SFD (272070)BUILDING PERMIT
DEPARTMENT OF BUILDING & SAFETY
COUNTY OF RIVERSIDE
CONSTRUCTION ESTIMATENO. 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
WASHFR (AI1Th1 (DI HI
DST
APPLIANCE
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GARBAGE DISPOSAL
SQ. FT. @
POR.
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6
SQ''FT. @
GAR.
LAUNDRY TRAY
SO. FT. (9
CAR P.
_
SO.FI. @
WALL
KITCHEN SINK j
SO. FT. @
ABSORPTION SYSTEM 0 B.T.U.
�'
TEMP USE PERM SVC
SO. FT. @
ESTIMATED CONSTRUCTION VALUATION $
NOTE: Not to be used as property tax valuation
COMPRESSOR HP
MECHANICAL FEES
POLE, TEMP/PERM
VENT SYSTEM
❑ FAN ❑"EVAP. COOL O 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 (AI1Th1 (DI HI
DST
APPLIANCE
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GARBAGE DISPOSAL
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FURNACE O UNIT ❑ WALL O FLOOR O SUSPENDED
USEOF PERMIT
6
F.C.
DATE
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LAUNDRY TRAY
76
AIR HANDLING UNIT CFM
_
IDLE METER
KITCHEN SINK j
ABSORPTION SYSTEM 0 B.T.U.
�'
TEMP USE PERM SVC
DST
WATER CLOSET '
ROOMS
COMPRESSOR HP
SUPPOPER
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POLE, TEMP/PERM
LAVATORY
HEATING SYSTEM O FORCED O GRAVITY
NTS
AMPERES SERV ENT
SHOWER
BOILER � B.T.U.
�.
SQ FT @ a
COPIES
BATHTUB
LEGALDESCRIPTION
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MECHANICAL FEE
SQ FT @ a
$
WATER HEATER
SET BACK
SIZE ZONEUSE
SQ FT RESID. @, 14
GRP
SEWAGE DISPOSAL
)LOT
/}
SQ FT GARAGE @ 1/2¢
HOUSESEWER
PERMIT FEE
GAS PIPING
'CIy13Y
MOBILE HOME PERMIT FEE $
$
PERMIT FEE
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PERMIT FEE
PLAN CHECKER
PERMIT NO.TOTAL
272070
FEES.•
MOB. HM.FEE
MICRO FEE
MECH. FEE
PL. CK. FEE
CONST. FEES
ELECT. FEE
A1 ; <
SMI FEE
FEE
PLUMB. FES
J F M A M J J A S O N D
74
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USEOF PERMIT
6
F.C.
DATE
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PE MI O
X 2 0 7 0
76
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_
->>�°
M H PERMIT FEE
$ /�
�'
COMMUNITY
/A A
DST
UNITS
ROOMS
VALUATION
SUPPOPER
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TFFiCEF
NTS
.y�S1.
7%
�.
MICROFILM FEE
COPIES
$
LEGALDESCRIPTION
r%/ .olJ.�"�',�%tNPH i/1%rrdC
MECHANICAL FEE
&Btl
$
SET BACK
SIZE ZONEUSE
NO.
GRP
TYPE
)LOT
/}
f
'CIy13Y
PLAN CHECK FEE
$
BOND AMT.
PLAN NO.
PLAN CHECKER
FINAL DATE
INSPECTOR
- __1 q
A1 ; <
CONSTRUCTION FEE
l99lt_
$
NAME OF CONST. LENDER BRANCH
OFFICE
NO LENDER INV VED
coo
ELECTRICAL FEE
$
ADDRESS CITY
STATE
STRONG MOTION
$
OWNER/AGENT-S.SIGNATURE �W j' _ r
CONTRACTOR
INSTRUMENTATION FEE.
id c lvrsz r �{
-
FEE
$
ADDRESS- f
m- f �yLlr % y'!� tl jc.i3 ���iL)2 "
ADDRESS
PLUMBING FEE
'PJBC
$
CITY ZIP CODE,
CITY ZIP CODE
TOTAL FEES *0
TEL. NO.
TEL. NO. LICENSE
CASH ❑ CH.ECK M.O. O N.C. ❑
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN' 120 DAYS. CESSA-
OF WORK FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
�j1T� / I HEREBY AGREE THAT ALL WORK IN CONNEGTION WITH THIS PERMIT WILL BE DONE IN AC-
RECEIVED BY , U
TREES REQUIREDN
--Fp
CORDANCE WITH THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, I ALSC
LL
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AGREE TO CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLIANCE WITH THE
II 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.