205990 (RPL)BUILDING PERMIT
EIGN
WASHER (AUTO) (DISH)
DEPARTMENT OF BUILDING & SAFET
COUNTY OF RIVERSIDE
FIELD OFFICE
CONSTRUCTION ESTIMATE
ELECTRICAL FEES
OUTLETS ! (%
PLUMBING FEES
1ST FL.
2ND FL,
POR.
GAR.
CAR P.
WALL
�T+1 f st
Q�
FIXTURE OR SOCKET (j
SQ. FT. @
GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
NO.
NO.
COMPRESSOR HP
SQ. FT. @
LAVATORY
SQ. FT. @ MOTOR 1 OR LESS H.P.
AMPERES SERV. ENT.
SQ. FT. @ MOTOR 5 OR LESS H.P.
ABSORPTION SYSTEM O B.T.U.
SQ. FT. @ MOTOR 20 OR LESS H.P.
DRAINAGE PIPING
SQ. FT. @
DRINKING FOUNTAIN
SQ. F.T. @
URINAL
K.W,UNITS
WATER PIPING
ESTIMATED VALUATION $
EQ. FT. GARAGE @ z Q
HOUSE SEWER
FLOOR DRAIN
9ALANCE OF MIN. FEE
MECHANICAL FEE§
MOBILEHOME
40
WATFR q)FTF NFA
VENT SYSTEM ❑ FAN ❑ EVAP.COOL ❑ HOOD
EIGN
WASHER (AUTO) (DISH)
APPLIANCE
TRANSFORMER OK•W.
GARBAGE DISPOSAL
FURNACE❑UNIT ❑WALL❑FLOOR ❑SUSPENDED
OUTLETS ! (%
LAUNDRY TRAY
AIR HANDLING UNIT CFM
FIXTURE OR SOCKET (j
KITCHEN SINK
GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
CONST. SERV. ENTRANCE
WATER CLOSET
COMPRESSOR HP
FOLE
LAVATORY
APPLIANCE VENT
AMPERES SERV. ENT.
SHOWER
ABSORPTION SYSTEM O B.T.U.
SQ. FT.@ q
BATH TUB
INCINERATOR ❑ DOMESTIC ❑INDUS. OR COMM.
SQ. FT.@ (r'
/WATER HEATER
HEATING SYSTEM ❑ FORCED ❑ GRAVITY
SQ. FT. RESID. @ 1 ?
SEWAGE DISPOSAL
BOILER E== B.T.U.
EQ. FT. GARAGE @ z Q
HOUSE SEWER
PERMIT FEE
9ALANCE OF MIN. FEE
, GAS PIPING'
MOBILEHOME HOOKUP FEE I$ I I I ' /' IPERMIT FEE I v� p Cl I PERMIT FEE I ) 0
PERMIT NUMBER TOTAL FEES MOB. HOOK FEE HEAT 8 VENT FEE DBl FL. CK. FE CONST. FEE DBL ELEC. FEE DBL FEE PLUMBING _EEE 03L
J F I.M I A M J J A S O
N D
JOB ADDRESS
IOWNER
' o, r
La , c G �d
73
USE OF BUILDING
F.C.
DATE
RERMIT NO.
205990
74
; ,
a.
- -�
75
C MMUNITY DST
UNITS
ROOMI
VALUATION U
Q►f
SUPP. TO PERMIT
OFFICE
76
"7"'
!am
ao
MOBILEHOME
$
LEGAL DESCRIPTION
HOOKUP FEEU
- / .— 41 / —O "I `C1
'
DBL
SET BACK
LOT SIZE
ZONE
USE NO.
GRP
TYPE
CK BY
MECHANICAL FEE
$
/
F s R., -t
7 4)
j
f
BOND AMT.
PLAN rl O.
PLAN CHECKER
FINAL DATE INSPE
TOR
PLAN CHECK FEE
$
v
I
DBL
NAME OF CONST. LENDER
BRANCH OFFICE
NO LENDER INVO�
CONSTRUCTION FEE
dQ
i
DBL
ADDRESS
CITY STATE
ELECTRICAL FEE
$
$
THIS PERMIT Sf;ALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 60 DAYS.
CESSATION OF WOP.K 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
PLUMBING FEEORNIA.
I ALSO AGREE TO CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES_
{'
COMPLIANCE WITH THE LAWS OF THE STATE OF CALIFORNIA COVERING CONTRACTORS:
v
IS ALSO GUARANTEED.
1 HEREBY CERTGFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFI-
TOTAL FEES $
CATIONS HAS DONE SO IN ACCORDANCE WITH SECTION 5541 OF TKb BUSINESS AND
PROFESSIONS CODE OF THE STATE OF CALIFORNIA.
CASHF1 CHECK lam" M.O. ❑ N.C. a
OWNER
CONTRACTOR J
SY+ G
Received By
ADDRESS
ADDRESS
Sewage System
T
LL
P
CITY
CITY
Trees Required
Yes
No
INFORMATION
TEL. NO.
TEL. NO. LICENSE
d
FORM 284-208 (REV. 4/71) c F/
O '� � &