297205 (OFC),z
- DEPARTMENT OF BUILDING & SAFETY -
BUILDING PERMIT __.._._.. __ _.•.___.__
FIELD OFFICE
J F �M A M J J A S O N D
PERMIT NO, 5
20
NEW
L.VVIYI I Vr-RIYCRmVC
DST
CONSTRUCTION ESTIMATE
DST
.
NO. ELECTRICAL FEES
77
NO. PLUMBING FEES
78
EL
1ST FL.
2ND F.L.
FOR.
GAR.
CAR P.
WALL
ESTIMATED CONSTRUCTION
SQ. FT. @
,
UNITS
USE O PE MIT
'
SUPP:TO PERT
SQ. FT. @ YARD SPKLR SYSTEM
N
SQ. FT. @ MOBILEHOME SVC. BAR SINK ..
SQ. FT. @ POWER OUTLET ROOF DRAINS
SQ. FT: @ DRAINAGE PIPING
0
SQ. FT. @ DRINKING FOUNTAIN
SQ. FT. @ URINAL
7201
VALUATION $ r WATER PIPING
NOTE: Not to be used os property tax valuation
ISWIM POOL, PVT
FLOOR DRAIN
MECHANICAL FEES
SWIM POOL, COMM
COPIES
WATER SOFTENER
PAGE PA,;4LEGAE DESCRIPTION
VENT SYSTEM FAN ❑ EVAP. COOL ❑ HOOD
Oak
SIGN
WASHER (AUTO)(DISH).
MECHANICAL FEE
DBL
APPLIANCE ❑ DRYER
GARBAGE DISPOSAL,
�11NEJGRP �CK
f7� &
f/j��j �/y
R �'
JR2,6 I
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
LAUNDRY TRAY
PLAN CHECK FEE
AIR HANDLING UNIT CFM
IDLE METER
PLAN NOS�^+^ PLANCHECKERV
KITCHEN SINK
INSPECTOR t
ABSORPTION SYSTEM B.T.U.
TEMP USE PERM SVC
WATER CLOSET
Com,
COMPRESSOR HP
QQ
POLE, TEMP/PERM
LAVATORY Af
C:70
HEATING SYSTEM . FORCED ❑ GRAVITY
GL%
AMPERES SERV ENT
$
SHOWER
NAME OF CONST. LENDER
BRANCH OFFICE
BOILER B.T.U.
SQ.FT. @ ¢
BATH TUB._.:+- "
ELECTRICAL FEE
SQ.FT. @. a
$
WATER HEATER
ADDRESS
CITY
STATE
SQ.FT.V,'@ 11144
dy
SEWAGE DISPOSAL
11t
SQ.FT.GAR @ 3/4a
HOUSE SEWER
s
STRONG MOTION
$
GAS PIPING
CONTRAC
'
INSTRUMENTATION FEE
PERMIT FEE
.CJP!
PERMIT FEE
Qm
PERMIT FEE
DBL.
TOTAL FEES 'i
MOB.MM.FEE
MICRO EE
M .FEE
PL. CK. FEE
CONST. FEE
- ELECT. FEE
SMI FEE
FEE PL
B- FEE
J F �M A M J J A S O N D
/ -
JOB ADDRESS SP NO
� I
OWNER
e
C.4
76
e
+l
DST
.
OFFICE
77
CO M ITY - VALUATION,DATE
�L. t r $1
78
EL
M H PERMIT FEE
$
USE O PE MIT
'
SUPP:TO PERT
PE IT
N
0
9g
7201
�.
MICROFILM FEE
COPIES
$
PAGE PA,;4LEGAE DESCRIPTION
•Book
SET BACK LOT SIZE B
USE NO. (Jr� �yry�
MECHANICAL FEE
DBL
$
�11NEJGRP �CK
f7� &
f/j��j �/y
R �'
JR2,6 I
J �+r� I J I S y� S
rug
PLAN CHECK FEE
$
BOND AMT.
PLAN NOS�^+^ PLANCHECKERV
FINAL DATE
INSPECTOR t
`7
J
CONSTRUCTION FEE
DBL
$
NAME OF CONST. LENDER
BRANCH OFFICE
NO LENDER INVOLVED
.rr
ELECTRICAL FEE
DBL
$
ADDRESS
CITY
STATE
s
STRONG MOTION
$
OWNER/AGENTS SIGNATURE
CONTRAC
'
INSTRUMENTATION FEE
/7 t/
SPECIAL :NSP
$
ADDRESS
ADDRESS
DEMOLITION
REGISTRATION
PLUMBING FEE
DBL
$
CITY. ZIP CODE
CITY ZIP CODE
•
SL
0
��.yy
to
TOTAL FEES $
TEL. NO. -
AREA CODE
TEI. NO.
AREA CODE
LICE SE tt
CASH❑CHECR.O.❑N.C.❑ Z.,.�,L.
�. " (`S7/44
RECEIVED B , SrTREES REQUIREDJ
S PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF
K FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
1
SEWAGE SYSTEM
1 HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE
T LL
P
WITH THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA I nlsO er,RFF Tn revvv
FORM 284-208 (REV. 6.76)
.� .IIV(V IIv�UKHrvLt Urvry Mr tMFLUYtts. COMPLIANCE WITH THE LAWS OF THE STATE OF
CALIFORNIA COVERING CONTRACTORS 15 ALSO GUARANTEED.
I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE
SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSHESS AND PROFESSIONS CODE OF THE STATE
OF CALIFORNIA.