173205 (SFD)1st FL Sq. Ft. @V^
2nd FI. Sq. Ft. @
Por. Sq. Ft. @
Gar. Sq. Ft. @
Car P. Sq. Ft. @
Wall Sq. Ft. @
Sq. Ft. @
ESTIMATED VALUATION Is
MECHANICAL FEES
VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD
APPLIANCE
} FURNACE UNIT 1:1 WALL FLOOR SUSPENDED
AIR HANDLING UNIT
GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
COMPRESSOR �HP
APPLIANCE VENT
ABSORPTION SYSTEM O
INCINERATOR DOMESTIC ❑ INDUS. ❑ COMM.
HEATING SYSTEM ❑ FORCED ❑ GRAVITY
BOILER F B.T.U.
Sc6DSii.T.6�1w6E,E SQ. FT.
PERMIT FEE
'ERMIT NUNUPE . — — w r IREN. IDBL. ITOTAL FE
JIr I.V. I"
DEPARTMENT OF BUILDING & SAFETY
COUNTY OF RIVERSIDE
! p ELECTRICAL FEES
G/
NO.
FIELD OFFICE
PLUMBING,FEES
ES
POLES
LOT SIZE
SIGNS -
JOB ADDRESS 1•� IG OWNER
ORAINAGE PIPING
S
TRANS. AND/
OR T. CLK.
DRINKING FOUNTAIN
ZONE'USIE
MOTOR
H. P.
URINAL
�
MOTOR
H. P.
- WATER PIPING .-
+awr"
MOTOR
H. P*.
FLOOR DRAIN
DISTRICT
MOTOR
H. P.
WATER SOFTENER
MOTOR
H. P.
WASHER (AUTO) (DISH)
'
FIXTURES
GARBAGE DISPOSAL
OUTLETS
MECHANICAL FEE
LAUNDRY TRAY
SUB-PAMEL
KITCHEN SINK -
WATER CLOSET
RANGE AND/OR OVEN
LAVATORY '
LEGAL DESCIAIPTIOi4
WATER HEATER
PERMIT NUMISE
3 2 0 5
SHOWER
B.T.U.
SPACE HEATER
BATH TUB
�17
CONSTRUCTION POLE
WATER HEATER
SPEC. INSP.
SERVICE ENTRANCE
SEWAGE DISPOSAL
ELECTRICAL FEE
RE5I0. IC SO. FT.
HOUSE SEWER
GARAGE i Q SO. FT.
GAS PIPING
PLAN CHECKER
f
PERMIT FEE
gypy
r/ 4/ PERMIT FEE
CASH ']PLAN
HEAT
& VENT FEE•••PLN•
CK. FEECONST.
'FEE _
EL'EC. FEE
PLUMB. FEE
M
J J JAI
S
O N D
SET BACK
LOT SIZE
USE a
JOB ADDRESS 1•� IG OWNER
S
R
ZONE'USIE
OF BUIL15ING -
DATE
PLAN CHECK FEE
�
-
CH E K D BY
COMMUNITY
DISTRICT
F.C.
UNI 5
VALUATION
�.,
MECHANICAL FEE
_�'
'
GR P]"WPF
LEGAL DESCIAIPTIOi4
PERMIT NUMISE
3 2 0 5
-CONSTRUCTION FEE
/'" -
�17
YA
SPEC. INSP.
SUPP. TO PERMIT
ELECTRICAL FEE
.14 ...e 7 7
_ -
PLAN CHECKER
BOND $
BOND
CASH ']PLAN
FILE #
FINAL DATE
INSPECTOR
PLUMBING FEE
TOTAL FEES
,!
$
% !�
yr
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.
I HEREBY AGREE THAT ALL WORK IN CONNECTION WITH TH13
CASH CHECK 101 M.O. N.C.
ECEIVED BY
-
SEWAGE SYSTEM
PERMIT WILL BE DONE IN ACCORDANCE WITH THE LAWS OF RIVEF-
SIDE COUNTY AND THE STATE OF CALIFORNIA. I ALSO AGREE TO
T
LL
P
CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPL-
ANCE WITH LAWS OF THE STATE OF CALIFORNIA COVERING COIF
INFORMATION
TRACTORS IS ALSO GUARANTEED.
NAME CF CONSTRUCTION.
OWNERJj
CONTRACTOR
ADDRESS-
`,r • •' �
ADDRESS
ADDRESS '
m ass
-
TEL. NO.
TEL. NO.
LICENSE NO. -
84-208 11/67i,/