296594 (PAT)DEPARTMENT OF BUILDING & SAFETY FIELD OFFICE
BUILDING PERMIT
J I F I M A M J J A S O N D
PERMIT NO.
29 9 4d
I -ow
+VVI\1 t Vt• RIYCR7IVC .1111W.
0,0
DST
T
CONSTRUCTION ESTIMATE
COMMUNITY
NO. ELECTRICAL FEES
NO. PLUMBING FEES
OFFICE
1 ST FL. SQ.
2ND FL.
FOR.
GAR.
CAR P. SQ.
WALL SQ.
ESTIMATED CONSTRUCTION
FT. @ $
$ee
UNITS
I
78
SQ. FT. @ YARD SPKLR SYSTEM
SQ. FT. @ A' o t ? MOBILEHOME SVC. BAR SINK
SQ. FT. @ POWER OUTLET ROOF DRAINS
F.C.
FT. @ DRAINAGE PIPING
PERMIT NO.
FT. @ DRINKING FOUNTAIN
SQ. FT. @ URINAL
VALUATION is C3 WATER PIPING
NOTE: Not to be used as property tax valuation
SWIM POOL, PVT
FLOOR DRAIN
MECHANICAL FEES
COPIES
SWIM POOL, COMM
WATER SOFTENER
BOOK 'PAGE PARCEL
LEGAL DESCRIPTION
VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD
SIGN
WASHER (AUTO)(DISH)
}f
APPLIANCE ❑ DRYER
DBL
$
GARBAGE DISPOSAL
USE NO.
ZONE
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
LOTpS/IZE
GRP
LAUNDRY TRAY
CK BYr
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
HEATING SYSTEM ❑ FORCED ❑ GRAVITY
AMPERES SERV ENT
SHOWER
/
R�SJ
VJ��I
BOILER B.T.U.
SQ.FT. @ a
BATH TUB
$
BOND AMT.
SQ.FT. @ a
WATER HEATER
FIN DATE INSPECTOR
SQ.FT.RESID @ 11/4¢
SEWAGE DISPOSAL
SQ.FT.GAR @ a/4¢
HOUSE SEWER
GAS PIPING
CONSTRUCTION FEE
PERMIT FEE
$
PERMIT FEE
PERMIT FEE
NO ENDER INVOLVED
DBL.
TOTAL FEES
MOB.HM.FEE
%MICRO FEE
MEC H. FEE
PL. CK. FEE
CONST. FEE ELECT. FEE
r . s
SMI FEE
FEE
PLUMB. FEE
J I F I M A M J J A S O N D
JOB ADDRESS I SP NO
� I
OWNER
� 1
fl,
76
0,0
—
A)
77
it—
COMMUNITY
VALUATION
A E DST
OFFICE
$ee
s[r
I
78
M H PERMIT FEE
$
SE ER ITj
F.C.
WISP. TO PERMIT
PERMIT NO.
MICROFILM FEE
COPIES
$
BOOK 'PAGE PARCEL
LEGAL DESCRIPTION
}f
MECHANICAL FEE
DBL
$
USE NO.
ZONE
SET BACK/�
LOTpS/IZE
GRP
TYPE
CK BYr
J
�axoTs
--
_
SjC✓
/
R�SJ
VJ��I
PLAN CHECK FEE
$
BOND AMT.
PLAN NO,
PLAN CHECKER
FIN DATE INSPECTOR
CONSTRUCTION FEE
DBL
$
NAME OF CONST, LENDER BRANCH
OFFICE
NO ENDER INVOLVED
ELECTRICAL FEE
DBL
$
ADDRESS CITY
STATE
STRONG MOTION
$
OIIIRIAANISXGN URE CONTRACTOR
INSTRUMENTATION FEE
'SPECIALINSP
$
ADDRESS ADDRESS
DEMOLITION
REGISTRATION
PLUMBING FEE
DBL
$
c Y ZIP CODE CITY
ZIP CODE
TOTAL FEES $
TEL. AREA
CODE TEL.
NO.
AREA CODE
LICENSE a
CASH❑CHECK .O.❑N•C.❑
RECEIVED BYT ES REQUIREDArC)AAPFMqATInMiMcliDAKIr
THIS PERMIT SHALL BECOME VOID IF WORK 15 NOT COMMENCED WITHIN 120 DAYS. CESSATION OF
WORK FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
SEWAGE SYSTEM
I HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE
T LL PWITH
THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, I ALSO AGREE TO CARRY
C I IDl ki . 1—vCCf
FORM 284.208 (REV. 6-76)
CALIFORNIA COVERING CONTRACTORS IS AL50 GUARANTEED.
I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE
SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE
OF CALIFORNIA.