PAT (280616)BUILDING PERMIT
DEPARTMENT OF BUILDING & SAFETY
COUNTY OF RIVERSIDE -4
,CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES
I ST FL SQ FT @ I IUNITS
2ND FL.
SQ. FT. @
POR.
SQ. FT. @
GAR.
SQ. FT. @
CAR P.SQ.FT.
@
WALLS� 11 ��//
32
SQ. FT. @
SQ. FT. @13
ESTIMATED CONSTRUCTION
VALUATION $
NOTE: Not to be used as property tax valuation
MECHANICAL FEES
COMPRESSOR
VENT SYSTEM O FAN ❑ EVAP. COOL ❑ HOOD
"C"
MOBILEHOME SVC.
POWER OUTLET
SWIM POOL, PVT
SWIM POOL, COMM
SIGN
FIELD OFFICE
r.&
NO. PLUMBING FEI
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
FLOOR DRAIN
WATER SOFTENER
U/Af WrD 1AI ITnl Inl4ZUl
/DST
APPLIANCE
.JOB ADDRESS j� / SP NO
�"t�
JOWNER /_
P�Zd
GARBAGE DISPOSAL
FURNACE Cl UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
C:. K Auto u-) / t
LAUNDRY TRAY
AIR HANDLING UNIT
CFM
IDLE METER
KITCHEN SINK
ABSORPTION SYSTEM
B.T.U.
TEMP USE PERM SVC
WATER CLOSET
COMPRESSOR
HP
POLE, TEMP/PERM
LAVATORY
HEATING SYSTEM ❑ FORCED ❑ GRAVITY
AMPERES SERV ENT
SHOWER
BOILER 0 B.T.U.
ROOMS
SQ FT @ a
BATH TUB
OFFICE
SQ FT @ ¢
WATER HEATER
u ��f�
SOFT RESID @ 1¢
SEWAGE DISPOSAL
83 3, °°
SOFT GARAGE @ 1/7a
HOUSESEWER
PERMIT FEE
COPIES
$
GAS PIPING
MOBILE HOME'PERMIT FEE
$
PERMIT FEE
PERMIT FEE
2 _PE$MIT NO_ 6
8061
TOTAL F�
g
MOB. HM.FEE
MICRO FEE
MECH. FEE
DBL.
PL. CK. FEE
CONST. FEE
q v°
DBL.
ELECT. FEE
DBL.
SMI FEE
r b
F.EEJ
PLUMB. FEETBL.
F I M A I M I J I ) I A I S 1 Q 1 N I D
74
.JOB ADDRESS j� / SP NO
�"t�
JOWNER /_
P�Zd
J 5 /T ✓L�%k Aoldoz'4
C:. K Auto u-) / t
75
US OF PERMIT ��
Coller .. PAS 17
F.C.
DATE
% /`/
76
la x ly'
7412'8N0616
M H PERMIT FEE
$
Co MUNITY
DST
UNITS
ROOMS
VALUATION
SUPP. TO PERMIT
OFFICE
u ��f�
83 3, °°
MICROFILM FEE
COPIES
$
LEGA DESCRIPTION
lPi1'7-73-N3-664 -/at/9 el- //a S19AA)
MECHANICAL FEE
DBL
$
SETBACK LOT SIZE ZONE
USE NO.
GRP
TYPE
C Y
F S R /-
>
,S— f
PLAN CHECK FEE
$
BOND AMT.
PLAN CHECKER
FINAL DATE
I PECTOR
IPLANNO.
3 .a -s. � 7
J- - :%
CONSTRUCTION FEE
DBL
$
x.10
w
NAME OF CONST. LENDER BRANCH
OFFICE
NO LENDER INVOLVED
ELECTRICAL FEE
DBL
$
ADDRESS CITY
h
STATE
STRONG MOTION
$/
OWNER/A($ENT-S'8tGN*W ;. -
CONTRACTOR
INSTRUMENTATION FEE
, ab
� 0�
f kf' Cl AJ
FEE
$
ADDRESS
LPs 0, rr%
ADDRESS
,Jn b I S
PLUMBING FEE I
DBL
$
CITY ZIP CODE
CITY ZIP CODE
TOTAL FEES
$ h
{7J
OC L
T� NO.
T
TEL. NO. LICENSE
CASH ❑ CHECK.( M.O. ❑ N.C. ❑
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSARECEIVED
PTIN OF WORK FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
BY(a 6el
TREES REQUIRED
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 ALSC
SEWAGE SYSTEM
T
LL
p
AGREE TO CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLIANCE WITH THE
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.