217794 (SPIN)DEPARTMENT OF BUILDING & SAFET FIELD OFFICE
BUILDING PERMIT ,
COUNTY OF RIVERSIDE
CONSTRUCTION ESTIMATE ELECTRICAL FEES PLUMBING FEES
@I NO. I NO.
1ST FL.
2ND FL..
SQ. FT.
SQ. FT. @
POR. _
SQ. FT.
GAR.
SQ. FT. @
CAR P.
SQ. FT.
WALL
SQ. FT. @
FIXTURE OR SOCKET
SQ. FT. @
ESTIMATED VALUATION Is
MECHANICAL FEES
MOTOR 1 OR LESS H.P.
MOTOR 5 OR LESS H.P.
MOTOR 20 OR LESS H.P.
K.W. UN
DRAINAGE PIPING
DRINKING FOUNTAIt,
URINAL
WATER PIPING
FLOOR DRAIN'
WATI=R Cr1FTFMFi7
VENT SYSTEM ❑ FAN ❑ EVAP.COOL ❑ HOOD
SIGN
WASHER (AUTO) (DISH)
APPLIANCE
TRANSFORMER OK.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 O 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. @ 1 q
SEWAGE DISPOSAL
BOILER O B.T.U.
SQ. FT. GAR AGE @ i q
HOUSE SEWER
PERMIT FEE
BALANCE OF MIN. FEE
GAS PIPING
MOBILEHOME HOOKUP FEE I$ I I I ' IPERMIT FEE I I ' I PERMIT FEE I I
PERMIT NUMBER I TOTAL f5'E�� M09. HOOK FEE I HEAT & VENT FEE OBl PL: CK. FEE CONST. FEE ABL LEL -CE-E DBL FFEEEE,, I -'l I PLUMBING FEE DBL
17
J
J F M A M J J A S O
N D
SOB ADDRESS
OwN�
Av_73
72
go J�/(7�9 !/JJv��i V
fC,
USES OFFF BUILDING
�r t,V. e�
F.C.
DATE4
�7?-
P ERMIT NO.
217794
74
75j
COMMUNITY
DST
UNITS�OOIVALUATICN'
SUPP. �TO PERMIT
OFFICE
76
�r
MOBILEHOME
$
LEGAL DESCRIPTION
HOOKUP FEE
Ze' % e > Tz Z /
MECHANICAL FEE
DBL
$
, SET BACK
LOT SIZE
ZONE
USE NO. -
GRP
TYPE
1;�,BY
�
F S . R
BOND AMT.
PLAN NO.
PLAN CHECKER
INSPE)TOR
PLAN CHECK FEE
$
JFINALDATE
T--
DBL
-NAME OF CONST. LENDER
BRANCH OFFICE.
NO LENDER IN LVED
CONSTRUCTION FEE
DBL
ADDRESS
CITY STATE
ELECTRICAL FEE
$
71e c' I �
$
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 60 DAYS.
��Zyl
l: �V FEE
CESSATION OF WORK FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
/ G/
I HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE 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-
CATIONSIONHAS DONE. SOT IN ACCORDANCEWARN SECTION 5541 OF THE BUSINESS AND
TOTAL FEES $
06>
! Q
TE OFF CALL
PROFESPA.
CO
CASH F -I CHECKffi . ❑ N.C. 0
O R � TR TOR
� �
Received By
DRE S ADDRESS
Sewage System T
LL
P
s
Trees Required
Yes
-
NO .
ITYfj,� ` C/A�CITY
ZA l[J/%%j
/