204539 (SFD)VENT SYSTEM ❑ FAN ❑ EVAP. COOL % HOOD
SIGN WASHER (AUTO#PISH)
APPLIANCETRANS-
DEPARTMENT OF BUILDING & SAFETY
FIELD OFFICE
OUTLETS LAUNDRY TRAY
AIR HANDLING UNIT CFM
FIXTURE OR SOCKET KITCHEN SINK
• COUNTY OF RIVERSIDE
CONST. SERV. ENTRANCE WATER CLOSET
COMPRESSOR HP
CONSTRUCTION ESTIMATE ELECTRICAL FEES
PLUMBING FEES
1,5T FL.
..-'
SO. Fr.
@
g '�� �„� .�• NO.
NO.
SQ. FT.
@
PERMIT FEE
BALANCE OF MIN. FEE GAS PIPING ? ,.•
2ND FL.
PERMIT FEE- �', f PERMIT FEE j
SQ. FT.,
@
MOTOR 1 OR LESS H.P.
PL. CK. FEE CONST,
POR.
DBL. ELEC. FEE
SQ.FT.
@
"� % ��� �-� MOTOR 5 OR LESS H.P.
'
GAR.
SQ. FT.
.@
MOTOR 20 OR LESS H.P.
DRAINAGE PIPING
CAR P.
WALL
SQ.FT.
@
N D
DRINKING FOUNTAIN
SQ. FT.
@
.LOT SIZE
URINAL
JOB ADDRESS3+jVOWNER
f
OK.W. UNITS
WATER PIPING
,5ET
F -
ESTIMATED VALUATION
$
!" Y's- "''..,.
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM ❑ FAN ❑ EVAP. COOL % HOOD
SIGN WASHER (AUTO#PISH)
APPLIANCETRANS-
FORMER D K.W. GARBAGE DISPOSAL
FURNACE ❑ UNIT p WAL ❑ FLOOR ❑ SUSPENDED
OUTLETS LAUNDRY TRAY
AIR HANDLING UNIT CFM
FIXTURE OR SOCKET KITCHEN SINK
GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
CONST. SERV. ENTRANCE WATER CLOSET
COMPRESSOR HP
!J POLE LAVATORY .r
APPLIANCE VENT�.
AMPERES SERV. ENT. SHOWER g'
ABSORPTION SYSTEM O B.T.U. SQ. FT. @ ¢ BATH TUB
INCINERATOR ❑ DOMESTIC ❑ INDUS._ OR COMM.
SQ. FT. @ d WATER HEATER
HEATING SYSTEM FORCED ❑ GRAVITY
a r ?SQ. FT. RESID. @) Q /3 V SEWAGE DISPOSAL
BOILER 0 B.T.U.1
SQ. FT. GARAGE @I�2dHOUSE SEWER
PERMIT FEE
BALANCE OF MIN. FEE GAS PIPING ? ,.•
TRAILER ISSUANCE FEE - PERMIT FEE
PERMIT FEE- �', f PERMIT FEE j
PER2`045391
TOTAL FEES _
�5
REN. TRAILER FEE HEAT & VENT. FEE
PL. CK. FEE CONST,
FEE
DBL. ELEC. FEE
IDBL.ISPEC:
INSP. FEE
PLUMBING FEE DBL.
.
J F M A
M J .J A S O
N D
"Alb,'
.LOT SIZE
USE #
JOB ADDRESS3+jVOWNER
f
,5ET
F -
S %S
R
f7'�CI �J � 6. 9IYla ,�4L1.,.,
d �i
�'r� -
.�•/�•y }�- I�
J'��.1 Sr Z,6 V .0O3
ZONE
USE OF BUILDING
DATE
PLANCHECK FEE
g
k L� t!Y 41�' ./ Ti 6-14 RA 4G
'
CHECKED'SY'COMMUNITY
F.C.
UNITS/
VALUATION OFF CE
MECHANICAL FEE
g
` P
VCRS j
JOISTR�ICT
+v I -
!
DBL
G
P
TYPE
LEGAL DES RIPTIONPERMIT
NUMBER
CONSTRUCTION FEE
g
!!�
S3
20
. 5 3 9
DBL
-
PLAN CHECKER
SUPP. TO PERMI"
/{ f
ELECTRICAL FEE
DBL
BOND
§OND
CASH
PLAN FILE# FINAL
DATE
INSPECTOR
PLUMBING FEE
TRAILER IT
NAME
OF. CONSTRUCTION LENDER
BRANCH OFFICE
VOLVEl
SSUANCEEF E
g
_
INP}LENDER
/
ADDRESS
CITY
STATE
FEE
g
•
TOTAL FEES
Q
y
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 60 DAYS. CESSATION
WORK
OF FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
I HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCOR-
CASH Q CHECK M.O. N.C.
DANCE WITH THE LAWS OF RIVERSIDE COUNTY AND TH.E STATE OF CALIFORNIA. I ALSO AGREE TID
CARRY. COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLIANCE WITH THE LAWS OF THE STAIE
RECEIVED BY WAGE SYSTEM
OF CALIFORNIA COVERING CONTRACTORS IS ALSO GUARANTEED.
¢!�
I HEREBY CERTIFY THATTHE INDIVIDUALWHO PREPAREDTHE PLANS AND SPECIFICATIONS HAS DOtI
�yLiLL P
SO IOF CAFOIA N ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STA71E
INFORMATION
OWNER ... --.;a+..a
CONTRACTOR
ADDRCSV
liz fJ. 1
ADDRESS
FT.
NO.
TEL. NO.
Clan., no. •fno In CSI I 'ln1 /d.h �'
LICENSE -NO.
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