205973 (PLBG)BUILDING PERMIT
•
DEPARTMENT OF BUILDING & SAFET
COUNTY OF RIVERSIDE
APPLIANCE
FIELD OFFICE
GARBAGE DISPOSAL
CONSTRUCTION ESTIMATE
ELECTRICAL FEES
LAUNDRY TRAY
PLUMBING FEES
IST FL.
2ND FL.
POR.
GAR.
CAR P.
WALL
KITCHEN SINK
SQ. FT. @
CONST. SERV. ENTRANCE
NO.
COMPRESSOR HP
NO.
SQ. FT. @
APPLIANCE VENT
SQ. FT. @ MOTOR 1 OR LESS H.P.
SHOWER
SQ. FT. @ MOTOR 5 OR LESS H.P.
rah
SQ. FT. @ MOTOR 20 OR LESS H.P.
DRAINAGE PI NG
SQ. FT. Ca) %. Jh✓J-P(r /Xt i
DRINKING FOUNTAIN
SQ. FT. @
URINAL
OK.W.UNITS
WATER PIPING
ESTIMATED VALUATION $
HOUSE SEWER
PERMIT FEE
BALANCE OF MIN. FEE
FLOOR DRAIN
MECHANICAL FEES
MOBILEHOME
WATER C(1 CTG MFG
VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑. HOOD
SIGN
WASHER (AUTO) (DISH)
APPLIANCE
TRANSFORMER OK.W.
GARBAGE DISPOSAL
FURNACE❑UNIT ❑WALL❑FLOOR ❑SUSPENDED'
OUTLETS
LAUNDRY TRAY
AIR HANDLING UNITI CFM
FIXTURE OR SOCKET
KITCHEN SINK
GAS PIPE ❑NATURAL ❑ L.P.G. ❑ OIL
CONST. SERV. ENTRANCE
WATER CLOSET
COMPRESSOR HP
POLE
LAVATORY
APPLIANCE VENT
AMPERES SERV. ENT.
SHOWER
ABSORPTION SYSTEM B.T.U.
SQ. FT.@ 2
BATH TUB
INCINERATOR ❑ DOMESTIC ❑ INDUS. OR COMM.
SQ. FT.@ ¢.
WATER HEATER
HEATING SYSTEM ❑ FORCED ❑ GRAVITY
SQ. FT: RESID. @ 1 T
SEWAGE DISPOSAL
BOILER E== B.T.U.
SQ. FT. GARAGE @ z ¢
HOUSE SEWER
PERMIT FEE
BALANCE OF MIN. FEE
/10401 1 GAS PIPING
MOBILEHOME HOOKUP FEE I$ I I I I / IPERMIT FEE I 01010 I /1 PERMIT FEE I 4,,41 y U
PERMIT NILMBIER TOTAL FEES MOB. HOOK FEE HEAT & VENT FEE DBL PL. CK. FEE CONST. FEE DBL ELEC. FEE DBL„ j-7PLUMBING FEE DBL
J F M A M J J A S O
N D
JOB ADDRESS
OWNER
72
72 57d0 1!7? a
co b
73
USE OF BUILDINGF.C.
DATE
PER�11
74
G 7 5 / 1j/v.
�y
_" c*'�
ONS 973
75
C MMUNITY
DST UNITS
OOMJ
VALUATION b
SUPP. TO PERMIT
OFFICE
760
6 a s�
MOBILEHOME
$
LEGAL DESCRIPTION
HOOKUP FEE
h (i r c'r vl ✓� c�(j/��7s�. Q-O�
DBL
SET BACK
LOT SIZE ZONE
USE NO.
GRP
.TYPE
MECHANICAL FEE
$
?--I
JCK
F S R
BOND AMT.
PLAN NO.
PLAN CHECKER
FINAL DATE INSP
CTOR
PLAN CHECK FEE
$
/U ,50 .2.,
10/
I
DBLNAME
OF CONST. LENDER
BRANCH OFFICE
NO LENDER INV LVED
CONSTRUCTION FEE
•
DBL
ADDRESS -
CITY - STATE
ELECTRICAL FEE
$
L
4q
$
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
1 HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE
IN ACCORDANCE WITH THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIF -
DBL
PLUMBING FEEORNIA.
I ALSO AGREE TO CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES.
�/
oU
COMPLIANCE WITH THE LAWS OF THE STATE OF CALIFORNIA COVERING CONTRACTORS
IS ALSO GUARANTEED.
I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFI-
TOTAL FEES $
9
�+�
CATIONS HAS DONE SO IN ACCORDANCE WITH SECTION; 5 'F TVIE PfJSINESS AND
PROFESSIONS CODE OF THE STATE OF CALIFORNIA.
CASH Ce CHECK ❑ M.O. ❑ N.C. O
OWNER
CONTRACTOR
a'•tea ) JP7
Received By
ADDRESS
ADDRESS
Jr
Sewage System
T
LL
P
CITY
CITY
Trees Required
Yes
No
% f
INFORMATION
OTEL.
NO.
TEL. NO. LI9ENSE
FORM 284-208 (REV. 4/71)Ad
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