260273 (SFD) BUILDING PERMIT DEPARTMENT OF BUILDING&SAFETY 7FEE:S::COUNTY OF RIVERSIDE FIELD OFE 0 IEDST
CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBIN
I ST FL. a -r SOFT. @ UNITS
2ND FL. SO.FT. @ !1'}' YARD SPKLR SYSTEM
POR. 99 SO.FT. @ +G� P�/ ��--- MOBILEHOME SVC. BAR SINK
GAR. SO.FT. @ �/OL:I `I. 7 dv POWER OUTLET ROOF DRAINS
CAR P. SO.FI. @ DRAINAGE PIPING
WALL SQ.FT. @ DRINKING FOUNTAIN
SO.FT. @ URINAL
ESTIMATED CONSTRUCTION VALUATION $ (��J _ WATER PIPING G7
NOTE:Not to be used as property tax voluotion SWIM POOL,PVT FLOOR DRAIN
MECHANICAL FEES SWIM POOL,COMM WATER SOFTENER
VENT SYSTEM3 fAN ❑ EVAP. COOL JX HOOD � SIGN WASHERIAUTO*ISHI !JL?
APPLIANCE t f� tett GARBAGE DISPOSAL
FURNACE ❑UNIT ❑WALL ❑FLOOR ❑ USPENDED LAUNDRY TRAY
AIR HANDLING UNIT CFM IDLE METER KITCHEN SINK ter)
ABSORPTION SYSTEM B.T.U. TEMP USE PERM SVC .J WATER CLOSET A71 (?
COMPRESSOR _T--r � HP r POLE,TEMP/PERM LAVATORY �r�
0
HEATING SYSTEM 3<FORCED ❑ GRAVITY ,U AMPERES SERV ENT ! 0 "'� SHOWER
BOILER�B.T.U. SQ FT @ a BATH TUB
SQ FT @ C / WATER HEATER
SQ FT RESID @ 1¢ S SEWAGE DISPOSAL 14b 0<!9
SQ FT GARAGE @ '/:a (Mr7 HOUSE SEWER
PERMIT FEE GAS PIPING S L�
MOBILE HOME PERMIT FEE $ / PERMIT.FEE i PERMIT FEE
PERMIT NO. 1 TOTAL FEESMOB.HM.FEE MICRO FEE MECH,FEE DBL. PL.CK.FEE CONST.FEE DBL. ELECT.FEE IDBL.j SMI FEE I FEE PLUMB.FEE DBL.
26027' - 13
JOB ADDRESS . SP NO OWNER {"
J F M A M J J A 5 O N D `� /
74 � ` f c7F' I �U H 't=0�.I'!J:/d
75 USSEEE`O�F PERMIT ��p - F.C. DATE P M N(q,� 7
76 r Y4t1 J f? a��`7 .V Q �C'� (7 f.^J �� 2 b V 2 1
M H PERMIT FEE $ COMMUNITY DST UNITS ROOMS I VALUATIONSUPP.TO PERMIT OFFICE
G�
MICROFILM FEE COPIES $ LEGAL DESCRIPTION
/a - / 1 2 '6C(, �
MECHANICAL FEE DBL $ SET BACK LOT SIZE ZONE USE NO. GRP TYPE CK BY
,/U
PLAN CHECK FEE $ BOND AMT. PLAN NO. PLAN CHECKER FINAL DATE JINSPECTOR
q. 8 )G
CONSTRUCTION FEE DBL $ ;7�,,F;ONST.LENDER BRANCH OFFICE NO LENDER INVOLVA
ELECTRICAL FEE �Og $ ADDRESS CITY sr
STRONG MOTION $ QWNE,R/AGENTKS,StGN TU�RE �•_ (- T Com. CONTRACTOR
INSTRUMENTATION FEE (�
.�
$ ADDRESS/ j� / ADDRESS
FEE �,GJ• 'Rio x f _
PLUMBING FEE DBL $ CITY ZIP CODE urY ZIPCZDE
-j� od 1A 4)01 A17-4
�
TEL.NO. TEL.NO. LICENSE
TOTAL FEES $ aJ 4 ' Lf ---,/7
CASH ❑ CHECK M.O. ❑ N.C. ❑ –� THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS.CESSA-
RECEIVED BY � Qy TREES REQUIRED XJr�ION OF WORK FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
df/O I HEREBY AGREE.THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN AC-
SEWAGE SYSTEM CORDANCE WITH THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, I ALSO
IT LL I P 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 THE PLANS AND SPECIFICATIONS
FORM 284-208 (Rev. 10-74)pL HAS DONE SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE I
OF THE STATE OF CALIFORNIA.