301835 (SFD)DEPARTMENT OF BUILDING & SAFETY
BUILDING PERMIT • COUNTY OF RIVERSIDE �I
NO. I ELECTRICAL FEES
UNITS
HOME SVC.
OUTLET
SWIM POOL, PVT
FIELD OFFICE
NO. I PLUMBING FEES
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
TER PIPING
OR DRAIN
CONSTRUCTION ESTIMATE
1 ST FL.
L2<'(
SQ. FT.
@ t
2ND FL.
10
SQ. FT.
@
POR.
SQ. FT.
@
GAR.
G
SQ. FT.
@
CAR P.
PE
SQ. FT.
@
WALL'
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
SQ. FT.
@
LAUNDRY TRAY
SQ. FT.
@
ESTIMATED CONSTRUCTION
VALUATION
$
NOTE: Not to be used os property tax valuation
NO. I ELECTRICAL FEES
UNITS
HOME SVC.
OUTLET
SWIM POOL, PVT
FIELD OFFICE
NO. I PLUMBING FEES
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
TER PIPING
OR DRAIN
F M A M J T A S O N D
MECHANICAL FEES
76
SWIM POOL, COMM
COMMUNITY0
WATER SOFTENER
DST OFFICE
10
VENT SYSTEM FAN ❑ EVAP. COOL V HOOD
4t)
SIGN
WASHER(AUTO)4P454
!�
APPLIANCE
DRYER
USE OF PERMIT
F.C. SUPP. TO PERMIT
PE
GARBAGE DISPOSAL
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
LAUNDRY TRAY
'
f- 4 -/t
AIR HANDLING UNIT CFM
IDLE METER
KITCHEN SINK
ABSORPTION SYSTEM
B.T.U.
w
TEMP USE PERM SVC
WATER CLOSET
COMPRESSOR
HP
COPIES
POLE, TEMP/PERM
LAVATORY
HEATING SYSTEM FORCED ❑ GRAVITY
MPERES SERV ENT
MECHANICAL FEE
SHOWER
$
BOILER B.T.U.
ZONE
SQ.FT. @ a
TYP/E�+C
BATH TUB
SQ.FT. @ a
'y
WATER HEATER
/��B�Y
e.
I.jIQ.FT.RESID @ 1'/4a
6
SEWAGE DISPOSAL
PLAN CHECK FEE
$
q45SQ.FT.GAR @ 3/4a
BOND AMT.
HOUSE SEWER
PLAN CHECKER
FINAL DATE
INSPE OR
GAS PIPING
PERMIT FEE�(f
CONSTRUCTION FEE
DBL
$
PERMIT FEE
NAME OF CONST, LENDER
PERMIT FEE
NO LENDER INVOLVED
DBL.
TOTAL :!SdMOB.HM.FEE1
MICRO FEE
M H. FEE
PL. CK. FEE
CONST. FEE
ELECT. FEE}}
SMI FEE
FEE
PLU . FE'�EE��
F M A M J T A S O N D
.IOB ADDRESS SP NO OWNER
� 3 / v 6,vig N I f ere fi9vs jo
76
77
COMMUNITY0
VALUATIONN DATE
DST OFFICE
10
78
/�
4A
``y t
�d••-
M H PERMIT FEE
$
USE OF PERMIT
F.C. SUPP. TO PERMIT
PE
MIT NO.
'
f- 4 -/t
831
w
MICROFILM FEE
COPIES
$
BOOK PAGE PARCEL EGAL DESCRIPTION
ao L a -e; a i 8L..3 Z I I
MECHANICAL FEE
DBL
$
USE
ZONE
SET BACK LOT SIZE GRP
TYP/E�+C
'y
/��B�Y
e.
PLAN CHECK FEE
$
BOND AMT.
PLAN NO.
PLAN CHECKER
FINAL DATE
INSPE OR
CONSTRUCTION FEE
DBL
$
NAME OF CONST, LENDER
BRANCH OFFICE
NO LENDER INVOLVED
ELECTRICAL FEE
DBL
$
ADDRESS
CITY
STATE
STRONG MOTION
$
OWNER/AGENTS SIGNATURE
CONTRACTOR'
1 '
INSTRUMENTATION FEE
!914
SPECIAL INSP
$
ADDRESS
A DRESS
DEMOLITION
FEE
�`�"%
REGISTRATION
Ok 1f
PLUMBING FEE
DBL
$
CITY ZIP CODE
CITY ZIP CODE
TOTAL FEES is
TEL. NO. AREA
CODE
T . NO.
AREA CODE
LICENSE n
CASH❑CHECK .O.❑N.C.❑ � 09
`
F—
f O40
RECEIVED BY TREES REQUIRED
SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF
20 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
SEWAGE SYSTEM
L j
BY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE
T LL
P Q !
THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, I ALSO AGREE TO CARRY
I
FORM 284-208 IREV. 6-761
�.�vrvl.&R' Crvlrt.v1CCGlb-IJIY\r UNIVI-C **IIn I n C
t,1*a yr Inc JI I IC yr
CALIFORNIA COVERING CONTRACTORS IS ALSO GUARANTEED.
I HEREBY CERTIFY THAT THE 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.