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259066 (PLBG)
BUILDING PERMIT DEPARTMENT OF BUILDING & SAFETY FIELD OFFICE ,A& COUNTY OF RIVERSIDE Aft CONSTRUCTION ESTIMATE 1 ST FL. SQ.FT. @ 2ND FL. SQ. FT. @ POR. SQ. FT. @ GAR. SQ. FT. @ CAR P. SQ.FT. @ WALL SQ. FT. @ SQ FT @ a BATH TUB SQ. FT. @ ESTIMATED CONSTRUCTION VALUATION $ NOTE: Not !o be used as property tax valuation MECHANICAL FEES /rAIT CVCTrAA n rAAI rl r\/AD rnnl I—I Hnnn ELECTRICAL FEES MOBILEHOME SVC. POWER OUTLET SWIM POOL, PVT SWIM POOL, COMM SIGN NO.I PLUMBING FEES BOILER B. BAR SINK ROOF DRAINS DRAINAGE PIPING DRINKING FOUNTAIN URINAL WATER PIPING FLOOR DRAIN WATER SOFTENER WASHER (AUTO) (DISH) // APPLIANCE GARBAGE DISPOSAL FURNACE ❑ UNIT 0 WALL O FLOOR ❑ SUSPENDED LAUNDRY TRAY AIR HANDLING UNIT CFM IDLE METER KITCHEN SINK ABSORPTION SYSTEM 0 B.T.U. TEMP USE PERM SVC WATER CLOSET COMPRESSOR 0 HP POLE, TEMP/PERM LAVATORY HEATING SYSTEM D FORCED OGRAVITY AMPERES SERV ENT SHOWER SQ FT @ a BATH TUB SQ FT @ a WATER HEATER SQ FT RESID @ 1 a SEWAGE DISPOSAL SQ FT GARAGE @ '/)Q HOUSE-5'EWER j _r U PERMIT FEE TEMP ELEC SVC GAS PIPING MOBILE HOME PERMIT FEE $ PERMIT FEE PERMIT FEE25 O U R T 0 TOTAL FEES IMOB. HM. FEEMICRO FEE MECH. FEE- DBL. PL. CK. FEE CONST. FEE DBL. ELECT. FEE DBL. SMI FEE FEE PLUMB. FEE DBL J I F I M A M I J IJ A I S 1 O 1 N D JOB ADDRESS /� J / I SP NO y�'r�l�l� l 01� �17f-/`.t �%{. 1 OWj 73 74 USE OF PERMIT r F.C. DATE PFr$M .N O 6 6 75 M H PERMIT FEE $ COMMUNITY DST UNITS ROOMS VALUATION SUPP. TO PERMIT OFFICE MICROFILM FEE COPIES $ LEGAL DESCRIPTION / MECHANICAL FEE DBL $ SET BACK LOT SIZE ZONE/ I USE NO. GRP TYPE CK BY i!/lfr F S R PLAN CHECK FEE $ BOND AMT. PLAN NO. PLAN CHECKER FINAL DATE p CONSTRUCTION FEE DBL $ NAME OF CONST. LENDER BRANCH OFFICE NO LENDER INVOLOD 4--" ELECTRICAL FEE DBL $ ADDRESS CITY STATE SMI FEE $ THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 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- CORDANCE 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. 1 HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE SO IN ACCORDANC WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE ' OF THE STATE OF CALIFORNIA/, FEE $ PLUMBING FEE DBL $ TOTAL FEES /� Civ OWNER/AGENT'S SIGNATURE f• J % CONTRACTOR r t' -tip `f Sdsr� CASH CHECK p M.O. ❑ N.C. 0 ADDRESS /i J ;? Uri 1 !•r r '- ADDRESS ` r �4C. ! 14. POO F �✓ } , RECEIVED BY TREES REQUIRED *f SEWAGE SYSTEM T LL PvX(�� CITY ZIP CODE /` ,sr `^i/� ,CITY ZIP CODE S t.i �� j 7 :/ f INFORMATIONTEL. FORA 284208,Rev. 9.73, ©s +vlJfl�a. NO. ' TEL. NO. LICENSE r r, 2 i 3