268275 (AR)BUILDING PERMIT
DEPARTMENT OF BUILDING & SAFETY
COUNTY OF RIVERSIDE
FIELD OFFICE
'
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
ST FL.
2ND FL.
POR.
GAR.SQ.
CAR P. ®
WALL/.l//y
SQ.FT. @
,Q -.
UNITS
HEATING SYSTEM FORCED ❑ GRAVITY
SQ. FT. @
YARD SPKLR SYSTEM
SQ. FT. @ =� �i MOBILEHOME SVC.
BAR SINK
FT. @ �-Zs` �' S2- POWER OUTLET
ROOF DRAINS
F"
SQ.FT. @ � � si✓ �'�+-
DRAINAGE PIPING
SQ. FT. @ ^l y°� l "'�
DRINKING FOUNTAIN
SO. FT. @
' ESTIMATED CONSTRUCTION VALUATION $/'���
_
VALUATTION�3
URINAL
WATER PIPING
' NOTE: Not to be used as property tax valuation
WATER HEATER
SWIM POOL, PVT
FLOOR DRAIN
MECHANICAL FEES
SQ FT RESID @aj
SWIM POOL. COMM
WATER SOFTENER
VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD
SIGN
WASHER (AUTO) (DISH)
3
APPLIANCE
PERMIT FEE
GARBAGE DISPOSAL
MECHANICAL FEE
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
GAS PIPING
LAUNDRY TRAY
Is
AIR HANDLING UNIT I
I CFM
IDLE METER
KITCHEN SINK
10
DSS/Ty
C I
ABSORPTION SYSTEM
0 B.T.U.
OWNER I
TEMP USE PERM SVC
WATER CLOSET
COMPRESSOR 2 - A-rE`� HP
USE OF PERMIT + py }A,� j'/F� .. �,S �i
POLE, TEMP/PERM
DATE
LAVATORY
HEATING SYSTEM FORCED ❑ GRAVITY
Oc
AMPERES SERV ENT
SHOWER
BOILER 0 B.T.U.
$
SQ FT @ C
COMMUNITY
BATH TUB
UNITS
ROOMS
VALUATTION�3
SQ FT @ a
OFFICE
WATER HEATER
SQ FT RESID @aj
SEWAGE DISPOSAL
I
SQ FT GARAGE @
3
HOUSESEWER
PERMIT FEE
3 O
MECHANICAL FEE
DBL
GAS PIPING
MOBILE HOME PERMIT FEE
Is
LOT SIZE ZOpNNE!
PERMIT FEE
.
PERMIT FEE
PERMIT NO,
268275
TOTAL FEES
2 79
MOB. HM.FEE
MICRO FEE
MECH. FEE
do
DBL.
PL. CK. FEE
�0=
CONST. FEE
���a
DBL.
ELECT
/�,__
DBL.
SMI FEE
Fj1
FEE
PLUMB. FEE
DBL.
J I F I M A I M I J I J A I S 1 O 1 N D
JOB ADDRESS SP NO
OWNER I
74
75
USE OF PERMIT + py }A,� j'/F� .. �,S �i
F.C.
DATE
PE MIT NO.
X68275
76
1400 r ��/ .0g//-(-.�
M H PERMIT FEE
$
COMMUNITY
DST
UNITS
ROOMS
VALUATTION�3
SUPP. TO PERMIT
OFFICE
I
I
MICROFILM FEE
COPIES
$
LEGAL DESCRIPTION
/�� ggs�-�ay-��n •.fie! -/a- �.C-a �Sa. -� A-44WC1i7A �
MECHANICAL FEE
DBL
$
SET BACK
LOT SIZE ZOpNNE!
USE NO.
GRP
TYPE BY
1
dd
F S R {�
PLAN CHECK FEE
$
BOND AMT.
PLAN NO.
PLAN CHECKER
FINAL DATE
INSPECTOR
CONSTRUCTION FEE
DBL
$
NAME OF CONST. LENDER BRANCH
OFFICE
NO LENDER INVOL ED
ELECTRICAL FEE
DBL
$
ADDRESS CITY
STATE
STRONG MOTION
$
OWNER/ ENT'SSIGNATURE
CONTRACTOR
INSTRUMENTATION FEE
FESS
$
AD
ADDRESS
FEE
PLUMBING FEE
DBL
$
CITYZIP CODE
CITY ZIP CODE
TOTAL FEES
$
79
TEL. NO.
m CJ
TEL. NO. LICENSE
CASH ❑ CHECKpy M.O.-❑ N.C. p
,/ THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSA
f',VJTION OF WORK FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
RECEIVED BY
TREES REQUIRED
0^ J 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
n v
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) Qr L HAS DONE SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE
OF THE STATE OF CALIFORNIA.