197340 (SOTB)VENT•SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD
- SIGN
DEPARTMENT OF BUILDING & SAFETY
FIELD OFFICE
APPLIANCE
TRANS-`
ORMER K.W.K
D
• COUNTY •
'
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
=
OF•RIVERSIDE-
A
AIR HANDLING UNIT CFM
CONSTRUCTION ESTIMATE
ELECTRICALFEES
PLUMBING FEES "S7
1 ST FL.
•
sQ. Fr. @
NO. _
N04.
SQ. FT. @
LAVATORY
2ND'FL.
POR.
SQ. FT.,. @
' MOTOR I OR LESS H.P.
'
SQ. FT. @ _ d
SQ.FT. @
MOTOR 5`OR LESS H.P.
"
GAR.
CAR P: •
WATER HEATER '
SO. FT. @
MOTOR 20 OR LESS H.P. '
DRAINAGE PIPING ,
SO.FT. @
f
DRINKING FOUNTAIN
WALL
BALANCE OF MIN. FEE
SQ. FT. @
GAS PIPING i.
URINAL _
PERMIT FEE
a� J
PERMIT FEE
OK W. UNITS
WATER PIPING
REN. ]TRAILER FEE
ESTIMATED VALUATION' $
PL. C'K FEE .
FLOOR -DRAIN
OBL.
MECHANICAL FEES
+.
WATER SOFTENER
VENT•SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD
- SIGN
WASHER (AUTO) (DISH)
APPLIANCE
TRANS-`
ORMER K.W.K
D
GARBAGE DISPOSAL
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
' ' OUTLETS
S
LAUNDRY TRAY
AIR HANDLING UNIT CFM
FIXTURE OR SOCKET
,f7; lr'7#/ f 'G0 wC��J /lel J `f,5
KITCHEN SINK
GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
CONST_. SERV: ENTRANCE
ZONE
jjj�
WATER CLOSET • ' ''
COMPRESSOR 0•HP
POLE
LAVATORY
APPLIANCE VENT
AMPERES SERV. ENT.
SHOWER'
ABSORPTION SYSTEM B.T.U:
SQ. FT. @ _ d
CHECKED BY
BATH TUB
INCINERATOR ❑ DOMESTIC ❑ INDUS. OR COMM.
SQ. FT. @ Q
UNITSt
WATER HEATER '
HEATING SYSTEM ❑ FORCED ❑ GRAVITY_
SQ. FT. RESID. @ 14
SEWAGE DISPOSAL
BOILER B.T.U.
SO. FT. GARAGE @112¢
HOUSE SEWER
PERMIT FEE
BALANCE OF MIN. FEE
GAS PIPING i.
TRAILER ISSUANCE FEE-- PERMIT FE'E
PERMIT FEE
a� J
PERMIT FEE
PER �1
J!
TOTAL„F.��S--
`/,/s�Ei
REN. ]TRAILER FEE
HEAT 8 VENT. FEE
PL. C'K FEE .
CONST. FEE
1.C
OBL.
ELEC, .E.E
u
oaL.
SPEC. INSP. FEE
PLUMBING FEE
DBL.
.FORM 284-208 (REV. 1-70) ®5& + -
LOT. SIZE
USE # .. -
JOBB ADDRESS /- - _`i ,,j0g�r.•� `fir 7ER{j) l j f,�C�yw` �
7If_ t..�' +ly W-"'. 1•.
F
S
R
,f7; lr'7#/ f 'G0 wC��J /lel J `f,5
$
ZONE
jjj�
USE OF BUILDING
C: �`!'2rG l�T`'i[
DATE-
IO
PLAN CHECK FEE
I.
C (a�JU.,<.• /•lJ I�
• -
f
$
CHECKED BY
COMMUNITY;,,IDISTRICT
F. C.
UNITSt
"VALUATION
pFFI E
MECHANICAL FEE
•
'
DBL _
-
$ _
GROUP
'TYPE
LEGAL' DESCRIPTION - - - f
+�(�T!L'E� �' f.� �"°
E T UM ER' -
�Q
CONSTRUCTION FEE.
• -
DBL
�T
PLAN CHECKER
-
- SUPP. TO PERMIT
$ '
—024
'Ls� �+�+�
ELECTRICAL FEE
J
DBL.
-
BOND $
BOND
CASH
PLAN FILE•�I
FINAL DATE
:INSPECTOR
PLUMBING FEE
TRAILER PERMIT
f
NAME OF, CONSTRUCTION' LENDER. ... •-
BRANCH OFFICE.- - -
N LENDER
OLVED
ISSUANCE FEE
ADDRESS _
CITY
STATE -
FEETHIS
g
TOTAL FEES.
I
$ �^^'
E VOID IF WORK NOTCOMMENCEDWITHIN 60' DAYS. CESSATION
TBE
OF WORKPERMIT FOR-120SHALL
DAYSBSHAALL ALSO CAU SE PERM T O VOID,
- i HEREBY AGREE THAT, ALL WORK IN CONNECTION WIT 'THIS•PERMIT-WILL BE DONE IN ACCOR-
~DANCE
'CHECK' N.C:
CASH Q M.O. ,. Q •
WITH THE LAWS OF RIVERSIDE, COUNTY AND T. STATE OF CALIF I ALSO AGREE TO
CARRY. COMPENSATION INSURANCE UPON MY EMPLOY COMPLIANCE -WITH TH AWS OF THE STATE
OF CALIFORNIA COVERING CONTRACTORS IS ALSO G A�NTEEI -
RECEIVED BY SEWAGE SYSTEM'
T LL
P
.I HEREBY CERTIFY THATTHEINDIVIDUALWHOPRE AREDTHE NS PCIFICATIONS DONE
50 IN ACCORDANCE WITH SECTION 5541 OF THE B - I ¢-¢P E55E F HE ST TE
OF -CALIFORNIA.- Y
' INFORMATION
-._ •.
•
OW NER'
J�•f(
Z'�.r P�3 l V [O I .J "i li� y�
O TO Rt } r -. -
e f-�i f. %A V A P. / !"
A./`"j/�
{qj! ,y
ADD/}E
'
TEL.
TEL. NO yS )q
C4/ �j• jam,
LIC ENSE 'N r
�/y
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.FORM 284-208 (REV. 1-70) ®5& + -