BLCK (193404)VENT SYSTEM Cl FAN ❑ EVAP. COOL ❑ HOOD SIGN WASHER (AUTO) (DISH)-
'
TRANS- FORMER O K.W. GARBAGE DISPOSAL
DEPARTMENT OF BUILDING & SAFETY
• COUNTY OF RIVERSIDE •
FIELD OFFICE
CFM FIXTURE OR SOCKET KITCHEN SINK
CONSTRUCTION ESTIMATE
ELECTRICAL FEES
PLUMBING FEES
1 ST FL.
APPLIANCE VENT
SQ. FT.
@
NO.
NO.
SQ. FT.
@
SQ. FT. GARAGE @1�2¢ HOUSE SEWER
PERMIT FEE
.2ND FL.
TRAILER ISSUANCE FEE - PERMIT FEE
SQ. FT.
@
MOTOR I OR LESS. H.P.
REN. TRAILER
^ POR.
Pi. CK. FEE, CONST.
SQ.FT.
@
MOTOR 5 OR LESS H.P.
INSP. FEE
GAR.
DBL.
SQ. FT.
@
MOTOR 20 OR LESS H.P.
DRAINAGE PIPING
CAR P.
WALL
SO FT.
@' -'� a
-
DRINKING FOUNTAIN
JM
_. _ _ _
_ .J� _ .F.. M _ .A .._�•..
..�.��
__ M J� .! A,.-�----•+.. 5 0
SQ. FT.
@
SET RA
URINAL
LOT SIZE .. '.
USE #
OK W. UNITS
WATER PIPING
ESTIMATED VALUATION
$
F
FLOOR DRAIN
R
MECHANICAL FEES
-
WATER SOFTENER
VENT SYSTEM Cl FAN ❑ EVAP. COOL ❑ HOOD SIGN WASHER (AUTO) (DISH)-
APPLIANCE
TRANS- FORMER O K.W. GARBAGE DISPOSAL
FURNACE ❑ UNIT ❑ WALL Cl FLOOR ❑ SUSPENDED OUTLETS LAUNDRY TRAY
AIR HANDLING UNIT
CFM FIXTURE OR SOCKET KITCHEN SINK
GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
CONST. SERV, ENTRANCE WATER CLOSET
COMPRESSOR 0 HP
POLE LAVATORY
APPLIANCE VENT
AMPERES SERV. ENT: SHOWER
ABSORPTION SYSTEM O B.T.U.. SQ. FT. @ BATHTUB
INCINERATOR ❑ DOMESTIC 'Cl INDUS. OR COMM. SQ. FT: @ Q WATER HEATER
HEATING SYSTEM ❑ FORCED ❑ GRAVITY
SQ. FT. RESID. @ 14 SEWAGE DISPOSAL
BOILER 0 B.T.U.' -
SQ. FT. GARAGE @1�2¢ HOUSE SEWER
PERMIT FEE
BALANCE OF MIN. FEE GAS PIPING
TRAILER ISSUANCE FEE - PERMIT FEE
PERMIT FEE PERMIT FEE
'PERTOTAL-FEES
REN. TRAILER
FEE HEAT 8' VENT.'FEE
Pi. CK. FEE, CONST.
FEE
DBL.1 ELEC. FEE
INSP. FEE
PLUMBING FEE
DBL.
I
]DII]SPEC.
J
JM
_. _ _ _
_ .J� _ .F.. M _ .A .._�•..
..�.��
__ M J� .! A,.-�----•+.. 5 0
N D
SET RA
LOT SIZE .. '.
USE #
JOB - OWNER,.
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F
S
R
-
,,ADDRESS
33
^
,/^•i✓' "":' d `.G� 4101
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tr c✓ "Z•._;J
ZONE '
-
US OF BUILDING
DATE
PLAN CHECK FEE
$
!
I !
arw r• C .Ii }" ' L X G'lJ'
�'
•
CHECKED BY
COMMUNITY DISTRICT
F. C.
UNITS
VALUATION OFFICE
MECHANICAL FEE
f
e +
r ZZd h
7—
I
DBL
f
GROUP
TYPE
T R
9
CONSTRUCTION FEE
4o-!
c
DBL
PLAN CHECKER
- �-
SUPP. TO PERMIT
ELECTRICAL FEE_
f
DBL
•
BOND $
BOND
CASH
FINAL
DATE
INS PE .OR
PLUMBING FEE
f
j.lCANfILE,#
I
� ,
NAME OF. CONSTRUCTION LENDER- 1
BRANCH OFFICE
LENDER
TRAILER PERMIT
$
1146
INVOLVED
ISSUANCE FEE
ADDRESS
CITY
STATE
FEE
s
I
TOTAL FEES 1$0
THIS PERMIT SHALL BECOME, VOID IF WORK" IS NOT COMMENCED WITHIN 60 DAYS. CESSATION .
WORK VOID.
F FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME -
1 HEREBY AGREE THAT Ail WORK IN CONNECTION WITH THIS PERMIT -WILL BE DONE IN-?ACCOR-
DANCE.WITH•THE LAWS OF RIVERSIDE COUNTY AND TI -LE STATE OF CALIFORNIA. I ALSO AGREE TO -
CARRY. COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLIANCE WITH THE LAWS OF THE STATE -
CASH Q CHECK M.O. Q N.C. 0•
RECEIVED BY. SEWAGE SYSTEM
OF CALIFORNIA COVERING CONTRACTORS IS ALSO GUARANTEED.
I HEREBY CERTIFY THATTHE INDIVIDUALWHO PREPAREDTHE PLANS AND SPECIFICATIONS HAS DONE
✓Y>? T LL P
SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE
OF CALIFORNIA.
FOR M ATION-
T y
OWN?,— r ,
CONTRACTOR
ADDRESS '''r y T
�� � ._ • ^ Ad �. � A�,.+S-� R��/'.:.
AOb RESS
d` A` a°,. :�Y S� S .e� . %,F' i- r+ s; e.;.'aJ •c M..'e'�f
• •-•-
.
4r ` C 7
t
SEL. NO. -
TEL. NO.
_-
LIC ENSE 'NO. l '
FORM 284-208 (REV. 1-701 0sV