268391 (SPIN)BUILDING PERMIT 1 DEPARTMENT OF BUILDING & SAFETY
COUNTY OF RIVERSIDE i
CONSTRUCTION ESTIMATE
I ST FL. SQ.FT. @
2ND FL. SO. FT. @
POR. SO. FT. @
GAR. SQ. FT. @
CAR P. SOFT. @ `
WALL SO. FT. @
SO. FT. @
ESTIMATED CONSTRUCTION VALUATION $
NOTE: Not to be used as property tax voluotion
MECHANICAL FEES
VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD
NO. I ELECTRICAL FEES
UNITS
MOBILEHOME SVC.
POWER OUTLET
SWIM POOL, PVT
SWIM POOL. COMM
SIGN
FIELD OFFICE
NO. PLUMBING FEES
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
FLOOR DRAIN
WATER SOFTENER
WASHER (AUTO) (DISH)
DST
APPLIANCE
JOB ADDRESS SP NO
OWNER
GARBAGE DISPOSAL
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
J
LAUNDRY TRAY
AIR HANDLING UNIT
CFM
IDLE METER
KITCHEN SINK
ABSORPTION SYSTEM
0 B.T.U.
TEMP USE PERM SVC
WATER CLOSET
COMPRESSOR 0
HP
POLE, TEMP/PERM
LAVATORY
HEATING SYSTEM ❑ FORCED ❑ GRAVITY
AMPERES SERV ENT
SHOWER
BOILER � B.T.U.
ROOMS
SQ FT @ ¢
BATH TUB
OFFICE
MICROFILM FEE
SQ FT @ ¢
WATER HEATER
LEG"ENCRIPTION
SQ FT RESID @ la
SEWAGE DISPOSAL
$
SOFT GARAGE @ '/]¢
HOUSE SEWER
PERMIT FEE
USE NO.
GRP
GAS PIPING
MOBILE HOME PERMIT FEE
$
PERMIT FEE
PERMIT FEE
PE MIT NO,
26 391
TOTAL �S
MOB. HM.FEE
MICRO FEE
MECH. FEE
DBL.
PL. CK. FEE
CONST. FEE
DBL.
ELECT. FEE DBL. �; I F
p -t1/0
00
-
BOND AMT.
PLAN NO.
J F M A M J J A $ O N D
JOB ADDRESS SP NO
OWNER
7478-440
Calle Feline
J
75
USE OF PERMIT
F.C.
76Gqq
JDATE
I_lq_76
1pn83 91
M H PERMIT FEE
$
COMMUNITY IVA
MEN
DST
UNITS
ROOMS
I VALUATION
SUPP. TO PERMIT
OFFICE
MICROFILM FEE
COPIES
$
LEG"ENCRIPTION
MECHANICAL FEE
DBL
$
SET BACK
LOT SIZE ZONE
USE NO.
GRP
TYPE
CK BY
F S R
PLAN CHECK FEE
$
BOND AMT.
PLAN NO.
PLAN CHECKER
FINAL DATE
INSPECTOR
CONSTRUCTION FEE
DBL
$
NAME OF CONST. LENDER BRANCH
OFFICE
NO LENDER INVOLVED
ELECTRICAL FEE
DBL
$
ADDRESS CITY
STATE
STRONG MOTION
$
OWNER/AGENT'S SIGNATURE
CONTRACTOR /
INSTRUMENTATION FEE
P9 e /�
<
f7♦♦6-A,
$
ADDRESS
A
FEE
l0
PLUMBING FEE
DBL
$
CITY ZIP CODE
CITY ZIP CODE
1$07EL.
TOTAL FEES
NO.
T .'` LICENSE
-
/40
o
Q
>. /
3r/6 -&a 2— z 4
CASH ❑ CHECK M.O. C]N.C. ❑
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSA.
y�rION 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
T
LL
p m
AGREE TO CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLIANCE WITH THE
A.c— E CTA TE � � r n i 1—nA1 A rw Air-i-r� ITnAr-T—C is A i c r� r� i IA nA kiTc
I I HEREBY CERTIFY THAT THE INDIVIDUAL' WHO PREPARED THE PLANS AND SPECIFICATIONS
FORM 284-208 (Rev. 10-74) Or L HAS DONE SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE
A-OF'THE STATE OF CALIFORNIA. '