301836 (SFD)DEPARTMENT OF BUILDING 81 SAFETY FIELD OFFICE
BUILDING PERMIT e.^I IwITv ^e mI's clne I
J' F M A M J J A I S O N D
PERMIT'NO.
3018361
OWNER
+VVI\I I Vr RI v 4 LJ r.
lk�S
77
DST
ll
CONSTRUCTION ESTIMATE
DATE%
NO. ELECTRICAL FEES
FFICE
NO. PLUMBING FEES
1ST FL. SQ.
2ND FL. SQ.
POR. SQ.
GAR. SQ.
CAR P. SQ.
WALL SQ.
ESTIMATED CONSTRUCTION
FT. @ $
UNITS
78
M H PERMIT FEE
FT. @ YARD SPKLR SYSTEM
FT. @ .� MOBILEHOME SVC. BAR SINK
F.C.
FT. @ 7 POWER OUTLET ROOF DRAINS
PEIMIf
FT. @ DRAINAGE PIPING
FT. @ DRINKING FOUNTAIN
SQ. FT. @ URINAL
VALUATION f�F9 WATER PIPING
O'c'
NOTE: Not to be used as property tax valuation
301
SWIM POOL, PVT
83G
FLOOR DRAIN
COPIES
$
MECHANICAL FEES
BOOK AGE PARCEL
SWIM POOL, COMM
WATER SOFTENER
VENT SYSTEM XFAN ❑ EVAP. COOL HOOD
SIGN
DBL
WASHER (AUTO)(q6-*
12 do
U E NO.
APPLIANCE RYER
4,00
OT SIZE
GRP
GARBAGE DISPOSAL
CK BY
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
LAUNDRY TRAY
!Gj
AIR HANDLING UNIT CFM
IDLE METER
KITCHEN SINK
$
ABSORPTION SYSTEM B.T.U.
BOND AMT.
TEMP USE PERM SVC
PLAN CHECKER
WATER CLOSET+
R
COMPRESSOR P HP
POLE, TEMP/PERM
LAVATORY
t
C�
HEATING SYSTEM FORCED ❑ GRAVITY
CONSTRUCTION FEE
AMPERES SERV ENT
Q®
SHOWER
NAME OF CONST. LENDER BRANCH
OFFICE
BOILER B.T.U.
SQ.FT. @ a
BATH TUB
G?!?
ELECTRICAL FEE
SQ.FT. @ a
$
WATER HEATER
t �'
STATE
Q.FT.RESID @ 11/44
/
SEWAGE DISPOSAL
00
STRONG MOTION
Vlqf_SQ.FT.GAR @ 3/4a
$
HOUSE SEWER
OWNER/AGENTS SIGNATURE CONTRACTOR
'
p�
GAS PIPING2
A�
INSTRUMENTATION FEE
PERMIT FEE
C7�
PERMIT FEE
GY3
PERMIT FEE
SPECIALINSP
DBL.
[��EEs
,
MOB.HM.FEE
'
MICRO FEE
M . FEE
PL. CK. FEE
CONST. FEE
ELE . FEE
SMI FEE
/�'
FEE
PL B. FEE
'
J' F M A M J J A I S O N D
JOB ADDRESS SP NO
I
OWNER
76
lk�S
77
COMMUNITY-
ALUATION/
DATE%
DST
FFICE
$ >> .01 {71
78
M H PERMIT FEE
$
USE OF E IT
F.C.
SUPP, O PERMIT
PEIMIf
NO.
DXa, 444#,
00
301
83G
MICROFILM FEE
COPIES
$
BOOK AGE PARCEL
LEGAL DESCRIPTION -
MECHANICAL FEE
DBL
$
U E NO.
ZONE
SET BACK
OT SIZE
GRP
TYPE
CK BY
!Gj
_IS
PLAN CHECK FEE
$
BOND AMT.
PLAN NO.
PLAN CHECKER
FINAL DATE INSPE
R
C�
CONSTRUCTION FEE
DBL
$
NAME OF CONST. LENDER BRANCH
OFFICE
NO Lj7bER INVOLVED
ELECTRICAL FEE
DBL
$
ADDRESS CITY
STATE
APO% e3
��yy
00
.�..-
STRONG MOTION
$
OWNER/AGENTS SIGNATURE CONTRACTOR
'
p�
A�
INSTRUMENTATION FEE
.r•
SPECIALINSP
$
ADDRESS A
D s
DEMOLITION
FEE
�l
REGISTRATION
, s�d
PLUMBING FEE
DBL
$
CITY ZIP CODE CITY
ZIP CODE
..-
92-2-<
TOTAL FEES $
TEL. NO. AREA
CODE TEL`.
N`O. AREA CODE
LICENSE n
CASH ❑CHECK .O.❑N.C.❑
/
RECEIVED BY .r TREES REQUIRED
IT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF
THRB
120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
SEWAGE SYSTEM
AGREE THAT All WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE
T LL p
H THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, I ALSO AGREE TO CARRY
CIAADFtJC ATIlKIC1 to Aw 0I
(l
CALIFORNIA COVERING CONTRACTORS IS ALSO GUARANTEED.
1 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
FORM 284.208 (REV. 6-761 OF CALIFORNIA.