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208565 (AR)BUILDING PERMIT SIGN DEPARTMENT OF BUILDING & SAFETO COUNTY OF RIVERSIDE FIELD OFFICE TRANSFORMER OK.W. CONSTRUCTION ESTIMATE ELECTRICAL FEES PLUMBING FEES 1ST FL. 2ND FL. POR. GAR. CAR P. WALL { / SQ. FT. @ ° !KITCHEN SINK % NO. NO. SQ. FT. COMPRESSOR HP SQ. FT. Co) MOTOR 1 OR LESS H.P. LAVATORY SQ. FT, CZMOTOR 5 OR LESS H.P. AMPERES SERV. ENT. SQ. FT. @ MOTOR 20 OR LESS H.P. DRAINAGE PIPING SQ. FT. @ DRINKING FOUNTAIN SQ. FT. P URINAL OK.W.UNITS WATER PIPING ESTIMATED VALUATION Is 2 z FLOOR DRAIN HOUSE SEWER MECHANICAL FEES BALANCE OF MIN. FEE GAS PIPING WATcr7 cncTCAlc17 VENT SYSTEM p FAN ❑ EVAP.COOL ❑ HOOD SIGN WASHER (AUTO) (DISH) APPLIANCE TRANSFORMER OK.W. GARBAGE DISPOSAL FURNACE❑UNIT ❑WALL❑FLOOR❑SUSPENDED' OUTLETS LAUNDRY TRAY AIR HANDLING UNIT 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. O B.T.U. SQ. FT.'@ T BATH TUB INCINERATOR ❑ DOMESTIC C] INDUS. OR COMM. SQ. FT.@ T. WATER HEATER HEATING SYSTEM ❑ FORCED ❑ GRAVITY SQ. FT. RESID. @ 1 (r G; EWAGE DISPOSAL BOILER E:= B.T.U. SQ. FT. GAR AGE @ i Q HOUSE SEWER PERMIT FEE BALANCE OF MIN. FEE GAS PIPING MOBILEHOME HOOKUP FEE I$ I I I ' IPERMIT FEE I �I f -IC -1 I PERMIT FEE PERMIT NUMBER .U565 TOT L FE MOB. HOOK FEE HEAT 6 VENT FEE DBL PL. CONT. FEES.,, DBl EL EC�OBL DATE ,x, >-�?08565 � I PLUMBING FEE DBL J J F M A M J J A S O N D JOB ADDRESS SOW •Hilo eo OWNER 1.2,;�►!y� ee�^G 72 l8Z� 73 USE OF BUILDING f�y(J /1, �* �tw, V.5 al.Q� �:�I F.C. 020 DATE ,x, >-�?08565 PE21T NO.74 75 COMMUNITY DST T I UNITS OOMJ VALUATION ,,, I Ci SUPP. TO PERMIT OFFI 76 Q4111v i MOBILEHOME $ LEGAL D�EESCRIPTION HOOKUP FEE Z13T f/'Gr;•v:r1G�F �S7fiir? ��r'3 iP1%' JIRD" p� MECHANICAL FEE DBL $ SET BACK LOT SIZE 12 ZONE 1.2-1 USE NO. GRP TYPE JCKBY /}� ees F s 12 R /Vp �` PLAN CHECK FEE $ BOND AMT. PLAN NO. PLAN CHECKER cc^^��"" FI N�� INSPECTOR //-(,c -7� DBL NAME OF CONST. LENDER BRANCH OFFICE NO LEN ER INVOLV D CONSTRUCTION FEE % ©�to� DBL ADDRESS CITY STATE ELECTRICAL FEE $ -+ �^ t $ THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 60 DAYS. •••o ` I CESSATION 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 ACCORDANCE WITH THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIF- DBL ORNIA. I ALSO AGREE TO CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLIANCE WITH THE LAWS OF THE STATE OF CALIFORNIA COVERING CONTRACTORS IS ALSO GUARANTEED. 1 HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFI- CATIONS HAS DONE SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND TOTAL FEES $ 91 PROFESSIONS CODE OF THE STATE OF CALIFORNIA. CASH ❑ CHECK M.O. N.C. OWNER —__ CONTRACTOR Received By ADDRESS ADDRESS Vf�'1' n� �.� 30 4 i�f 1 � 78 Z- O" I Sewage System T L P iv�r� " ` ` t Trees Required Yes No CITY #iy 3�,.-- LA ��"i1t ( CITY Fl �_ INFORMATION INFORMATION `, TEL. NO. TEL. NO. LICENSE 41 'SORM 284-209 (REV. 4/71)