280666 (SPIN)BUILDING PERMIT { DEPARTMENT OF BUILDING & SAFETY
COUNTY OF RIVERSIDE
CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES
1 ST FL. SQ.FT. @ IUNITS
2ND FL. • SQ. FT. @
POR. SQ. FT. @ MOBILEHOME SVC.
GAR. POWER OUTLET
.CAR P.� SQ.FT. @
WALL • SO. FT. @
SQ. FT. @
ESTIMATED CONSTRUCTION VALUATION.• $
NOTE: Not to be used as property tax valuation
MECHANICAL FEES
VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD
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
WATERSOFTENER
WASHER (AUTO) (DISH)
APPLIANCE
JOB ADDRESS SP NO
77-0 CAfte Port
MtJ)A
GARBAGE DISPOSAL
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
&)A) I
LAUNDRY TRAY
AIR HANDLING UNIT
CFM
IDLE METER
KITCHEN SINK
ABSORPTION SYSTEM
0 B.T.U.
TEMP USE PERM SVC
WATER CLOSET
COMPRESSOR
HP
POLE, TEMP/PERM
LAVATORY
HEATING SYSTEM ❑ FORCED ❑ GRAVITY
AMPERES SERV ENT
SHOWER
BOILER � B.T.U.
COPIES
SQ FT @ ¢
BATH TUB
LEGAL DESCRIPTION
SQ FT @ ¢
WATER HEATER
771,/- p7- -Ga ,5;- Zoe-
SOFT RESID @ 1 a
SEWAGE DISPOSAL
$
ti `SQ FT GARAGE @ 'ha
HOUSE SEWER
PERMIT FEE
GRP
TYPE
GAS PIPING
MOBILE HOME PERMIT FEE
Is
PERMIT FEE
PERMIT FEE -
ER IT NO.
2��66
TOTAL FEES
/41 a=
MOB. HM.FEE
MICRO FEE
MECH. FEE
DBL.
PL. CK. FEE
CONST. FEE
DBL.
ELECT. FEE
DBL.
SMI F E
C FEE
/o;�►�
PLUMB. FEE
DBL.
T J I F I M. A I M 1J 1 A S Q N D
JOB ADDRESS SP NO
77-0 CAfte Port
MtJ)A
74
a
&)A) I
75
76
USE OF PEkMIT ,
5p-cr-w) I��I Spe�.t��N
F.C.
DATE
9 ,co1PE2'90'666
O
M H PERMIT FEE
$
A
C``OMMUNITY-
G� 014 1014
DDST
/
I UNITS
ROOMS
I VALUATION JSUPP.TO
PERMIT
OFFICE
MICROFILM FEE
COPIES
$
LEGAL DESCRIPTION
771,/- p7- -Ga ,5;- Zoe-
MECHANICAL FEE
DBL
$
SETBACK LOT SIZEZONE
/
USE NO.
GRP
TYPE
CK�Y C
F j a S� ]1 �iy R z
[J ��'
. (l
i\\
PLAN CHECK FEE
$
BOND AMT.
PLAN NO. PLAN CHECKER
FI♦IINAL DATE
I CTOR
CONSTRUCTION FEE
DBL
$
NAME OF CONST. LENDER BRANCH
OFFICE
NO LENDER INVOLVED
ELECTRICAL FEE
DBL
$
ADDRESS CITY
STATE
STRONG MOTION
INSTRUMENTATION FEE
$
A NE T'S SI ATURE
CONTRACTOR
iJ
�(J
FEE
$ lV
ADDRE
ADDRESS
FC�hus'p 'e-
G%1(
PLUMBING FEE
••
DBL
$
CITY ZIP CODE
L� ��u�I�fR:
CITY ZIP CODE
•
TOTAL FEES
$
/0
TEL. NO.
:5
TEL. NO. LICENSE
CASH ❑ CHECK M.O. ❑ N.C. ❑
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.
RECEIVED BY
TREES REQUIRED. J'
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 SYSTEM1
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.