303512 (SFD)FIELD OFFICE
DEPARTMENT OF BUILDING & SAFETY
BUILDING PERMIT
S O
J F M A M J J A N D
`SEWAGE
PERMIT NO.
OWNER
77
t7876
COMMUNITY VALUATION
DATE
OSTI
�i
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
7 ./t �7�xl
NO. PLUMBING FEES
1ST FL. SO.
2ND FL. SQ.
FOR. SQ.
GAR. Z SQ.
CARP. SQ.
WALL SQ.
ESTIMATED CONSTRUCTION
FT. @ $
/
UNITS
USE OF PERMIT F.C. SUPP. TO'PERMTr PERMIT NO,
FT. @ YARD SPKLR SYSTEM
FT. @ 64 MOBILEHOME SVC. BAR SINK
®a! 035
FT. @ 4 2.4 POWER OUTLET ROOF DRAINS
COPIES
FT. @ DRAINAGE PIPING
FT. @ DRINKING FOUNTAIN
SQ. FT. @ URINAL
VALUATION $ WATER PIPING
NOTE: Not to be used as property tax valuation
DBL
SWIM POOL, PVT
FLOOR DRAIN
ZONE,/)
SET B CK
MECHANICAL FEES
SWIM POOL, COMM
BY
WATER SOFTENER
VENT SYSTEM XFAN ❑ EVAP. COOL HOOD
SIGN
WASHER (AUTO)(DlSm)
ICK
APPLIANCE DRYER
GARBAGE DISPOSAL
ZZ
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
— /
+�
LAUNDRY TRAY
""
AIR HANDLING UNIT CFM
IDLE METER
I
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERM SVC
CfYO
2,.WATER CLOSET
S
R
COMPRESSOR """�� HP
^"
POLE, TEMP/PERM
LAVATORY
na
$
HEATING SYSTEM ❑ FORCED ❑ GRAVITY
BOND AMT.j
e&ERES SERV ENT
PLAN CHECKERFINAL
SHOWER
1 ECTOR
BOILER [::= B.T.U.
SQ.FT. @
DATH TUB
cp-1
CONSTRUCTION FEE
SQ.FT. @ a
$
WATER HEATER
NAME OF CONST. LENDER
RANCH OFFICE
NO LEN ER INVOLVED
Q.FT.RESID @ 11/4a
SEWAGE DISPOSAL
ELECTRICAL FEE
SQ.FT.GAR @ 3/4a
$
HOUSE SEWER
ADDRESS
CITY
STATE
ry
6
GAS PIPING
PERMIT FEE
a
$
PERMIT FEE
t�
PERMIT FEE
INSTRUMENTATION FEE
DBL.
I TOTAL FEES
��
MOB.HM.FEE
MICRO FEE
MECFT. FEE
PL. CK. FEECONST.
FEE
ELECT. FEE
SMI FEE
f
FEE
PLUMB. FEE
3 a
S O
J F M A M J J A N D
`SEWAGE
JOB ADDRESS SP NO
I
-s
OWNER
77
t7876
COMMUNITY VALUATION
DATE
ST
OFFICE
$
j,F t A .e 00
7 ./t �7�xl
M H PERMIT FEE
$
USE OF PERMIT F.C. SUPP. TO'PERMTr PERMIT NO,
®a! 035
MICROFILM FEE
COPIES
$
BOOK PAGE PAFMIELLEGAL DESC TIO
MECHANICAL FEE
DBL
$
USE NO.
ZONE,/)
SET B CK
LOT SIZE GRP
TYPE
BY
ICK
ZZ
-Z0\
— /
+�
""
`e
Y!v
I
CfYO
S
S
R
,ddt
PLAN CHECK FEE
$
BOND AMT.j
PLAN NO.
PLAN CHECKERFINAL
DATE
1 ECTOR
74
cp-1
CONSTRUCTION FEE
DBL
$
NAME OF CONST. LENDER
RANCH OFFICE
NO LEN ER INVOLVED
end
ELECTRICAL FEE
DBL
$
ADDRESS
CITY
STATE
ry
6
STRONG MOTION
$
OWNER/AGENTS SIGNATURE
CONTRACTOR
+�..._,.,.. 151
INSTRUMENTATION FEE
SPECIALINSP
$
ADDRESS
A DRE5
DEMOLITION
FEE
�l
REGISTRATION
PLUMBING FEE
DBL
$
CITY ZIP CODE
CITY ZIP CODE
37
a
'LICE
TOTAL FEES $
TEL. NO.
AREA CODE
T L. NO.
AREA COD
LICENSE #
CASH❑CHECKQ0lIi.O.❑N.C.❑ .o3
/
� ` 3
7/�
qkl/
RECEIVED BYTREES REQUIRED
IT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF
120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
I tt�� AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE
Vi�47rS T LAWS
SYSTEM
J
T /� LL
P Y�
e1 OF RIVERSIDE COUNTY AND THE STATE Of CALIFORNIA, I ALSO AGREE TO CARRY
C)AAPPNCATInbJ 11,1111DAMr-C I 10 11 AAV CAA --C I I A I—C %A/ITU TUC I A%A/C — TUC CT ATC —
CALIFORNIA COVERING CONTRACTORS IS ALSO GUARANTEED.
I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HA56DONE
SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE
OF CALIFORNIA.