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280571 (RR)BUILDING PERMIT DEPARTMENT.OF BUILDING & SAFETY COUNTY OF RIVERSIDE CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES INO 1 ST FL.-,'SQ.FT. @ UNITS 2ND FL.. SQ. FT. @ POR. SO. FT. @ MOBILEHOME SVC. GAR. POWER OUTLET - CAR P. SO.FT. @ ' SQ. FT. @ i��SO. FT.'@ oV. ESTIMATED CONSTRUCTION VALUATION $ NOTE: Not to be used as property tox valuation MECHANICAL FEES VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD APPLIANCE SWIM POOL. PVT SWIM POOL. COMM SIGN FIELD OFFICE PLUMBING FEES YARD SPKLR SYSTEM' BAR SINK ROOF DRAINS DRAINAGE PIPING DRINKING FOUNTAIN URINAL WATER PIPING FLOOR DRAIN WATER SOFTENER WASHER IAUTOI (DISHI GARRAGF DISPC)SAI /! I FURNACE ❑ UNIT •,❑ WALL ❑ FLOOR ❑ SUSPENDED _ - - . J F M A M J J A $ Q N D JOB ADDRESS` l.�_ _ SP 7� 7?7 ` !/� l�t� LAUNDRY TRAY AIR HANDLING UNIT CFM IDLE METER KITCHEN SINK ABSORPTION SYSTEM B. T. TEMP USE PERM SVC WATER CLOSET COMPRESSOR HP POLE, TEMP/PERM LAVATORY HEATING SYSTEM ❑ FORCED ❑ GRAVITY I AMPERES SERV ENT SHOWER BOILER � B.T.U. SQ FT @ a BATH TUB UNITS ROOMS SQ FT @ a WATER HEATER SQ FT RESID @ 1 a SEWAGE DISPOSAL IikA SQ FT GARAGE @ '/2a HOUSE SEWER PERMIT FEE MICROFILM FEE GAS PIPING MOBILE HOME PERMIT FEE $ LEGAL DESCRIPTION PERMIT FEE PERMIT FEE 2. _PERM Ij-jj 1 8057 �TOTAL65 5i.Jrj CJ MOB. HM.FEE MICRO FEE MECH. FEE DBL. PL. CK. FEE CONST. SEE 1y o DBL. ELECT. FEE DBL. SMI FEE E F:r PLUMB. FEE DBL. 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. JOB ADDRESS` l.�_ _ SP 7� 7?7 ` !/� l�t� - OWNER_,rt _ T - DLL. J L 74 i�'�iCJQ< lU IJ P 7j U/fSE OF PERMIT. j } . ((II) F: C. JDATA f �� (I, N PFgMN� 5 71' L 76 /l�'roo .L/tt.)Cf M H PERMIT FEE $ COMMUNITY DST UNITS ROOMS VALUATION h SUPP. TO PERMITFO FICE _ IikA MICROFILM FEE COPIES $ LEGAL DESCRIPTION fiV LQ / /�- AL. ;16Y MECHANICAL FEE DBL $ SETBACK LOT SIZE / ZONE USE NO. GRP TYPE CQJY r\ FS IR J/ PLAN CHECK FEE $ BOND AMT.PLAN NO. PLAN CHECKER FINAL DATE K�SR�ECT^OOR t-a�'�� l CONSTRUCTION FEE DBL $ / (� NAME OF CONST. LENDER BRANCH OFFICE NO LEND ANVOLVED _ T ELECTRICAL FEE DBL $ ADDRESS CITY % fj PATE STRONG MOTION INSTRUMENTATION FEE $ OWNER/AGENT'S SIGNATURE C6N.T (RF1R / i/rI t� i f <j . FEE $ ADDRESS ADDRESS (j J`aF' 1.._a1' .�"/j,�!_•r,J (IC,� f,� %a" 1� PLUMBING FEE DBL $ CITY ZIP CODE CITY ZIP CODE L TOTAL FEES $ j 4 Q TEL. N0. TEL. NO. ,�/� �, r c� S A LICENSE t/ .I f -3-) 7 � 6, *7/41 17 S CASH CHECK ❑ M.O. O N.C. ❑('.�'�� THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSA PION OF WORK FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID. J RECEIVED BY TREES REQUIREDi 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 ALSC SEWAGE SYSTEM T LL P AGREE TO CARRY COMPENSATION INSURANCE UPON MY. EMPLOYEES. COMPLIANCE WITH THE 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.