301843 (SFD)DEPARTMENT OF BUILDING & SAFETY
BUILDING PERMIT
PERMIT NOCOUNTY OF RIVERSIDE
,
3 1
CONSTRUCTION ESTIMATE
1 ST FL. , SQ. FT. @'
2ND FL. SQ. FT. @
POR. SQ. FT. @
GAR. Z-1 1 SQ. FT. L r
CAR P. SQ. FT. @ 1
WALL SQ. FT, @
SQ. FT. Q
ESTIMATED CONSTRUCTION VALUATION $
NOTE: Not to be used as properly tax valuation
NO. I ELECTRICAL FEES
UNITS
MOBILEHOME SVC.
=+ POWER OUTLET
SWIM POOL. PVT
FIELD OFFICE
NO.I PLUMBING FEES
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
FInnR DRAIN
MECHANICAL FEES
A M J
SWIM POOL, COMM
A S O N D
WATER SOFTENER
OWNER
VENT SYSTEM UFAN ❑ EVAP. COOL 5k HOOD
SIGN
WASHER(AUTO)/D
APPLIANCE DRYER
I IV —,01
e s c,., a�►s14%-5/1V
GARBAGE DISPOSAL
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDEDI
COMMUNITY t VALUATI
IOON
4-}�"V-� $ ks ��1
DATE /
LAUNDRY TRAY
OFFICE J
AIR HANDLING UNIT CFM
IDLE METER
KITCHEN SINK
ABSORPTION SYSTEM 0 B.T.U.
TEMP USE PERM SVC
FC.
WATER CLOSET
MIT N
I
COMPRESSOR L HP
POLE, TEMP/PERM
LAVATORY
HEATING SYSTEM FORCED ❑ GRAVITY
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AMPERES SERV ENT
SHOWER
BOILER B.T.U.
COPIES
SQ.FT. @ ¢
�-°
BATH TUB
LEGAL DESCRIPTION
SQ. FT. @ ¢
WATER HEATER
L t I ez /6 S SIV / T 17
MECHANICAL FEE
DBL
{ t Q.FT.RESID @ 1)/a¢
SEWAGE DISPOSAL
ZO/NNEE'j
SET BACK
LDT SfZ£
� �
�I SQ.FT.GAR @/a¢
-
HOUSE SEWER
.�
GAS PIPING
PERMIT FEE
I � S �
PERMIT FEE
/
PERMIT FEE
too
DBL.
TOTAL FEES
� z�
IMOELHM.FEEI
MICRO FEE
S ista
M CH. FEE
�l°
PL CK FEE
CONST, FEE
jiy1`�
ELECT. FEE
a-,
SMI FEE FEE
P�
PLUMB. FEE
�l
J F M
A M J
J
A S O N D
JOB ADD RE5SI SP N0
7 I
6 /1 /<
OWNER
76
I IV —,01
e s c,., a�►s14%-5/1V
77
COMMUNITY t VALUATI
IOON
4-}�"V-� $ ks ��1
DATE /
DST
OFFICE J
78
M H PERMIT FEE
$
USE OF PERMIT ,
FC.
SUPP- TO PERMrl PE
MIT N
I
.
g ff 7
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MICROFILM FEE
COPIES
$
�-°
BOOK PAGE Pr, -1
A L
LEGAL DESCRIPTION
W 71f
L t I ez /6 S SIV / T 17
MECHANICAL FEE
DBL
$
USE NO
ZO/NNEE'j
SET BACK
LDT SfZ£
� �
GRP
TYYPE
CK BY
.�
'r•
I 1
I � S �
S� R �
/
•
f �
r
PLAN CHECK FEE
$
BOND AMT
J.
PLAN NO PLAN CHECKER
FINAL DATE INSPEC.'COR
CONSTRUCTION FEE
DBL
$
NAME OF CONST LENDER BRANCH
OFFICE
NO IY DER INVOLVED
ELECTRICAL FEE
DBL
$
ADDRESS CITY
STATE
$
-I o
OWNER/AGENTS SIGNATURE CONTRACTOR
STRONG MOTION
INSTRUMENTATION FEE
�/
/
y -
'SPECIAL
$
ADDRESS ADDRESS
INSP
DEMOLITON
FEEf,.
'
REGISTRATION
( J
PLUMBING FEE
DBL
$
CITY ZIP CODE CITY
ZIP CODE
37,
TOTAL FEES $
TEL NO.
AREA CODE TEL,
NO,
AREA CODE
LICENNNSSE #
CASH ❑CHECK. ,O.❑N-C.❑ /
;�..L.
13
-f
,
,a X60
RECEIVED BY TREES REQUIRED
�
T SHALL BECOME VOID IF WORK IS NOT COMMEr CFD WITHIN 120DAYS. CESSATION OF
120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
SEWAGE SYSTEMT
c�
ALL
P / % /
rj C
ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE
I THE LAWS
AWS OF R]VERSIDE COUNTY AND THE STATE OF CALIFORNIA. I.ALSO AGREE TO CARRY
FORM 264-208 (REV 6-76)
r c:r�n(• ", "'o UIS /�IVL� Llr u" rlI tf"r LUT Cts. tsVNW FIA IVS_I W I I Fi IMt ULWS OF IHt! TA 11: VI -
CALIFORNIA COVERING CONTRACTORS 15 ALSO GUARANTEED.
I HEREBY CERTIFY THATTHE 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
I