SFD (268407)BUILDING PERMIT
• FIELD OFFICE
DEPARTMENT OFx6UILDING & SAFETY
COUNTY OF RIVERSIDE
CONSTRUCTION ESTIMATE/NO. ELECTRICAL FEES "INC). PLUMBING FEES
I ST FL. ' SQ.FT. @ Ce �i/ 7F ` —2— UNITS' i
2ND FL. SO. FT. @ _
POR.. -y SQ. FT. -@ r>
GAR. SQ. FT.
CAR P. SQ.FT. @
WALL SO. FT. @
• SO. FT: @
ESTIMATED CONSTRUCTION VALUATION
NOTE: Not to be used as property tax valuation
MECHANICAL FEE`.
VENT SYSTEM ❑ FAN Cl EVAP. COOL
ti.1y� I I MOBILEHOME SVC.
POWER OUTLET
SWIM POOL, PVT'
SWIM POOL, COMM
SIGN
YARD SPKLR .SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
FLOOR DRAIN
WATER SOFTENER
/ wncuFa rnnrrirn Iw�ru.. "� n� y
APPLIANCE
r
09
�/!� _ C�(/ E/►2 G�+ ✓�'�' 6th Cs�%6?J r i
75
USE OF PERMIT
GARBAGE DISPOSAL
PE MIT NO.
FURNACE ❑ UNIT ❑ WALL ❑ FL OR ❑ SUSPENDED
�.
JDATE
e
268407
LAUNDRY TRAY
•
$
AIR HANDLING UNIT
CFM
I DSTj
IDLE METER
I ROOMS
VALUATION
KITCHEN SINK
OFFICE
ABSORPTION SYSTEM
B.T.U.
TEMP USE PERM SVC
WATER CLOSET
Gf /
COMPRESSOR
HP
,BOLE, TEMP/PERM
COPIES
$
LAVATORY
4,1
U
HEATING SYSTEM FORCED ❑ GRAVITYU
AMPERES SERV ENT
„
SHOWER
DBL
$.
BOILER 0 B.T.U.
SETBACK LOT SIZE ZONEUSE
SQ FT @ ¢
GRP
TYPE
BATH TUB -
Y/ 6�•
SQ FT @' a
%
WATER HEATER
Ga✓
r^
PLAN CHECK FEE
SQ FT RESID L�0¢0
/
SEWAGE DISPOSAL
U OG'
.0
INSPECTOR
SQ FT GARAGE /
Y.HOUSE
SEWER
•,.
PERMIT FEE •'
GAS PIPING
MOBILE HOME PERMIT FEE
Is
$ _
- "
PERMIT FEE
ry
NO LENDER INVOLV
PERMIT FEE'
PERMIT NO.
268407
TOTAL FEES
MOB. HM.FEE
MICRO FEE
MECH. FEE
f
DBL.
PL CK. FEE
CONST. FEE'
a .
DBL.
ELECT. FEE DBL.
�, ..1
SMI FEE
FEE
_ .•-
PLUMB. E
DBL.
J I F I M A I M I J I J I A I S 1 O 1 N I D
JOB ADDRESS SP NO OWNER
74
�/!� _ C�(/ E/►2 G�+ ✓�'�' 6th Cs�%6?J r i
75
USE OF PERMIT
F.C.
PE MIT NO.
76
�.
JDATE
e
268407
M H PERMIT FEE
•
$
COMMUN
I DSTj
UNITS •
I ROOMS
VALUATION
SUPP. TO PERMIT
OFFICE
MICROFILM FEE
COPIES
$
LEGAL DESCRIPTION
MECHANICAL FEE
DBL
$.
SETBACK LOT SIZE ZONEUSE
NO.
GRP
TYPE
BY
Y/ 6�•
�j
%� S� R e;
l
I
r^
PLAN CHECK FEE
$
BOND AMT.
PLAN NO. PLAN CHECKER
FINAL DATE
.0
INSPECTOR
•,.
CONSTRUCTION FEE
DBL
$ _
- "
NAME OF CONST. LENDER BRANCH
OFFICE
NO LENDER INVOLV
fief
/
ELECTRICAL FEE
DBL
$
ADDRESS
CITY
STATE
STRONG MOTION
$
OWNER/AGENT'S SIGNATURE
CONTCTOR
INSTRUMENTATION FEE
.
$
ADDRESS
DDRESS
ADDRESS-
FEE
FEE
/
PLUMBING FEE
DBL
$
CITY ZIP CODE
CITY ZIP CODE
TOTAL FEES
$
/7
TELNO.
TEL. NO. LICENSE
CASH ❑ CHECK . M.O. ❑ N.C. ❑
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSA
t;T TION OF WORK FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
RECEIVED BY
TREES REQUIRED D
_
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
/is�r9
rlL
T
LL
P
AGREE TO CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLIANCE WITH THE
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 554.1 OF THE BUSINESS AND PROFESSIONS CODE
OF THE STATE OF CALIFORNIA.