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AR (219699)77511 Calle Madrid 219699 BUILDING PERMIT SIGN DEPARTMENT OF BUILDING & SAFETO COUNTY OF RIVERSIDE FIELD OFFICE TRANSFORMER OK•W• CONSTRUCTION ESTIMATE ELECTRICAL FEES PLUMBING FEES 1ST FL. 2ND FL. POR. GAR. CAR P. SAdr?F AIR HANDLING UNIT CFM SQ. FT. @ KITCHEN SINK NO. NO. SQ. FT. @ COMPRESSOR HP SQ. FT. @ MOTOR 1 OR LESS H.P. LAVATORY SQ. FT. Co) MOTOR 5 OR LESS H.P. AMPERES SERV. ENT. SQ. FT. Co) MOTOR 20 OR LESS H.P. DRAINAGE PIPING SQ. FT. @ DRINKING FOUNTAIN _.._ SQ. FT. @ URINAL OK.W.UNITS WATER PIPING ESTIMATED VALUATION is SEWAGE DISPOSAL BOILER O B.T.U. FLOOR DRAIN HOUSE SEWER MECHANICAL FEES BALANCE OF MIN. FEE GAS PIPING WATFR Cr1CTFMFR VENT SYSTEM ❑ FAN ❑ EVAP.COOL ❑ HOOD SIGN WASHER (AUTO) (DISH) APPLIANCE TRANSFORMER OK•W• GARBAGE DISPOSAL FURNACE❑UNIT ❑WALL❑FLOOR ❑SUSPENDED OUTLETS LAUNDRY TRAY AIR HANDLING UNIT CFM FIXTURE OR SOCKET KITCHEN SINK GAS PIPE [:]NATURAL ❑ L.P.G. ❑ OIL CONST. SERV. ENTRANCE WATER CLOSET COMPRESSOR HP POLE LAVATORY APPLIANCE VENT AMPERES SERV. ENT. SHOWER ABSORPTION SYSTEM O B.T.U. S(r SQ. FT.@ y ¢ ,/' BATH TUB INCINERATOR ❑ DOMESTIC ❑ INDUS. OR COMM. SQ. FT.@ ¢. WATER HEATER HEATING SYSTEM ❑ FORCED ❑ GRAVITY SQ. FT. RESID. @ 1 It SEWAGE DISPOSAL BOILER O B.T.U. SQ. FT. GARAGE @ i ¢ HOUSE SEWER PERMIT FEE BALANCE OF MIN. FEE GAS PIPING MOBILEHOME HOOKUP FEE $ JOB AD ESStl 0 ,AZ 4L 4619 I4D i& PERMIT FEE d - PERMIT FEE PERMIT NUMBER LOFEr 9699 'JDBL MOB. HOOK FEE HEAT & VENT FEE USEf OF BUILDING PL. CK. FEE CONST. FEE DBL ELEC f -w/ DBL %EE -- PLUMBING FEE DBL J F M A M J J A S O N I D JOB AD ESStl 0 ,AZ 4L 4619 I4D i& OWNERER ') M 13LH CA(Q.),-4 72 I ` 11cl06„ 73 USEf OF BUILDING F.C. X41 DATE PE IT 19699 N 74 ADO jTtl N STvi s 11-112- . 75 COMMUNITY 4A i2u/.vrq DST UNITS OOM VA/L UATION SUPP. TO PERMIT OFFF`IEE 76 / MOBILEHOME $ LEGAL DESCRIPTIONp - r o o HOOKUP FEE OTS --43Y .24 13t 2 5O uw r..2 ` I,,, Aols MECHANICAL FEE DBL $ SET BACK LOT SIZE ZONE USE 140f GORP TYPE CK BY F U S 25- R ;2)0R< t _ f PLAN CHECK FEE $ BOND AMT. I PLAN NO. PLAN CHECKER FIN DA -Z INSPECTOR i 3 9" CONSTRUCTION FEE DBL $ NAME OF CONST. LENDER BRANCH OFFICE NO LENDER INV ED ,✓ " U ELECTRICAL FEE DBL $ i'i 0,67 ADDRESS CITY STATE $ ds THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 60 DAYS. CC, ,.. j CESSATION OF WORK FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID. ,/0% I FEE I HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE WITH THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIF- DBL ORNIA. I ALSO AGREE TO CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLIANCE WITH THE LAWS OF THE STATE OF CALIFORNIA COVERING CONTRACTORS IS ALSO GUARANTEED. TOTAL FEES $ / I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFI- CATIONS HAS DONE SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF TH STATE OF CALIFORNIA. CASH F CHECK @K M.O. ❑ N.C. ONAL ji / CONTRACTOR j! e Received By ADDRESS .-4017 MitL Z r yl) ADDRESS Sewage System LL P C CI Y CITY Trees Required Yes No •) INFORMATION TEL. _UO. TEL. NO. LICENSE FORM 284-208 (REV. 4/71 )✓ r // S& T W& (,#/-