272677 (SATT)BUILDING PERMIT DEPARTMENT OF BUILDING & SAFETY
COUNTY OF RIVERSIDE
DST
CONSTRUCTION ESTIMATE NO- ELECTRICAL FEES NO, PLUMBING FEES
1 ST FL. f r�''
2ND FL.
POR.
GAR, ' "f
CAR P.
WALL
ESTIMATED CONSTRUCTION
SQ.FT. @
SO. FT. @
SQ. FT. @
SQ. FT- @
SQ.FT. �9
SO- FT- @
-
UNITS
YARD SPKLR SYSTEM
MOBILEHOME SVC.
BAR SINK
POWER OUT LET
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
SO. FT. @
VALUATION
URINAL
$ 7 -_
WATER PIPING
NOTE: Not to be used as property tax valuation
SWIM POOL, PVT
FLOOR DRAIN
MECHANICAL FEES
SWIM POOL COMM
WATER SOFTENER
VENT SYSTEM ❑ FAN ❑ EVAP. COOL E- HOOD
SIGN
WASHER (AUTO)4DISH+
_
APPLIANCE •
GARBAGE DISPOSAL
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
IDLE METER
KITCHEN SINK
p
ABSORPTION SYSTEM � B T U
TEMP USE PERM SVC
WATER CLOSET
COMPRESSOR HP
POLE, TEMP/PERM
LAVATORY
HEATING SYSTEM 0 FORCED ❑ GRAVITY
j
AMPERES SERV ENT
SHOWER
BOILER B.T U.
SQ FT @ C
!
BATH TUB
SQ FT @ ¢
'
WATER HEATER
_f
SOFT RESID (off - 1'e
SEWAGE DISPOSAL
SQ FT GARAGE @ -.'/fs
HOUSESEWER
PERMIT FEE
j
GAS PIPING
MOBILE HOME PERMIT FEE Is
I
PERMIT FEE
PERMIT FEE
-
po _PP EE1:• IT [p`IN 0'
TOTAL FEES
MOB HIMFEE
'dICRO FEE MECH, FEE
DBL
PL CK. FEE CONST FEE
DBL
[ELECT FEE
DBL. SMI FEE
FEE
PLUMB FEE
DBL
J
F
M
A
M
J
5
,D
N
D
JVB M1DDRES& SP NO
OWNER
74
75
LI$E OF P`e Rh511 I-.0 DATE
PEI�i111,
2 2677
76
M H PERMIT FEE
$
:;r7 AMII 11T•
DSI
':
ALOA T IDN SD PP. TO PERMIT OFF ICE
I.77ROOMS
MICROFILM FEE
COPIES
$
LEGAL DESCRIPTION _
MECHANICAL FEE
DBL
$
SET BACK
LOT SIZE 70NE
USE NO,
GRP
TYPE CK BY
r
PLAN CHECK FEE
$
BOND AMT
PLAN NO
PLAN CHECKER
FINAL DATE
INSPECTOR
C
CONSTRUCTION FEE
DBL
$
NAME ^f�'^""' "'^ BRANCH OFFICE NO LENDER INVOLVED
AD CITY STATE
ELECTRICAL FEE
DBL
$
ou CONTRACTOR
STRONG MOTION
$
INSTRUMENTATION FEE
}[wd�
F �J
Al ADDRESS
FEE
-,,:
C1 � �-' CODE CITY ZIP CODE
PLUMBING FEE
DBL
$
'
TOTAL FEES
$
TEL NO
TEL. NO. LICENSE
CASH ❑ CHECK a M,O ❑ N C ❑
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS- CESSA
r, TION OF WORK FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID -
RECEIVED BY
TREES REQUIRED
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 ALSC
SEWAGE SYSTEM
It
AGREE TO CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES- COMPLIANCE WITH THI
LL
P
F THE STATE OF CAI IFORNIA COVERING CONTRACTORS IS -ALSO GUARANTEED
LAWS O
I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS
FORM 284-208 (Rev. 10-74) OQ L HAS DONE SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE
OF THE STATE OF CALIFORNIA.
i
BUILDING PERMIT
DEPARTMENT OF BUILDING & SAFETY
COUNTY OF RIVERSIDE
FIELD OFFICE
NO.
ELECTRICAL FEES
BST
CONSTRICTION
ESTIMATE
NO,
PLUMBING FEES
I ST FL.. 40 41
50.FT. @ � { •)' J ��. �s?
UNITS
YARD-.SPKLR SYSTEM
2ND FL.
50. FT_ 3
POR.
SO- FT. �� !x J
MOBiLEHOME SVC-
BAR SINK
GAt
SQ. Fl, (91 '� `s - 7 0
POWER OUTLET
ROOF DRAINS
DRAINAGE PIANG
CARP.
S(],Fl. Q
DRINKING FOUNTAIN
WALL
SO. FT.
$0. FT.
URINAL
WATER PIPING
STIMATED CONSTRUCTION VALUATION
NOTtt Not to be used as property tax valuation'
SWIM POOL, PVT
FLOOR DRAIN
MECHANICAL FEES
SWIM POOL, COMM
WATER SOFTENER.
VENT SYSTEM ❑ FAN., ❑ EVAP. COOL ti HOOD
SIGN
WASHER (AUTC)4016Fi
;2
y
APPLIANCE 41 y
GARBAGE DISPOSAL
FURNACE 0 UNIT ❑ WALL ❑ FLOOR SUSPENDED
LAUNDRYTRAY
AIR HANDLING UNIT CFM-
IDLEAAETER
KITCHEV SINK
3
-ABSORPTION SYSTEM B.T-U,
T5MP'USE PERM SVC
WATER CLOSET
d
fsT
COMPRESSOR . HP
POLE, TEMPlPERM
LAVATORY
�G
HEATING SYSTEM .FORCED ❑ GRAVITY
O �j� AMPERES SERV ENTSHOWER
SOi ER B-T.U.
so FT Q BATH TUB 2 �
so FT a e WATER HEATER "2' c;
SC) FT RESID . a 1 ' e� / SEWAGE DISPOSAL 61
1109
SQ FT GARAGE @ HOUSE SEWER
PERMIT FEE
f GAS PIPING
MOBILE HOME PERMIT FEE $
PERMIT FEE PERMIT FEE
H IN-7 TOTAL FE f. OB. HMFEE M ICfiO FEE
MEC y. �DBILJ PL CIL FEE COMST-FEE DBL, ELECT FEE DBL 5MIFEE FEE PLUMB.FCE DBL..2�.�
I Y�
. 4
-
J
F
M
'A
. M
J
1
•A
S 1 p
N..__
p
"7
� f C'0 Cam_ i`7Ir%- r Cc
•DATE
74
75
USE OF PERMIT
�.
IpE21U� �1I
-�
76
I� � � — {
All H PERMIT FEE
'y
COMMUNITY DST UNITS Rgoms VALUATION SUPP. 70 PERMIT OFFICE
I
MICROFILM FEE
COPIES
LEG ALDESCRIPTION
7,:2 - Pg Sj " ' C3 t3 4 W
MECHANICAL FEE
DEL
$
- .. i - -
SETBACK LOT5IZE 20NE USE NO- GRP TYPE CNBY
44
PLAN CHECK FEE
$
BOND AM'r. PLAN NO. PLAN CHECKER FINgL. OAT£ INSPECTol?
CONSTRUCTION FEE
DBL
NAME Of CaNST LENDER BRANCH OFFICE NO LENDER INVOLVED
Is
ELECTRICAL FEE
DEL
$
ADDRESS C. ITY STATE
'
7
gym' �
� •J
-
STRONG MOTION
OWN WAGE NT-s SIG N16TNRE CONTRACTOR
INSTRUMENTATION FEE
/f
{
+•
f
y +
r
ADDRESS AD
ADDRESSFEE
PLUMBING FEE DBL $
CITY ZiP CODE
CITY ZIP CODE
TOTAL FEES $
�'
TEL NO
_�
7EL. NO. LICENSE
h
_:� r 3 <o f
CASH ❑ HECK M.O. ❑ N.C. ❑
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS, CESSA-
TION OF WORK FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
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 CALI:FORNIA, I ALSO
RECEIVED BY �� �� f TREES REQUIRED
SEwAGESYSTEM
ILL
r C
T'
P ., ;AX
AGREE TO CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLIANCE WITH THE
LAWS OF THE STATE OF CALIFORNIA COVERING CONTRACTORS IS -ALSO GUARANTEED.
I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS
FORAA 784-?nR (Pa i n-7A) n
HAS DONE SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE