280525 (SFD) FIELD OFFICE
BUILDING PERMIT DEPARTMENT OF BUILDING&SAFETY
COUNTY OF RIVERSIDE IIIIIIIIIIIIIIIIIIIIIIIII 19
IE r_DST
CONSTRUCTION ESTIMATE q i NO. ELECTRICAL FEES NO. PLUMBING FEES
I ST FL. •i0 6 - SQ.FT. @ I ...rte UNITS
2ND FL. SQ.FT. @ YARD SPKLR SYSTEM
POR. SO.FT. @ � A I , MOBILEHOME SVC. BAR SINK a �.
GP' If�() SQ.FT. @'J '�" ()' POWER OUTLET ROOF DRAINS
LeltP SQ.FT. @.5. 7 DRAINAGE PIPING
WALL SO.FT. @ a 1, „' DRINKING FOUNTAIN
SQ.FT. @ URINAL
ESTIMATED CONSTRUCTION VALUATION $ j WATER PIPING
NOTE:Not to be used as property tax voluotion SWIM POOL,PVT / FLOOR DRAIN
MECHANICAL FEES SWIM POOL,COMM WATER SOFTENER
VENT SYSTE FAN ❑ EVAP. COOL HOOD ', SIGN WASHER(AUTOf1DISH) �+
APPLIANCE A� G GARBAGE DISPOSAL
FURNACE Cl UNIT ❑WALL ❑FLOOR ❑SUSPENDED LAUNDRY TRAY
AIR HANDLING UNIT CFM IDLE METER , KITCHEN SINK
ABSORPTION SYSTEM 0 B.T.U. TEMP USE PERM SVC WATER CLOSET
COMPRESSOR D4)0 HP POLE,TEMP/PERM LAVATORY Wu
HEATING SYSTEM &FORCED ❑ GRAVITY ;?OO AMPERES SERV ENT SHOWER
BOILER B.T.U. SQ FT @ ¢ BATH TUB
SQ FT @ ¢ / WATER HEATER
,.7607 -SQ FT RESID @AV , SEWAGE DISPOSAL .�
SQ FT GARAGE @ HOUSE SEWER
PER FEE GAS PIPING
MOBILE HOME PERMIT FEE is PERMIT FEE 3PERMIT FEE 3
2 pER1Y11T1 2 TO F OB.HM.FEE MICRO FEE MECH.FEE DBL. 3K.jFEE 1 E� DBL. ELECT`FEE DBL. `I`F FEE MB. DBL.
37
T 8 0 5 7 1011 AAAD,(DDRRES9[}e - (/�Jy)'� _ _ SP-Na -IOWNNf ER - T _-•_
J I F I M A I M I J I J A 5 1 O 1N D 4,,,,,�h f 1
75 USE.L!° PERMIT /�I( �� � �i0/ DAT1 7 x� PE MI °0525
76 !( !7J
M H PERMIT FEE $ COMMUNITY DST I UNITS I ROOMS I VALUATION SUPP.TO PERMIT OFi1GFr
3c- 9/7 Q° ,.
MICROFILM FEE COPIES $ LEGAL DESCRIPTION
Zptz0 7k 6 0 A 4( Pv'f 07-3-10- a//
MECHANICAL FEE DBL $ Q SETBACK LOT SIZE ONE E`NO. GRP TYPE CK BY
IAO
ISS-/S—
S S' R/4) /!�X 60 /Als5
PLAN CHECK FEE Pd $ q� BOND AMT. PLAN NO. PLAN CHECKER FINAL DATE IINSPECTRR
S
CONSTRUCTION FEE DBL $ O�. NAME OF CONST.LENDER BRANCH OFFICE NO LENDER INVOLVED
ELECTRICAL FEE DBL $ K ADDRESS CITY STATE
39 --
STRONG MOTION $ qAGEN�S' NATI.Tq •���t •s C�1�� CONTRACTOR
INSTRUMENTATION FEE
$ ADDRESS ♦ ` / ADDRESS
FEE �9~x'30 �✓//� }�/�, t
PLUMBING FEE DBL 1$ ,07 CITYZIP CODE CITY ZIP CODE
01$ ,,-)73
TEL.NO. TEL.NO. LICENSE
TOTAL FEES �7 3 "i q—40 3e
CASH ❑ CHECK M.O. ❑ N C ❑ 1 �\ THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS.CESSA-
RECEIVED BY TREES REQUIRE TION 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 AC.
SEWAGE SYSTEM /O� X CORDANCE WITH THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, I ALSO
T LL 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)(E)L HAS DONE SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE
OF THE STATE OF CALIFORNIA.