204531 (SFD)APPLIANCE
DEPARTMENT OF BUILDING & SAFETY
FURNACE ❑ UNIT ❑ WALL ❑ F OR ❑ SUSPENDED
OUTLETS LAUNDRY TRAY
•
COUNTY OF RIVERSIDE
FIELD OFFICE
CONST. SERV. ENTRANCE WATER CLOSET• f •-
COMPRESSOR + HP
�ej POLE LAVATORY
APPLIANCE VENT-
AMPERES SERV. ENT. % SHOWER
CONSTRUCTION ESTIMATE
ELECTRICAL FEES
PLUMBING FEES
IST FL.
SQ. FT. @ �-_
NO.
NO.
2ND FL.
SQ. FT. @
BALANCE OF MIN. FEE GAS PIPING
POR.
SQ. FT. @
MOTOR I OR LESS H.P.
PERTOTAL FEES` REN. TRAILER FEE .HEAT $ VENT. FEE
`04531
GAR.
SQ.FT. @ ^ "'
MOTOR 5 OR LESS H.P.
SPEC. INSP. FEE PLUMBING FEE
CAR P.
SQ. FT. @
MOTOR 20 OR LESS H.P.
DRAINAGE PIPING
WALL
SQ.FT. @
DRINKING FOUNTAIN
i M A y_ M '!. r .l A S �.r
SQ. FT. @
URINAL
LOT SIZE
OK W. UNITS
WATER PIPING
ESTIMATED VALUATION Is
�°
FLOOR DRAIN
MECHANICAL FEES
IWATER SOFTENER
VENT SYSTEM FXL FAN ❑ EVAP. COOL [a -HOOD
sQ SIGN
L l I WASHER (AUTO LSH)
APPLIANCE
FORMER O K.w. GARBAGE DISPOSAL 4 y w >
FURNACE ❑ UNIT ❑ WALL ❑ F OR ❑ SUSPENDED
OUTLETS LAUNDRY TRAY
AIR HANDLING UNIT CFM
FUTURE OR SOCKET KITCHEN SINK
GAS PIPE ❑ NATURAL ❑ L.P.G.' ❑ OIL
CONST. SERV. ENTRANCE WATER CLOSET• f •-
COMPRESSOR + HP
�ej POLE LAVATORY
APPLIANCE VENT-
AMPERES SERV. ENT. % SHOWER
ABSORPTION SYSTEM O B.T.U.
SQ. FT. @ Q t BATH TUB
INCINERATOR ❑ DOMESTIC Cl INDUS. OR COMM.
SQ. FT. @ d WATER HEATER
HEATING SYSTEM FORCED ❑ GRAVITY
s SQ. FT. RESID. @ I Q G�! SEWAGE DISPOSAL
BOILER B.T.U.
SQ. FT. GARAGE @1124 HOUSE SEWER
PERMIT FEE
BALANCE OF MIN. FEE GAS PIPING
TRAILER ISSUANCE FEE - PERMIT FEE
PERMITFEE PERMITTEE ozo,
PERTOTAL FEES` REN. TRAILER FEE .HEAT $ VENT. FEE
`04531
PL. CK. FEE CONST.
FEE
DBL. ELEC. FEE DBL.
SPEC. INSP. FEE PLUMBING FEE
DML.
L.
i M A y_ M '!. r .l A S �.r
O� N D -—
LOT SIZE
USE #
JOB ADDRESS
OWNER
J
ZONE
USE OF BUILDING �" -
DATE
PLAN CHECK FEE
$
y�j
'
mow '
CHECKED BY
-
COM' NI DISTRICT
F.0 UNITS
VALUATION OFFICE
MECHANICAL FEE
(J u77
DBL
TYPE
LEGAL DES• T ON j
IT NUMBEL
CONSTRUCTION FEE
$
26"4531
DBL
$���
PLAN CHECKER
SUPP. TO PERMIT
ELECTRICAL FEE.
DBL
BOND $
BOND
CpSX
PLAN FILE FINAL
DATE
INSPE• OR •
PLUMBING FEE
$
-
9
• a, 7: i�-
v
TRAILER PERMIT
NAME OF CONSTRUCTION
LENDER t
c< 5}�.-v��;i
BRANCH OFFICE
ISSUANCE FEE..
$
/�
s
JNO/LENCER
INVOLVEID
/4
y . y. ,, .S� f r1epar7
ADDRESS ,
�
STATE
FEE
$
TOTAL FEES•$
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.
L HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCOF-
CASH CHECK M.O. N.C.
Q "�
❑
DANCE WITH THE LAWS OF RIVERSIDE COUNTY AND T.HE STATE OF CALIFORNIA. I ALSO AGREE T7
CARRY. COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLIANCE WITH THE LAWS OF THE STALE
RECEIVED BY' SEWAGE SYSTEM
__�
OF CALIFORNIA COVERING CONTRACTORS IS ALSO GUARANTEED.
4&,a.AT P
I HEREBY CERTIFY THAT THE INDIVIDUALWHQ PREPARED THE PLANS AND SPECIFICATIONS HAS DONE
SO IN ACCORDANCEWITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE
NFORM ATIONL
OFC IF I
— '
OWNEfl �'^t '
Y 1„I
CONTRACTOR
.o
Sn
1
ADDRE
W
ADDRESS '
TEL.
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•
LICENSE -NO.
O M 284-2 1 O) S m ✓.