BLCK (272956)54180 Avenida Madero
272956
BUILDING PERMIT
DEPARTMENT OF BUILDING & SAFETY
COUNTY OF RIVERSIDE
CONSTRUCTION ESTIMATE NO. I ELECTRICAL FEES
I ST FL SO FT I UNITS
MOBILEHOME SVC.
POWER OUTLET
SWIM POOL, PVT
SWIM POOL, COMM
SIGN
FIELD OFFICE
NO. PLUMBING FEES
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
FLOOR DRAIN
WATER SOFTENER
WASHFR IAtITt711nISH1
DST
APPLIANCE
.JOB ADDREESS/ SP NO
OWNER
2ND FL.
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
SO. FT. @
POR.
AIR HANDLING UNIT
SO. FT. @
GAR.
KITCHEN SINK
SO. FT. @
CAR P.
TEMP USE PERM SVC
ISO.Fl. @
WALL %
HP
SO. FT. @ % -^
LAVATORY
HEATING SYSTEM ❑ FORCED ❑ GRAVITY
AMPERES SERV ENT
SO. FT. @
ESTIMATED CONSTRUCTION VALUATION $
NOTE: Not to be used as property tax voluotion
SO FT @ a
MECHANICAL FEES
VENT SYSTEM
❑ FAN ❑ EVAP. COOL ❑ HOOD
MOBILEHOME SVC.
POWER OUTLET
SWIM POOL, PVT
SWIM POOL, COMM
SIGN
FIELD OFFICE
NO. PLUMBING FEES
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
FLOOR DRAIN
WATER SOFTENER
WASHFR IAtITt711nISH1
DST
APPLIANCE
.JOB ADDREESS/ SP NO
OWNER
GARBAGE DISPOSAL
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
J
LAUNDRY TRAY
AIR HANDLING UNIT
CFM
IDLE METER
KITCHEN SINK
ABSORPTION SYSTEM
j B.T.U.
TEMP USE PERM SVC
WATER CLOSET
COMPRESSOR
HP
POLE, TEMP/PERM
LAVATORY
HEATING SYSTEM ❑ FORCED ❑ GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
ROOMS
SO FT @ a
BATH TUB
OFFICE
`
SO FT @ a
WATER HEATER
SO FT RESID @ 1 a
SEWAGE DISPOSAL
SO FT GARAGE @ '/Ta
HOUSE SEWER
PERMIT FEE
COPIES
$
GAS PIPING
MOBILE HOME PERMIT FEE
Is
PERMIT FEE
PERMIT FEE
2 729
'THS
AL FEES
I ! r
MOB. HM.FEE
MICRO FEE
MECH. FEE
DBL.
PL. CK. FEE
r .
ONST, FEE
DBL.
ELECT. FEE
DBL.
SMI FEE
FEE
PLUMB. FEE
DBL.
J I F I M A I M I J I J A I S 1 O 1 N D
.JOB ADDREESS/ SP NO
OWNER
74
J
75
USE OF PERMIT
F.C.
PE I O.
76
! /I i. r! _ l /%11. j
JDATE//
o
` — `Ci
rr2956
M H PERMIT FEE
$
COMMUNITY
DST
UNITS
ROOMS
VALUATION
P. TO PERMIT
OFFICE
MICROFILM FEE
COPIES
$
LEGAL DESCRIPTION C' f N/
MECHANICAL FEE
DBL
$
SET BACK
LOT SIZE ZONE
USE NO.
GRP
TYPECK
BY
F _15 R
PLAN CHECK FEE
$
BOND AMT.
PLAN NO.
PLAN CHECKER
FINAL DATE
INSPECTOR
J
CONSTRUCTION FEE
DBL
$
NAME OF CONST. LENDER BRANCH
OFFICE
NO LENDER INVOLVED
ELECTRICAL FEE
DBL
$
ADDRESS CITY
STATE
STRONG MOTION
$
OWNER/AGENT'S SIGNATURE
CONTRACTOR
INSTRUMENTATION FEE
,
$
ADDRESS
ADDRESS
FEE
PLUMBING FEE
DBL
$
CITY ZIP CODE
CITY ZIP CODE
TOTAL FEES
$ _
TEL. NO.
TEL. NO. LICENSE
CASH ❑ CHECK 8" M.O. ❑ N.C. ❑
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSA
ON OF WORK FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
RECEIVED BYt, / r
TREES REQUIRED •,.
// .
y-
h f I HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN AC
1' CORDANCE WITH THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, I ALSC
SEWAGE SYSTEM
— - , ''
T
LL
P :nJ
AGREE TO CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLIANCE WITH THE
I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPAREDTHEPLANS AND SPECIFICATIONS
FORM 284-208 (Rev. 10-74) @L HAS DONE SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE
I OF THE STATE OF CALIFORNIA.