215422 (RPL)BUILDING PERMIT
•
DEPARTMENT OF BUILDING & SAFETIS
COUNTY OF RIVERSIDE
FIELD OFFICE
TRANSFORMER =K•W•
CONSTRUCTION ESTIMATE
ELECTRICAL FEES
OUTLETS f OO
PLUMBING FEES
1ST FL.
2ND FL.
POR.
GAR.
CAR P.
LL
JH
FIXTURE OR SOCKET % Q
SQ. FT. @
GAS PIPE ❑NATURAL ❑ L.P.G. ❑ OIL
NO.
NO.
COMPRESSOR E== HP
SQ. FT. @ 0
LAVATORY
SQ. FT. @ MOTOR 1 OR LESS H.P. ` Qr%
AMPERES SERV. ENT.
SQ. FT. @ MOTOR 5 OR LESS H.P.
ABSORPTION SYSTEM E:= B.T.U.
SQ. FT. @ MOTOR 20 OR LESS H.P.
DRAINAGE PIPING
SQ. FT. @
DRINKING FOUNTAIN
SQ. FT. @
URINAL
4 Q OK.W.UNITS
WATER PIPING
ESTIMATED VALUATION $
SQ. FT. GARAGE @21 2
H'CP�E / O
PERMIT FEE
FLOOR DRAIN
GAS PIPING
MECHANICAL FEES
MOBILEHOME
I
IWATER Cr)FTFNFR
VENT SYSTEM ❑ FAN ❑ EVAP.COOL ❑ HOOD
SIGN
WASHER (AUTO) (DISH)
APPLIANCE
TRANSFORMER =K•W•
GARBAGE DISPOSAL
FURNACE❑UNIT ❑WALL❑FLOOR ❑SUSPENDED
OUTLETS f OO
LAUNDRY TRAY
AIR HANDLING UNIT CFM
FIXTURE OR SOCKET % Q
KITCHEN SINK.
GAS PIPE ❑NATURAL ❑ L.P.G. ❑ OIL
CONST. SERV, ENTRANCE
WATER CLOSET
COMPRESSOR E== HP
POLE
LAVATORY
APPLIANCE VENT
AMPERES SERV. ENT.
SHOWER
ABSORPTION SYSTEM E:= B.T.U.
SQ. FT.@ Q
BATH TUB
INCINERATOR ❑ DOMESTIC ❑ INDUS. OR COMM.
SQ. FT.@ Q.
WATER HEATER
HEATING SYSTEM ❑ FORCED ❑ GRAVITY
SQ. FT. RESID. @ 1 2
SEWAGE DISP SAL
BOILER B. T. U.
SQ. FT. GARAGE @21 2
H'CP�E / O
PERMIT FEE
BALANCE OF MIN. FEE
GAS PIPING
MOBILEHOME HOOKUP FEE $
j PERMIT FEE
1 C0"
O
PERMIT FEE
PERMIT NUMBER
TOTAL F� OB. HOOK FEE
HEAT & VENT FEE
PL. CK. FABS
CONST, FEE
DBl
ELEC. F
DBL
FEEje
P/L`UM BINri'419'g
DBL
915422
I 6-7
I
1081_
DS -T
UNITS
OOM
VALUATION
7
OFFICE
J
a Qv + i'i�C7
/
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4
MOBILEHOME
LEGAL DESCRIPTION
HOOKUP FEE
J F M A M J J A S O
N D
JOB ADDRESS
72
73
USE OF BUILDING
F.C.
DATE
��-
PERMIT NO
215422
74,,,,,,,,y,�
a
75
COMMUNITY J
DS -T
UNITS
OOM
VALUATION
SUPP. TO PERMIT
OFFICE
76
a Qv + i'i�C7
/
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4
MOBILEHOME
LEGAL DESCRIPTION
HOOKUP FEE
f f ? —0
DBL
SET BACK
LOT SIZE
ZONE
USE NO.
GRP
TYPE
MECHANICAL FEE
$
1
+ i
I
JCKJ3Y
AAA
F S // R,&
BOND AMT.
PLAN NO.
PLAN CHECKER
FINAL DATE
I
TOR l
PLAN CHECK FEE
$ /
/
O 0
/_fit,
11
DBL
NAME OF CONST. LENDER
BRANCH OFFICE
NO LENDER INVOLVED
CONSTRUCTION FEE
L�
, /
0 0
DBL
ADDRESS
CITY STATE
ELECTRICAL FEE
$
Q 0
1
$
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 60 DAYS.
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.
I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPAREDJHE PLANS AND SPECIFI-
TOTAL FEES $
CATIONS HAS DONE SO IN ACCORDANCE WITH S ION 5,41' OF THE B 6INESS AND
7
PROFESSIONS CODE OF THE STATE OF CALIFORNIA]
CASH Q CHECK E�6e M.O. ❑ N.C. Q
OWNER
CONTRAC
Received By
ADDRESS
ADDR SS
— i
Sewage System
T
LL
P
CITY
CITY 61
Trees Required
Yes
No_1
45'a �f `T 1
INFORMATION
TEL. NO.
TEL. NO. IC SE
cr
k, =
6 3
FORM 284-208 (REV. 4/7I1
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