209945 (PLBG)BUILDING PERMIT
0
DEPARTMENT OF BUILDING & SAFET
APPLIANCE
TRnNSFORMER OK•W•
GARBAGE DISPOSAL
COUNTY, OF RIVERSIDE
OLTLETS
LAUNDRY TRAY
CONSTRUCTION ESTIMATE
ELECTRICAL FEES
KITCHEN SINK
1ST'FL.
CONST. SERV. ENTRANCE
SQ. FT. @
COMPRESSOR O HP
NO.
LAVATORY
2ND FL.
AMPERES SERV. ENT.
SQ. FT. @
ABSORPTION SYSTEM O B.T.U.
SQ. FT.@ q
BATH TUB
POR.
SQ. FT.@ It:
SQ. FT. @
HEATING SYSTEM ❑ FORCED ❑ GRAVITY
MOTOR 1 OR LESS H.P.
SEWAGE DISPOSAL
GAR.
SQ.'FT. GARAGE@ 2 q
SQ. FT. @
PERMIT FEE
MOTOR 5 OR LESS H.P.
GAS PIPING
CAR P.
SQ. FT. @
MOTOR 20 OR LESS H.P.
SQ. FT. Ca
$
WALL
HOOKUP FEECG.�D��/
SQ. FT_. @
O
DBL
SET BACK
D K.W. UNITS
ZONE
ESTIMATED VALUATION $
GRP
TYPE
CK BY
MECHANICAL FEE
MECHANICAL FEES
$
FIELD OFFICE
PLUMBING FEES.
DRAINAGE PIPING
DRINKING FOUNTAII,
URINAL
WATER PIPING
FLOOR DRAIN
WATER SOFTENER
VENT SYSTEM ❑ FAN ❑ EVAP.COOL ❑ HOOD
SIGN
WASHER (AUTO) (DISH)
APPLIANCE
TRnNSFORMER OK•W•
GARBAGE DISPOSAL
FURNACE❑UNIT ❑WALL❑FLOOR❑SUSPENDED'
OLTLETS
LAUNDRY TRAY
AIR HANDLING UNIT CFM
FI}TURE OR SOCKET
KITCHEN SINK
GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
CONST. SERV. ENTRANCE
WATER CLOSET
COMPRESSOR O HP
POLE
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.@ It:
WATER HEATER
HEATING SYSTEM ❑ FORCED ❑ GRAVITY
SQ. FT. RESID. @ 1 q
SEWAGE DISPOSAL
BOILER =B.T.U.
SQ.'FT. GARAGE@ 2 q
HOUSE SEWER
PERMIT FEE
SA._ANCE OF MIN. FEE
GAS PIPING
MOBILEHOME HOOKUP FEE I$ I I ' IPERMIT FEE. I I PERMIT FEE I �
PERMIT NUMBER TOTAL FEES MOB. HOOK FEE HEAT & VENT FEE DBL P-. CK. FEE CONST. FEE' IDBLI ELEC. FEE DBL FEE PLUMBING FEE JOB'
J
- --
J F M A M J J A S O
N D
JOB ADDRESS
�6—
1
OWNER
'C
r
M&O
72
/1i
h
/'70, f
73
USE OF BUILDINGF.C.
DATE
I
NO.
741
-,--17
.E
9945
75
COMMUNITY
DSf
UNITS
OOM _VALUATION
Q
SUPP. TO PERMIT I
OFFICE
76
MOBILEHOME
$
LEGAL DE RIPTION y c� /� — -7
HOOKUP FEECG.�D��/
O
DBL
SET BACK
LOT SIZE
ZONE
USE NO.
GRP
TYPE
CK BY
MECHANICAL FEE
$
I?-
<D J<�
F s R
BOND AMT.
PLAN 170. '.PLAN
CHECKER
FIN T INSPECTOR
PLAN CHECK FEE
$
I
_ r
CONSTRUCTION FEE
DBL
NAME OF CONST. LENDER
BRANCH OFFICE
NO LENDER INVOLV
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
.-
1 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 -
COMPENSATION INSURANCE UPON MY EMPLOYEES.
DBL
CV
PLUMBING FEE
ORNIA. I ALSO AGREE TO CARRY
COMPLIANCE WITH.THE LAWS OF THE STATE OF CALIFORNIA COVERING CONTRACTORS
IS ALSO GUARANTEED.
I HEREBY CERT FY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFI-
TOTAL FEES $
CATIONS HAS DONE SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND
PROFESSIONS CODE OF THE STATE OF CALIF ORpA ._
CASH F-1CHECK�dV'' I.O. � N.C. O
OWNER �
CONT" CTOR�
Received B
ADDRESS
ADDRESS ['�J
X �'
Sewage System
T LL
P
Trees Requiredves
No
• INFORMATION yy
" �/
TEL. NO.
-fEL. NO. LICENSE
X!57// L� v
FORM 284-208 (REV. 4/71) Q �O
L.s� ly % `�