236260 (PLBG)BUILDING PERMIT
DEPARTMENT OF BUILDING & SAFETY
COUNTY OF RIVERSIDE Is
ELECTRICAL FEES,..,..,._,.
NO. I I NO.
NOTE: Not to be used as property tax valuation
MECHANICAL FEES
VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD
APPLIANCE
FURNACE ❑ UNIT ❑ WALL ❑FLOOR ❑SUSPENDED
AIR HANDLING UNIT I I CFM
GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
COMPRESSOR 0 HP
APPLIANCE VENT
ABSORPTION SYSTEM 0 B.T.U.
INCINERATOR ❑ DOMESTIC ❑ INDUS. OR COMM.
HEATING SYSTEM ❑ FORCED ❑ GRAVITY
BOILER 0 B.T.U.
PERMIT FEE
MOBILE HOME HOOKUP FEE Is
GJ
2 3P�gMt) yJ6 TOTAL Fe-EES MOB. HK. FEE MICRO FEE
{
J I F I M A I M I J I J A I S 1 O 1 N I D
73
74
75
M.H. HOOKUP FEE $
MICROFILM FEE I COPIES $
MECHANICAL FEE I DBL I$ I I
I
I PLAN CHECK FEE
CONSTRUCTION FEE
i
ELECTRICAL FEE
' SMI FEE
FEE
PLUMBING FEE
DBL $
DBL $
$
TOTAL FEES 01
i CASH Lit
RECEIVED BY
SEWAGE SYSTEM
I TREES REQUIRED
CHECK ❑ M.O. ❑
T I LL
YES
INFORMATION
FORM 284-208 (Rev. 11/721
6 'era
r
FIELD OFFICE
PLUMBING FEES I Ds"
CONSTRUCTION ESTI
1 ST FL.
SQ. FT.
Ca _
2ND FL.
MOTOR 20 OR LESS H.P.
SQ. FT.
Ca _
POR.
DRINKING FOUNTAIN
SQ. FT.
Cat_
GAR.
SQ.FT.
@_
CAR P.
SQ. FT.
@_
WALL
WATER SOFTENER
SO.FT.
SIGN
WASHER (AUTO) (DISH)
SQ. FT.
@_
ESTIMATED CONSTRUCTION VALUATION
DEPARTMENT OF BUILDING & SAFETY
COUNTY OF RIVERSIDE Is
ELECTRICAL FEES,..,..,._,.
NO. I I NO.
NOTE: Not to be used as property tax valuation
MECHANICAL FEES
VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD
APPLIANCE
FURNACE ❑ UNIT ❑ WALL ❑FLOOR ❑SUSPENDED
AIR HANDLING UNIT I I CFM
GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
COMPRESSOR 0 HP
APPLIANCE VENT
ABSORPTION SYSTEM 0 B.T.U.
INCINERATOR ❑ DOMESTIC ❑ INDUS. OR COMM.
HEATING SYSTEM ❑ FORCED ❑ GRAVITY
BOILER 0 B.T.U.
PERMIT FEE
MOBILE HOME HOOKUP FEE Is
GJ
2 3P�gMt) yJ6 TOTAL Fe-EES MOB. HK. FEE MICRO FEE
{
J I F I M A I M I J I J A I S 1 O 1 N I D
73
74
75
M.H. HOOKUP FEE $
MICROFILM FEE I COPIES $
MECHANICAL FEE I DBL I$ I I
I
I PLAN CHECK FEE
CONSTRUCTION FEE
i
ELECTRICAL FEE
' SMI FEE
FEE
PLUMBING FEE
DBL $
DBL $
$
TOTAL FEES 01
i CASH Lit
RECEIVED BY
SEWAGE SYSTEM
I TREES REQUIRED
CHECK ❑ M.O. ❑
T I LL
YES
INFORMATION
FORM 284-208 (Rev. 11/721
6 'era
r
FIELD OFFICE
PLUMBING FEES I Ds"
r "/-51- %-13 1 atn —
NAME OF CONST. LENDER BRANCH OFFICE .NO LENDER INVOLVED
Y
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-
CORDANCE WITH THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, I ALSO
r 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 PREPARED THE PLANS AND SPECIFICATIONS
HAS DONE 50 IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS
—1 CODE F THE STATE OF CALIFORNIA.
OWNER, CONTRACTOR
N.C. ❑� 01,E
'�� r`
&J-4. fJilw! ,� 01 ,E ✓, � -- .LLQ lc /I , t
ADDRESS ADDRESS j
P �3 -A
CITY ��;•A t /[/ ��fi/5��,
CITY cin
NO � lnti % 4� i • P,16 G /l/t ` A f �[ 'S•
TEL. NO. TEL. NO. LICENSE
MOTOR I OR LESS H.P.
MOTOR 5 OR LESS H.P.
_ G O
MOTOR 20 OR LESS H.P.
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
D K.W. UNITS
WATER PIPING
FLOOR DRAIN
WATER SOFTENER
SIGN
WASHER (AUTO) (DISH)
TRANS -DISPOSAL
FORMER D
OUTLETS
LAUNDRY TRAY
FIXTURE OR SOCKET
KITCHEN SINK
CONST. SERV. ENTRANCE
WATER CLOSET
POLE
LAVATORY
AMPERES SERV. ENT.
SHOWER
SO. FT. Qa Q
BATH TUB
SQ. FT. @ Q
WATER HEATER
-+SO. FT. RESID. @ 1 Q
SEWAGE DISPOSAL
SQ. FT. GARAGE@1124
HOUSE SEWER
BALANCE OF MIN. FEE
GAS PIPING
PERMIT FEE
PERMIT FEE
MECH. FEE
11)BUI
Pl. CK: FEE
I CONST. FEE
I DBL. ELECT. FEE DBL.
7
t,7
SMI FEE
I FEE
I PLUMB. FEE
44
DBL.
J
JOB ADDRESS
"27 i
2-Dz.
OWNER
r&/-
USE OF BUILDING
, j�,eralt�'c J'V S77 ,"
I F.C.
DATE PERMLINGG���
/o
6 2 6 O
COMiM�UN,IT/Y}
DST
I UNITS
ROOMS I
VALUATIIOO,N/�
SUPP. TO PERMIT OFFICE
LEGAL DESCRIPTION
SETBACK
LOT SIZE
ZONE_
USE NO.
GRP
TYPE
C�KtBY
r "/-51- %-13 1 atn —
NAME OF CONST. LENDER BRANCH OFFICE .NO LENDER INVOLVED
Y
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-
CORDANCE WITH THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, I ALSO
r 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 PREPARED THE PLANS AND SPECIFICATIONS
HAS DONE 50 IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS
—1 CODE F THE STATE OF CALIFORNIA.
OWNER, CONTRACTOR
N.C. ❑� 01,E
'�� r`
&J-4. fJilw! ,� 01 ,E ✓, � -- .LLQ lc /I , t
ADDRESS ADDRESS j
P �3 -A
CITY ��;•A t /[/ ��fi/5��,
CITY cin
NO � lnti % 4� i • P,16 G /l/t ` A f �[ 'S•
TEL. NO. TEL. NO. LICENSE