215621 (SPIN)BUILDING PERMIT
CONSTRUCTION ESTIMAT
1ST FL.
SQ. FT. @
2ND FL.
SQ. FT. @
POR.
SQ. FT. @
GAR.
SQ. FT. @
. CARP.
SQ. FT. @
WALL
SQ. FT. @
CONST. SERV. ENTRANCE
SQ. FT. @
ESTIMATED VALUATION $
MECHANICAL FEES
0 DEPARTMENT OF BUILDING & SAFET
J&
COUNTY OF RIVERSIDE
E I ELECTRICAL FEES
NO.
MOTOR 1 OR LESS H.P.
MOTOR 5 OR LESS H.P.
MOTOR 20 OR LESS H.P.
K.W. UN
FIELD OFFICE
PLUMBING FEES
DRAINAGE PIPING
DRINKING FOUNTAIt•
URINAL
WATER PIPING
FLOOR DRAIN
W ATCO C!•1CTGAICO
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 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 E:= B.T.U.
SQ. FT.@ R
BATH TUB
INCINERATOR ❑ DOMESTIC ❑ INDUS. OR COMM.
SQ. FT.@
WATER HEATER
HEATING SYSTEM ❑ FORCED ❑ GRAVITY
SQ. FT. RESID. @ 1 2
SEWAGE DISPOSAL
BOILER E== B.T.U.
SQ. FT. GARAGE@ i Q
HOUSE SEWER
PERMIT FEE
BALANCE OF MIN. FEE
GAS PIPING
MOBILEHOME HOOKUP FEE I$ I I I I IPERMIT FEE I I I I PERMIT FEE
PERMIT NUMBER TOTAL FE 'MOB. HOOK FEE HEAT 1, VENT FEE DBL PL, CK, FEE I CONST. FEE I..LIELEC.FEE IDSL FEEL PLUMBING FEE JDBL
1C Q
J F M A M J J A S O
N D
JOB AOD�E�
7/�e
OE
��_�_
72
73
USE OF BUILDING /J C,'�
�jj �/ r�rJ A.V/
F.C.
DAT,
{ �� 7G�
PEFjl.Al1 N
6 21
74
l
//��%%''
75
COMMU I T Y
DST
UNITS
OOM
VALUATION
SUPP. TO PERMIT
OFFICE
76
1
,a
MOBILEHOME
HOOKUP FEE
$
LEGAL DESCRIPTION
/—c,;—/�,/ TIZ 9 4—)
MECHANICAL FEE
DBL
$
SET BACK
LOT SIZE
ZONE
/ —I
E NO.
r
GRP
TYPE
ICKBY
F S
R
/L-
C55
PLAN CHECK FEE
$
BOND AMT.
PLAN NO.
PLAN CHECKER
FI _�F. Q INSPECTOR
Vim✓
CONSTRUCTION FEE
DBL
NAME OF CONST. LENDER
BRANCH OFFICE
NO LENDER IN VOLV D
ELECTRICAL FEE
DBL
$
ADDRESS
CITY STATE
$
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 60 DAYS.
�j�
��-- FEE
D
/y1
ALSO CAUSE TI TOOT ME D.
CESSATIONIHE
FOR1A20 OWORKFALL IN
,S,19VC,
��•/
EBYOAGREE THATWORK
CONNECTION WITH IS PERMIIT
WILLOBE DONE
IN ACCORDANCE WITH THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIF -
DBL
PLUMBING FEE
ORNIA. 1 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 ANDSPECIFI-
ATIONSIN ACCORDANCE
DONEOTHE
TOTAL FEES $
/
0(�
OF ,,FI B • INESS AND
PR0
ESSIDNS CODE OFHAS
STATE OF ALI OIRNIAECT"41,
CASH EDCHECK M. E]N.C. 0
OWNER
CONTRACTOR
Received By
ADDRESS
ADDRESS
7-3,7%%v`—fT`��
/1� �'
Sewage System
T
LL
P
F • '
Trees Required
Yes
No
CITY
GIT
INFORMATION
TEL. NO.
TEL. NO. LICEN%SEry
FORM 284-208 (REV. 4/71)
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