217792 (SPIN)BUILDING PERMIT DEPARTMENT OF BUILDING & SAFET
0 COUNTY OF RIVERSIDE fe
FIELD OFFICE
VENT SYSTEM ❑ FAN ❑ EVAP.COOL ❑ HOOD
SIGN
WASHER (AUTO) (DISH)
APPLIANCE
TRANSFORMER OK•W•
CONSTRUCTION ESTIMATE
ELECTRICAL FEES
PLUMBING FEES
1ST FL.
2ND FL.
POR.
GAR.
CAR P.
WALL
AIR HANDLING UNITI I CFM
SQ. FT. @
NO.
NO.
SQ. FT. @
WATER CLOSET
SQ. FT. @ MOTOR 1 OR LESS H.P.
POLE
SQ. FT. Co) MOTOR 5 OR LESS H.P.
APPLIANCE VENT
SQ. FT. @ MOTOR 20 OR LESS H.P.
DRAINAGE PIPING
SQ. FT. @
DRINKING FOUNTAIN
SQ. FT. @
URINAL
OK.W.UNITS
WATER PIPING
ESTIMATED VALUATION Is
SQ. FT. RESID. @ 1 ¢
FLOOR DRAIN
BOILER E== B.T.U.
MECHANICAL FEES
HOUSE SEWER
WGTF17 CfiGTGKIPP
VENT SYSTEM ❑ FAN ❑ EVAP.COOL ❑ HOOD
SIGN
WASHER (AUTO) (DISH)
APPLIANCE
TRANSFORMER OK•W•
GARBAGE DISPOSAL
FURNACE❑UNITE] WALL❑FLOOR ❑SUSPENDED
OUTLETS
LAUNDRY TRAY
AIR HANDLING UNITI I CFM
FIXTURE OR SOCKET
KITCHEN SINK
GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
CONST. SERV. ENTRANCE
WATER CLOSET
COMPRESSOR E== HP
POLE
LAVATORY
APPLIANCE VENT
AMPERES SERV. ENT.
SHOWER
ABSORPTION SYSTEM O B.T.U.
SQ. FT.@ Q
-BATH TUB
INCINERATOR ❑ DOMESTIC E] INDUS. OR COMM.
SQ. FT.@ Q.
WATER HEATER
HEATING SYSTEM ❑ FORCED ❑ GRAVITY
SQ. FT. RESID. @ 1 ¢
SEWAGE DISPOSAL
BOILER E== B.T.U.
SQ. FT. GARAGE@ i q
HOUSE SEWER
PERMIT FEE -
BALANCE OF MIN. FEE
GAS PIPING
MOBILEHOME HOOKUP FEE 1$ 1 1 1 1 IPERMIT FEE I I I I PERMIT FEE
GSI PLUMBING FEE I DBL
J F M A M J J A S O
N D
JOB ADDRESS
OWNER
72
73
USE OF BUILDING
s �" �, 1, c/"
F.C.
DATE
i� -3� �--
PERMIT NO.
217792
74
L C� C.
75
CO MUNIT,Y
DST
UNITS
OOM
VALUATION
SUPP. TO PERMIT
OFFICE
76
m'vtl y��
MOBILEHOME
$
LEGAL DESCRIPTION
Zor ^/ -2 �C
HOOKUP FEE
12 11
DBL
SET BACK
LOT SIZE
ZONE
USE NO.
GRP
TYPE
BY
MECHANICAL FEE
$
1/2-11
ICK
F s R
BOND AMT.
PLAN NO.
PLAN CHECKER
FINALDATE INSP
CTOR
PLAN CHECK FEE
$
/ �
I %F
DBL
NAME OF CONST. LENDER
BRANCH OFFICE
NO LENDER INV LVED
CONSTRUCTION FEE
$
DBL
ADDRESS
CITY STATE
ELECTRICAL FEE
$
I E�/
$
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 60 DAYS.
/jp
��
CESSATIONIHEREBY OF WORK FOR ALSO CAUSE PERMIT TO BECOME IN OBE
(I
AGREE THATIALLDAYS WORKFALL
CONNECTION WITH THIS PERMIT WILL 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 WITH THE LAWS OF THE STATE OF CALIFORNIA COVERING CONTRACTORS
IS ALSO GUARANTEED.
I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFI-
TOTAL FEES $ %/'1
00
CATIONS HAS DONE SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND
1 v
PROFESSIONS COD OF THE STATE OF CALIFORNIA.
W R IaAc R
CASH F-1 CHECK . 0 N.C. ED
Received By
ss 'ADDRESS
Sewage System
T
LL
P
r v
CI Y CITY
Trees Required
Yes Ivo
..
INFORMATION
FORM 284-208 (REV. 4/71