302026 (SFD)DEPARTMENT OF BUILDING & SAFETY FIELD OFFICE
BUILDING PERMIT I
PERMF NO 026
COUNTY OF RIVERSIDE
]�/
DIST
CONSTRUCTION ESTIMATE
NO.
ELECTRICAL FEES
NO.
PLUMBING FEES
1ST FL. !*
2ND FL.
POR.
GAR. -
CAR P.
WALL
ESTIMATED CONSTRUCTION
SQ. FT, C
SQ. FT. @
SO. FT. @
SQ. FT. @
SQ. FT, @
SQ. FT. @
SQ. FT. @
VALUATION
$
UNITS
YARD SPKLR SYSTEM
MOBILEHOME SVC.
BAR SINK
C
POWER OUTLET
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
$
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. COOLAV CODS
SIGN
WASHER (AUT H)
APPLIANCE RYERD
GARBAGE DISPOSAL
O!'7
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT
CFM
IDLE METER
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERM SVC
WATER CLOSET
COMPRESSOR HP
402
POLE, TEMP/PERM
LAVATORY
4 9
HEATING SYSTEM ORCED ❑ GRAVITY
44mX2
AMPERES SERV ENT
CX�
4
SHOWER
BOILER B.T.U.
SQ. FT. @ a
BATH TUB
SQ. FT. @ a
'WATER HEATER
OIC/
FT.RESID @ 1144
SEWAGE DISPOSAL
%SQ.FT.GAR @ 1/na
MOUSE SEWER
GAS PIPING
PERMIT FEE
PERMIT FEE
40
(PERMIT FEE
DBL.
TOTAL FEES
MO B.HM.FEE
MICRO FEE
M H. F££
L CK FEE
[7��EE
ELE .FEE
SMI FEE
FEE'
PLUMB- FEE
J
F
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A
M
J
J
A
5
C
N
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JOB ADDRESS I SP NO
I
OWNER
Z6
77
COMMUNITY
VALUATION
DST
OFFICE
t
7 d0Lz
78//
M H PERMIT FEE
USE-OFFERMIT
SUP.. TO PER T
PERM N
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302026
MICROFILM FEE
COPIES
$
BOOK P At,. E PARCEL
LEGAL DESCRIPTION
MECHANICAL FEE
DBL
$
USE ZONE
SET BACK LDT SIZE
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/NO-
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1 it S 5 R U
PLAN CHECK FEE
$
BOND AMT.
PLAN NO.
PLAN CHECKER
FINAL DATE INSP OR
CONSTRUCTION FEE
DBL
NAME OF CO NST. LENDER Ar
BRANCH OFFICE
NO LENDER INVOLVED
ELECTRICAL FEE
DBL
$
i`
G
ADDRESS
CITY
STATE
STRONG MOTION
pp
$
l�
6
OWNER/AGENTS SIGNATURE
CONTRACTORDIn
INSTRUMENTATION FEE
r`
'SPECIAL INSP
$
ADDRESS
ADDRESS
EON
FEE
REGISTRATION
R
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!/y "]
PLUMBING FEE
DBL
$
CITY ZIP CODE
CITY ZIP CODE
- ]
TOTAL FEES
TEL NO- AREA
CODE
TEL- N .
AREA COTE
LICENSE ri
Is
CASH❑CHECK A.❑N.C.❑ 3
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RECEIVED BY. ` TREES REQUIRED
THIS PE IT SHALL BECOME VOID IF WORK is NOT COMMENCED WITHIN 1 20 LAYS- CESSATION OF
f] DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
REE THATALLWORT( INCONNECTIONW" TIHIS PERMITWILLBE DOME iNACCORDANCE
LWADF.IQATi�
SEWAGE SYSTEM
r
LL
d
S OF RIVERSIVE COUNTY AND T}HE STATE Ol CAILIFORNIA, i ALSO AGREE TO CARRY
-
k-ALIFC]RNIA F6'V'ERING CONTRACTORS4ISfAi5O GUARANTEED -
I n Inc Ln+�� �r n� IH1C Vr
I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE
FORM 284-208 (REV 6-76) SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE
OF CALIFORNIA-