173189 (SFD)DEPARTMENT OF BUILDING & SAFETY
COUNTY OF RIVERSIDE
FIELD OFFICE
LOT SIZE
CONSTRUCTION ESTIMATE
ELECTRICAL FEES
PLUMBING FEES
1st Fl.
2nd FI.
Por.
Gar.
Car P.
Wall
Sq. Ft. @
NO.
NO.
USE OF BUILDING DATE
Sq. Ft. @
Sq. Ft. @01, �
�•• , ,
Sq. Ft. @�POLES
Sq. Ft. @ SIGNS DRAINAGE PIPING
TRN
Sq. Ft. @ OR ATSCLK D/ DRINKING FOUNTAIN
COMMUNITY
Sq. Ft. @ MOTOR H. P. URINAL
F.C.
MOTOR N.P. WATER PIPING
{rte
ESTIMATED VALUATION $MOTOR
A ,
H. P.
FLOOR DRAIN
MECHANICAL FE $ ~
[VALUATION �,/.,✓y
7
MOTOR
H. P.
WATER SOFTENER
GROUP
VENT SYSTEM ❑ FAN ❑ EVAP. COOLX000
LEGAL DESCRIPTION
MOTOR
H.P.
WASHER (AUTO " `DISH)
APPLIANCE
FIXTURES
GARBAGE DISPOSAL%
Jp
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
SPEC. INSP.
OUTLETS
SUPP. TO PERMIT
LAUNDRY TRAY
AIR HANDLING UNIT
SUB-PAMEL
KITCHEN SINK
GAS PIPE ❑'NATURAL ❑ L.P.G. ❑ OIL
PLAN CHECKER
BOND $
BOND
401 WATER CLOSET
PLAN FILE #
COMPRESSOR HP
INSPECTOR
RANGE AND/OR OVEN
LAVATORY
!V O
IV
APPLIANCE VENT
WATER HEATER
SHOWER
RQ
ABSORPTION SYSTEM O B.T.U.
TOTAL FEES
SPACE NEATERBATH
TUB
3-0 :
INCINERATOR DOMESTIC ❑ INDUS. ❑ COMM.
t•�
CONSTRUCTION POLE
WATER HEATER
IECEIVED BY
HEATING SYSTEM XFORCFD ❑ GRAVITY
SERVICE ENTRANCE
SEWAGE DISPOSAL
a�
BOILER �8.T. U.
RESID. IQ SQ. FT.
72
HOUSE SEWER
R _%Uj&Aj&4.F &E SQ.FT.�N
SIDE COUNTY AND THE STATE OF CALIFORNIA. I ALSO AGREE TO
GARAGE iQ SQ. FT. jy%'
GAS PIPING
LL
PERMIT FEE
P
PERMIT FEE
i*
PERMIT FEE
0�
>ERMIT NU 8 9
T73,
REN. JDBL:
VAM OP C° TfMC OI(
TOTAL FEES
HEAT & VENT FEE
PLN.
CK. FEE �.
CON5T. 'FEE
ELEC.
FEE
IP UMB. FEE
J F M A M J
A
5
O N D
�-
SET BACK
_
LOT SIZE
USE V
JOB ADDRESS I I OWNER '
79-460 Calle low 11 om Realty Co.
201s
R 23
ZONE
USE OF BUILDING DATE
PLAN CHECK FEE ry..►�
�•• , ,
`�, { `a
*w Dw ►with Z-� *r-attsc>a�sd . ar# 1 lk-69
CHECKED BY
COMMUNITY
DISTRICT
F.C.
UNITS
OFFICE
`1s�
MECHANICAL FEE 1r
A ,
t$
'�
J_X
[VALUATION �,/.,✓y
7
GROUP
I TYPE
LEGAL DESCRIPTION
PTM NUMBECONSTRUCTION �
FEE ++�
�y.
Lot zS • Tv -20 3448118
Jp
SPEC. INSP.
SUPP. TO PERMIT
ELECTRICAL FEE
PLAN CHECKER
BOND $
BOND
I CASH
PLAN FILE #
FINAL DATE
INSPECTOR
PLUMBING FEE
,1
TOTAL FEES
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED'
t•�
WITHIN 60 DAYS. CESSATION OF WORK FOR 120 DAYS SHALL ALSO
CAUSE PERMIT TO BECOME VOID.
I HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS
CASH CHECK M.O. N.C. I
IECEIVED BY
SEWAGE
SYSTEM
PERMIT WILL BE DONE IN ACCORDANCE WITH THE LAWS OF RIVER-
`
SIDE COUNTY AND THE STATE OF CALIFORNIA. I ALSO AGREE TO
TI
LL
P
CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLI-
ANCE WITH LAWS OF THE STATE OF CALIFORNIA COVERING CON -
i*
C/ INFORMATION
TRACTORS IS ALSO GUARANTEED.
VAM OP C° TfMC OI(
UNDER
OWNER
CONTRACTOR'
ADDRESS
AD FRYAM +
ADDRESS
Cd,li
A
t4
So L=11
x
TEL. NO.
TEL. NO.
Y
LICENSE NO.
t84-208 11/67
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.