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268273 (PLBG)FIELD OFFICE BUILDING PERMIT DEPARTMENT OF BUILDING & SAFETY AML COUNTY OF RIVERSIDE Amikk CONSTRUCTION ESTIMATE I ST FL. SO.FT. @ 2ND FL. SO. FT. @ POR. SO. FT. @ GAR. -SO.FT. @ CAR P. SO.FT. @ WALLSO. FT. @ ---dSO. FT. @ ESTIMATED CONSTRUCTION VALUATION $ NOTE: Not to be used as property tax voluation MECHANICAL FEES VENT SYSTEM O FAN ❑ EVAP. COOL O HOOD NO. I ELECTRICAL FEES UNITS MOBILEHOME SVC. POWER OUTLET SWIM POOL. PVT SWIM POOL, COMM SIGN NO.I PLUMBING FEES YARD SPKLR SYSTEM BAR SINK ROOF DRAINS DRAINAGE PIPING DRINKING FOUNTAIN URINAL WATER PIPING FLOOR DRAIN WATER SOFTENER WASHER (AUTO) (DISH) APPLIANCE JOB ADDRESS SP NO 3'i -y95' �// coh GARBAGE DISPOSAL 74 FURNACE O UNIT O WALL O FLOOR O SUSPENDED LAUNDRY TRAY USE OF.PERMITF.C. � w,El/ F.A- Sr d.��lr v, AIR HANDLING UNIT CFM IDLE METER KITCHEN SINK 76 ABSORPTION SYSTEM 0 B.T.U. TEMP USE PERM SVC WATER CLOSET COMPRESSOR HP POLE, TEMP/PERM LAVATORY HEATING SYSTEM ❑ FORCED (:1 GRAVITY AMPERES SERV ENT SHOWER ROOMS BOILER 0 B.T.U. - SO FT @ a BATH TUB SO FT @ ¢ WATER HEATER t ulmra SO FT RESID @ 1 ¢ SEWAGE DISPOSAL SO FT GARAGE @ 'h¢ HOUSES47M / 7` PERMIT FEE $ GAS PIPING LEGAL DESCRIPTION MOBILE HOME PERMIT FEE Is PERMIT FEE PERMIT FEE 0 2 pERIYIIT fj0.� TOTTALFEES F10 MOB. HM.FEE MICRO FEE MECH. FEE DBL. PL. CK. FEE CONST. FEE DBL. ELECT. FEE DBL. SMI FEE FEE PLUMBB.FEE I11111., Po fy�/� / J T M A M J J A S O N D JOB ADDRESS SP NO 3'i -y95' �// coh OWNER �3�1I H".)gs 74 "41 75 USE OF.PERMITF.C. � w,El/ F.A- Sr d.��lr v, DATE —6 -�� PE IT 0. 2 7 3- 76 , M H PERMIT FEE $ COMMUNITY DST I UNITS ROOMS I VALUATION dd SUPP. TO PERMIT OFFICE t ulmra MICROFILM FEE COPIES $ LEGAL DESCRIPTION MECHANICAL FEE DBL $ SET BACKLOT SIZE ZO1,0 NE USE NO. GRP TYPE CK BY fy�/� / ,, ( F 5 R PLAN CHECK FEE $ BOND AMT. PLAN NO. PLAN CHECKER FINAL DATE INSPECTOR CONSTRUCTION FEE DBL $ NAME OF CONST. LENDER BRANCH OFFICE NO LENDER INVOLVED L ELECTRICAL FEE DBL $ ADDRESS CITY STATE /7 STRONG MOTION INSTRUMENTATION FEE $ OWNER/AGENT'S SIGNATURE CONTRACTOR r i2 �• ,I ;" �N PL/Nc FEE $ ADDRESS ADDRESS fJ )2,y q w�-/Q I��U PLUMBING FEE DBL $ �f CITY ZIP CODE CITY / ZIP CODE TOTAL FEES $ dD TEL. NO. T . N0. LICENSE CASH CHECK ❑ M.O. ❑ N.C. ❑ THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSA if, ONOF WORK FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID. RECEIVED BY TREES REQUIRED �i 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 SEWAGE SYSTEM T LL P`'��C��� AGREE TO CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLIANCE WITH THE 1A\AICt C TUC CTATC r C! -A1 ICIIDAII A r- %/CDI1.1t'_r' KITDArTnDC IC A I Cn(�I IA DA AITCCn I I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS FORM 284-208 (Rev. 10-74) OP L HAS DONE SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA.