240803 (SFD)BUILDING PERMIT
.;CONSTRUCTION ESTIMATE
1 ST FL. —mvj SQ.FT. @�..' { .1 ,T
2ND FL. 201 SQ. FT. @
POR. SQ. FT. @ �t�
GAR. SO. FT. @ 4.25 1,1
CAR P. 250 SO.FT. @ 2.5
WALL SO. FT. @
SQ. FT. @
ESTIMATED CONSTRUCTION VALUATION $
NOTE: Not to be used as property tax valuation
MECHANICAL FEES
VFNT SYSTEM -THAN nl FVAP- COOL 0 HOOD
DEPARTMENT OF BUILDING & SAFETY
COUNTY OF RIVERSIDE
NO. ELECTRICAL FEES
D25.
MOBILEHOME SVC.
POWER OUTLET
SWIM POOL, PVT
SWIM POOL, COMM'
SIGN
fiELD OFFICE
NO. PLUMBING. FEES
BOILER � B.T.U.
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
a WATER PIPING
FLOOR. DRAIN '
WATER SOFTENER
WASHER (AUTO) ISH)
til
APPLIANCE -1'3 00 GARBAGE DISPOSAL
FURNACE 0 UNIT 0 WALL 0 FLOOR 0 SUSPENDED LAUNDRY TRAY
AIR HANDLING UNIT I CFM IDLE METER r KITCHEN SINK
ABSORPTION SYSTEM 0 B.T.U. TEMP USE PERM SVC WATER CLOSET `its
COMPRESSOR HP POLE, TEMP/PERM LAVATORY
HEATING SYSTEM CIZFORCED 0 GRAVITY 00 AMPERES SERV ENT T 00 SHOWER
SQ FT @ ¢ I BATH TUB i 50
SQ FT @ ¢ WATER HEATER
SQ FT RESID @ I ¢ iii 03 SEWAGE DISPOSAL
SQ FT GARAGE @ 'he 1 37 HOUSE SEWER
PERMIT FEE 3100 TEMP ELEC SVC GAS PIPING
MOBILE HOME PERMIT FEE $
PERMIT FEE 1 4 0 PERMIT FEE
PERMIT 140.
TOTAL FEES
MOB. HM, FEE MICRO
FEE
MECH. FEE
DBL.
PL. CK. FEE
CONST. FEE
DBL.
ELECT. FEE
DBL.
SMI FEE
FEE PLUMB. FEE
q
155.00
19.04
31. N
62. at)
16.40
1.• 1
25.50
IDOL.
"-"'""J"'-F- M-• A- I M -1--- J- -A -I S.1-0- 1.N- D-
JOB ADDRESS — -.--. _ i SP NO
54-235 m�e.uluz. I
OWNER
1 Fcifies. Western
73
74
USE OF PERMIT
Dwilt I& att- - 'garageoul
F.C.
DATE
I-10-74
PERMIT NO.
75
M H PERMIT FEE
$
COMMUNITY DST
UNITS
ROOMS
VALUATION
SUPP. TO PERMIT
O FICA
1.3 .. uin 11.
3.5.7: 2.00
MICROFILM FEE
COPIES
$
LEGAL DESCRIPTION
Lot 12,BIock 236Saata Ca lits #24- PC 774-I 024
MECHANICAL FEE
DBL
$
SET
LOT SIZE ZONE
USE NO.
GRP
TYPE
CK BY
-1 I
I
/BACK /��.�g 2,5
F 267 S 5 on iR
PLAN CHECK FEE
$
BOND AMT.
PLAN NO.
PLAN CHECKERI-FINAL�DATE
✓ INSPEC�TORA
00
CONSTRUCTION FEE
DBL
$
NAME OF CONST. LENDER BRANCH
OFFICE
NO LENDER INVOLV
ELECTRICAL FEE
DBL
$
J
ADDRESS CITY
STATE
P**
SMI FEE
Is
THIS PERMIT SHALL BECOME VOID LF WORK IS NOT COMMENCED WITHIN 12 DAYS. CESSA-
TION OF WORK FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
THEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN AC.
$
FEE
CORDANCE WITH THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, I ALSO
AGREE TO CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLIANCE WITH THE
LAWS OF THE STATE OF CALIFORNIA COVERING CONTRACTORS IS ALSO GUARANTEED.
PLUMBING'FEE
DBL
$
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 OF CALIFORNIA.
OWNER/AGENT'S SIGNATURE '
r d ...•.,p;.
CONTRACTOR
-
(�
TOTAL FEES
,55
� � - L, - -4%-
AD RESS
ADDRESS
CASH 0 CHECK M.O. 0 N.C. 0
RECEIVED BY. TREES REQUIRED
Cin
I ZIP CODE
CITY ZIP CODE
SEWAGE SYSTEM
' T LL P
aa
INFORMATION
I
TEL. TEL. NO.
TEL. NO. LICENSE
FORM 284208 (Rev. 9-73)' OP5
Construction is NOT PERMITTED - 235 4�/W4
on the following Code Holidays: ' `�3, a vlsz CA 9? 2_�
Year's Day ;A, oFo.o/s �o-�° DoE c*
Martin LutherlGngJr. DW:w O20•/,#! j'OR �{C//2SEC./3 T.6SI�6E.
President's Day o2°:a 9 "AN ADEQUATELY SIZED DEBRIS CONTAINER A RE MSPECTION FEE OF $30
Memorial Day o=- s IS REQUIRED ON THE JOB SITE DURING ALL WILL BE CHARGED IF THE APPROVEDt
Independence Day °PO''?` PHASES OF CON UCTION AND MUST BE PIANS AND JOB CARD ARE NOT ON
Labor Day EMPTIED AS NEARY. FAILURE TO DO SO THE SITE f� A SCHEDULED
Veteran's L IM IQ,NJAE TIECONTAINER ) INSP CTION.
Thanksgivin..g} EWrTH Y.QWNWRII
"• Christmas D M C - - -
I n1
O
dfr—
nA eeo -Nl ICI
•• '° r P® PS ® 2
CONSTRUCTION HO
October. lst -April 30
Monday - Friday: 7:00 a.m. to
Saturday: 8:00 am. to 5:0
Sunday: None
Government Code Holidays:
May 1st - September 30th
Monday - Friday: 6:00 a.
Saturday: 8:00 ro I
Sunday: None
Government Code Holidays '9?
a
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CITY OF LA QUIit'A
BUILDING & SAFETY DEPFfe
APPROVED...
FOR CONSTRUCTION -
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BUILDING PERMIT
DEPARTMENT OF BUILDING & SAFETY
FIELD OFFICE
0.
COUNTY OF RIVERSIDE
- ---
00 GARBAGE DISPOSAL
=CONSTRUCTION ESTIMATE
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1 ST FL. SQ.FT. @
3 •
UNITS'
ABSORPTION SYSTEM
j B.T.U.
TEMP USE PERM SVC WATER CLOSET
BOILER � B.T.U.
2ND FL. SQ. FT. @
4 00 POLE, TEMP/PERM L LAVATORY
HEATINGSYSTEM L-11FORCE0 ❑GRAVITY
201 2.50
5€12. 50
MOBILEHOME SVC.
BAR SINK
POR. SQ. FT. @
4* 25
1.,164- 5�?
POWER OUTLET
ROOF DRAINS
GAR. SQ. FT. @
2.54
625.00
PERMIT FEE
DRAINAGE PIPING
CAR P. SO.FT. @
MOBILE HOME PERMIT FEE'
is
PERMIT FEE L I PERMIT FEEI Zi
PERMIT NO.
TOTAL,FEES
DRINKING FOUNTAIN
WALL SQ. FT. @
MECH. FEE
DBL.
PL. CK. FEE
SQ. FT. @
DBL.
ELECT. FEE
URINAL
ESTIMATED CONSTRUCTION VALUATION $15 j, 7 32. 00
FEE PLUMB. FEE
WATER PIPING
NOTE: Not to be used as property tax valuation
155. flfl
SWIM POOL, PVT
FLOOR DRAIN
MECHANICAL FFFS.
SWIM POOL. COMM
WATER SOFTENER
DST
11
VENT SYSTEM C33=AN ❑ EVAP. COOL 0 HOOD
5 001 SIGN WASHER (AUTO)&ISHI
APPLIANCE3
Dr3rer
00 GARBAGE DISPOSAL
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT
CFM
IDLE METER KITCHEN SINK
ABSORPTION SYSTEM
j B.T.U.
TEMP USE PERM SVC WATER CLOSET
COMPRESSOR HP
4 00 POLE, TEMP/PERM L LAVATORY
HEATINGSYSTEM L-11FORCE0 ❑GRAVITY
4 00 AMPERES SERV ENT 1 00 SHOWER
SOFT @ a I BATH TUB 50
SQ FT @ a WATER HEATER
SQ FT RESID @ la 10 03 L SEWAGE DISPOSAL U
SQ FT GARAGE @ '/aa 1 37 HOUSE SEWER
PERMIT FEE
3 001 TEMP ELEC SVC GAS PIPING
MOBILE HOME PERMIT FEE'
is
PERMIT FEE L I PERMIT FEEI Zi
PERMIT NO.
TOTAL,FEES
MOB. HM. FEE MICRO
FEE
MECH. FEE
DBL.
PL. CK. FEE
CONST. FEE
DBL.
ELECT. FEE
DBL.
SMI FEE
FEE PLUMB. FEE
DBL
240801 ji
155. flfl
19.00
31.00
62.00
16.40
1..1
125.5Q
J I F I M I A JM I J JI
A I S O 1 N I D
JOB ADDRESS SP NO
.54-235 Ave. Diaz I
OWNER
Pacifier Western
73
74
USE OF PERMIT
& att. garage 001
F.C.
DATE
1-10-74
PERMIT NO.
751w1
M H PERMIT FEE
$
COMMUNITY DST
UNITS
ROOMS
VALUATION
SUPP. TO PERMIT
La uint& 11
15j 32.00
]dFFI(fle
MICROFILM FEE
COPIES
$
LEGAL DESCRIPTION
Lot 12,Block 256 Sauta Carmelite #24- PC 774-194:-024
MECHANICAL FEE
DBL
$
SET BACK
LOT SIZE ZONEUSE
NO.
GRP
TYPE
CK BY
19
nn
-1
rs
F 20 S 5-104C[ R 25
PLAN CHECK FEE
$J
BOND AMT.
PLAN NO.
PLAN CHECKER
FINAL DATE INSPECTOR
7
— _ s%
A
/
;—
CONSTRUCTION FEE
DEL
$
NAME OF CONST. LENDER BRANCH
OFFICE
NO LENDER INVOLV
6_2
2apkof 4
ELECTRICAL FEE
DBL
$
ADDRESS CITY
STATE
SMI FEE
$
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 127DAYS. CESSA.
TION OF WORK FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
T
I 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 ALSO
FEE
AGREE TO CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLIANCE WITH THE
LAWS OF THE STATE OF CALIFORNIA COVERING CONTRACTORS IS ALSO GUARANTEED.
PLUMBING FEE
DBL
$
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. ,.
$
OWNER/AGENT'S SIGNATURE
' ' �.�
CONTRACTOR
TOTAL FEES
X55
nQ^
X
1
CASH ❑ CHECK OXM.O. ❑ N.C. ❑"
AD ESS
ADDRESS
RECEIVED BY �� �a TREES REQUIRED
CI;$!t740 ventum ZIP CODE
CITY ZIP CODE
SEWAGE SYSTEM T
I P
LL
Tarzana
INFORMATION
TEL. NO.
TEL. NO. LICENSE
1
FORM 284-208 (Rev. 9.731 05
i