272671 (SFD)BUILDING PERMIT
APPLIANCE
DEPARTMENT OF BUILDING & SAFETY
74
GARBAGE DISPOSAL
COUNTY OF RIVERSIDE
F.C. DATE
PEI
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR O SUSPENDED
R
CONSTRUCTION ESTIMATE
LAUNDRY TRAY
NO. ELECTRICAL FEES
1ST FL��%
SO.FT. @J i �—' '
.)E'er �
U UNITS
2ND FL.
KITCHEN SINK
SO. FT. @
OFFICE
ABSORPTION SYSTEM
POR.
/
f -F
50. FT. @
{.b Q
MOBILEHOME SVC.
GAR
COMPRESSOR
c� — e
{~C.%
POWER OUTLET
CAR P.
WALL SO. FT. @
SQ. FT. @
ESTIMATED CONSTRUCTION VALUATION
NOTE: Not to be used as property tax voluation SWIM POOL, PVT
MECHANICAL FEES SWIM POOL. COMM
VENT SYSTEM O FAN ❑ EVAP. COOL (HOOD SIGN
FIELD OFFICE
{ DST
NO. PLUMBING FEES
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING -FOUNTAIN
URINAL
WATER PIPING (�
FLOOR DRAIN
I WATER SOFTENER
WASHER (AUTO)IDI'SFIr _i
J I F I M A I M I J I 1 A 1 $ -O 1 N I D
APPLIANCE
! 1—S' -,a, , ,mss /0 f)
74
GARBAGE DISPOSAL
USE OF PERMIT
F.C. DATE
PEI
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR O SUSPENDED
J
LAUNDRY TRAY
$
AIR HANDLING UNIT
CFM
IDLE METER
ROOMS
KITCHEN SINK
SUPP. TO PERMIT
OFFICE
ABSORPTION SYSTEM
0 B.T.U.
TEMP USE PERM SVC
WATER CLOSET
UU
COMPRESSOR
HP 'fj
POLE, TEMP/PERM
LAVATORY
, y�
$
HEATING SYSTEM A FORCED ❑ GRAVITY
67,rl AMPERES SERV ENT
G�" p0
0
SHOWER
�
Ff %(
7 !:. .r A +F^+. %i ! / �� J .G. f_/ f Y7•% uI�
MECHANICAL FEE
BOILER B.T.U.
$
SQ FT @ ¢
j
BATH TUB
USE NO.
GRP
TYPE
SQ FT @ ¢
WATER HEATER
Lf i
SQ FT RESID )i
t`f
SEWAGE DISPOSAL
PLAN CHECK FEE
$
SQ FT GARAGE @&c ¢
E/
PLAN NO.
HOUSE SEWER
FINAL DATEIySRECTOR
PERMIT FEE
fj
GAS PIPING
OL}
MOBILE HOME PERMIT FEE
Is
CONSTRUCTION FEE
PERMIT FEE
IJ U
1
PERMIT FEE
C 1.0
R IT O.%
TOTAL FEES,. -MOB.
HM.FEEMICB.CLFEE
/tizq
MECH. FEE I DBL.
PL. CK. FEE
CONST. FEE
DBL.
i
ELECT. FEE
I DBL.
SMI FEE
FEE
PLUMB. FEE
IDBL.
J I F I M A I M I J I 1 A 1 $ -O 1 N I D
JOB AD/DRESSSP NO
OWNER
74
75
USE OF PERMIT
F.C. DATE
PEI
J
M H PERMIT FEE
$
COMMUNITY /
DST
UNITS
ROOMS
VALUA' ION
SUPP. TO PERMIT
OFFICE
I
MICROFILM FEE
COPIES
$
LEGAL DESCRIPTION Ile
•
i.f
/
l./`'.•"�
Ff %(
7 !:. .r A +F^+. %i ! / �� J .G. f_/ f Y7•% uI�
MECHANICAL FEE
DBL
$
SET BACK
LOT SIZE ZONE
USE NO.
GRP
TYPE
CK BY.
PLAN CHECK FEE
$
BOND AMT.
PLAN NO.
PLAN CHECKER
FINAL DATEIySRECTOR
l- -
l//�Ot�1�13- (f
CONSTRUCTION FEE
DBL
$
NAME OF CONST. LENDER BRANCH
OFICE
NO LENDER INVOLVED
/tizq
ELECTRICAL FEE
DBL
$
ADDRESS CITY
STATE
STRONG MOTION
$
OWNER/AGENT'S SIGNATURE
yr v
c' N Rd00 -r• C7
INSTRUMENTATION FEE
/
/�
<
(�iJ✓P
$
ADDRESS
ADDRESS
FEE
PLUMBING FEE
DBL
$
CITY ZIP CODE
CITY ZIP CODE
TOTAL FEES
$
�
TEL. NO.
TESL, NO LICENSE
CASH ❑ CHECK t6lM.O. ❑ N.C.
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 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 THE LAWS OF RIVERSIDE COUNT`' AND THE STATE OF CALIFORNIA, I ALSC
RECEI ED Bl(
TREES REQUIRED
SEWAGE SYSTEM
T/ AA 4 LL)
AGREE TO CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLIANCE WITH THE
I HEREBY 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
I OF THE STATE OF CALIFORNIA.