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268485 (PLBG)I BUILDING PERMIT DEPARTMENT OF BUILDING & SAFETY COUNTY OF RIVERSIDE 1 CONSTRUCTION ESTIMATENO. ELECTRICAL FEES ! 1 ST Cl FT UNITS . SO. . @ 2ND FL. SQ. FT. @ POR. SO. FT. @ GAR. SO. FT. @ CAR P. SO.FI. @ WALL SO. FT. @ SO. FT. @ JDATE'flT ESTIMATED CONSTRUCTION VALUATION $ NOTE: Not to be used as property tox voluot ion MECHANICAL FEES VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD MOBILEHOME SVC. POWER OUTLET SWIM POOL, PVT SWIM POOL. COMM SIGN FIELD OFFICE NO. PLUMBING FEES YARD SPKLR SYSTEM BAR SINK ROOF DRAINS DRAINAGE PIPING DRINKING FOUNTAIN URINAL WATER PIPING FLOOR DRAIN WATER SOFTENER WASHER (AUTO) IDISHI DST &0 APPLIANCE SP NO .IOB ADDRES�S> OWNER GARBAGE DISPOSAL ) /f FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED 75 LAUNDRY TRAY F.C. AIR HANDLING UNIT CFM IDLE METER KITCHEN SINK JDATE'flT ABSORPTION SYSTEM 0 B.T.U. TEMP USE PERM SVC WATER CLOSET $ COMPRESSOR 0 HP POLE, TEMP/PERM LAVATORY ROOMS HEATING SYSTEM ❑ FORCED ❑ GRAVITY AMPERES SERV ENT SHOWER BOILER 0 B.T.U. SQ FT @ a BATH TUB SQ FT @ a WATER HEATER MICROFILM FEE COPIES SQ FT RESID @ 1 a SEWAGE DISPOSAL LEGAL DESCRIPTION SQ FT GARAGE @ '/aa HOUSESEWER ,-/- G� --!I' -//- / ..-,5� PERMIT FEE DBL $ GAS PIPING SET BACK MOBILE HOME PERMIT FEE $ USE NO. PERMIT FEE PERMIT FEE � � PERMIT NO.TOTAL 268485 FEES -`'% MOB. HM.FEE MICRO FEE MECH. FEE DBL. PL. CK. FEE CONST. FEE DBL. ELECT. FEE DBL. SMI FEE FEE PLUMB. FEE DBL. J I FM A M J J A S O N D SP NO .IOB ADDRES�S> OWNER ) /f 75 USE OF PERMIT F.C. 76 r % P JDATE'flT /-- r�'' iGi 8 4 8 5 M H PERMIT FEE $ O MUNITY DST UNITS ROOMS VALUATION SUPP. TO PERMIT OFFICE MICROFILM FEE COPIES $ LEGAL DESCRIPTION ,-/- G� --!I' -//- / ..-,5� MECHANICAL FEE DBL $ SET BACK LOT SIZE ZONE USE NO. GRP TYPE CK BY / F 5 R� fel PLAN CHECK FEE $ BOND AMT. PLAN NO. PLAN CHECKER FINAL DATE INSPECTOR r CONSTRUCTION FEE DBL $ NAME OF CONST. LENDER BRANCH OFFICE NO LENDER INVOLVED ELECTRICAL FEE DBL $ ADDRESS CITY �= STATE r fI STRONG MOTION INSTRUMENTATION FEE $ OWNER/AGENT'S SIGNATURE CONTRACTOR ♦ N,�_ o ., s l $ ADDRESS ADDRESS 'FEE PLUMBING FEE DBL $ CITY ZIP CODE CITY ZIP CODE TOTAL FEES $ TEL. NO. TEL. NO. LICENSE CASH CHECK CHECK ❑ M.O. ❑ N.C. ❑ THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSA ON OF WORK FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID. RECEIVED BYR/' TREES REQUIRED ,41 11I D HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN AC WITH THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, I ALSC SEWAGE SYSTEM ICORDANCE , T LL P AGREE TO CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLIANCE WITH THI r �A1. Air 1-1—A IT -1 it A.-- Trrn I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS FORM 284-208 (Rev. 10-74) @L HAS DONE SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA.