217963 (MECH)I BUILDING PERMIT
CONSTRUCTION ESTIMAT
1ST FL.
SQ. FT. @
2ND FL.
SQ. FT. @
POR.
SQ. FT. @
GAR.
SQ. FT. @
CAR P.
SQ. FT. @
WALL
SQ. FT. @
CONST. SERV. ENTRANCE
SQ. FT. @
ESTIMATED VALUATION $
MECHANICAL FEES
DEPARTMENT OF BUILDING & SAFET
COUNTY OF RIVERSIDE
E ELECTRICAL FEES
NO. I I I I NO.
MOTOR 1 OR LESS H.P.
MOTOR 5 OR LESS H.P.
MOTOR 20 OR LESS H.P.
K.W.
FIELD OFFICE
PLUMBING FEES
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
FLOOR DRAIN
WATFR SOFTFNFR
VENT SYSTEM ❑ FAN Cl EVAP.COOL ❑ HOOD
SIGN
WASHER (AUTO) (DISH)
APPLIANCE
TRANSFORMER =K.W.
GARBAGE DISPOSAL
FURNACE❑UNITED WALL❑FLOOR ❑SUSPENDED
OUTLETS
LAUNDRY TRAY
AIR HANDLING UNITI 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 B.T.U.
SQ. FT.@ Q
BATH TUB
INCINERATOR ❑ DOMESTIC ❑ INDUS. OR COMM.
SQ. FT.@ T.
WATER HEATER
HEATING SYSTEM ❑ FORCED ❑ GRAVITY
SQ. FT. RESID. @ 1 ?
SEWAGE DISPOSAL
BOILER E== B.T.U.
SQ. FT. GARAGE @ i Q
HOUSE SEWER
PERMIT FEE p/
BALANCE OF MIN. FEE I
GAS PIPING
MOBILEHOME HOOKUP FEE
I$ I �j
I I IPERMIT FEE I
I I I PERMIT FEE I 1
PERMIT NUMBERTOTAL FEES
MOS. HOOK FEE
HEAT B VENT FEE
PL. CK. FEE CONST. FEE
ELEC. FEE
FEE
PLUMBING FEE
DBL
217963
Ny
�°=
JDBL�
12-9-72
JDBLJ JDBLJ
9 6 3
75
COMMUNITY
DST
UNITS
VALUATION
SU PP. TO PERMIT
OFFICE
J F M I A M J J A S O
N D
JOB ADDRESS
OWNER
72
78-050 Corowdos Cr
73
USE OF BUILDING
F.C.
DATE
PERA
Ny
74
z Ton AIC
12-9-72
9 6 3
75
COMMUNITY
DST
UNITS
VALUATION
SU PP. TO PERMIT
OFFICE
I
rOOMI
76
La QuintA
T
MOBILEHOME
$
LEGAL DESCRIPTION
HOOKUP FEE
Lot b _ Tr -MS
DBL
SET BACK
LOT SIZE
ZONE
USE NO.
GRP
TYPE
CK BY
MECHANICAL FEE
$ 7
!rte
F S R
1-1Avers
BOND AMT.
PLAN NO.
PLAN CHECKER
FINAL DATE INSPECTOR
PLAN CHECK FEE
$
q, 6 ? l
FEE
DBL
NAME OF CONST. LENDER
BRANCH OF
OFFICE
NO LENDER INVOLVED
✓
CONSTRUCTION
$
DBL
ADDRESS
CITY STATE
ELECTRICAL FEE
$
$
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 PREPARED THE PLANS AND SPECIFI-
TOTAL FEES $
Vp
CATIONS HAS DONE SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND
PROFESSIONS CODE OF THE STATE OF CALIFORNIA.
CASH 0 CHECK � M.O. Q N.C. C1
OWNER
CYNTACT R /
Received By ly
ADDRESS
DDRE S I
yam,.
Sewage System
T
LL
P
Trees Required
Yes
No
CITY
CITY ,.
INFORMATION
TEL. NO.
TEL. NO. LICENSE
r'1� ��1•`
FORM 284-208 (REV. 4/71) V V�"µ1j
v J�. p✓! 7 `-