303505 (SFD). DEPARTMENT OF BUILDING&SAFETY FIELD OFFICE
•
BUILDING PERMIT e-nt lklTV ne oweocine I
3
PERMIT NO.
03 5
05 1
76
DST
[P
CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES
1ST FL. SQ. FT. @ $ 2.7UNITS '
2ND FL. SQ. FT. @ YARD SPKLR SYSTEM
POR. SQ. FT. @ Ad 00' e4ts MOBILEHOME SVC. BAR SINK
GAR. SQ. FT. @ POWER OUTLET ROOF DRAINS
CAR P. SQ. FT. @ DRAINAGE PIPING
WALL SQ. FT. @ DRINKING FOUNTAIN
SO. FT. @ URINAL
ESTIMATED CONSTRUCTION VALUATION is " WATER PIPING
NOTE: Not to be used as property tax valuation SWIM POOL, PVT FLOOR DRAIN
OFFICE
MECHANICAL FEES SWIM POOL, COMM WATER SOFTENER
D
$
VENT SYSTEM QkFAN ❑ EVAP. COOL DCHOOD SIGN WASHER (AUTO) (DLSh4,
APPLIANCE RYER GARBAGE DISPOSAL
78
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
COMPRESSOR HP POLE, TEMP/PERM LAVATORY
MIT
HEATING SYSTEM FORCED ❑ GRAVITY AMPERES SERV ENT SHOWER
BOILER B.T.U. SQ.FT. @ a BATH TUB
505-
SQ.FT. @ a ' WATER HEATER
MICROFILM FEE
Q.FT.RESID @ 11144 SEWAGE DISPOSAL
$
SQ.FT.GAR @ 3/4a HOUSE SEWER
BOOK PA E PARCE L GAL DESC PTION
GAS PIPING
PERMIT FEE js
PERMIT FEE PERMIT FEE
MECHANICAL FEE
DBL, I
TOTAL FEES
?-� 3
MOB.HM.FEE
MICRO FEE M . FEE . CK. FEE
-sea
CONST. FEE ELE . FEE SMI FEE
/�-
FFEE PLU FEE
J F M A M J J A 5 O N D
JOB ADDRESS SP NO
I
OWNER
76
77
COMMUNITY VALUATION
DATE
DST
OFFICE
D
$
78
M H PERMIT FEE
$
USE OF PERMIT j?_"F_C7_.
SUPP. TO RMIT PE
MIT
NO.
505-
MICROFILM FEE
COPIES
$
BOOK PA E PARCE L GAL DESC PTION
ora -l -ifs 4ecvp znC AN '
MECHANICAL FEE
DBL
$
USE NO.
ZONE S BACK
LOT SIZE
GRP TYPE
CK BY
�.. ..
(�
S S R
PLAN CHECK FEE
$
BOND AMT.
PLAN NO,
PLAN CHECKER
FINAL DATE INSPECTOR
CONSTRUCTION FEE
DBL
$
NAME OF CONST. LENDER
BRANCH OFFICE
NO LE DER INVOLVED
040
ELECTRICAL FEE
DBL
$
ADDRESS
CITY
STATE
STRONG MOTION
$
OWNER/AGENTS SIGNATURE
CONTRAC
INSTRUMENTATION FEE
SPECIALINSP
$
ADDRESS
ADDRESS
DEMOLITONFEE
REGISTRATION
<"
PLUMBING FEE
DBL
$
CITY ZIP CODE
CITY ZIP CODE
�
7 L� �4
TOTAL FEES $
TEL. NO.
AREA CODE
TCL. NO.
AREA CODE
LICENSE o
CASH ❑CHECK .O. N.C;:j
gs
f
+
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.
OHTHE
SEWAGE SYSTEM ,//fi�y�
GREE THAT ALL WORK IN CONNECTION WITH TWS PERMIT WILL BE DONE IN ACCORDANCE
LL
P�%E�7
4WS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, I ALSO AGREE TO CARRY
C-UM"N lA nvry INaUKANC.t UYUN MY tMYLUTttS. C.UMPLIANC.t WIIH IHC LAWS OF IHt JIAIt Ur
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.