217795 (RER)BUILDING PERMIT
SIGN
DEPARTMENT OF BUILDING & SAFET
•
_. COUNTY OF RIVERSIDE
APPLIANCE
FIELD OFFICE
GARBAGE DISPOSAL.,
CONSTRUCTION ESTIMATE
ELECTRICAL FEES
LAUNDRY TRAY
PLUMBING FEES
IST FL.
2ND FL.
POR.
GAR.
CAR P.
A -LL
SQ. FT. @
CONST, SERV. ENTRANCE
NO.
NO.
POLE
SQ. FT.
APPLIANCE VENT
SQ. FT. @ MOTOR 1 OR LESS H.P.
-
SQ. FT. @ MOTOR 5 OR LESS H,P.
SQ. FT.@ Q
SQ. FT. @ MOTOR 20 OR LESS H.P.
DRAINAGE PIPING
SQ. FT. @
DRINKING FOUNTAIN
SQ. FT. @
URINAL
OnP K.W. UNITS
WATER PIPING
ESTIMATED VALUATION $
HOUSE SEWER
PERMIT FEE
BALANCE OF MIN, FEE
FLOOR DRAIN
/.�ROOMJ,
MECHANICAL FEES
, &V
ZoySi
wnTro cnrT=Kl o
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 UNITI I 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.@ 2•
WATER HEATER
HEATING SYSTEM ❑ FORCED ❑ GRAVITY
SQ. FT. RESID. @ i Q
SEWAGE DISPOSAL
BOILER E== B.T.U.
SQ. FT. GARAGE @ z Q
HOUSE SEWER
PERMIT FEE
BALANCE OF MIN, FEE
GAS PIPING
MOBILEH_OME HOOKUP FEE
I$ I I
I I (PERMIT FEE I
I ' I PERMIT FEE
72
PERMIT- NUMBER
7
TOTAL FEESMOB,
��
HOOK FEE
NEAT 6 VENT FEE DBL
PL, CK. FEE
CON ST�.pFEE
V
DBL ELEC. FEE DBL
FE;02,
�
PLUMBING FEE
CBL
74
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1 795
C
75
COMMUNITY
J F M A M J J I A S 0
N D
JOB ADDRESS
OWNER
72
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73
'
USE OF BUILDING L-I-01ij J;Z:
F.C.
DATE
74
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1 795
C
75
COMMUNITY
DST
UNITSVALUATION
�=
SUPP. TO PERMIT
OFFICE
76
.
ofn zijc rr
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ZoySi
F-
MOBILEHOME
$
LEGAL DESCRIPTION
HOOKUP FEE
'
D7- /'r die o?
MECHANICAL FEE
DBL
$
SET BACK
LOT 512E
Z NE
JUSENO.
GRP
TYPE
JCKBY
F S R
•'" j
'
BOND AMT.`
PLAN NO.
PLAN CHECKER
FINAL DATE INSPECTOR
PLAN CHECK FEE
$
A � Y5
CONSTRUCTION FEE
DBL
NAME OF CONST. LENDER
BRANCH OFFICE
NO LENDER INVOLVED
N.
DBL
ADDRESS
CITY STATE
ELECTRICAL FEE
$'
$
��y
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 60 DAIS.
-CESSATION OF WORK FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
FEE
II
HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE
ACCORDANCE WITH THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIF-
DBL.IN
ORNIA. I ALSO AGREE TO CARRY COMPENSATION INSURANCE UPON MY EMPLOYE -S.
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 $
+(-
CATIONS HAS DONE SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AVD
PROFE SIONS PODE THE STATE OF CALIFORNIA.
CASH F-1 CHECK M.O.0 N.C. 0
N R C R
Received By
-A F� _ - DDRESS
Sewage System
T
LL ql
'l
CITY .
Trees Required
Yes
No
/ •
• TEL. NO. LICENSE
FORM 284-208 (REV. 4/71) {Qy.I/.���'��' , • -