230285 (SFD)BUILDING PERMIT DEPARTMENT OF BUILDING & SAFETY
• COUNTY OF RIVERSIDE
TOTAL FEES
f 9 % �q
FIELD OFFICE
CONSTRUCTION ESTIMATE.,,.,,, _
DBL.
,;�. , ELECTRICAL FEES,.,.
CONST. FEE
—
PLUMBING -FEES
SMI FEE
j ,tel
DST
1 ST FL. SQ. FT. @ 13ye !G � ,ff v
i
2ND FL. SQ. FT. @ _
POR. SO. FT. @
GAR. SQ.FT. @
CAR P. �" SQ. FT. @a / "�
WALL SQ.FT. @
SQ. FT. @
ESTIMATED CONSTRUCTION VALUATION $ 9 /J
NO14
MOTOR 1 OR LESS H.P.
MOTOR 5 OR LESS H.P.
MOTOR 20 OR LESS H.P.
OK W. UNITS
NO.
At
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
f
$"O
- NOTE: Not to be used as property tax valuation
USE OF BUILDING
� Y-- Al C,4 R '0A -r
kF.C.�-
DATE .
,� - �
FLOOR DRAIN
75
M.H. HOOKUP FEE
MECHANICAL FEES
$
COMMUNITV
WATER SOFTENER
I UNITS
ROOMS
VENT SYSTEM;[a7 FAN ❑EVAP. COOL PkHOOD
-9 00
OFFICE
MICROFILM FEE
WASHER (AUTO DISH)
'3
APPLIANCE /��;�
MECHANICAL FEE
TRANSIGN
FORMER O K.W.GARBAGE
$
/
DISPOSAL
B
SET CK
LOT SIZE
i FURNACE ❑ UNIT ❑ WALL ❑F OOR ❑SUSPENDED
USE NO.
OUTLETS
TYPE
LAUNDRY TRAY
SAi J
PLAN CHECK FEE
an
AIR HANDLING UNIT CFM
$BOND
moi'
FIXTURE OR SOCKET
AMT.
KITCHEN SINK
PLAN CHECKER
3 �i
GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
CONSTRUCTION FEE
CONST. SERV._ ENTRANCE
3
WATER CLOSET
NAME OF CONST. LENDER BRANCH
SD
COMPRESSOR 017' HP
iij
POLE
--/
LAVATORY
ADDRESS CITY
(%Ci
APPLIANCE VENT
SMI FEE
AMPERES SERV. ENT.
00yi0�
SHOWER
THIS PERMIT -SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 60 DAYS. CESSA-
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 -
CORD NCE WITH THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, I 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 ?VPARED THE PLANS AND SPECIFICATIONS
HAS DONE SO IN ACCORDANCE WITH SECTION f5p1 THE BU ESS AND PROFESp IOf4S
STATE OF CALIFORNIA. ii ✓ + 11++
e). Z) '
ABSORPTION SYSTEM B.T.U.
$
SO. FT. @ Q
PLUMBING FEE
BATH TUB
$
/
O
INCINERATOR ❑ DOMESTIC ❑ INDUS. OR COMM.
$
SQ. FT. O° Q
WATER HEATER
OWNER,
�-
��.�r_ b
CON-TRACTO- '+
aTm ,Ir + Ii } :f !� +.� +i♦
HEATING SYSTEM FORCED ❑ GRAVITY
Ly%
SQ. FT. RESID. @14
SEWAGE SYSTEM
SEWAGE DISPOSAL
/v
o
_
BOILER 0 B.T.U.
YES
SO. FT. GARAGE @1�2Q
q0
HOUSE SEWER
INFORMATION
j1FORM 284.208 (Re, 11/721a,
7(.
_
PERMIT FEE
_-3 Cb
BALANCE OF MIN. FEE
%
GAS PIPING
%
l%
MORILE HOME HOOKUP FEE % 1
PERMIT FEE
PERMIT FEE
2 JU8
TOTAL FEES
f 9 % �q
MOB. HK. FEE MICRO FEE
MECH.FEE
01 �.010
DBL.
PL. CK. FEE
-1700
CONST. FEE
—
DBL. ELECT. FEE DBL.
19:s-
SMI FEE
j ,tel
FEE PLUMB. FEEDBL.
3� v�
J I F I M A M J J A I S 1 O 1 N I D lJOBADDRESS
IV
'�I `i� - �t�' �.� d o �' .� D
OWN77-Al,
�/ ♦�
/moi tl,5 • Al,C- 13,
73
74
USE OF BUILDING
� Y-- Al C,4 R '0A -r
kF.C.�-
DATE .
,� - �
ERM N
0285
75
M.H. HOOKUP FEE
$
COMMUNITV
ST
I UNITS
ROOMS
VALUATION
ISUPP. TO PERMIT
OFFICE
MICROFILM FEE
COPIES
$
LEGAL DESCRIPTION
MECHANICAL FEE
DBL
$
/
B
SET CK
LOT SIZE
ZONE
/,/i�
USE NO.
GRP
TYPE
CK BY
T
SAi J
PLAN CHECK FEE
an
$BOND
moi'
0
100
AMT.
PLAN NO.
PLAN CHECKER
FINAL DATE INSPECTOR
�-�%
11-6-73
s7
o "..eiV
CONSTRUCTION FEE
DBL
$
o 6
NAME OF CONST. LENDER BRANCH
OFFICE J.NO
LENDER INVOLVED
ELECTRICAL FEE
DBL
$
19
3$'
ADDRESS CITY
STATE
SMI FEE
$
1
'3
THIS PERMIT -SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 60 DAYS. CESSA-
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 -
CORD NCE WITH THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, I 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 ?VPARED THE PLANS AND SPECIFICATIONS
HAS DONE SO IN ACCORDANCE WITH SECTION f5p1 THE BU ESS AND PROFESp IOf4S
STATE OF CALIFORNIA. ii ✓ + 11++
FEE
$
PLUMBING FEE
DBL
$
/
TOTAL FEES
$
/Ygr _
1 ✓
"
CASH ❑ CHECK M.O. ❑ ' N.C. ❑
OWNER,
�-
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CON-TRACTO- '+
aTm ,Ir + Ii } :f !� +.� +i♦
RECEIVED By
ADDRESS 4
'q c��� i $�#>3 ;;lk
ADDRESS tt
4fia50 +T• fit
SEWAGE SYSTEM
LL
P
TREES REQUIRED
YES
NOi
CITY -
�'a *�• k
CITY
INFORMATION
j1FORM 284.208 (Re, 11/721a,
7(.
TEL. NO. p-� LICENSE