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BLCK (272117)BUILDING PERMIT DEPARTMENT OF BUILDING & SAFETY COUNTY OF RIVERSIDE CONSTRUCTION ESTIMATE NO. I ELECTRICAL FEES 1 ST Cl 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 WASHER IAHT01 (DISH) DST APPLIANCE JOB ADDRESS SP NO 2ND FL. SO. FT. @ POR. SO. FT. @ - GAR. SQ. FT. @ CAR P. SOFT. @ WALL SQ. FT. @ 0 B.T.U. SQ. FT. @ ESTIMATED CONSTRUCTION VALUATION $ NOTE: Not to be used as property tax valuation HP MECHANICAL FEES LAVATORY 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 WASHER IAHT01 (DISH) DST APPLIANCE JOB ADDRESS SP NO GARBAGE DISPOSAL FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED -GWNNEER^ LAUNDRY TRAY AIR HANDLING UNIT CFM IDLE METER KITCHEN SINK ABSORPTION SYSTEM 0 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 SQ FT @ a BATH TUB OFFICE SQ FT @ ¢ WATER HEATER SQ FT RESID @ 1 ¢ SEWAGE DISPOSAL ISUPP. SQ FT GARAGE @ 'hrt HOUSE SEWER PERMIT FEE COPIES $ GAS PIPING MOBILE HOME PERMIT FEE $ PERMIT FEE PERMIT FEE E IT NO. 2 117 TOTAL FEES MOB. HM.FEE MICRO FEE MECH. FEE DBL. PL. CK. FEE CONST. 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 Q 1 N I D JOB ADDRESS SP NO 74 -GWNNEER^ 75 USE OF PERMIT F, C. DATE 76 - -�� � 6" 1 s- x �. r a �lY72117 M H PERMIT FEE $ COMMUNITY DST+ UNITS ROOMS VALUATION TO PERMIT OFFICE ISUPP. I MICROFILM FEE COPIES $ LEGAL DESCRIPTION t 777.3- 0�0��`�/i`T'j< MECHANICAL FEE DBL $ SET BACK LOT SIZE ZONE USE NO. GRP TYPE BY T/ I ICK +��� F S R ! PLAN CHECK FEE $ BOND AMT. PLAN NO. PLAN CHECKER FINAL DATE INSPEC OR CONSTRUCTION FEE DBL $ NAME OF CONST. LENDER BRANCH OFFICE NO LENDER INVO VED ELECTRICAL FEE DBL $ ADDRESS CITY STATE STRONG MOTION $ OWNER/AGENT'S SIGNATURE CONTRACTOR INSTRUMENTATION FEE �^arr ! 1' -1 •�/� $ ADDRESS �/ ADDRESS FEE / PLUMBING FEE DBL $ CITY ZIP CODE CITY ZIP CODE j t_/rrd TOTAL FEES � $ _ � �� TEL. NO. ��� ,.. �f+•'�/`y �-- TEL. NO. LICENSE CASH Ej CHECK ❑ M.O. O N.C. ❑ THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSA f LON OF WORK FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID. RECEIVED BY//5� TREES REQUIRED 4 1 HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN AC CORDANCE WITH THE .1 SEWAGE SYSTEM �t LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, I ALSC T LL P ��N AGREE TO CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLIANCE WITH THI I 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.