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268095 (SPIN)BUILDING PERMIT CONSTRUCTION, ESTIMATE IST FL. SQ.FT. @.. 2ND FL. SQ. FT. @ POR. SO. FT. @ GAR. SQ. FT. @ CAR P. SQ.FT. @ WALL SO. FT. O SQ. FT. @ ESTIMATED CONSTRUCTION VALUATION. $ NOTE: Not to be used os property tax valuation MECHANICAL FEES VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ DEPARTMENT OF BUILDING St SAFETY COUNTY OF RIVERSIDE NO. ELECTRICAL FEES UNITS MOBILEHOME SVC. POWER OUTLET FIELD OFFICE NO. PLUMBING FEES ST OWNER GARBAGE DISPOSAL YARD SPKL R SYSTEM BAR SINK AIR HANDLING UNIT ROOF DRAINS' IDLE METER DRAINAGE PIPING ABSORPTION SYSTEM, DRINKING FOUNTAIN, - TEMP USE PERM SVC URINAL COMPRESSOR WATER PIPING' POLE, TEMP/PERM FLOOR DRAIN HEATING SYSTEM ❑ FORCED ❑ GRAVITY WATERSOFTENER SHOWER WASHER (AUTO) (DISH) ROOMS APPLIANCE J F'�M A M' J J A S O N D 'JOB ADDRESS 5P'No qFql OWNER GARBAGE DISPOSAL FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED LAUNDRY TRAY AIR HANDLING UNIT CFM IDLE METER KITCHEN SINK ABSORPTION SYSTEM, 0 B.LU. TEMP USE PERM SVC WATER CLOSET ? COMPRESSOR HP POLE, TEMP/PERM LAVATORY HEATING SYSTEM ❑ FORCED ❑ GRAVITY AMPERES SERV ENT, SHOWER BOILER B.T.Ui ROOMS SQ FT @ ¢ BATHTUB OFFICE SQ FT @ ¢ WATER HEATER (4val �✓T SQ FT RESID @ 1 ¢ SEWAGE DISPOSAL SQ FT GARAGE @ 'h¢ HOUSE SEWER PERMIT FEE COPIES $ GAS PIPING MOBILE HOME PERMIT FEE $ PERMIT FEE PERMIT FEE PERMIT NO. 268095 TOTAL FEES 1�� MOB. HM.FEE MICRO FEE MECH. FEE DBL. PL. CK. FEE CONST. FEE DBL. ELECT. FEE DBL. SMI FEE - ,A�IJ-Qa FEE PLUMB. FEE DBL. I I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED vTHE `PLANS AND SPECIFICATIONS FORM •284-208 (Rev. 10.74) (DIL HAS DONE SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA. 'JOB ADDRESS 5P'No qFql OWNER 74 75 USE OF PERMIT S 7557- F.C. DATE :1py,608095 . 76 ,,�. ,� .� IA -.5-175 M H PERMIT FEE $ C019MUNAITY �A DST UNITS ROOMS VALUATION SUPP. TO PERMIT OFFICE (4val �✓T .� MICROFILM FEE • COPIES $ LEGAL DESCRIPTION �� =fel,% 6 /� - �o j J %'�� 0 T- 5� - - �/`/�' MECHANICAL FEE DBL $ SETBACK LOT SIZE ZONE USE NO. GRP TYPECK B 111 F S PLAN CHECK FEE $ BOND AMT. PLAN NO. PLAN CHECKER FINAL DATE I PECTOR CONSTRUCTION FEE DBL $ NAME OF CONST. LENDER BRANCH OFFICE NO LENDER INVOLVED ELECTRICAL FEE DBL $ ADDRESS CITY STATE n STRONG MOTION $ OWNER/AGENT'S SIGNATURE CONTRACTOR wi`-' s 1+j•< ri INSTRUMENTATION FEE ldhl7F x $ ADDRESS. ADDRESS E? •� P rS7' FEE' / 1 �/ t �. ..- 7,90 Aj PLUMBING FEE DBL $ CITY ZIP CODE CIT ZIP CODE TOTAL FEES � $ " � TEL. NO. TEL. NO. _ LICENSE j>`71 � lOC)02� �^'. � - � 4 • �> CASH ❑ CHECK M.O. Cl N.C. ❑ THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN•l20 DAYS. CESSA TION OF WORK FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME.VOID. ' I HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN AC CORDANCE WITH THEAAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, I ALSC RECEIVED BY TREES REQUIRED SEWAGE SYSTEM T LL p-• AGREE TO CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLIANCE WITH THE I I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED vTHE `PLANS AND SPECIFICATIONS FORM •284-208 (Rev. 10.74) (DIL HAS DONE SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA.