SFD (280315)+ FIELD OFFICE
BUILDING PERMIT DEPARTMENT OF BUILDING & SAFETY .
COUNTY OF RIVERSIDE Affilikk -
CONST UCTION ESTIMATE
I ST FL. ! U SOFT. @ 71
2ND FL. SO. FT. @
POR. e _' SQ. FT. @ -
GAR. IV •Sr 7 SO. FT. @4 -
CAR
4.CAR P. SO.FT. @
WALL SO. FT. @
SQ. FT. @
ESTIMATED CONSTRUCTION -VALUATION $
NOTE: Not to be used as property tox valuation
' MECHANICAL FEE!
VENT SYSTEM 19FAN Cl EVAP. COOL
NO. I ELECTRICAL FEES
UNITS
U. MOBILEHOME SVC.
7. POWER OUTLET
SWIM POOL, PVT
SWIM POOL. COMM
SIGN
APPLIANCE J'` l.I
DST/..
NO. PLUMBING FEES
USE OF PER IT
{. , , t . err tx
GARBAGE DISPOSAL
YARD SPKLR SYSTEM
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DST
DRINKING FOUNTAIN
CFM
URINAL
IDLE METER
WATER PIPING .L 0
FLOOR DRAIN
KITCHEN SINKG
WATERSOFTENER
ABSORPTION SYSTEM
WASHFR (At ITn11Rf'!Ml
MECHANICAL FEE
APPLIANCE J'` l.I
JOB ADDRESS SP NO
J l
div/i nlit",
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75
76 , ,,
USE OF PER IT
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GARBAGE DISPOSAL
A
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
M H PERMIT FEE
$
LAUNDRY TRAY
DST
AIR HANDLING UNIT
CFM
VALUATION
IDLE METER
OFF•1GL
MICROFILM FEE
KITCHEN SINKG
$
ABSORPTION SYSTEM
B.T.U.
MECHANICAL FEE
TEMP USE PERM SVC
$
WATER CLOSET
o4f
COMPRESSOR, -A
HP
-%
POLE, TEMP/PERM
CK9V
IGYf,d.
F.:2fi S iJR/0,!
LAVATORY
()
HEATING SYSTEM ;5FORCED ❑ GRAVITY
-=-` ;? AMPERES SERV ENT
rJt.
PLAN NO.
SHOWER
FINAL DATEPl..&
//- I (''
BOILER B.T.U.
CONSTRUCTION FEE
SQ FT @ ¢
$
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BATH TUBI
tj
NO LENDER INVOLVED
ELECTRICAL FEE
DBL
50 FT @ ¢
jJ^
ADDRESS / CITY
/' ..Ae-fll- / Mr
WATER HEATER
0 C
STRONG MOTION
INSTRUMENTATION FEE
$
%$Oe SOFT RESID @14A
S t
CONTRACTOR
SEWAGE DISPOSAL
t. V
$
ADDRESS //
%S'" Gtr -J
SQ FT GARAGE @-4,c
_3 ..
DBL$
HOUSESEWER
<j}
PERMIT FEE
CITY ZIP CODE
a
TOTAL FEES
j "'
$ / !
f
GAS PIPING
C
MOBILE HOME PERMIT FEE
$
RECEIVED BYI,4 60 1,11 -TREES
REQUIRED
PERMIT FEE
a..
/
PERMIT FEE
e 4:
ER Th
TOTAL EES
MOB. HM.FEE
MI O FEE
MECH. FEE
I DBL.
PL. CK. FEE
CONST. FEEf).L.I
ELECT. FEE
DBL.
I SMI F
f
FEE
PLUMB. Fl E
f
DBL.
J F M A M' J J A S O N D
74
JOB ADDRESS SP NO
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OWNER "
) f '7
/,plc/,u kt: wv/h Ct7, 1"r
75
76 , ,,
USE OF PER IT
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F.C. JDATE
A
PE MIT O
0 315
M H PERMIT FEE
$
COMMUNITY
DST
UNITS
ROOMS
VALUATION
SUPP. TO PERMIT
OFF•1GL
MICROFILM FEE
COP ES
$
LEGAL DESCRIPTION
MECHANICAL FEE
DBL
$
SETBACK
LOT SIZE ZONE
USE NO.
GRP
TYPE
CK9V
IGYf,d.
F.:2fi S iJR/0,!
PLAN CHECK FEE
$
BOND AMT.
PLAN NO.
PLAN CHECKER
FINAL DATEPl..&
//- I (''
PECTOR
e ,
CONSTRUCTION FEE
DBL
$
/j 47
NAME OF CONST. LENDER BRANCH
OFFICE
NO LENDER INVOLVED
ELECTRICAL FEE
DBL
$
jJ^
ADDRESS / CITY
/' ..Ae-fll- / Mr
STATE
STRONG MOTION
INSTRUMENTATION FEE
$
:^
OWNER/AGENT'S SIGNATURE /
f
At4dA- r0diel Cc J'./C.
CONTRACTOR
FEE
$
ADDRESS //
%S'" Gtr -J
ADDRESS
PLUMBING FEE
DBL$
-
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CITY ZIP CODE
CITY ZIP CODE
TOTAL FEES
j "'
$ / !
f
TEL. NO. / r„
TEL. NO. LICENSE
CASH ❑ CHECKX M.O. ❑ N.C. ❑
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSA
TION OF WORK FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
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 ALSC
AGREE TO CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLIANCE WITH THE
RECEIVED BYI,4 60 1,11 -TREES
REQUIRED
SEWAGE SYSTEM
10-,04'
IT'
LL
jI
P %3C ✓
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
OF THE STATE OF CALIFORNIA.