268932 (SFD)C FIELD OFFICE
BUILDING PERMIT DEPARTMENT OF BUILDING&SAFETY IIIIIIIIIIIIIIIIIIIIIIIII
COUNTY OF RIVERSIDE 42
IE IT
CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING F Es.
. IST FL. 119ylSQ.FT. @ / ✓v r j UNITS
2ND FL. SO.FT. @ YARD SPKLR SYSTEM
POR. SQ.FT. @ MOBILEHOME SVC. / BAR SINK (lG7
�� 2 POWER OUTLET ROOF DRAINS
GAR. -6 SQ.FT. @ v
CAR P. SO.FI. @ DRAINAGE PIPING }
WALL C9` SQ.FT. @ I--�'S�� 5 ld q DRINKING FOUNTAIN
.
SQ.FT. @ URINAL
ESTIMATED CONSTRUCTION VALUATION $ �a WATER PIPING
NOTE:Not to be used as property tax valuation SWIM POOL,PVT FLOOR DRAIN
MECHANICAL FEES SWIM POOL,COMM WATERSOFTENER
VENT SYSTEM FAN ❑ EVAP. COOL a(HOOD 700 SIGN / WASHER IAUTO*ISHI do
APPLIANCE R �� v OU GARBAGE DISPOSAL
FURNACE ❑UNIT ❑WALL ❑FLOOR ❑SU PENDED LAUNDRY TRAY
AIR HANDLING UNIT CFM IDLE METER KITCHEN SINK QQ
ABSORPTION SYSTEM 0 B.T.U. TEMP USE PERM SVC v WATER CLOSET G'D
COMPRESSOR ® HIP If POLE,TEMP/PERM LAVATORY 00
HEATING SYSTEM . FORCED ❑ GRAVITY Q!U ;t 00 AMPERES SERV ENT SHOWER 0 0
BOILER�B.T.U. SQ FT @ ¢ BATH TUB 60
SQ FT @ ¢ WATER HEATER 0 0
SQ FT RESID @ p� SEWAGE DISPOSAL '0
SQ FT GARAGE @ 'h¢ HOUSE SEWER
PERMIT FEE C3 GAS PIPING . CG
MOBILE HOME PERMIT FEE $ f PERMIT FEE 3 PERMIT FEE (�A
PERMIT NO. TOTAL FEE•j HM.FEE MICRO FEE MECH.F� DBL. P CK. E CONST.FEE DBL. ELECT.FEE DBL. SMI FEE FEE PLUMB.FEE DBL.
268932 69111011,
arc= o /s/ oo p,� � y;
t J I F I M A I M I J IJ A S O N D l08 ADDRESS T - ^- 'P"
OVJNLH
74Cid v, /a Dl's. Sm HAIIE,,QFl/Z
75 USE OF PERMIT ` F.C. DATE PE MIT NO.
7e '. �r G% P.41,-,m 0 - -J, 68932
M H PERMIT FEE $ COMMUNITf DST I UNITS ROOMS I VALUATION SUPP.TO PERMIT OFFICE
MICROFILM FEE COPIES $ LEGAL DESCRIPTION
MECHANICAL FEE DBL $ SET BACK LOT SIZE ZONE 1 USE NO. GRP TYPE jcly
F)
PLAN CHECK FEE $ BOND AMT. PLAN NO. PLAN CHECKER FINAL DATE IN ECTOR
CONSTRUCTION FEE DBL $ NAME OF CONST.LENDER BRANCH OFFICE NO LENDER INVOLVED
ELECTRICAL FEE DBL $ ADDRESS CITY STATE
STRONG MOTION $ OWNER/AGENT'S SIGNATURE C NTAACfOR t 1 Z - t.4f,1�—
INSTRUMENTATION FEE f) l't``l�t t{ ^.(9c.. f„ `
$ ADDRESS ADDRESS �/
FEE �'%- x'30 A IJ J lA
PLUMBING FEE DBL $ CITY ZIP CODE CITY ZIP CODE
�/5 v /A v>A/TA C �i
TEL.NO. TEL. LICENSE
TOTAL FEES $ 4 c -j
CASH ❑ C ECK M.O. ❑ N.C. ❑ F14N IS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS.CESSA-
RECEIVED BYTREES REQUIRED UTION OF WORK FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
4 I HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN AC-
LL TP
u CORDANCE WITH THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, I ALSO
T
SEWAGE SYSTEM AGREE TO CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLIANCE WITHJHE
LAWS OF THE STATE OF CALIFORNIA COVERING CONTRACTORS 15 ALSO GUARANTEED.
I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS
FORM 284-208 (Rev. 10-74)&L HAS DONE SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE
OF THE STATE OF CALIFORNIA.