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268979 (AR)t FIELD OFFICE BUILDING PERMIT DEPARTMENT OF BUILDING $ SAFETY + COUNTY OF RIVERSIDE CONSTRUCTION ESTIMATE 1 ST FL. SQ.FT. @ 2ND FL. SO. FL" @ POR. SO. FT. @ GAR. SQ. FT. @ CAR P. SO.FI. @ WALL SO. FT. @ SQ. FT. @ WATER CLOSET ESTIMATED CONSTRUCTION VALUATION $ NOTE: Not to be used os property tax valuation MFCHANICAI FFFS NO. ELECTRICAL FEES UNITS ` MOBILEHOME SVC. POWER OUTLET SWIM POOL, PVT SWIM POOL COMM NO. PLUMBING FEES YARD SPKLR SYSTEM YEAR SINK ROOF DRAINS DRAINAGE PIPING DRINKING FOUNTAIN URINAL WATER PIPING FLOOR DRAIN WATFR SnFTFNFR L •3O VENT SYSTEM O FAN ❑ EVAP. COOL O HOOD SIGN WASHER (AUTO) (DISH) APPLIANCE �R�/k/(TiLQ GARBAGE DISPOSAL FURNACE O UNIT O WALL ❑ FLOOR ❑ SUSPENDED USE OF PERMIT Ago Ago i LAUNDRY TRAY AIR HANDLING UNIT CFM IDLE METER KITCHEN SINK ABSORPTION SYSTEM T. U. TEMP USE PERM SVC WATER CLOSET COMPRESSOR HP POLE, TEMP/PERM LAVATORY HEATING SYSTEM ❑ FORCED O GRAVITY AMPERESSERV'ENT SHOWER BOILER B.T.U. SQ FT @ ¢ BATHTUB VALUATION SQ FT @ ¢ WATER HEATER SQ FT RESID @ 1¢ SEWAGE DISPOSAL SOFT GARAGE @ '/z¢ HOUSE SEWER PERMIT FEE GAS PIPING MOBILE HOME PERMIT FEE $ PERMIT FEE PERMIT FEE 2 _PEgM1T fJQ - 6897 TO��EES op MOD. HM.FEE MICRO FEE MECH. FEE DBL PL. CK. FEE CONST. FEE DBL. ELECT: FEE DBL. SMI FEE 1.DLO FEE PLUMB. FEE IDBL. J f M A M J J A $ O •N D JOB ADDRESS SP NO OWNE7R' 74 �R�/k/(TiLQ Ci`a7V5 t 75 USE OF PERMIT Ago Ago i F. C. DATE - ����, P M N 9 7 9 76 .��-,res ; M H PERMIT FEE $' COMMUNITY DST UNITS ROOMS VALUATION SUPP. TO PERMIT OFFICE MICROFILM FEE COPIES $ LEGAL DESCRIPTION MECHANICAL FEE DBL $ SET BACK LOT SIZE Z.ONNES USE NO. GRP TYPE CK BY F 5 R ! PLAN CHECK FEE $ BOND AMT.PLAN NO. PLAN CHECKER FINAL DATE INSPECTOR 11, ?G 'L, CONSTRUCTION FEE DBL $ NAME OF CONST. LENDER BRANCH OFFICE NO LENDER I� D r ELECTRICAL FEE DBL $ ADDRESS CITY +moi STATE STRONG MOTION $ - OWNER/AGENT'S SIGNATURE�t. C", INSTRUMENTATION FEE /t1 bAl �"vNsi $ ADDRESS `.+./" ADDRESS FEE 115 e PLUMBING FEE DBL $ CITY ZIP CODE CIT ZIP CODE toe TOTAL FEES � $ � GD TEL. NO. TEL. NO.LICENSE ✓�6'�'j �-'}`��,/�/! CASH CHECK ❑ M.O. O N.C. O y/ 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 O 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 SYSTEM T LL P AGREE TO CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLIANCE Wi.TH THI nic n crnrc �c gni i n r•rwrni r.r r I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS FORM 284-208 (Rev. 10-74) OL HAS DONE SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE I OF THE STATE OF CALIFORNIA.