268393 (SPIN)BUILDING PERMIT T DEPARTMENT OF BUILDING,& SAFETY
COUNTY—OF RIVERSIDE
CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES'
I ST FL SQ FT UNITS '
MOBILEHOME SVC.
POWER OUTLET
SWIM POOL, PVT
SWIM POOL, COMM
SIGN
FIELD OFFICE .
i..
NO- PLUMBING` FEE`.
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING' FOUNTAIN
URINAL
WATER PIPING
FLOOR DRAIN
WATER SOFTENER
WASHER (AUTO) (DISH)
APPLIANCE
ADUHL»� "- -' '^ :'. '�-- "-'r-`$'P NO"
@
2ND FL.
78-447 C611e diens@
SO. FT. @ . •-
POR.
IDLE METER
SQ. FT. @
GAR.
TEMP USE PERM SVC
SO. FT. @
-CAR P:
POLE, TEMP/PERM
SO.Fi @
WALLSO.
AMPERES SERV ENT
FT. @
�
50. FT.. @ '
ESTIMATED CONSTRUCTION VALUATION $
NOTE: Not to be used ILS property tax voluotion
SQ FT @ ¢
MECHANICAL FEES
SUPP. TO PERMIT
VENT SYSTEM
O FAN ❑ EVAP. COOL ❑ HOOD
MOBILEHOME SVC.
POWER OUTLET
SWIM POOL, PVT
SWIM POOL, COMM
SIGN
FIELD OFFICE .
i..
NO- PLUMBING` FEE`.
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING' FOUNTAIN
URINAL
WATER PIPING
FLOOR DRAIN
WATER SOFTENER
WASHER (AUTO) (DISH)
APPLIANCE
ADUHL»� "- -' '^ :'. '�-- "-'r-`$'P NO"
GARBAGE DISPOSAL
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
78-447 C611e diens@
LAUNDRY TRAY
AIR HANDLING UNIT CFM
IDLE METER
KITCHEN SINK
ABSORPTION SYSTEM 0 B.T.U.
TEMP USE PERM SVC
WATER CLOSET =
COMPRESSOR 0 HP
POLE, TEMP/PERM
LAVATORY
HEATING SYSTEM ❑ FORCED ❑ GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SQ FT @ ¢
BATH TUB
UNITS
SQ FT @ ¢
WATER HEATER
SUPP. TO PERMIT
SOFT RESID @ 1 a
SEWAGE DISPOSAL
SQ FT GARAGE @ 'ha
HOUSE SEWER
PERMIT FEE`
I
GAS PIPING
MOBILE HOME PERMIT FEE $
PERMIT FEE
PERMIT FEE
O.
26R§ 9
TOTAL FEES
10 v
MOB. HM.FEE
MICRO FEE
MECH. FEE
OBL.
PL. CK. FEE
- CONST. FEE
DBL.
ELECT. FELE:
DBL.
S I FEE
FEE
-o
PLUMB. FEE DBL.
- -. --JOtl
J F M A M �J J A S O N D
ADUHL»� "- -' '^ :'. '�-- "-'r-`$'P NO"
OWNER
74
78-447 C611e diens@
RL ICE>r RP
CO
75
USE OF PERMIT
F.C.
DATE f
PE EIT O.
7e
Special Cas 1 -ns .
1-1.9.76
8 3 9 3
M H PERMIT FEE
$
COMMUNITY DST
UNITS
ROOMS
VALUATION
SUPP. TO PERMIT
OFFICE
LA INTA 11
I
MICROFILM FEE
COPIES
$
LEGAL DESCRIPTION
PC -617-442-013 = Lot -53 Tr -3446
MECHANICAL FEE
DBL
$
SET BACK
LOT SIZE ZONE
USE NO..
GRP
TYPE'
CK BY
R-2lAvers
F S R
PLAN CHECK FEE-
$
BOND AMT.
PLAN NO.
PLAN CHECKER
FINAL DATE
INSP TOR
CONSTRUCTION FEE
DBL
$
NAME OF CONST. LENDER , BRANCH
OFFICE
NO LENDER INVOLVED
ELECTRICAL FEE _
DBL
$
ADDRESS CITY
STATE
STRONG MOTION
$
OWNER/AGENT'S SIGNATURE
CONTRACTOR'%-
INSTRUMENTATION FEE
`J4
$
ADDRESS
ADDRESS
-or,-por,
FEE
�� •
®�
�.� ^ �%() � �•t3 / � I
PLUMBING FEE
DBL
$
CITY ZIP CODE
CITY ZIIPyCC3D'E
TOTAL FEES
/
TEL. NO.
TEL. NO. LICENSE
CASH ❑ CHECK 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 REQUIRED
Cy
V�TION
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
T
LL
P
AGREE TO CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLIANCE WITH THI
ItHEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS
FORM 284.208 (Rev. 10-74) @L HAS DONE SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE
1 OF THE STATE OF CALIFORNIA.