272492 (SFD)BUILDING PERMIT DEPARTMENT OF BUILDING & SAFETY
COUNTY_';OF RIVERSIDE
CONSTRUCTION' ESTIMATE NO. - ELECTRICAL FEES _
� d
1'ST FL. f �'`� SQ.FT. @ ;4 s �J —" UNITS `
2N9 FL., SQ. FT. @
POR. SQ. FT. @ MOBJLEHOME SVC.
GAR. >rU SQ. FT. 2_f. POWER OUTLET
CAR P. SQ.Fl. -@
WALLSQ. FT. @
SO. FT. @
ESTIMATED CONSTRUCTION VALUATION $
NOTE: Not to be used as property tax voluation SWIM POOL, PVT
MECHANICAL FEES . SWIM POOL. COMM
VENT SYSTEM X. FAN ❑ EVAP. COOL A HOOD „J-�_0,9 I I SIGN
FIELD OFFICE
`DST
NO. PLUMBING FEES
; /
�
)0
YARD SPKLR SYSTEM
/ /--Y /P,tr'
BAR SINK
GARBAGE DISPOSAL
ROOF DRAINS
�/ %C^IP272492
Y' DRAINAGE PIPING
76
DRINKING'FOUNTAIN
URINAL
WATER PIPING
FLOOR DRAIN
AIR HANDLING UNIT
WATER SOFTENER
)DST
f
{ WASHER (AUTO) (Dt$N'
IDLE METER
APPLIANCE
V4 , fz Q
�
)0
.3� .
/ /--Y /P,tr'
75
GARBAGE DISPOSAL
F.C. JDATE
�/ %C^IP272492
FURNACE ❑ UNIT Cl WALL ❑ FLOOR ❑ SUSPENDED
76
(JIJ1� . G S A !'+�
J�-J
LAUNDRY TRAY,
$
AIR HANDLING UNIT
CFM
)DST
f
UNITS
IDLE METER
VALUATION
91;? CJ
SUPP. TO PERMIT
KITCHEN SINK
d Z
ABSORPTION SYSTEM
0 B.T.U.
Gy�1J AJ 7,A ,A
!
TEMP USE PERM SVC
�F/
WATER CLOSET
tv G
COMPRESSOR j
,HP
{�_
POLE, TEMP/PERM
fi
LAVATORY
a7
HEATING SYSTEM 9 FORCED ❑ GRAVITY
.G
/!9D 00 AMPERES SERV ENT
7(J
$
SHOWER
SETBACK
BOILER 0 B.T.U.
USE NO.
GRP
SQ FT @ ¢
CK BY
�C/yK{�BY
!
BATH TUB
—�
SQ FT @ a
t
WATER HEATER
47
$ r� !!
�(
EBONDAMT.
PLAN NO.
SQ FT RESID @%-.
FINAL DATE JEECTORA-L/•r
SEWAGE DISPOSAL
/'G
C
t
j; SQ FT GARAGE @ 'hc
�f.�
$
HOUSE SEWER
NAME OF CONST. LENDER BRANCH
OFFICE
PERMIT FEE
�?
GAS PIPING
ELECTRICAL FEE
DBL
MOBILE HOME. PERMIT FEE
$
'
STATE
PERMIT FEE
s' 0'0
$
PERMIT FEE
OWNER/AGENT'S SIGNATURE
E MIT O.
272_4 9
TOTAL FEES
� �
MOB. HM.FEE
MICRO FEE
MECH. FEE
1✓
DBL.
PL. CK/.yFEE
CONST. FEE
%)r't
DBL.
ELECT. FEE
DBL.
SMI FEE
FEE
P�LUMB, FEE
DBL:
J I F I M A I M 1J ) A S O N D
JOB ADDRESS SP NO
17�v
JOWNER/ER
74
.3� .
/ /--Y /P,tr'
75
USE OFF PERMIT �
e,4iyd 100v
F.C. JDATE
�/ %C^IP272492
76
(JIJ1� . G S A !'+�
J�-J
M H PERMIT FEE.
$
COMMUNITY r,t
f : ! /
)DST
f
UNITS
ROOMS
VALUATION
91;? CJ
SUPP. TO PERMIT
OFFICE
Gy�1J AJ 7,A ,A
!
0
�F/
MICROFILM FEE
COPIES
$
LEGAL DESCRIPTION
i,
MECHANICAL FEE
DBL
$
SETBACK
LOT SIZE ZONE
USE NO.
GRP
TYPE
CK BY
�C/yK{�BY
�„� Ra L'
—�
t
PLAN CHECK FEE
$ r� !!
�(
EBONDAMT.
PLAN NO.
PLAN CHECKER
FINAL DATE JEECTORA-L/•r
t
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
_FA 0 P4;- P, h
/A61,5
$
ADDRESS
ADDRESS
FEE
113- " -o /- j-' e4 Al 7
PLUMBING FEE
DBL
$
CITY ZIP CODE
CITY ZIP CODE
TOTAL FEES$
19-5—
TEL. NO.
TEL. NO. LICENSE
02 -."CASH
❑ CHECK,f M.O. ❑ N.C. ❑
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSA
lk TION 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
t
SEWA E SYSTEM
!
�yr =U
`
o
T
LL
P 7'
AGREE TO CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLIANCE WITH THI
r c 11 I n r -r I non i c� r•i i
.0I 1 HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPAREDvTHE.PLANS AND SPECIFICATIONS
FORM t84-208 (Rev. 10-74) OP L _HAS DONE SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE
I OF THE STATE OF CALIFORNIA.