210179 (RPL)BUILDING PERMIT DEPARTMENT OF BUILDING & SAFETY
0 COUNTY OF RIVERSIDE 0
FIELD OFFICE
CONSTRUCTION ESTIMATE
ELECTRICAL FEES
PLUMBING FEES
1ST FL.
2ND FL.
POR.
GAR.
CAR P.
LL
i/S!f?1%7
SQ. FT. @
NO. i
NO.
SQ. FT. @
U
SQ. FT. @ MOTOR 1 OR LESS H.P.
U
SQ. FT. @ MOTOR 5 OR LESS H.P.
AIR HANDLING UNIT CFM
SQ. FT. @ MOTOR 20 OR LESS H.P.
DRAINAGE PIPING
SQ. FT. @
DRINKING FOUNTAIN
SQ. FT. @
URINAL
OK•W.UNITS
J WATER PIPING
ESTIMATED VALUATION Is
LAVATORY
FLOOR DRAIN
MECHANICAL FEES
AMPERES SERV. ENT.
WATER SOFTENER '
VENT SYSTEM p FAN ❑ EVAP.COOL ❑ HOOD
SIGN
WASHER (AUTO) (DISH)
oaf /
APPLIANCE
TRANSFORMER OK•W.
GARBAGE DISPOSAL
TOTAL FE
FURNACE❑UNIT ❑WALL❑FLOOR ❑SUSPENDED
OUTLETS %
LAUNDRY TRAY
PL. CK. FEE CONST. FE
AIR HANDLING UNIT CFM
% FIXTURE OR SOCKET !00
KITCHEN SINK
' FEE
GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
CONST. SERV. ENTRANCE
WATER CLOSET
6-7-72
COMPRESSOR HP
POLE
LAVATORY
APPLIANCE VENT
AMPERES SERV. ENT.
SHOWER
ABSORPTION SYSTEM E:= B.T.U.
SQ. FT.@ q
BATH TUB
JDBL
INCINERATOR ❑ DOMESTIC ❑ INDUS. OR COMM.
SQ. FT.@ C
WATER HEATER
HEATING SYSTEM ❑ FORCED ❑ GRAVITY
SQ. FT. RESID. @ 1 R
SEWAGE DISPOSAL
F
BOILER E::� B.T.U.
SQ. FT. GARAGE @ 'z ¢
H;;;;;;;;;'
PERMIT FEE
BALANCE OF MIN. FEE
% GAS PIPING
MOBILEHOME HOOKUP FEE
I$ I I I I / IPERMIT FEE
I PI
oaf /
I PERMIT FEE
1 _41 d U
PERMIT NUMBER
TOTAL FE
OB. HOOK FEE
HEAT & VENT FEE
USE OF BUILDINGF.C.
PL. CK. FEE CONST. FE
BL
ELEC.
DBL
' FEE
PLUMBING FEE
Private Svils Pool
21017
6-7-72
9
�-�JOB]
75
COMMUNITY
��
I UNITSOOM
VALUATION�v
SUPP. TO PERMIT
OFFICE
JDBL
J F M A M J J A S O
N D
JOB ADDRESS
OWNER
72
48-800 Sten Lucas Ave.
Schroder. ohn
73
USE OF BUILDINGF.C.
DATE PER IT
1
N
179
74
Private Svils Pool
-ip
6-7-72
75
COMMUNITY
DST
I UNITSOOM
VALUATION�v
SUPP. TO PERMIT
OFFICE
76
LA QuintsT
p�t9 ""'
F
MOBILEHOME
$
LEGAL DESCRIPTION
HOOKUPFEE
Lot 61 - La Quints Golf Ests.#1 - PC -617-290-034
DBL
SET BACK
LOT SIZE
ZONE
GRP
TYPE
CK BY
MECHANICAL FEE
$
1 8-1
JUSENO.
Avers
F 6 Is 6-7 IR 7
BOND AMT.
PLAN NO.
PLAN CHECKER
FINAL DATE
IN PEC TOR
PLAN CHECK FEE
$
I
DBL
NAME OF CONST. LENDER
BRANCH OFFICE
NO LENDER IN VED
CONSTRUCTION FEE
V
DBL
ADDRESS
CITY
STATE
ELECTRICAL FEE
$
7
U
$
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 60 DAYS.
CESSATION OF WORK FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
FEE
AI HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE•DONE
IN CCORDANCE WITH THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIF -
DBL
PLUMBING FEE
ORNIA. I ALSO AGREE TO CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES.
/I
!
t"!1
�.7
COMPLIANCE WITH THE LAWS OF THE STATE OF CALIFORNIA COVERING CONTRACTORS
IS ALSO GUARANTEED.
I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED �HE_PLANS AND SPECIFI-
TOTAL FEES $
}
CATIONS HAS DONE SO IN ACCORDANCE WITH SECTION 5541 O I D
PROFESSIONS CODE OF THE STATE OF CALIFORNIA.
CASH 0 CHECK Ck M.O. 0 N.C. EI
OWNER
CONTRACTOR
�SlryO/y
Received By
ADDRESS
ADDRESS
Sewage System
T
LL
P
CITY
CITY
Trees Required
Yes
No
P
V
INFORMATION
TEL. NO.
TEL. NO. LICENSE
FORM 284-208 (REV. 4/71)
-,290 7 l !