301841 (SFD). DEPARTMENT OF BUILDING & SAFETY -
BUILDING PERMIT I
FIELD OFFICE
J F M AIM J J A S O N D
PERMIT NO.
301 8 41
OWNER
�
i.VYI\1 1 Vr RIYGR7IYG
"llow'
DST
CONSTRUCTION ESTIMATE
DATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ.
2ND FL. SQ.
FOR.
GAR.
CAR P. SQ.
WALL SQ.
ESTIMATED CONSTRUCTION
FT. @ $
UNITS
M H PERMIT FEE
FT. @ YARD SPKLR SYSTEM
SQ. FT. @ MOBILEHOME SVC. BAR SINK
F.C.
SQ. FT. @ !Xi POWER OUTLET ROOF DRAINS
FT. @ DRAINAGE PIPING
184,
FT. @ DRINKING FOUNTAIN
SQ. FT. @ URINAL
COPIES
VALUATION $ �- WATER PIPING
NOTE: Not to be used os property tax valuation
LEGAL DESCRIPTI N
SWIM POOL, PVT
FLOOR DRAIN
MECHANICAL FEES
SWIM POOL, COMM
WATER SOFTENER
$
VENT SYSTEM §<AN ❑ EVAP. COOL HOOD
CSCo
SIGN
WASHER (AUTO)PLI:q
!29
APPLIANCE RYER
CSC
GARBAGE DISPOSAL
C?d
��K
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
LAUNDRY TRAY
�,,
AIR HANDLING UNIT CFM
a
IDLE METER
KITCHEN SINK
$
ABSORPTION SYSTEM B.T.U.
PLAN NO.
TEMP USE PERM SVC
WATER CLOSET
QQ
COMPRESSOR tt.4 HP
POLE, TEMP/PERM
LAVATORY
lZ
HEATING SYSTEM ORCED ❑ GRAVITY
40
/.MPERES SERV ENT
SHOWER
$
BOILER B.T.U.
BRANCH OFFICE
SQ. FT. @a
SQ.FT. @ a
BATH TUB
WATER HEATER
Ga0
f
0�
Q.FT.RESID @ 11/4a
SEWAGE DISPOSAL
(riGS
DBL
$
SQ.FT.GAR @ 1/aa
HOUSE SEWER
STATE
gg
GAS PIPING
v
PERMIT FEE
ey,O
PERMIT FEE
GaG> / PERMIT FEE
OWNER/AGENTS SIGNATURE
CONTRACTOR"
DBL.
TOTAL FEES
r 1
MOB.HM.FEEJ
MICRO FEE
MEM -1. FEE
AW,4
L. CK. FEE
��,
CONST. FEE
- .
EL T. FEE SMI FEE
V
FEE PL
FEE
oQ
J F M AIM J J A S O N D
JOB ADDRESS SP NO
� 1
/ 1
OWNER
�
76
77
MMUNI
VALUATION
DATE
D T O ICE
78
M H PERMIT FEE
$
USE O ER IT
F.C.
SUfrP.jfO PER T 'PERMIT
184,
MICROFILM FEE
COPIES
$
BOOK gAGE PARCEL
LEGAL DESCRIPTI N
MECHANICAL FEE
DBL
$
5
SET BACK LOT SIZE
GR BY
110FE
�
��K
r,�,�
�,,
I S 5 R (�Q
a
PLAN CHECK FEE
$
BOND AMT.
PLAN NO.
PLAN CHECKER
FINAL DATE INSP
lZ
t
CONSTRUCTION FEE
DBL
$
NAME OF CONST. LENDER
BRANCH OFFICE
NO E DER INVOLVED
0�
ELECTRICAL FEE
DBL
$
ADDRESS
CITY
STATE
gg
$
OWNER/AGENTS SIGNATURE
CONTRACTOR"
STRONG MOTION
"� 1,.,�
INSTRUMENTATION FEE
a
SPECIAL INSP
$
ADDRESS
A
DEMOLITION
fEE
REGISTRATION
' a
PLUMBING FEE
DBL
$
CITY ZIP CODE
CITY ZIP CODE
,ry !
TOTAL FEES $
TEL. NO. AREA
CODE
TEL. Na.
AREA CODE
LICENSE I
CASH❑CHECK .O.❑N.C.❑=.R
RECEIVED BY TREES REQUIREDT
SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF
20 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
&FBI
SEWAGE SYSTEM
GREE THATALLWORK IN CONNECTIONWITH THIS PERMITWILLBE DONE INACCORDANCE
T LL P
WS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, I ALSO AGREE TO CARRY
llJ IIvry IrvJUKANI-r UYVIN MT tMYLVT r.3. LUMI'LIANLt WIIH Irlt LAWJ Ur INt JI A It Ur
CALIFORNIA COVERING CONTRACTORS IS ALSO GUARANTEED.
I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE
FORM 294-206 IREV. 6-761 SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE
OF CALIFORNIA.