224884 (MISC)BUILDING PERMIT
DEPARTMENT OF BUILDING & SAFETY
"?
WASHER (AUTO) (DISH).
COUNTY OF RIVERSIDE
CONSTRUCTION EST IMATE=v -_�<•• ,,.•• -
- �,EL-ECTRICAL•FEH
T FL.
50. FT: Cia
NO..
2ND FL.
SQ. FT. Cia
DBL..
POR.
SQ. FT. Ca
MOTOR I OR LESS H.P.
GAR.
SQ.FT.
MOTOR 5 OR LESS H.P.
CAR P.
_
SQ. FT. Cal
MOTOR 20 OR LESS H.P.
WALL
SQ.FT. Cia
I
&VW,
C4� SQ. FT. @
s
ESTIMATED CONSTRUCTION
VALUATION $
� K.W. UNITS
NOTE: Not to be used as property tox valuation
F.
INCINERATOR ❑ DOMESTIC ❑ INDUS.OR COMM.
MECHANICAL FEES
WATER HEATER
FIELD OFFICE
- PLUMBING FEE
DRAINAGE PIPING
DRINKING FOUNTAIN
'URINAL
WATER PIPING
FLOOR DRAIN
WATER SOFTENER'
-MORII F HOME HOOKUP FEE 1% 1 1 I I NtKMII rtt - . I 1 I YCKMII I-tt ' - I 'I
PT
VENT SYSTEM ❑ FAN ❑EVAP. COOL O HOOD
SIGN
WASHER (AUTO) (DISH).
PL. CK: FEE
APPLIANCE i
TR MER D K.W.
GARBAGE DISPOSAL i
DBL.
FURNACE ❑ UNIT ❑ WALL ❑FLOOR ❑SUSPENDED,
OUTLETS
LAUNDRY TRAY
DBL..
AIR HANDLING UNIT I CFM
FIXTURE OR SOCKET
KITCHEN SINK
J
GAS PIPE ❑ NATURAL O L.P.G. 0011.
CONST. -SERV. ENTRANCE
WATER CLOSET
COMPRESSOR HP
POLE
LAVATORY
I
APPLIANCE VENT
AMPERES SERV. ENT.
SHOWER
OWNER,�r �4 +--
/7 s5 ��� 6. Nb -'
ABSORPTION SYSTEM 0 B.T.U.
SQ. FT. @ 4
BATH TUB
F.
INCINERATOR ❑ DOMESTIC ❑ INDUS.OR COMM.
SQ. FT. @ •
WATER HEATER
75
HEATING SYSTEM O FORCED O GRAVITY.
-f SQ. FT. .RESID. Cai 14
SEWAGE DISPOSAL
BOILER 0 B.T.U.
SQ"FT. GARAGE @ I)y4
HOUSE SEWER
^ _
PERMIT FEE
BALANCE OF MIN. FEE
GAS PIPING �-
-MORII F HOME HOOKUP FEE 1% 1 1 I I NtKMII rtt - . I 1 I YCKMII I-tt ' - I 'I
PT
TOTAL_FEES . IrvMB,
HK..EEE MICRO FEE
MECH. FEE .DBL.
PL. CK: FEE
. CONST. FEE
DBL.
- SMI FEE
FEE -PLUMB. FEE
DBL..
J
IDBL.IELECT.FEE
I
I
.4
J I F I M A I M I J I J I A $ 1 O 1 N I D
JOB ADDRESS
r
%� 00-.�iV :..�.eea%d
OWNER,�r �4 +--
/7 s5 ��� 6. Nb -'
73
74 - .USE
OF BUILDING Cv/a� +!.
ri' A .'
F.
C. DATE - I
PERM N4 884
-
75
M.H: HOOKUP FEE
$
COMMUNITY DST UNITS
ROOMS
VALUATION'
TO PERMIT •r OFFICE
.
ISUPP.
MICROFILM FEE
`COPIES''
V
LEGAL DMSCRIPTION
-MECHANICAL'-FEE
-
DBL'.
$'
SETBACK
LOT SIZE, ZONE
USE NO.
GRP
_
TYPE - CK BY
~FINAL
F S R
-PLAN CHECK -FEE ••
$"
BOND AMT.
PLAN NO.
PLAN CHECKER
DATE .' INSPECT
R
-
CONSTRUCTION FEE'. •
DBL: •
$,
NAME OF CONST. LENDER BRANCH
... - .
OFFICE- - .� - .NO
•
LENDER INVOLVED
�•
f
-
ELECTRICAL FEE
DBL
$•
ADDRESS CITY
-A - STATE.
-
-
'•E.
THIS. PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 60 DAYS. CESSA-
TION OF WORK FOR] 20 DAYS SHALL'ALSO CAUSE PERMIT TO BECOME VOID.
oU T p'�`iJ li��
2,,
$
t T
4W 'I
HEREBY 'AGREE THAT ALL WORK,IN CONNECTION WITH THIS PERMIT WILL BE DONE IN AC. f
CORDANCE WITH-TflE'LAWS OF•R[VERSIDE COUNTY AND THE STATE. OF CALIFORNIA, I ALSO
PLUMBING'FEE.
.-DBL
$
AGREE TO CARRY COMPENSATION INSURANCE "UPON MY EMPLOYEES. COMPLIANCE WITH
•
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
, r
)JAS. DONE SO IN ACCORDANCE WITH SECTION 5541 .OF THE E BUSINESS AND PROFESSIONS
-*�+CODE
F THE STATE OF CALIFORNIA.
= CASH ❑ CHECK R_-,M.O. O'"' N.C. ❑
owNE �rW��c-r�,�r�:,
ins Iri A�.�', -57 � G IiS �>�F
cp T�dgGI J3 +
��!�' - ., . .�
- •
_ _
RECEIVED BY
ADDRESS
r y '
�J 2`</ A r'E
ADDRESS
SF AGESYSTEM
�-
T LL
p
c
arr_ _
.,. arr ?
TREES REQUIRED YES
NO -11i .
4
IN FORMATION, /,^._ .'��+
J:1 p �}�Z .
TEL. NO._ ^
TEL. NO. - LICENSE
nI/,
FORM 4.2081Rev..T 1/72f