176707 (AR)DEPARTMENT OF BUILDING & SAFETY
VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD
0
COUNTY OF RIVERSIDE
•
FIELD OFFICE
GARBAGE DISPOSAL
CONSTRUCTION ESTIMATE
OUTLETS
ELECTRICAL FEES
PLUMBING FEES
1st FI.
2nd FI.
Por.
Gar.
Car P.
Wall
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C7
1
Sq. Ft. @ ��"•
....� NO.
WATER CLOSET
COMPRESSOR �HP
NO.
Sq. Ft. @
APPLIANCE VENT
Sq. Ft. @
SHOWER
Sq. Ft. @ POLES
SPACE HEATER 47-
Sq. Ft. @ SIGNS
DRAINAGE PIPING
Sq. Ft. @ OR
DRINKING FOUNTAIN
Sq. Ft. @ o MOTOR H. P.
••��
URINAL
MOTOR M.P.
WATER PIPING
ESTIMATED VALUATION $
HOUSE SEWER
MOTOR
H. P.
FLOOR DRAIN
MECHANICAL FEES
PERMIT FEE
MOTOR
K. P.
WATER* SOFTENER
VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD
MOTOR H. P.
WASHER (AUTO) (DISH)
APPLIANCE
FIXTURES
GARBAGE DISPOSAL
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
OUTLETS
LAUNDRY TRAY
AIR HANDLING UNIT
SUB -PANEL
KITCHEN SINK
GAS PIPE C1 NATURAL ❑ L.P.G. 11 OIL
/
WATER CLOSET
COMPRESSOR �HP
RANGE AND/OR OVEN
LAVATORY
APPLIANCE VENT
WATER HEATER
SHOWER
ABSORPTION SYSTEM j B.T.U.
SPACE HEATER 47-
BATH TUB
INCINERATOR DOMESTIC 11 INDUS. ❑ COMM.
CONSTRUCTION POLE
WATER HEATER
HEATING SYSTEM [I FORCED ❑ GRAVITY
SERVICE ENTRANCE
SEWAGE DISPOSAL
BOILER B.T.U.
y- RESID. 19!50. FT. .�
HOUSE SEWER
PERMIT FEE
GARAGE zQ SO. FT.
GAS PIPING
=EIL
PERMIT FEE , �'
PERMIT FEE
PERMIT N
J
F
PLAN CHECK FEE $
MECHANICAL FEE $
CONSTRUCTION FEE $
ELECTRICAL FEE $
PLUMBING FEE $
TOTAL FEE
CASH CHECK
RECEIVED BY
Az T
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REN. JDBL.
[TOTAL FE F:S
HEAT & VENT FE1=
PLN. CK. FEEE/�,
CONST. FLEE
JELEC. FEE JPLUMB.
FEE
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M A M J J A S O N
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LOT SIZE
USE &
JOB ADDRESS OWNER
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CO M TY' STRIC F.Y UNIT . VALU Tt N OFFICE
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TYPE
L AL D IPT ON - . r PERMIT NUMB R
t''C , 27 / _ v q ,
1767
SPEC. INSP.
SUPP. TO PERMIT
PLAN CHECKER
BOND
BOND
�A. H
`PLAN FILE 0
FINAL DATE
INSPECTOR
: —
G - s ?
l/\/�✓{u,.arm -.S�
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED
WITHIN 60 DAYS. CESSATION OF WORK FOR 120 DAYS SHALL ALSO
CAUSE PERMIT TO BECOME VOID.
I HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS
PERMIT WILL BE DONE IN ACCORDANCE WITH THE LAWS OF RIVER-
M.O. N.C.
SEWAGE SYSTEM
I
SIDE COUNTY AND THE STATE OF CALIFORNIA. I ALSO AGREE TO
LL
P 14 --"AA
CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLI-
I ADDRESS
j CITY STATE
NO LENDER
D �
INFORMATION
84-208 12/88-.r — v
ANCE WITH LAWS OF THE STATE OF CALIFORNIA COVERING CON-
TRACTORS IS ALS .GUARANTEED.
OWNER CONTRACTOR
AWIR SS ADDRESS
EL. NO. TEL. NO.
LICENSE NO.