A S O N D
JOB ADDRESS SP NO
I
OWNER
76
77
COMMUNITY
VAL ATION
DATE
DST
OFFICE
i
$.a� � 470► °
1/77
t !
I
78%
M H PERMIT FEE
$
USE OF PERMIT F.C. SUPP. TO PERMITPERMIT NO.
46401 I30351 0
PAGE PARCEL L G L DESC RIPT O
MICROFILM FEE
COPIES
$
�BOOK
_2
✓ -
fG3� El D 4ZO7 T -
MECHANICAL FEE
DBL
$
USE NO.
ZONE SET BACK LOT SIZE GRP
TYPE
BY
p r
3
ICK
5 5 R
7�'W
PLAN CHECK FEE
$
BOND AMT.
PLAN NO.
PLAN CHECKER
-
INSPECTOR
/J-.', A- 77
CONSTRUCTION FEE
DBL
$
NAME OF CONST. LENDER
BRANCH OFFICE
NOL NDER INVOLVED
ELECTRICAL FEE
DBL
$
ADDRESS
CITY
STATE
�
I
STRONG MOTION
$
OWNER/AGENTS SIGNATURE
CONTRACTOR toy
INSTRUMENTATION FEE
SPECIAL INSP
$
ADDRESS
Ac -..---
D ssDEMOLITION
DEMOLITION
FEE
�j
REGISTRATION
PLUMBING FEE
DBL
$
CITY ZIP CODE
06�m
CITY ZIP CODE
..y
TOTAL FEES $
TEL. NO.
AREA CODE
TLIL. N
LICENSE a
CASH�CHECK .O.ON.Qi❑ CLQ
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7r5
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RECEIVED BY TREES REQUIRED
IT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF
120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE ,
Of
SEWAGE SYST M
/GREE
/ /
T f�
11
P (�
AWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, I ALSO AGREE TO CARRY
(-(IMUFhICATI(lAl IwICI IDAwI!'C IIDl1w1 . V cue�llvccc I"Iluei,e ul'C C fTATC 11C
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.