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210177 (RPL)
BUILDING PERMIT DEPARTMENT OF BUILDING & SAFETO FIELD OFFICE • COUNTY OF RIVERSIDE CONSTRUCTION ESTIMATE I ELECTRICAL FEES PLUMBING FEES IST FL. SQ. FT. @ 2ND FL. SQ. FT. POR. SQ. FT. @ GAR. SQ. FT. LM CAR P. SQ. FT. WALL SQ. FT. @ GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL SQ. FT. WATER CLOSET COMPRESSOR O HP ESTIMATED VALUATION $ MECHANICAL FEES NO. MOTOR 1 OR LESS H.P. MOTOR 5 OR LESS H.P. MOTOR 20 OR LESS H.P. K.W, Hell DRAINAGE PIPING DRINKING FOUNTAIN URINAL WATER PIPING FLOOR DRAIN WGTFR Cr117TFNFR VENT SYSTEM ❑ FAN ❑ EVAP.COOL❑ HOOD SIGN WASHER (AUTO) (DISH) APPLIANCE TRANSFORMER =K.W. GARBAGE DISPOSAL FURNACE❑UNIT ❑WALL❑FLOOR❑SUSPENDED' OUTLETS 77 LAUNDRY TRAY AIR HANDLING UNITI I CFM FIXTURE OR SOCKET G 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 E] INDUS. OR COMM. SQ. FT.@ T. WATER HEATER `v HEATING SYSTEM ❑ FORCED ❑ GRAVITY SQ. FT. RESID. @ 1 q SEWAGE DISPOSAL 901LER B. T.U. SQ. FT. GARAGE @ = q HYTCISL"51�7PE y' Cr (� PERMIT FEE BALANCE OF MIN. FEE % GAS PIPING MOBILEHOME HOOKUP FEE 1$ F I I I I IPERMIT FEE I Tj d©I /I PERMIT FEE 1 011 Q a J F M A M J J A S O N D JOB ADDRESS OWNER 172 �^ 1 i.11 -4/.P0 6z)Ile 47 cG, 0, 4a ] I-eiM 73 USE OF BUILDING F.C. DATE PER iT N X177 74 / �imr�/r� /O / 3O G-7 71 75 COMMUNITY DST UNITS OOM V ALUATION SUPP. TO PERMIT OFFICE 76 aa/ �-+.�. 1 t;+ l & 1 Q ii MOBILEHOME $ LEGAL DESCRIPTION HOOKUP FEE t�C� P+Y •f i (I S t l U�7 T � .Z Ale 5?" MECHANICAL FEE DBL SET BACK LOT SIZE ZONE USE NO. GRP TYPE F s R $ • I ICKBY PLAN CHECK FEE $ BOND AMT. PLAN NO. PLAN CHECKER FINAL DATE INSPECTOR / c�"U /0 3a -7�— CONSTRUCTION FEE DBL G V NAME OF CONST. LENDER BRANCH OFFICE NO LENDER INVOLV D ELECTRICAL FEE DBL $ ADDRESS CITY STATE 1 � G V $ THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 6Q DAYS. ',0/' FEE s ESSATION OF WORK FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID. 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 'zi ORNIA. I ALSO AGREE TO CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLIANCE WITH THE LAWS OF THE STATE OF CALIFORNIA COVERING CONTRACTORS IS ALSO GUARANTEED. I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLA 0SPECIFI- CATIONS HAS DONE SO IN ACCORDANCE WITH SECTKKQ 5. 1/.OF H S AND TOTAL FEES $ ,,;�S V PROFES810NS CODff OF THE STATE OF CALIFORNIA.f% JV CASHED CHECK E]r M.O. ED N.C. ED OWNER CONTRACTOR .,, .� � ' eN; y ca Received By ADDRESS ADDRESS % Sewage System T LL P CITY CITY Trees Required Yes No ++ / INFORMATION ' TEL. NO. TEL. NO. `, FORM 284-208 (REV. 4/711 �VV��I /LICENSE