268903 (RPL)BUILDING PERMIT ,
DEPARTMENT OF BUILDING & SAFETY
116 COUNTY OF RIVERSIDE i
CONSTRUCTION ESTIMATE
I ST FL. SOFT. @
2ND FL. SO. FT. @
POR. SO. FT. @
GAR. SO. FT. @
CAR P SOFT. @
WALL SO. FT. @
• SGS. FT. @
ESTIMATED CONSTRUCTION VALUATION $
NOTE: Not to be used as property tax voluotion
MECHANICAL FEES
VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD
ELECTRICAL FEES
UNITS
MOBILEHOME SVC.
POWER OUTLET
SWIM POOL, PVT
SWIM POOL. COMM
SIGN
FIELD OFFICE
NO.I PLUMBING FEES
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING.
FLOOR DRAIN
WATER SOFTENER .
WASHER (AUTO)IDISH)
DST
I/
APPLIANCE
.IOB ADDRESS SP NO
OWNER
74
GARBAGE DISPOSAL
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR Cl SUSPENDED
USE OF PERMIT r.,, '• Y' �, �'b
F.C.
LAUNDRY TRAY
PE IT O.
AIR HANDLING UNIT
CFM
IDLE METER
�- 3-�%�
KITCHEN SINK
M H PERMIT FEE
ABSORPTION SYSTEM
B.T.U.
TEMP USE PERM SVC
COMMUNIT
/,4
WATER CLOSET
UNITS
COMPRESSOR 0
HP
POLE, TEMP/PERM
OFFICE
L
LAVATORY
HEATING SYSTEM ❑ FORCED ❑ GRAVITY
AMPERES SERV ENT
W-rA
SHOWER
BOILER � B.T.U.
SQ FT @ a
BATH TUB
COPIES
$
SQ FT @ a
MECHANICAL FEE
WATER HEATER
$
SETBACK
SQ FT RESID @ 1 ¢
SEWAGE DISPOSAL
GRP
TYPE
BY
SQ FT GARAGE @ I/]a
HOUSE SEWER
PERMIT FEE
GAS PIPING
MOBILE HOME PERMIT FEE
is
PERMIT FEED
PERMIT FEE
PLAN NO.
26"640_e111L.1U_MB
TOT®�ES
MOB. HM.f EE
MICRO FEE
MECH. FEE
DBL.
PL. CK. FEE
CONST. FEE
DBL.
ELE�JEE
3 —a � ' )b
SMIFEE
FEE
PLU MnB� EE
DBL.
J F M A M J J A $ O N D
.IOB ADDRESS SP NO
OWNER
74
755
USE OF PERMIT r.,, '• Y' �, �'b
F.C.
DATE
PE IT O.
76
Feoz sp,4 T"
�- 3-�%�
X8903
M H PERMIT FEE
$
COMMUNIT
/,4
DST
//
UNITS
ROOMS
VALUATION d0
. U S4
SUPP. TO PERMIT
OFFICE
L
W-rA
MICROFILM FEE
COPIES
$
LEGAL DESCRIPTION
�C°- 7j��d�o -tea) -,loT -� �' � • o f S4ar4 (Ar?MZ//Z:4
MECHANICAL FEE
DBL
$
SETBACK
LOT SIZE ZONE
USE NO.
GRP
TYPE
BY
R�-)
F S a.. R
PLAN CHECK FEE
$
BOND AMT.
PLAN NO.
PLAN CHECKER
FINAL DATEPECTOR
3 —a � ' )b
C1/, k_t_4_c
CONSTRUCTION FEE
DBL
$
NAME OF CONST. LENDER BRANCH
OFFICE
NO LENDER INVOLV D
ELECTRICAL FEE
DBL
$
ADDRESS CITY
STATE
0
I
'': .
STRONG MOTION
$
OWNER/AGENT'S SIGNATURE
CONTRACTOR r'44.7,dr 40'-t r r ' - "
INSTRUMENTATION FEE
Svc /1 /�G• S' q
FEE
$
ADDRESS
ADDRESS (!� �y
7a1 /a2
PLUMBING FEE
DBL
$
CITY ZIP CODE
ZIP CODE
TOTAL FEES
$
TEL. NO.
TEL. NO. '/ LICENSE
3: 16-16 � e,,,c� 8' /.> / 7 - S�
CASH ❑ CHECK)( M.O. ❑ N.C. ❑
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSA
F_ 1l TION OF WORK FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
RECEIVED BY �,
TREES REQUIRED
�
j" 1 HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN AC
CORDANCE WITH THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, I ALSC
SEWAGE SYSTEM
T
LL
�/1
P
AGREE TO CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLIANCE WITH THE
I A\A/C / C TUC CTATC /lC /'AI IC/ DKIIA /-/1\/CDIAI/: /-/IAITDArTn DC IC Al Cn r11A�DAAITI:m
I I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS
FORM 284-208 (Rei. 10-74) OP L HAS DONE SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE
I OF THE STATE OF CALIFORNIA.
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