303502 (SFD)DEPARTMENT OF BUILDING & SAFETY
BUILDING PERMIT
—Mlrti„ 1 0 COUNTY OF RIVERSIDE
CONSTRUCTION ESTIMATE
1 ST FL.
SQ. FT. @ $
2ND FL.
SQ. FT. @
POR.
SQ. FT. @ 0-0—
GAR.
SQ. FT. @
CAR P.
SQ. FT. @
WALL
SQ. FT. @
COMMUNITY _
,E .,I ��`,
SQ. FT. @
ESTIMATED CONSTRUCTION
VALUATION $
I NOTE: Not to be used as property tax valuation
NO. I ELECTRICAL FEES
UNITS
MOBILEHOME SVC.
POWER OUTLET
POOL, PVT
FIELD OFFICE
FllSjT
NO. "PLUMBING FEES
O
SWIM POOL, COMM
WATER SOFTENER
YARD SPKLR SYSTEM
76
BAR SINK
ROOF DRAINS
WASHER (AUTO) (WfIL4
DRAINAGE PIPING
COMMUNITY _
,E .,I ��`,
DRINKING FOUNTAIN
RYER
URINAL
OFFICE
WATER PIPING
M H PERMIT FEE
FLOOR DRAIN
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
J F M A M
1 J
MECHANICAL FEES
O
SWIM POOL, COMM
WATER SOFTENER
OWNER
,✓�
76
VENT SYSTEM AN ❑ EVAP. COOL OOD
SIGN
WASHER (AUTO) (WfIL4
COMMUNITY _
,E .,I ��`,
APPLIANCE
RYER
DST/
/
OFFICE
GARBAGE DISPOSAL
M H PERMIT FEE
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
LAUNDRY TRAY
F.C.
SUPP. O PERMIT
AIR HANDLING UNIT
I CFM
NO.
IDLE METER
KITCHEN SINKQ
ABSORPTION SYSTEM
B.T.U.
C
TEMP USE PERM SVC
WATER CLOSET
.
COMPRESSOR
HP
MICROFILM FEE
POLE, TEMP/PERM
LAVATORY
HEATING SYSTEMORCED
❑ GRAVITY
030
AMPERES SERV ENT
SHOWER
BOILER
B.T.U.
MECHANICAL FEE
SQ.FT. @
DATH TUB
0
US N(5.
ZOf�NEEJry
SET BACK LOT SIZE Gy�RP TV PE CK BV
SQ.FT. @ a
WATER HEATER
c9
BOND AMT.
PLAN NO. PLAN ESC KElR♦
FT.RESID @ 11/4aj
SEWAGE DISPOSAL
CONSTRUCTION FEE
DBL
$
SQ.FT.GAR @ 3/4a
HOUSE SEWER
GAS PIPING
DBL
$
PERMIT FEE
{{��^•rr./�j
922
CITY
PERMIT FEE
PERMIT FEE
Qom?
$
DBL.
TOTAL FEES
OB.H M.FEE
MICRO FEE
MECH- FEE
L. CK. FEE
CONST. FEE
ELE FEE SMI FEE
FEE
PLL B. FEE
J F M A M
1 J
A S
O
N D
JOB ADDRESS I SP NO
�,/ /� ,�/jJ
OWNER
,✓�
76
77
COMMUNITY _
,E .,I ��`,
VALUATION]
$ s7l 74�
DAT,E+j % �ry--�
/ ! / /
DST/
/
OFFICE
78
M H PERMIT FEE
$
USE O ERMI
F.C.
SUPP. O PERMIT
PERMIT
NO.
C
303501
MICROFILM FEE
COPIES
$
BOOK PAGE I PA,7;L
LEGAL DESCRIPTICIIN
i ... t
MECHANICAL FEE
DBL
$
US N(5.
ZOf�NEEJry
SET BACK LOT SIZE Gy�RP TV PE CK BV
PLAN CHECK FEE
BOND AMT.
PLAN NO. PLAN ESC KElR♦
FINAL.DATE
I PECTOR
CONSTRUCTION FEE
DBL
$
NAME OF CONST., LENDER
BRANCH OFFICE NOL DER INVOLVED
ELECTRICAL FEE
DBL
$
{{��^•rr./�j
ADDRESS
CITY
STATE
STRONG MOTION
INSTRUMENTATION FEE
$
Y
OWNER/AGENTS SIGNATURE s
CONTRAC OR*== ,i I
'SPECIALINSP
DEMOLITION
REGISTRATION
FEE
$
ADDRESS
ADDRESS
5/ 075 /f41 n4 /
PLUMBING FEE
DBL
$
3
CITY ZIP CODE
CITY ZIP CODE�e o Alm z -
TOTAL FEES $
TEL. NO.
TEL, NO.a AREA CODE
LICENSE a
CASH ❑CHECK O.❑N.C.❑
r,
7CODE
�
3 3�
RECEIVED BY
TREES REQUIRED
THIS PF IT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF
20 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE
TH LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, I ALSO AGREE TO CARRY
•nMDcwICATIrlwllwlCl IDAwI!'C I ollwl r l�,iTu T c fTnrcl�
,SEWAGE SYSTEM
T/ -k
/
P Xf
CALIFORNIA COVERING CONTRACTORS IS ALSO GUARANTEED.
I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE
FORM 284-208 (REV. 8-76I - SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE
OF CALIFORNIA.