280529 (SFD) FIELD OFFICE
BUILDING PERMIT DEPARTMENT OF BUILDING&SAFETY
COUNTY OF RIVERSIDE IIIIIIIIIIIIIIIIIIIIIl 76
DST'
CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUM G'f"E
I ST FL. `tSO.FT` @/7, r UNITS
2ND FL. SO.FT. @ YARD SPKLR SYSTEM
POR. SO.FT. @ we gO, MOBILEHOME SVC. BARSINK
GAR. 5.;? SQ.FT. @� POWER OUTLET ROOF DRAINS
CAR P. SO.FI. @ DRAINAGE PIPING
WALLSQ.FT. @ DRINKING FOUNTAIN
SO.FT. @ URINAL
ESTIMATED CONSTRUCTION VALUATION $ Z1 ;;Z 746, WATER PIPING
NOTE:Not to be used as property tax valuation SWIM POOL,PVT FLOOR DRAIN
MECHANICAL FEES SWIM POOL,COMM WATER SOFTENER
VENT SYSTEta X.FAN ❑ EVAP. COOL ,HOOD SIGN WASHER IAUTO>rTDISHI
APPLIANCE DR GARBAGE DISPOSAL
FURNACE ❑UNIT ❑WALL ❑FLOOR ❑SUSPENDED LAUNDRY TRAY
AIR HANDLING UNIT CFM IDLE METER KITCHEN SINK
ABSORPTION SYSTEM B.T.U. TEMP USE PERM SVC WATER CLOSET
COMPRESSOR 0&) HP 76 POLE,TEMP/PERM LAVATORY
HEATING SYSTEM 4FORCED ❑ GRAVITY 5 (a(J AMPERES SERV ENT 7 SHOWER
BOILER � B.T.U. SQ FT @ ¢ BATH TUB
SQ FT @ ¢ WATER HEATER C?r
I
SOFT RESID @&4 /�'� SEWAGE DISPOSAL
FT GARAGE @ HOUSE SEWER
PERMIT FEE GAS PIPING
MOBILE HOME PERMIT FEE $ PERMIT FEE PERMIT FEE 3
2 _P ESM IuIO_ AL FEES MOB HM.FEE MICRO ECH.FEE DBL. ��K S EAS DBL. ELECT DBL. F FEE /B.F DBL.
1 27- b 51y
F M A M J J A S Q N D i08 ADDRESS tl" SP NO OWNER
75 USE OF PERMIT F.C. DATE P M N
76 W���i, , � Q9 9- x.- 76 5 2 9
M H PERMIT FEE $ COMMUNITY DST UNITS ROOMS VALUATION SUPP.TO PERMIT OFFICE
J4 T� 1// 74 -1
MICROFILM FEE COPIES $ LEGAL DEStRIPTION
n ay/ JvT 7 ' yd 6 41
MECHANICAL FEE DBL $ �/1 SETBACK LOT SIZE / ZONE USE NO. GRP TYPE CK BY
PLAN CHECK FEE $ BOND AMT. PLAN NO. PLAN CHECKER FINAL DATE INSPECTOR
how I l 5__
CONSTRUCTION FEE DBL $ NAME OF CONST,LENDER BRANCH OFFICE NO LENDER INVOLVED
ELECTRICAL FEE DBL $ 17 ADDRESS CITY STATE
STRONG MOTION $ Q9 OWN teC '_S" GItTU. Ef t` t (' CONTRACTOR
INSTRUMENTATION FEE V,� 54;o Df y CO
FEE
$ ADDRESS • ADDRESS
1V f L
..� o �lj�AlL
PLUMBING FEE DBL $ � V CITY ZIP CODE CITY ZIP CODE
TEL. TEL.NO. LICENSE
TOTAL FEES $ �� �� � � �.•
CASH ❑ CHECKX M.O. ❑ N.C. ❑ THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS.CESSA-
RECEIVED a TREES REQUIRED WON N OF WORK FOR-]20 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
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 ALSO
SEWAGE SYSTEM
T f000 LL p �8F 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.