206290 (SFD)BUILDING PERMIT DEPARTMENT OF BUILDING & SAFETO FIELD OFFICE
0 COUNTY OF RIVERSIDE
VENT SYSTEM (*FAN ❑ EVAP.COOL [>eHOODSIGN
ESTIMATE
ELECTRICAL FEES
PLUMBING FEES
1ST FL.
2ND FL.
POR.
GAR.
CAR P.
WALL
�CONSTRUCTION
�7 7�
SQ. FT. @�3 -- :36NO.
OUTLETS
NO.
SQ. FT. @ /
io
FIXTURE OR SOCKET
:ti
SQ. FT. @ Z MOTOR 1 OR LESS H.P.
GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
SQ. FT. @ MOTOR 5 OR LESS H.P.
/N
SQ. FT. @ " MOTOR 20 OR LESS H.P.
DRAINAGE PIPING
SQ. FT. @
DRINKING FOUNTAIN
SQ. FT. Ca
URINAL
OK.W.UNITS
WATER PIPING
ESTIMATED VALUATION is z'
INCINERATOR ❑ DOMESTIC ❑ INDUS. OR COMM.
FLOOR DRAIN
WATER HEATER
a MECHANICAL FEES
I
I IWATrR SOFTFNFR
VENT SYSTEM (*FAN ❑ EVAP.COOL [>eHOODSIGN
' PERMIT
WASHER (AUTO ISH)
APPLIANCE R R
TRANSFORMER =K•W•
GARBAGE DISPOSAL
_E:
FURNACE❑UNIT ❑WALL❑ LOOR❑SUSPENDED
OUTLETS
LAUNDRY TRAY
AIR HANDLING UNITt CFM
FIXTURE OR SOCKET
KITCHEN SINK
GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
CONST. SERV. ENTRANCE
WATER CLOSET w�
COMPRESSOR ,j U HP
POLE
LAVATORY
APPLIANCE VENT
AV AMPERES SERV. ENT.
SHOWER
ABSORPTION SYSTEM E= B.T.U.
SQ. FT.@ ¢
BATH TUB "�-
INCINERATOR ❑ DOMESTIC ❑ INDUS. OR COMM.
SQ. FT.@ C.
WATER HEATER
HEATING SYSTEM 'FORCED ❑ GRAVITY
SQ. FT. RESID. @ 1 0
% SEWAGE DISPOSAL
901LER � B.T.U.
SQ. FT. GARAGE @ z q
HOUSE SEWER /
PERMIT FEE
BALANCE OF MIN. FEE
GAS PIPING 7 .--,
MOBILEHOME HOOKUP FEE $ 1 1 1 1 IPERMIT FEE I�j( -_- PERMIT FEE 1-21
' PERMIT
NUMBER
OWNER
I T5 AL FEEDS
MOB. HOOK FEE
NEAT1ENYj)
DBL
PL. �Y
CONST. FE E�
DBL ELEC. FES
D ��� FEER PLUM B�G FEOE
DB
J F I M I A MI J I J I A S O
N I D
JOB ADDS
OWNER
72
t
i
73
U^/5�7��0/F BUIL�D[IN�IGT� C.
DATE
PEFjM17
74
✓1�'�G. Y"4, • L_if r% U/
G �J
3��/ -/�
22 0
6 2 9
0
75
COMMUNITY
DST
UNITS DOM
VALUATION
-IT
SUPP. TO PERMIT
OFFICE
76
I
_��
1
MOBILEHOME
$
LEGAL DESCRIPTION ' C = 3� C07
HOOKUP FEE
yx
� Q/ UP 4 l) L///N//j �OiC1 fJf /Y//
SET BACK
LOT SIZE
ZONE
USE NO.
GRP
TYPE
CK BY
MECHANICAL FEE
PLAN CHECK FEE
RDB
BOND AMT.
PLAN NO.
PLAN CHECKER
FINAL DATE INSP
CTOR
CONSTRUCTION FEE
NAME OF CONST. LENDER
BRANCH OFFICE
NO LENDER INVOLVED
!
ELECTRICAL FEE
DBL
$
3 d
ADDRESS
CITYSTATE
514 Al. p /-, / "?
L.!,"4
$
.r
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 60 DAYS.
/
CESSATION OF WORK FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
FEE
I HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE
IN ACCORDANCE WITH THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIF -
OBL
PLUMBING FEE
ORNIA. I ALSO AGREE TO CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES.
COMPLIANCE WITH THE LAWS OF THE STATE OF CALIFORNIA COVERING CONTRACTORS
..►
IS ALSO GUARANTEED.
DISPE
INDIVIDUALHSECT
ICERTIFYTOTAL
FEES $
19
CAT IDNSEBY HAS DONE SOH NT ACCORDANCE WI HTHE
ON 5541PREPAREDTHF TL I:NB SIINES N
PROFESSIONS CODE OF THE STATE OF CALIFORNIA.
CASH F-1 CHECK Ell" M.O. CD N.C. F --j
OWNER
CONTR CTOR-
Received By
ADDRESS
optDRESS
Sewage System
7 60,
LL
CITY
CITY
Trees Required
Yes Q
No,'
, ��
INFORMtATION
TEL. NO.
TEL. NO. LICENSE
t
' ,
FORM 284-208 (REV. 4/71)
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