280469 (AR)BUILDING PERMIT
JOBB ADDDD'RESS_ ..—_._...._ _ ._ - SP NO
45_
DEPARTMENT OF BUILDING & SAFETY
GARBAGE DISPOSAL
t
COUNTY OF RIVERSIDE
LAUNDRY TRAY
AIR HANDLING UNIT CFM
Pm M N
� O469
CON STRUCTI0WESTIMATE
NO. =' ELECTRICAL FEES
1 ST FL.
SQ.FT.
@
UNITS
2ND FL.
POLE, TEMP/PERM
SO. FT.
@
POR.
SHOWER
SO. FT.
@
MOBILEHOME SVC.
GAR.
f Y TQk) 141 f- t, 1`
SQ. FT.
@
POWER OUTLET
CAR P
SO FT
@
— 144- 4 ti, J Sa n p U lVe T f &0 Od0
WALL SO, FT. @
SO. FT. @
ESTIMATED CONSTRUCTION VALUATION $
NOTE: Not to be used as property tax voluotion
MECHANICAL FEES'
VENT•SYSTEMX49CFAN Cl EVAP. COOL O HOOD
SWIM POOL, PVT
SWIM POOL, COMM
SIGN
FIELD OFFICE
NO. PLUMBING FEES
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
FLOOR DRAIN
WATER SOFTENER
WASHFR [At 1TC)I InISHI
%S7
APPLIANCE
JOBB ADDDD'RESS_ ..—_._...._ _ ._ - SP NO
45_
OWNE - ... JJ . \—
GARBAGE DISPOSAL
FURNACE O UNIT ❑ WALL O FLOOR O SUSPENDED
]j
LAUNDRY TRAY
AIR HANDLING UNIT CFM
Pm M N
� O469
IDLE METER
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERM SVC
WATER CLOSET
COMPRESSOR 3 —.57 Ti5f9 I HP
S
POLE, TEMP/PERM
LAVATORY e
HEATING SYSTEM FORCED O GRAVITY
AMPERES SERV ENT
SHOWER
BOILER � B.T.U.
SQ FT @ ¢
BATH TUB
f Y TQk) 141 f- t, 1`
7 U
SQ FT @ ¢
WATER HEATER
�JAj G U ti /
SQ FT RESID @ 1¢
SEWAGE DISPOSAL
— 144- 4 ti, J Sa n p U lVe T f &0 Od0
O
SQ FT GARAGE @ 'h¢
HOUSE SEWER
PERMIT FEE
MECHANICAL FEE
DBL
GAS PIPING
MOBILE HOME PERMIT FEE Is
SETBACK
LOT SIZE ZONE
PERMIT FEE
PERMIT FEE
2 _PUIT NOy
8046
TOTAL
a [/
M08. HMSEE
MICRO FEE •
�. FE)
fW
DBL.
PL. CK. FEE
CONS7FEEDBL.1
ELECT. FEE
DBL.
SMI FEE
FEE
PLUMB, FEE
JDBL,
J I F I M A I M I J I J I A I 5 1 0 N I D
JOBB ADDDD'RESS_ ..—_._...._ _ ._ - SP NO
45_
OWNE - ... JJ . \—
led
]j
USE OF PERMIT
N
ASW A c rdw44 Ae.?J- f oal
F.C. JDA;�
Pm M N
� O469
76
M H PERMIT FEE
$
COMMUNITYJ
Qu;
DS
UNITS
ROOMS
VALUATION
SUPP. TO PERMIT
OFG�GE
1 to 14
MICROFILM FEE
COPIES
$
LEGAL DESCRIPTION
MECHANICAL FEE
DBL
$0
67
1
0
SETBACK
LOT SIZE ZONE
USE NO.
GRP
TYPE
CK.BY
�
I ,
PLAN CHECK FEE
$
BOND AMT.
PLAN NO.
PLAN CHECKER
FINAL DATE
JINSPECTOR
,-- / 3
I
Q
CONSTRUCTION FEE
DBL
$
NAME OF CONST. LENDER BRANCH
OFFICE
NO LENDER INVOLVED
.
w
ELECTRICAL FEE
DBL
$
ADDRESS CITY
I !
STATE
! `
STRONG MOTION
INSTRUMENTATION FEE
$
OWNER/AGENT'S SIGNATURE
CONTRACTOR
cu p jA vkle co,
�C
FEE
$
ADDRESS
ADDDRESS
3 (40n lsaA)
PLUMBING FEE
DBL
$
CITY ZIP CODE
CITY ZIP CODE
010065"
TOTAL FEES
$
67-20
TEL. NO.
TEL. NO. LICENSE
CASH CHECK p M.O. O N.C.O
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSA
OF WORK FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
RECEIVED BY
TREES REQUIREDN
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
i
LL
P
AGREE TO CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLIANCE WITH THI
11Cn TI I r CT A TC lI r/' A, I r-11 /'/11 -11 -l -
I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS
FORM 284-208 (Rev. 10-74) OQ L HAS DONE SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE
r OF THE STATE OF CALIFORNIA.