272737 (SFD)APPLIANCE PF^ -1 j?
FIELD OFFICE ,
OWNER
,�1��r��r rO,.
=. BUILDING PERMIT DEPARTMENT OF BUILDING & SAFETY
GARBAGE DISPOSAL
F.C.
j COUNTY OF RIVERSIDE
FURNACE O UNIT O WALL O FLOOR O SUSPENDED
76
Y �E II
LAUNDRY TRAY
1 1
M H PERMIT FEE
AIR HANDLING UNIT CFM
CONSTRUCTION -ESTIMATE NO. ELECTRICAL FEES
NO. PLUMBING FEES
if
KITCHEN SINK
1 ST FL. V,;2 0 SQ.FT. @ i _'++ -ir Alb UNITS
ABSORPTION SYSTEM B.T.U.
VALUATION
2ND FL. SO. FT. @
YARD SPKLR SYSTEM
WATER CLOSET
POR. SO. FT. @ MOBILEHOME SVC.
BAR SINK
' (}
GAR. [/� SO. FT. _ @ 3,U ` POWER OUTLET
ROOF DRAINS
LAVATORY
-CAR P. SO.FT. @
DRAINAGE PIPING
HEATING SYSTEM -2k FORCED , O GRAVITY
WALL SO. FT. @
DRINKING FOUNTAIN
SHOWER
SQ. FT. @
URINAL
BOILER � B.T.U.
ESTIMATED CONSTRUCTION VALUATION $ S�r y `�j �'j ��-
WATER PIPING a
NOTE: Not to be used as property tox voluotion SWIM POOL, PVT
FLOOR DRAIN
iCJ
MECHANICAL FEES SWIM POOL, COMM
WATER SOFTENER
SQ FT @ ¢
VENT SYSTEM L7f FAN ❑ EVAP. COOL A HOOD fO I I SIGN
{ WASHER IAUT041SHI L„T f)L)
APPLIANCE PF^ -1 j?
, $ �Ci
OWNER
,�1��r��r rO,.
75
GARBAGE DISPOSAL
F.C.
DAT �/
FURNACE O UNIT O WALL O FLOOR O SUSPENDED
76
Y �E II
LAUNDRY TRAY
1 1
M H PERMIT FEE
AIR HANDLING UNIT CFM
$
IDLE METER
COMMUNITY
KITCHEN SINK
')C
ABSORPTION SYSTEM B.T.U.
VALUATION
TEMP USE PERM SVC
OFFICE
WATER CLOSET
fn OQ
COMPRESSOR HP
' (}
POLE, TEMP/PERM
'Y
LAVATORY
CiC
HEATING SYSTEM -2k FORCED , O GRAVITY
AMPERES SERV ENT
r
SHOWER
$
BOILER � B.T.U.
SQ FT @ a
BATH TUB
iCJ
MECHANICAL FEE
DBL
SQ FT @ ¢
WATER HEATER
)
NO.
19 14) SQ FT RESID @j yg
� tf ; 1
SEWAGE DISPOSAL
f} O G
1•) it U -SQ FT GARAGE @ ;/ia
3G
HOUSE SEWER
l
PERMIT FEE
j P7
F �_ Jr' S 0'" r R j -,R
PLAN CHECK FEE
GAS PIPING
$
MOBILE HOME PERMIT FEE $
BOND AMT.
I PLAN NO.
/ PERMIT FEE
'41 U
PERMIT FEE
R?�IT
2 L 3
TOTAL FEES
r , %L
j1 --
MOB. HM.FEE
MICRO FEE
lr� �c�
!
MECH. FEE
. u
d':�
DBL.
PL. CK. FEE
fid
CONST. FEE
r rx�
DBL.
ELECT. FEE
s7
DBL.
SMI FEE
�--
FEE
PLUMB. FEE
DBL.
J F M A M J• 1 A $ Q N D
74
.JOB ADDRESS SP NO
7�/��) Lel/�uJz
•L,/U)
OWNER
,�1��r��r rO,.
75
F PERMIT el 11
USDol9 671 R,
F.C.
DAT �/
PELI OL.
76
Y �E II
Ys•
1 1
M H PERMIT FEE
$
COMMUNITY
DST
UNITS
ROOMS
VALUATION
SUPP. TO PERMIT
OFFICE
v "J 7"A
0c
Z
MICROFILM FEE
COPIES
$
LEGAL DESCRIPTION
0 67
MECHANICAL FEE
DBL
$
SETBACK
LOT SIZE ZONEUSE
NO.
GRP
TYPE
CK BY
l
�. 'V/F. t
F �_ Jr' S 0'" r R j -,R
PLAN CHECK FEE
$
BOND AMT.
I PLAN NO.
PLAN CHECKER
FINAL DATE JINSPECTOR
—7 6
CONSTRUCTION FEE
DBL
$
NAME OF CONST. LENDER BRANCH
OFFICE
NO LENDER INVOLVED
}
ELECTRICAL FEE
DBL
$
ADDRESS CITY
STATE
19
'36
STRONG MOTION
$
OWNER/AGENT'S SIGNATURE
CONTRACTOR * �+
INSTRUMENTATION FEE
FEE
$
ADDRESS
D• -13o
ADDRESS
PLUMBING FEE
DBL
$ _
CITY ZIP CODE
A h
CITY// / ZIP CODE
Cat v / A I i SI
TOTAL FEES
$
TEL. NO. 1
?`1Gr y_ rl jC%�i
TEL. NO. LICENSE
CASH ❑ CHECK 2f, M.O. O N.C. O,a1L
f) THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSA
i TION OF WORK 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 AC
CORDANCE WITH THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, 'I ALSC
EMPLOYEES. COMPLIANCE WITH THI
RECEIVED BY
TREES REQUIRED "
SEWAGE SYSTEM
f
�2Lk
t/� K
T
LL
P
AGREE TO CARRY COMPENSATION INSURANCE UPON MY
I A A/C (1C TUC CTATCl C! Al IC —IIA l-!1\/CDIAI/"'r- KlTDA=- DC IC Al Cl f lIADAI.ITCCn
I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS
FORM 284-208 (Rev. 10-74) OL HAS DONE SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE
1 OF THE STATE OF CALIFORNIA.