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280752 (AR)
LD EEI BUILDING PERMIT DEPARTMENT OF BUILDING&SAFETY IIIIIIIIIIIIIIIIIIIIIIIII COUNTY OF RIVERSIDE 18 IE DST CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES �1 I ST FL. SO.FT. @ I UNITS 2ND FL. SQ.FT. @ YARD SPKLR SYSTEM POR. $O.FT. @ MOBILEHOME SVC. BAR SINK GAR. SQ.FT. @ POWER OUTLET ROOF DRAINS CAR P. SOFT. @ DRAINAGE PIPING WALL SO.FT. @ DRINKING FOUNTAIN SQ.FT. @ URINAL ESTIMATED CONSTRUCTION VALUATION $ WATER PIPING NOTE:Not to be used as property tax valuation SWIM POOL,PVT FLOOR DRAIN MECHANICAL FEES SWIM POOL,COMM WATERSOFTENER VENT SYSTEM O FAN O EVAP. COOL O HOOD SIGN WASHER(AUTO)IDISH) APPLIANCE GARBAGE DISPOSAL FURNACE O UNIT O WALL O FLOOR O SUSPENDED LAUNDRY TRAY AIR HANDLING UNIT CFM IDLE METER KITCHEN SINK ABSORPTION SYSTEM 0 B.T.U. TEMP USE PERM SVC WATER CLOSET COMPRESSOR L� HP POLE,TEMP/PERM LAVATORY HEATING SYSTEM O FORCED O GRAVITY AMPERES SERV ENT SHOWER BOILER�B.T.U. SQ FT @ a BATH TUB SQ FT @ a WATER HEATER d SQ FT RESID @1 SEWAGE DISPOSAL SOFT GARAGE @ '/a¢ HOUSE SEWER PERMIT FEE GAS PIPING MOBILE HOME PERMIT FEE $ PERMIT FEE 3 PERMIT FEE PERMIT NO. TOTAL FEES MOB.HM.FEE MICRO FEE MECH.FEE DBL. PL.CK.FEECOMI FEE FEE PLUMB.FEE DBL. 280752 9 -ys- 6NST.FEE DBL. ELECDBL. S�� J I F I M A I MJ J A $ O N D JOB ADDRESS SP NO OWNER 74 75 USE OF PERMITF.C. DATE PE MIT NO. 76 4iw 3,00r,, D�1 ©A/ 9-�Q-�� X80752 M H PERMIT FEE $ COMMUNITY DST, UNITS ROOMS I VALUATION ISUPP.TO PERMIT OFFICE MICROFILM FEE COPIES $ LEGAL DESCRIPTION �i -�2C> -•t31 ��T- ,�� " � � c�C� MECHANICAL FEE DBL $ SETBACK LOT SIZEZQt�E US NOF GRP TYPE::m: F•telt-} tPLAN R PLAN CHECK FEE $ BOND AMT. NO. CJ PLAN CHECKER FINAL DATE CPECTOR 2 ,77 CONSTRUCTION FEE DBL $ NAME OF CONST.LENDER BRANCH OFFICE NO LENDER INVOLVED ELECTRICAL FEE DEL. $ ADDRESS CITY STATE STRONG MOTION $ OWNER/AGENT'S SIGNATURE CONTRACTOR INSTRUMENTATION FEE D� "Uy ✓jam Dej , $ ADDRESS ADDRESS FEE 'Dj A Z� l) 11A PLUMBING FEE DBL $ CITY ,-1 ZIP CODE CITY ZIP CODE al Al TEL.NO. TEL.NO. LICENSE TOTAL FEES * $ Q :Z- ;'l, ..lip g CASH p CHECK M.O. p / N.C. O THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS.CESSA- RECEIVED BY TREES REQUIRED pi 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 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)©L HAS DONE SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA.