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272153 (SFD)APPLIANCE Now FIELD OFFICE BUILDING PERMIT DEPARTMENT OF. BUILDING & SAFETY GARBAGE DISPOSAL - FURNACE O UNIT O WALL O FLOOR O SUSPENDED COUNTY OF RIVERSIDE F.C." DATE LAUNDRY TRAY - DST CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES. NO. PLUMBING FEES I 1 ST FL. SQ.FT. @ UNITS. ABSORPTION SYSTEM 2ND FL. SQ. FT. @ YARD SPKLR SYSTEM POR. SQ. FT. @ MOBILEHOME SVC. BAR SINK GAR. SQ. FT. @ POWER OUTLET ROOF DRAINS CAR P. SO.FI. @ LAVATORY DRAINAGE PIPING WALL SQ. FT. @ AMPERES SERV ENT DRINKING FOUNTAIN SO. FT. @ BOILER B.T.U. URINAL ESTIMATED CONSTRUCTION VALUATION is SQ FT @ ¢ WATER PIPING '. NOTE: Not to be used as property tax voluotion SWIM POOL. PVT FLOOR DRAIN MECHANICAL FEES SWIM POOL. COMM WATERSOFTENER WATER HEATER VENTSYSTEM O FAN O EVAP. COOL O HOOD SIGN N/AcWPD IAI ITnl lnicl.l APPLIANCE JOB ADDRESS SP NO OWNER 74 / `/�j! r IH 1" 1.1/�:+7�. GARBAGE DISPOSAL - FURNACE O UNIT O WALL O FLOOR O SUSPENDED OF PERMIT" t„J� �, F.C." DATE LAUNDRY TRAY AIR HANDLING UNIT CFM IDLE METER 2 215 3 KITCHEN SINK ABSORPTION SYSTEM B.T.U. TEMP USE PERM SVC DST WATER CLOSET COMPRESSOR HP SUPP. 70 PERMIT POLE, TEMP/PERM LAVATORY HEATING SYSTEM O FORCED ❑ GRAVITY AMPERES SERV ENT SHOWER BOILER B.T.U. SQ FT @ ¢ MICROFILM FEE BATH TUB $ LEGAL DESCRIPTION - SQ FT @ ¢ WATER HEATER MECHANICAL FEE SQ FT RESID @ 1¢ $ SEWAGE DISPOSAL SETBACK LOT SIZE ZONE ' SQ FT GARAGE @ '/]¢ I HOUSESEWER PERMIT FEE / 3r1 / �j GAS PIPING MOBILE HOME PERMIT FEE $ PERMIT FEE PERMIT FEE 21 E2 NO 15 3 TOTAL FEES MOB. HM.FEE MICRO FEE MECH. FEE , �� ,� 'D9l: L PL. CK. FEE CONST. FEE .� : �.� RBC ELECT. FEE DBtt SMI FEE FEE PLUMB. FEE -� �, 081. J I F I M A I M IJ Y A $ Q N D JOB ADDRESS SP NO OWNER 74 / `/�j! r IH 1" 1.1/�:+7�. J 75 OF PERMIT" t„J� �, F.C." DATE P M 76 -US;'E t �.f�}i+) - � ::,� �� - /- 2 215 3 M H PERMIT FEE $ COMMUNITY DST UNITS ROOMS VALUATION SUPP. 70 PERMIT OFFICE MICROFILM FEE COPIES $ LEGAL DESCRIPTION - MECHANICAL FEE ABT` $ SETBACK LOT SIZE ZONE USE NO. GRP TYPE CK BY / 3r1 / �j f PLAN CHECK FEE $' BOND AMT.PLAN NO. PLAN CHECKER FINAL DATE INSPECTOR J CONSTRUCTION FEE -ft $ NAME OF CONST. LENDER BRANCH OFFICE NO LENDER INVOLVE ELECTRICAL FEE D'Bt- $ ADDRESS CITY STATE STRONG MOTION INSTRUMENTATION FEE $ OW ERr/AGENT'S SIGNAAT ,� /j CONTRACTOR .Y • $ ADDRESS , ADDRESS FEE PLUMBING FEE DBC $ CITY ZIP CODE CITY ZIP CODE -^� J TOTAL FEES $ - TEL. NO. TEL. NO. LICENSE CASH ❑ CHECK 'Lt M.O. O N.C. O ! THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSA fStfON OF WORK FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID. h 1 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 RECEIVED BY` a TREES REQUIRED SEWAGE SYSTEM, T LL p AGREE TO CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLIANCE WITH THE I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPAREDTHEPLANS AND SPECIFICATIONS FORM 284-208 (Rev. 10-74) OIL HAS DONE SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE 1 OF THE STATE OF CALIFORNIA..