222931 (SATT)BUILDING PERMIT'
-• CONSTRUCTION ESTIMQ
1 ST FL.
SQ. FT. @
2ND FL.
SQ: FT. ,@_
POR.
SQ. FT. @_
GAR.
SQ.FT. @
CAR P.
SQ. FT. @D_
WALL
SQ.FT. @_
FURNACE ❑ UNIT ❑ WALL ❑FLOOR ❑SUSPENDED
SQ. FT. @_
ESTIMATED CONSTRUCTION VALUATION
LAUNDRY TRAY
NOTE: Not to be used as property tax- valuation
- + AAC/•LJ -A AIIf— AI CCC
DEPARTMENT OF BUILDING & SAFETY
' COUNTY OF RIVERSIDE •
�t.,� •, .a ELECTRICAL FEES,_, .-
,�' ra
Non
MOTOR I OR LESS H.P.
S dye MOTOR 5 OR LESS H.P. f
MOTOR 20 OR LESS H.P.
-t -
$OK.W.UNIT$
FIELD OFFICE
,1 ---PLUMBING PLUMBING FEES ,.DST
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING % yQ
FLOOR DRAIN
WATER SOFTENER '
MOBILE HOME HOOKUP 1 -EE . � I X I 1 - 1 . I rCKMU rrc • • � I 4 1 L " 1 / I VCKMI I rtt - I -/I my
i
ITT NN0
VENT SYSTEM Cl FAN ❑EVAP. COOL HOOD
1 CI
SIGN
WASHER. (AUTO) (915+'1)
'
•
APPLIANCEjae " A
.60
FORMER D K.W.
GARBAGE DISPOSAL
FEE .,PLUMS. FEE
FURNACE ❑ UNIT ❑ WALL ❑FLOOR ❑SUSPENDED
.. OUTLETS. M
LAUNDRY TRAY
AIR HANDLING UNIT I =CFM
M/G
FIXTURE OR SOCKET
KITCHEN SINK
y (J
tj
GAS PIPE . ❑ NATURAL ❑ L.P.G. ❑ OIL
T•. J"' "F'^ .-M' A M 1'J' 'JT '�A -$_ 'O 'N� D
CONST'SERV• ENTRANCE
,+ WATER CLOSET.
y► (� `.
.,-
COMPRESSOR` ". 0 HP
I r=.ver-- 1'k- r
POLE
LAVATORY
J2 0 0
r
APPLIANCE VENT
75
gpg AMPERES SERV, ENT.
SHOWER
$
T
ABSORPTION SYSTEM 1 B.T.U.
DST
SO. FT. @
BATH TUB
VALUATION]
TO PERMIT,
INCINERATOR ❑ DOMESTIC ❑'INDUS. OR COMM.
_ SQ. FT. @
WATER HEATER
!a
/A
HEATING SYSTEM FORCED ❑GRAVITY
6o
r �fi'.SQ. FT. RESID. @ 1 �^
SEWAGE -DISPOSAL
gra
~�
BOILER 0 B.T.U. a
COPIES
r7v SO. FT.,GARAGE @/2 Q.
HOUSE SEWER
LEGAL DESCRIPTION
~
PERMIT FEE
+� =`3
BALANCE OF MIN. FEE
GAS PIPING
MECHANICAL'FEE
MOBILE HOME HOOKUP 1 -EE . � I X I 1 - 1 . I rCKMU rrc • • � I 4 1 L " 1 / I VCKMI I rtt - I -/I my
i
ITT NN0
TTOjTAL FEES
MOB. HK. FEE MICRO FEE
MECH. FEE
DBL.
PL: CK: FEE
CONST. FEE
DBL. ELECT. FELE+
DBL.
SMI FEE
FEE .,PLUMS. FEE
"SPE
M/G
tj
JDBL.,
T•. J"' "F'^ .-M' A M 1'J' 'JT '�A -$_ 'O 'N� D
JOB ADDRESS- — –
'i'
OWNER
73
�- �. A f r`+ .q 5 4f v
I r=.ver-- 1'k- r
74
USE OF,BUILDIN`G - • •
`rf^) X ,p/j 4 A 7— . j} fi d? � , r'
-UNITY
F.C.
66
DATE •
J
PERMI 1422931 �j
CL,B 2 9 3 1
75
M.H. HOOKUP FEE
$
COMM
DST
UNITS
ROOMS
VALUATION]
TO PERMIT,
OFFICE
/A
I
I
ISUPP.
MICROFILM FEE
COPIES
$
LEGAL DESCRIPTION
a�
MECHANICAL'FEE
DBL
$
. SET BACK
LOT SIZE ZONE
USE NO.
GRP
TYPE,,
BY
ICI
';'S""
PLAN CHECK FEE,' '..
$
BOND AMT. -
PLAN NO.
PLAN CHECKER
FINAL DATE INSPECTOR
$,•
' •
FEE,
DBL.
$,
CONSTRUCTION
-
,
:�
r
NAME OF CONST. LENDER ;• BRANCH
OFFICE ., .NO
LENDER INVOLVED
!
]
/` . .F�s f 11'
J
ELECTRICAL: FEE
_. .
DBL
$
3 a
ADDRESS - CITY
- - - STATE
!
,y,/
Hi f /di�U
✓f��D
4
SMI FEE
$
>
-THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 60 DAYS. CESSA-
TION OF WORK FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
A
FEE
$
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 ALSO
PLUMBING FEE
DBL
$
�y
3
AGREE TO CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLIANCE WITH
TtSS
THE LAWS OF THE STATE OF CALIFORNIA COVERING CONTRACTORS IS ALSO GUARANTEED..
•1 HEREBY CERTIFY�,THAT. THE +INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS
$
TOTAL FEES
'� :.
-"
'
HAS DONE.SO INrACCORD'ANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS
E OF CALIFORNIA.
-OWNER,
CASH ❑ CHECK Ey M.O`❑ N.C.'❑
fw,,,.-"'l+.r✓•
f
CONTRACTOR -
�r
RECEIVED BY'��
ADDRESS -
ADDRESS
Y
SEWAGE SYSTEM T
LL
P
C1TR-•
CITY ..
TREES REQUIRED
YES
NO
A414 < i fes•
I
' INFORMATION Z
TEL. NO. '
TEL. NO. LICENSE '
FORM 284-208 (Re, 1]/721
s..