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238364 (BLCK)
BUILDING PERMIT DEPARTMENT OF BUILDING & SAFETY ' p FIELD OFFICE .9 COUNTY OF RIVERSIDE / • CONSTRUCTION. ESTIMATE.,,,.,,.,_.,,,•,•._•, ELECTRICAL FEES._ __ -,- PLUMBING FEES,_ DST MICROFILM FEE _,^�„� NO. NO. I ST FL. SQ. FT. @ `�a MECHANICAL FEE r 2ND.FL. SQ. FT. @ SET BACKLOT SIZE POR. SQ. FT. @ MOTOR I OR LESS H.P. 'GRP TYPE GAR. SQ.FT. @ MOTOR 5'OR LESS H.P. CAR P. SQ. FT. @ MOTOR 20 OR LESS H.P. DRAINAGE PIPING l� WALL 'dNF' SOFT. @. DRINKING FOUNTAIN '' 4 URINAL ESTIMATED CONSTRUCTION VALUATION $ K.W. UNITS # WATER PIPING NOTE: Not to be used as property tax valuation ' FLOOR DRAIN MECHANICAL FEES $ WATER SOFTENER VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD SIGN FINAL DATE WASHER (AUTO) (DISH) APPLIANCE TRANS-- K.W. FORMER 0 GARBAGE DISPOSAL FURNACE ❑ UNIT ❑ WALL ❑FLOOR ❑SUSPENDED OUTLETS LAUNDRY TRAY AIR HANDLING UNIT I I CFM FIXTURE OR SOCKET KITCHEN SINK GAS PIPE ❑ NATURAL -❑ L.P.G. ❑ OIL CONST. SERV. ENTRANCE DBL WATER CLOSET COMPRESSOR 0 HP POLE LAVATORY APPLIANCE VENT AMPERES SERV. ENT. OFFICE J.NO SHOWER ABSORPTION SYSTEM O B.T.U. SQ. FT, @ d $ BATH TUB INCINERATOR ❑ DOMESTIC ❑'INDUS..OR COMM. SO. FT. @ Q WATER HEATER" HEATING SYSTEM ❑ FORCED ❑ GRAVITY '�■ SQ.'FT. RESID. @ 1 Q STATE SEWAGE DISPOSAL BOILER 0 B.T.U. SQ. FT. GARAGE @,'',I HOUSE SEWER PERMIT FEE BALANCE OF MIN. FEE GAS PIPING MOBILE HOME HOOKUP FEE„ ' ' Is PERMIT FEE PERMIT FEE 7J Jge� TOTAA��S FEE MICRO FEE. MECH FEE 14DBL. PL. OKSfEE DBL ELECT FEEDBL PLUMBING FEE SMIFEE FEE PlUM6.'FEE DBL. -2/�P FOB, AGREE TO' CARRY COMPENSATION - INSURANCE UPON -MY EMPLOYEES. COMPLIANCE WITH ��TFEE; THE LAWS. OF,THE STATE'OF CALIFORNIA COVERING .CONTRACTORS IS ALSO GUARANTEEd. I HEREBY-CERTLFY THAT THE INDIVIDUAL WHO PREPARED_ •THE PLANS AND SPECIFICATIONS, $ TOTAL FEES .. — J.: F. I M -A-1- M I . J I J A-1 $ 1 O 1 N-. D JOB ADDRESS. ... `\_+t- / •« ...tee _ —,d2© .�. DINNER �a HAS DONE SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND,PROFESSIONS r. 73 -%3 i�” •'"f,iJ 'll ' � ! !�©1,7? ' '74 US F BUILDING - - - �- � F.C. DATE j/ " �` ERMIT NO, -233364 7s l oe t /P ADDRESS ADDRESS SEWAGE SYSTEM M.H. HOOKUP. FEE j $ COMMUNITY.` - DST UNITS ' ROOMS VALUATION YES' SUPP. TO PERMIT.OFFICE CITY - �� - CITY i t _ - • INFORMATION4 - � TEL. NO. I .� El,'x(17: / r �" of i1C3ci 1. MICROFILM FEE COPIES $ LEGAL DESCRIPTION oT 1A MECHANICAL FEE ..DBL $ SET BACKLOT SIZE ZON�E USE NO. 'GRP TYPE ICK BY # ' PLAN CHECK FEE 7 $ BOND AMT. PLAN NO. PLAN CHECKER FINAL DATE INSPEC rR •`^"�^' CONSTRUCTION FEE DBL $ - • )� ` �q� F NAME OF CONST. LENDER, BRANCH • OFFICE J.NO LENDER INVOLVED `�^ ELECTRICAL FEE DBL $ ADDRESS' � i - - � , CITY STATE • SMI FEE $ THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 60 DAYS. CESSA- TION OF WORK FOR 120 DAYS SHALL"ALSO CAUSE PERMIT TO BECOME VOID , FEE $ 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 ALSO, PLUMBING FEE DBL $ AGREE TO' CARRY COMPENSATION - INSURANCE UPON -MY EMPLOYEES. COMPLIANCE WITH THE LAWS. OF,THE STATE'OF CALIFORNIA COVERING .CONTRACTORS IS ALSO GUARANTEEd. I HEREBY-CERTLFY THAT THE INDIVIDUAL WHO PREPARED_ •THE PLANS AND SPECIFICATIONS, $ TOTAL FEES s `� HAS DONE SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND,PROFESSIONS r. CODE OF THE STATE OF CALIFORNIA. - CASH ❑' CHECK' M.O. O'•- N. C. OWNER„ - CONTRACTOR - r RECEIVED BY ADDRESS ADDRESS SEWAGE SYSTEM j LL P _ TREES REQUIRED_ YES' NO CITY - �� - CITY i t _ - • INFORMATION4 - � TEL. NO. TEL. NO'. • . - LICENSE , FORM 284.2081Rm 11/721 ,e ?Al