21560948901 Avenida Anselmo
BUILDING PERMIT
DEPARTMENT OF BUILDING & SAFETY
COUNTY OF RIVERSIDE
FIELD OFFICE
111p177
CONSTRUCTION ESTIMATE
JFIVIAMJ21
ELECTRICAL FEES
PLUMBING FEES
1ST FL.
SQ. FT. @
NO.
J
A
S
NO.
N
D
JOB ADDRESS
- .,tl
SQ. FT. @
72
/
,W'/ft 6 t ,:,C/':
C
2ND FL.
POR.
SQ. FT. @
t
MOTOR 1 OR LESS H.P.
SQ. FT. @
MOTOR 5 OR LESS H.P.
USEOF BUILDING
.C.
DATE
PERiT
N
609
GAR.
SQ. FT. @
MOTOR 20 OR LESS H.P.
DRAINAGE PIPING
CAR P.
WALL
SQ. FT. @
DRINKING FOUNTAIN
SQ. FT. @
COMMUNITY
DST
UNITS
ROOMS
VALUATIONSUPP
URINAL
OFFICE
K.W. UNITS
WATER PIPING
ESTIMATED VALUATION $
MOBILEHOME
HOOKUP FEE
$
t
FLOOR DRAIN
DBL
$
MECHANICAL FEES '
SET BACK
LOT SIZE
ZONE
USE NO.
GRP
WATER SOFTENER
CK BY
KS
VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD
PLAN CHECK FEE
SIGN
BOND AMT.
PLAN NO.
WASHER (AUTO) (DISH)
FINAL DATE
1/- 7, .7''_
INSPE TOR
APPLIANCE
DEL
$ r
TRANSFORMER IK.W.
BRANCH OFFICE
NO LENDER INVOL ED
ELECTRICAL FEE
GARBAGE DISPOSAL
$ 7
OUTLETS
FURNACE❑UNIT Ell WALL❑ FLOOR SUSPENDED
STATE
5 j
FEE
(2-
$
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 60 DAYS.
CESSATION 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 ACCORDANCE WITH THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIF -
ORNIA. I ALSO 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 I HE PLANS ANDSPECIFI
ITH ECTION 5,5if}'W OE, THE BUSIN Sp AND
PROFESSIONS CODE OFNS HAS DONE OIN THE SAATORDANCE E OF CALIFORNIA.
LAUNDRY TRAY
DBL
$
AIR HANDLING UNIT CFM
TOTAL FEES $676
r
FIXTURE OR SOCKET
CONTRACTOR
Received By .t "d.
ADDRESS
KITCHEN SINK
Sewage System
GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
P
CITY
CITY„
CONST. SERV. ENTRANCE
Yes
No
INFORMATION
FORM 284-20B (REV. 4/71) "i^'ffi"v- ;:=w"s.
WATER CLOSET
TEL. NO. LICENSE4:2,4'
e`,,
COMPRESSOR HP
POLE
LAVATORY
APPLIANCE VENT
AMPERES SERV. ENT.
SHOWER
ABSORPTION SYSTEM B.T.U.
SQ. FT.0
BATH TUB
INCINERATOR ❑ DOMESTIC ❑ INDUS. OR COMM.
SQ. FT.;,) ¢.
WATER HEATER
HEATING SYSTEM ❑ FORCED ❑ GRAVITY
SQ. FT. RESID.:= 1 C
SEWAGE DISPOSAL
BOILER B.T.U.
SQ. FT. GARAGE @ z 0
"=
HOUSE __.. _.. ,t,
aO
PERMIT FEE
BALANCE OF MIN. FEE
;r
GAS PIPING
MOBILEHOME HOOKUP FEE
$
PERMIT FEE
3
PERMIT FEE
F
PERMIT. NUMBER
TOTAL F,5ES
MOB. HOOK FEE
HEAT & VENT FEE
DBL
PL. CK. F Ff
COAST. FEf
DBL
EIEC. F E
DBL
FEE y}'..
PLUMBIN
E
DBL
J
A
S
O
N
D
JOB ADDRESS
- .,tl
OWNER
v:
72
73
USEOF BUILDING
.C.
DATE
PERiT
N
609
75
COMMUNITY
DST
UNITS
ROOMS
VALUATIONSUPP
TO PERMIT
OFFICE
MOBILEHOME
HOOKUP FEE
$
LEGAL DESCRIPTION
P7 i'£.• ,_'f" a' p*°" -w. -5
MECHANICAL FEE
DBL
$
SET BACK
LOT SIZE
ZONE
USE NO.
GRP
TYPE
CK BY
KS
PLAN CHECK FEE
$
BOND AMT.
PLAN NO.
PLAN CHECKER
FINAL DATE
1/- 7, .7''_
INSPE TOR
CONSTRUCTION FEE
DEL
$ r
NAME OF CONST. LENDER
BRANCH OFFICE
NO LENDER INVOL ED
ELECTRICAL FEE
DBL
$ 7
ADDRESS
CITY
STATE
5 j
FEE
$
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 60 DAYS.
CESSATION 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 ACCORDANCE WITH THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIF -
ORNIA. I ALSO 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 I HE PLANS ANDSPECIFI
ITH ECTION 5,5if}'W OE, THE BUSIN Sp AND
PROFESSIONS CODE OFNS HAS DONE OIN THE SAATORDANCE E OF CALIFORNIA.
PLUMBING FEE
DBL
$
TOTAL FEES $676
'
CASH 0 CHECK M.O. C N.C.
OWNER
CONTRACTOR
Received By .t "d.
ADDRESS
ARE,1SS..
Sewage System
LL
P
CITY
CITY„
Trees Required
Yes
No
INFORMATION
FORM 284-20B (REV. 4/71) "i^'ffi"v- ;:=w"s.
TEL. NO.
TEL. NO. LICENSE4:2,4'
e`,,