290743 (SFD)FIELD OFFICE
• DEPARTMENT OF BUILDING & SAFETY •
BUILDING PERMIT ��. u.w —
J F M A M J J A S O N D6.0176
PERMIT NO.
[2907431
LV{JI.1 1 Vr RIYCR71YC
COMMUNITYy
�
VALUATION DATE
/ moi!
$ t
DST
CONSTRUCTION ESTIMATE
78
NO. ELECTRICAL FEES
NO. PLUMBING FEES
:
1 ST FL. ZC2,0 9
2ND FL.
POR.
GAR.
CAR P. SQ.
WALL SQ.
ESTIMATED CONSTRUCTION
SQ. FT. @
✓
UNITS
$
SQ. FT. @ YARD SPKLR SYSTEM
F.C. SUPP. TO PERMIT
SQ. FT. @ ✓ , MOBILEHOME SVC. BAR SINK
NO.
SQ. FT. @ POWER OUTLET ROOF DRAINS
FT. @ DRAINAGE PIPING
FT. @ DRINKING FOUNTAIN
SQ. FT. @ URINAL
VALUATION $ "� �y WATER PIPING
�s
NOTE: Not to be used as property tax valuation
SWIM POOL, PVT
FLOOR DRAIN
$
MECHANICAL FEES
SWIM POOL, COMM
WATER SOFTENER
VENT SYSTEM MAN ❑ EVAP. COOL HOOD
t
SIGN
WASHER(AUTO)(9161 1)Q
USE NO.
ZONNEE�/i}
APPLIANCE RYER
CsC?
TYPE ICK BY
GARBAGE DISPOSAL
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
LAUNDRY TRAY
. IfHr
AIR HANDLING UNIT CFM
IDLE METER
! KITCHEN SINK
d
PLAIN NO.
ABSORPTION SYSTEM B.T.U.
FINAL DATE INSPECTOR
•T
TEMP USE PERM SVC
�Z WATER CLOSET
-
COMPRESSORHP
b
POLE, TEMP/PERM
LAVATORY
S l
.f�
HEATING SYSTEM ORCED ❑ GRAVITY
da.
MPERES SERV ENT
` SHOWER
NAME OF CONST- LENDER
BRANCH OFFICE
BOILER B.T.U.
SQ.FT. @ ¢
BATH TUB
SQ.FT. @ 4
WATER HEATER
$
Ja
ADDRESS
CITY �,
SQ.FT.RESID @ 11144
SEWAGE DISPOSAL
Q.FT.GAR @ 3/4a
HOUSE SEWER
..
GAS PIPING
STRONG MOTION
PERMIT FEE
OWNER/AGENTS SIGNATURE
PERMIT FEE
PERMIT FEE
>'
DBL. I
TOTAL FE�EySy
t[�•-'�%0
MOB.H M.FEE
jml�R�EEMECH.
J
FEE
PL CK. FEE
CONST. FEE
ELECT.FEE SMI FFEEE,i/+yFEE
PLUMO. FEE
J F M A M J J A S O N D6.0176
JOB ADDRESS SP NO OWNER
�—! 6 " 1?&/ eep I D425-ele-)-
77
COMMUNITYy
�
VALUATION DATE
/ moi!
$ t
DST
OFFICE
78
/ fit ! i �
:
M H PERMIT FEE
$
USE OF PERMIT
F.C. SUPP. TO PERMIT
PE MIT
NO.
743
MICROFILM FEE
COPIES
$
BOOK PAGE PARCEL LEGAL DESCRIPTION
MECHANICAL FEE
DBL
$
USE NO.
ZONNEE�/i}
SET BACK LLOOTT/} ZZEE
GRP
TYPE ICK BY
S R :f �+V
. IfHr
PLAN CHECK FEE
$
BOND AMT.
PLAIN NO.
PLAN CHECKER
FINAL DATE INSPECTOR
•T
f ��
/C /?ASF'
S l
.f�
CONSTRUCTION FEE
DBL
$
NAME OF CONST- LENDER
BRANCH OFFICE
NO ENDER INVOLVED
ELECTRICAL FEE
DBL
$
Ja
ADDRESS
CITY �,
STATE
a,
..
STRONG MOTION
$
OWNER/AGENTS SIGNATURE
CO
INSTRUMENTATION FEE
.r
SPECIAL INSP
DEMOLITION
FEE
$
ADDRESS
A D
x 6 37
REGISTRATION
01 — '
((
PLUMBING FEE
DBL
$
/
CITY ZIP CODE
ZIP CODE
CITY 2.
TOTAL
TOTAL FEES $
TEL. NO. AREA
GODE
TEL NO. Q t� AREA CODE
7/�
LICENSE I
CASHOCHECK O.ClN.C.❑
X)(
1CJ4
RECEIVED BY REES REQUIRED
MIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF
RK 20 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
1 H GREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE
SEWAGE SYSTEM
,(i
LL
��
THESE LAWS OF RIVERSIDE COUNTY STATE OF I ALSO AGREE TO CARRY
T /�
P
AND THE CALIFORNIA,
-Z-MrCrvSA I I -N INSURANCE UPON Mi EMYLOYCCS. COMPUAINCE W I I H THE LAWS OF IMC STATE OF
CALIFORNIA COVERING CONTRACTORS IS ALSO GUARANTEED.
I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE
FORM 204-200 IREV. 0-761 SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE
OF CALIFORNIA.