208394 (RER)DEPARTMENT OF BUILDING &.SAFET FIELD OFFICE
BUILDING PERMIT -
• COUNTY OF RIVERSIDE
CONSTRUCTION ESTIMATE ELECTRICAL FEES PLUMBING FEES +
AST _FL.
SQ. FT. @
2ND FL,
SQ. FT. @
POR.
SQ. -FT. @
GAR.
SQ. FT. @
CAR P.
SQ. FT. @
WALL
SQ. FT.
GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
SQ. FT. @
G°o�vrii
COMPRESSOR HP
ESTIMATED VALUATION $ /
MECHANICAL FEES
1"s
MOTOR 1 OR LESS H.P.
MOTOR 5 OR LESS H.P.
MOTOR 20 OR LESS H.P.
K.W. UN
DRAINAGE PIPING
DRINKING.FOUNTAII,
URINAL
WATER PIPING
FLOOR DRAIN.
WGTFR Cr)FTFN;rP
VENT SYSTEM . ❑ FAN ❑ EVAP.COOL ❑ HOOD
SIGN
WASHER (AUTO)(DISH)
APPLIANCE
TRANSFORMER =K.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.@ Q
BATH TUB
INCINERATOR ❑ DOMESTIC ❑INDUS. OR -COMM.
SQ. -FT.@ Q:
WATER HEATER
HEATING SYSTEM ❑ FORCED ❑ GRAVITY
SQ. FT. RESID. @ 1 It
SEWAGE DISPOSAL
BOILER B.T.U.
SQ. FT. GAkAGE @ 2-
HOUSE SEWER
PERMIT FEE
BALANCE OF, MIN. FEE
GAS PIPING
MOBILEHOME HOOKUP FEE I$ I I I 1 IPERM,IT FEE I .I ' I PERMIT FEE
PERMIT NUMBER TOTAL FE ` MOB. HOOK FEE HEAT & VENT FEE �DBLJ,PL, CK, FEE I CONST. FC-VDBL ELEC. FEE JDBLJ FEE PLUMBING FEE DBl394
J F M A M J J A S O
N D
J B�/�DpRES ^ 1
�4 4N l�'1lr' %�"C�
0 4,
off��lS� Gl lr
72
73
�N�J.fi'D� F/="'.�%i'�I
F.C.
DATE f / �
PERMIT NO.
208394
74
76
CC/}MMUNITY
1A 0 a IN
DST
UNITS
OOM
VALUATION&b
SyJPyP JT/p IEyR IT
OF}F,�J&E
76
MOBILEHOME
$
L GA e
DESCRIIPTIO
Lt 1 �fr.�r s .2'�-6/7-0.21
HOOKUPFEE
t�I` dlArrA[%-or
MECHANICAL FEE
DBL
$
SET BACK
LOT SIZE
ZONE
/
USE NO.
GRP
TYPE
/e'�
J.CKBY
F S R
/ lyeg-S
'
PLAN CHECK FEE-
$
BOND AMT.
PLAN NO.
-PLAN CHECKER
FINAL DATE INS
CTOR
CONSTRUCTION FEE
DBL
��
-�""
NAME OF CONST. LENDER
-
BRANCH OFFICE
NO LENDER INVOLVED
'
ELECTRICAL FEE
DBL
$
ADDRESS
CITY STATE
$
v.
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.
/ J FEE
I HEREBY AGREE THAT ALL WORK IN CONNECTION IJH THIS PERMIT WILL BE DONE
OU Y AND THE STATE OF CALIF-
IN ACCORDANCE WITH THE LAWS OF RIVERSIDE COU;"
DBL
ORNIA. I ALSO AGREE TO CARRY. COMPENSATION I URANCE N MY EMPLOYEES.
COMPLIANCE WITH THE LAWS OF THE STATE OFC welulORNIA WVJFRING CONTRACTORS
ISALSO GUARANTEED.
I HEREBY CERTIFY THAT THE' INDIVIDUAL H . PAR EPL NS D SPECLFI-
CATIONS HAS DONE SO IN ACCORDANCE WI N INESS AND
TOTAL FEES
Gr.
PROFESSIONS CODE OF THE STATE OF-CALIFOR „% '
CASH EDCHECK C�r M.O. ❑ N.C. C]
O/"ER i%.�
�Avv l/ Y
U lV /Q
Received By
ADDRESS/
15. R �./1Al o
Ab/DRESS /
Sewage System
T
LL
P
C�
IT
-4 4%1,19V7,41"1�.. • 4
CIT
104, � V. A of i
Trees Required
Yes
No
,
INFORMATION
y
T
TEL.
r� O LICENSE
Q �„F ` / •� 9. !•J �� � . �
FORM 284-208 (REV. 4/71)