193420 (SATT)VENT SYSTEM ',o FAN ❑ EVAP. COOL . HOOD
SCJ SIGN WASHER (AUT(4, ISH)
DEPARTMENT OF BUILDING & SAFETY
FIELD OFFICE
FURNACE O UNIT ❑ WALL Cl FLOOR ❑ SUSPENDED
OUTLETS LAUNDRY TRAY
•
COUNTY OF RIVERSIDE •
GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
CONST. SERV. ENTRANCE T% WATER CLOSET s�M
CONSTRUCTION ESTIMATE
ELECTRICAL FEES
PLUMBING FEES
I ST FL.
�,'** .�
SQ. FT.
r
{ `-�--. NO.
NO.
2ND FL.
BOILER _j B.T.U.
SQ. FT.
@
trTi BALANCE OF MIN. FEE GAS PIPING r_r
TRAILER ISSUANCE FEE - PERMIT FEE
SQ. FT.
PER
MOTOR I OR LESS H.P.
FEES REN. TRAILER FEE HEAT & VENT. FEE
f
`
POR.
' a
SQ.FT.
Can't
240) MOTOR S OR LESS H.P.
? # r
GAR. s' •�
CAR P.
'
SQ. FT.
@
MOTOR 20 OR LESS H.P.
DRAINAGE PIPING
WALL
3J
SQ.FT.
@
DRINKING FOUNTAIN
SQ. FT.
@
URINAL
M.._ ... A M -
J F M A M
OKW. UNITS I
I WATER PIPING] G
ESTIMATED VALUATION
$
LOT SIZE
FLOOR DRAIN
MECHANICAL FEES
OWNER
WATER soFrENER
VENT SYSTEM ',o FAN ❑ EVAP. COOL . HOOD
SCJ SIGN WASHER (AUT(4, ISH)
APPLIANCE
FORMER O K.W. GARBAGE DISPOSAL`'}
FURNACE O UNIT ❑ WALL Cl FLOOR ❑ SUSPENDED
OUTLETS LAUNDRY TRAY
AIR HANDLING UNIT CFM
FIXTURE OR SOCKET KITCHEN SINK ' I
GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
CONST. SERV. ENTRANCE T% WATER CLOSET s�M
COMPRESSOR .._ , HP
Ca POLE A LAVATORY
APPLIANCE VENT
12,iC AMPERES SERV. ENT. SHOWER
ABSORPTION SYSTEM O B.T.U.
SO. FT. @ ¢ BATH TUB
INCINERATOR ❑ DOMESTIC ❑ INDUS. OR COMM.
SQ. FT. @ d WATER HEATER
HEATING SYSTEM FORCED ❑ .GRAVITY
cS SQ. FT. RESID. @ 14 SEWAGE DISPOSAL
BOILER _j B.T.U.
ASO. FT. GARAGE @11/24 -lic) HOUSE SEWER
PERMIT FEE;
trTi BALANCE OF MIN. FEE GAS PIPING r_r
TRAILER ISSUANCE FEE - PERMIT FEE
PERMIT FEE " PERMIT FEE
PER
t'j 4euTOTAL
FEES REN. TRAILER FEE HEAT & VENT. FEE
f
`
I.PL. CK. FEE
CONST. FEE
DBL. ELEC. FEE DBL.
SPEC. INSP. FEE
PLUMBING FEE
DBL.
U{
'
�'='
l %6�5
l�''tf.�
3J
cad
•J_.
I
M.._ ... A M -
J F M A M
.. J _ . ._ A.. _- S
JJ A S
D - N... D _
0 N D
S ET BA
LOT SIZE
USE #
JOB ADDRESS
OWNER
f
ZONE
USE OF BUILDING -
DATE '�`
PLAN CHECK FEE
$ 3
' S ,
t i -
!
0I 'v ' -rl • �S. I ? r G J t
- l
'
CHECKED BY
COMMUNITY
OF(F'I`C^E
MECHANICAL FEE
}
N-y�
^""'
G"' ,y{•i_
JDIST!R�l�UNITS
„I A�F1�+s13�
[VALUAI.10: ♦�
J s T�1F
•
DBL
$ f
GROUPTYPE
LEGAL DESCRIPTION
A ERtd IT U E
CONSTRUCTION FEE
%1
d `,t3
Tf ¢
E
DBL
PLAN CHECKER
SUPP. TO PERMIT
ELECTRICAL FEE
DBL
-
BOND $
BOND
CASH
PLAN FILE IFINAI
DATE
INSPECT R
PLUMBING FEE
✓
�.%
7-�5 %�
TRAILER PERMIT
NAME OF, CONSTRUCTION
LENDER BRANCH OFFICE ENDER
INV LVED
ISSUANCE FEE
$
IND
ADOREffaltsd
TY Main at I A
STA E
FEE
$
TOTAL FEES
s,L.
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 T.H,E STATE OF CALIFORNIA. 1 ALSO AGREE TO
CARRY. COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLIANCE WITH THE LAWS OF THE STATE
RECEIVED BY SEWAGE SYSTEM
OF CALIFORNIA COVERING CONTRACTORS IS ALSO GUARANTEED.
/�
fa►'._,`,� T �S ��
I HEREBY CERTIFY THATTHE INDIVIDUALWHO PREPAREDTHE PLANS AND SPECIFICATIONS HAS DONE
LL
OF IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE
OF CALIFORNIA,
, •Lpb O R M AnoN
OWNER ,
CON TR To /j
t !
ADDRESS
ADDRESS
•
TEL. NO.
TEL. N
'5v
LICENSE -NO.
_
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