AR (208580)BUILDING PERMIT
DEPARTMENT OF BUILDING & SAFETO
COUNTY OF RIVERSIDE
WASHER (AUTO) (DISH)
FIELD OFFICE
TRANSFORMER,=K.W.
CONSTRUCTION ESTIMATE
ELECTRICAL FEES
OUTLETS
PLUMBING FEES
IST FL.
2ND FL.
POR.
GAR.
CAR P.
LL
/itt' t'lAc
,n
(�UdiTI�AC
FIXTURE OR SOCKET
f 3
SO. FTA) P
..r NO.
CONST. SERV. ENTRANCE
NO.
SQ. FT. @
POLE
SQ. FT. Co) MOTOR 1 OR LESS H.P.
APPLIANCE VENT
SO. FT. @ MOTOR 5 OR LESS H.P.
SHOWER
SO. FT. @ MOTOR 20 OR LESS H.P.
DRAINAGE PIPING
SQ. FT. @ _
DRINKING FOUNTAIN
SO. . @ ��
FT
URINAL
OK.W.UNITS
WATER PIPING
ESTIMATED VALUATION $
BOILER E== B.T.U.
SQ. FT. GARAGE@ 1 Q
HOUSE SEWER
FLOOR DRAIN
BALANCE OF MIN. FEE
MECHANICAL FEES
WATFR Sr)FTFNPR
VENT SYSTEM ❑ FAN ❑ EVAP.COOL ❑ HOOD
SIGN
WASHER (AUTO) (DISH)
APPLIANCE
TRANSFORMER,=K.W.
GARBAGE DISPOSAL
FURNACE❑UNIT ❑WALL❑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 HP
POLE
LAVATORY
APPLIANCE VENT
AMPERES SERV. ENT.
SHOWER
ABSORPTION SYSTEM B.T.U.
SQ. FT.@ Q
BATH TUB
INCINERATOR ❑ DOMESTIC ❑ INDUS. OR COMM.
SQ. FT.@ 4.
WATER HEATER
HEATING SYSTEM ❑ FORCED ❑ GRAVITY
SQ. FT. RESID. @ 1 Q pC G"
SEWAGE DISPOSAL
BOILER E== B.T.U.
SQ. FT. GARAGE@ 1 Q
HOUSE SEWER
PERMIT FEE `"�
BALANCE OF MIN. FEE
GAS PIPING
MOBILEHOME HOOKUP FEE I$ I I
I . '
/IPERMIT FEE
I
SI `- ='
I PERMIT FEE
PERMIT NUMBER
TOTAL FEESMOB.
NOOK FEE
MEAT 8 VENT FEE DBL
PL: CK. F E CONST. FEE
DBL EIEC. FEE
DBL
FEE
PLUMBING FEE
DBL
/�%'1i p
s�r� ^ ��
I
75
J
J
DST
J
46 OU
SUPP. TO PERMIT
0F!II E
A
MOBILEHOME
$
LEGAL/ DESCRIPTION
�rj/ ;2 — 14, (p0,fA/774_ �C_ j_
. _7
J F M A M J J A S O
N D
JOB ArDDRESSSS A• '
OWNER -
72
73
USE OF BUILDING-�' -
F C.
DATyE�'
PE MONO,
0
74
/�%'1i p
s�r� ^ ��
V
75
COMMUNITY
IA �li/AI-riq
DST
I UNITS�OOMJVALUATION
46 OU
SUPP. TO PERMIT
0F!II E
A
MOBILEHOME
$
LEGAL/ DESCRIPTION
�rj/ ;2 — 14, (p0,fA/774_ �C_ j_
HOOKUP FEE
� 1L41
MECHANICAL FEE
DBL
$
DU
__
SET BACK
LOT SIZE
ZONE
`—Jy�'')
/
USE NO.
JbAP
TYPE
CK BY
!
�) �j
F v4 ~/ S i s R A 4
7
'/
4
BOND AMT.
PLAN NO.
PLAN CHECKER
FINAL DATE I
N SPIEC TOR
PLAN CHECK FEE
$
DBL
Gu
NAME OF CONST. LENDER
BRANCH OFFICE
NO LENDER INVOLVED
CONSTRUCTION FEE
iJ
ELECTRICAL FEE
DBL
$
�%v
ADDRESS
CITY STATE
51,
,r
$
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 60 DAYS.
31
CESSATION OF WORK FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
FEE
t HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE
IN ACCORDANCE WITH THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIF-
DBL
ORNIA. I ALSO.AGREE TO CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES.
COMPLIANCE W(TH"THE LAWS OF THE STATE_OF CALIFORNIA COVERING CONTRACTORS
IS ALSO GUARANTEED.
ITHE INDIVIDUALTOTAL
,
FEES $
CAT IDNSEBY HAS DONEYSOH IN ACCORDANCE WI HH ECT ON 554-1THE OF T ENB SPREPAREIIN SFI-
S AND
PROFESSI NS CODE OF • E,STATE OF CALIFORNIA.
CASH CHECK Fl M.O. E]N.C.
owN F -f; �-
ev
1 !,J. �J n Al
CONTRACTOR
t
Received By�y[�g�x
ADDRESS
ADDRESS.
� - 3 j i A tjF-' 1Ai/1 �) r3
A,�� F•1
Sewage System
T
LL
P
' " ' ,ej "
-
Trees Required
Yes
Not.�
CITY
II
�� !`�A��r��, A
CITY
INFORMATION
TEL. NO.
TEL. NO. LICENSE
l
-,,077
FORM 284-208 (REV. 4/71) 7/
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