24353 (BLCK)I BUILDING PERMIT
CONSTRUCTION ESTIMATE
1 ST FL. SQ.FT. @
2ND FL. SQ. FT. @
POR. SQ. FT. @
GAR. SQ. FT. @
CAR P. SQ.FT. @
WALL SQ. FT. @
SQ. FT. @
ESTIMATED CONSTRUCTION VALUATION $
NOTE: Not to be used as property tax valuation
MECHANICAL FEES
VFNT SYSTFM n FAN n FVAP. COOL ❑ HOOD
DEPARTMENT OF BUILDING & SAFETY
' COUNTY OF RIVERSIDE 4
NO. I ELECTRICAL FEES
MOBILEHOME SVC.
POWER OUTLET
SWIM POOL, PVT
SWIM POOL. COMM
SIGN
FIELD OFFICE
NO.] PLUMBING FEES
BOIlERI JI B.T.U.
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URNAL
WATER PIPING
FLUOR DRAIN
WATER SOFTENER
WASHER (AUTO) (DISH)
DST
APPLIANCE GARBAGE DISPOSAL
FURNACE ❑ UNIT O WALL O FLOOR ❑ SUSPENDED LAUNDRY TRAY
AIR HANDLING UNIT I 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 O FORCED ❑GRAVITY AMPERES SERV ENT SHOWER
SQ FT @ 4 BATH TUB
SQ FT @ ¢ WATER HEATER
SQ FT RESID @ I ¢ SEWAGE DISPOSAL
SQ FT GARAGE @ 'ha HOUSE SEWER
PERMIT FEE TEMP ELEC SVC GAS PIPING
MOBILE HOME PERMIT FEE Is
PERMIT FEE PERMIT FEE
R T
TOTAL FEES
MOB. HM. FEE
MICRO FEE
MECH. FEE
DBL
PL. CK. FEE
CONST. FEE
��
DBL. ELECT. FEE
DBL.
SMI FEE
FEE PLUMB. FEE
DBI
_24
J f 'A A ' ' 'J A 'S 1 O 1 ADDRESS 60
73 46-450 Caoeo Palau I
O':a7CA
Gillet, Randy G.
USE OF PERMIT
6x91 Block Wall
F.C. JDATE
1-3-74
PERMIT.'
2353
75
M H. PERMIT FEE
$
COMMUNITY
Palm Desert
I DST
11
UNITS
ROOMS
VALUATIONu ISUPP.
TO PERMIT
OFFICE
MICROFILM FEE
COPIES
$
LEGAL DESCRIPTION
Lot -10 - 3'r-2043 - PC -617-052-005
MECHANICAL FEE
DBL
$
SET BACK
LOT SIZE ZONE
R_l
A
JUSE
NO.
GRP
TYPE
CK BY
Ayer*
J
F S R
PLAN CHECK FEE
$
BOND AMT
PLAN NO.
PLAN CHECKER
FINAL DATE INSP
CTOR
CONSTRUCTION FEE
DBL
$
NAME OF CONST. LENDER BRANCH
OFFICE
NO ENDER INVOLVED
ELECTRICAL FEE
DBL
$
ADDRESS CITY
—
STATE
SMI FEE
$
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIf'10 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
AGREE TO CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLIANCE WITH THE
LAWS OF THE STATE OF CALIFORNIA COVERING CONTRACTORS IS ALSO GUARANTEED.
1 HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS
HAS DONE SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE
OF THE STATE OF CALIFORNIA.
FEE
$
PLUMBING FEE
DBL
$
TOTAL FEES
$
OWNER/AGENT'S SIGNATURE
CONTRACTOR
CASH ❑ CHECK M.O. ❑ N.C. ❑
ADDRESS
ADDRESS
RECEIVED BY
TREES REQUIRED
SEWAGE SYSTEM
T
LL P
CITY 21P CODE
CITY " ZIP CODE
INFORMATION
FORM 284-208 (Rev 973) 0s 64,0w, syr
TEL. NO
TEL. NO. LICENSE