RPL (260310)BUILDING PERMIT
SIGN
DEPARTMENT OF BU.I.LDING & SAFETY
APPLIANCE"
•
GARBAGE DISPOSAL .
COUNTY OF RIVERSIDE '
USE OF PERMIT
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CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
ST FL.
KITCHEN SINK
SQ.FT.
@
UNITS
SO. FT.
@
LAVATORY
2ND FL.
POR.
SHOWER -
SQ. FT.
@
MOBILEHOME SVC.
GAR.
SQ FT @ a
SQ. FT.
@
POWER OUTLET
• CAR P
SO FT
@
PERMIT FEE
WALL SQ. FT. @
S[.v, /�/ s=o SO. FT. @
ESTIMATED CONSTRUCTION VALUATION $ �%lJ
NOTE: Not to be used os property tox voluotion SWIM POOL, PVT
MFFHAmirAI FFFC SWIMPnni COMM
FIELD OFFICE
NO: PLUMBING FEES
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL,
WATER PIPING
FLOOR DRAIN
WATFR SnFTFNFP
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am
VENT SYSTEM ❑ FAN ❑ EVAP. COOL O HOOD
SIGN
WASHER IAUTOI (DISHI
APPLIANCE"
"'/9- 731 1441z ah/ r
GARBAGE DISPOSAL .
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑.SUSPENDED
USE OF PERMIT
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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 0 B.T.U.
r SQ FT @ ¢
BATH TUB
VALUATION
SQ FT @ a
WATER HEATER
SQPT'RESID+@ I¢
SEWAGE DISPOSAL
SQ FT GARAGE @ Iha
HOUSE SEWER
PERMIT FEE
GASPIPING
MOBILE HOME PERMIT FEE
PERMIT NO, TOTAL
260310
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_
J F M A M J J A S O N D
JOB ADDRESS -. _.` _ - _ .� .,,_.. _ , SP NO
OWNER- _ . _ _. - _- _ �._-- •_ -_...
74 1 1
"'/9- 731 1441z ah/ r
mov,e�5a ` 0Y, W 1
75 .-
USE OF PERMIT
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F.C.
JDATE
PERMIT NO.
2 6 0 310
76u
/(J! D'�D
h " �-_ y.�—
M H PERMIT FEE
$:
COMMUNITY}
DST
UNITS.
ROOMS
VALUATION
SUPP. TO PERMIT
OFFgIC—E`
k4 `�
f i A�Tis
MICROFILM FEE
COPIES'
$
LEGAL DESCRIPTION
MECHANICAL FEE
DBL
$
SET BACK
LOT SIZE ZONE
NO.
GRP
TYPE
BY
4USE
[i71
4K
IR
PLAN CHECK FEE
$
BONO AMT.
PLAN NO.
PLAN CHECKER
FINAL DATE
INSPE TOR
/
CONSTRUCTION FEE
DBL-
$
NAME OF CONST. LENDER BRANCH
OFFICE
NO LENDER INVOLVED
ELECTRICAL FEE
DBL
$
ADDRESS CITY
STATE
40
STRONG MOTION
$
OWNER/AGENT'S SIGNATURE
CONTRACTOR.�
INSTRUMENTATION FEE
141
Re,1 15 ed A45reeae l -la -y
-
$
ADDRESS
ADDRESS
FEE'
3i
PLUMBING FEE
DBL
$
e
CITY ZIP CODE
CITY ZIP CODE
W
'
TOTAL FEES
$ 60
TEL. NO.
TEL. NO. LICENSE
CASH ❑ CHECK M.O. ❑ N.C. ❑
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSA'
A ION OF WORK FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
RECEIVED BY
TREESREOUIREp
��
8 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
AGREE TO CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLIANCE WITH THI
T
LL
P
I A%AIC / C TUC CTATC nc ('AI IC(IDKIIA rn%/CDINI(_ rnKITDArTn DC IC Al Cn (_I IADAKITrrn
I
I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS
FORM 284-208 (Rev. 1074) QP L HAS DONE SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE
OF THE STATE OF CALIFORNIA.