PAT (189761)51771 Avenida Martinez
189761
DEPARTMENT OF BUILDING & SAFETY
PE.
VENT SYSTEM ❑ FAN ❑
0
COUNTY OF RIVERSIDE
•
FIELD OFFICE
APPLIANCE
CONSTRUCTION ESTIMATE
ELECTRICAL FEES
PLUMBING FEES
1st FI.
2nd FI.
Por.
Gar.
Car P.
W011
FURNACE ❑ UNIT ❑ WALL
Sq. Ft. @
NO.
OUTLETS
NO.
Sq. Ft. @
FY 4Jer ln Aj J
Sq. Ft.
SUB -PANEL
Sq. Ft. @ POLES
GAS PIPE ❑ NATURAL
Sq. Ft. @ SIGNS
DRAINAGE PIPING
Sq. Ft. @ ORATSCLK AND/
DRINKING FOUNTAIN
Sq. Ft. @ MOTOR H. P.
URINAL
MOTOR H. P.
WATER PIPING
ESTIMATED VALUATION Is
MOTOR
H. P.
FLOOR DRAIN
WATER HEATER
MECHANICAL FEES
ABSORPTION SYSTEM
0 ISTR It T F.C.
D B.T.U.
PE.
VENT SYSTEM ❑ FAN ❑
EVAP. COOL
❑ HOOD
MOTOR H. P.
WASHER (AUTO) (DISH)
APPLIANCE
JOB ADDRESS OWNER
FIXTURES
GARBAGE DISPOSAL
FURNACE ❑ UNIT ❑ WALL
❑ FLOOR ❑
SUSPENDED
OUTLETS
LAUNDRY TRAY
AIR HANDLING UNIT
FY 4Jer ln Aj J
SUB -PANEL
KITCHEN SINK -
GAS PIPE ❑ NATURAL
❑ L.P.G. ❑
OIL
WATER CLOSET
COMPRESSOR
HP
RANGE AND/OR OVEN
LAVATORY
APPLIANCE VENT
WATER HEATER
SHOWER
ABSORPTION SYSTEM
0 ISTR It T F.C.
D B.T.U.
SPACE HEATER
BATH TUB
INCINERATOR DOMESTIC
❑ INDUS.
❑ COMM.
CONSTRUCTION POLE
WATER HEATER
HEATING SYSTEM ❑ FORCED ❑ GRAVITY
SERVICE ENTRANCE
SEWAGE DISPOSAL
BOILER
B.T.U.
GR P
RESID. IQ SQ. FT.
HOUSE SEWER
PERMIT FEE
PERMIT NUMBER
CONSTRUCTION FEE $
GARAGE zQ SO. FT.
GAS PIPING
r
l /0
v
PERMIT FEE
PERMIT FEE
NUMBER REN, DBL, TOT}SFE ES (HEAT 11 VENT FEEIPLN. CK. FEE ICONST,`FEE
i F M `P ` , r' M J J A II 1 5
J IF
ELEC. FEE
O N.
PLUMB. FEE
SET BACK
LOT SIZE
USE #
JOB ADDRESS OWNER
F
5
R
FY 4Jer ln Aj J
ZONE
nLE OF BUILDING
DATE
PLAN CHECK FEE $
5, %;
•+j"„'
`
CHE K D BY
COMMU ITY
0 ISTR It T F.C.
UNITS
VALUATION
OFFICE
MECHANICAL FEE $
f
j.
III v
oc
GR P
YPE
LE AL D CR PTIONyy
PERMIT NUMBER
CONSTRUCTION FEE $
p
r
l /0
8 9761
SPEC. INSP.
SUPP. TO PERMIT
ELECTRICAL FEE $
Sr _ •Y- .""
PLAN CHECKER
B D BOND CASH PLAN FILE # INAI DAT
INSPECTOR
PLUMBING FEE $
J
(6L_1_"
7
TOTAL FEES
$
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED
"
WITHIN 60 DAYS. CESSATION OF WORK FOR 120 DAYS SHALL ALSO
CAUSE PERMIT TO BECOME VOID,
I HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS
CASH CHECK M.O. I N.C.
RECEIVED BY
SEWAGE SYSTEM
PERMIT WILL BE DONE IN ACCORDANCE WITH THE LAWS OF RIVER-
SIDE COUNTY AND THE STATE OF CALIFORNIA. I ALSO AGREE TO
fy " %lam
T
LL
P
CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLI-
ANCE WITH LAWS OF THE STATE OF CALIFORNIA COVERING CON-
TRACTORS IS ALSO GUARANTEED.
NAME OF CONSTRUCTION LENDER
OWNER
CONTRACTOR
BRANCH OFFICE
'- '-
ADDRESS
41:
ADDRESS
ADDRESS
CITY
STATE
G4
-
NO LENDER INVOLVED
j/-• -
INFORMATION
TEL. NO. -
TEL. NO.
LICENSE NO.
284-208 12/68