280870 (SATT)BUILDING PERMIT
DEPARTMENT OF BUILDING & SAFETY
COUNTY OF RIVERSIDE
CONSTRUCTION ESTIMATE .�/ NO. ELECTRICAL FEES
1 ST FL. AS SO.FT. @/711' / /J S UNITS
2ND FL. SO. FT. @ l
POR. Q SO. FT. @ �/ ! ° t '� MOBILEHOME SVC.
GAR. 'r SO. FT @S q l y-� POWER OUTLET
CARP. SOFT. @
WALL SO. FT. @
SO. FT. @
ESTIMATED CONSTRUCTION VALUATION $
NOTE: Not to be used as property tax voluotion
MECHANICAL FEES
VENT SYSTEM YFAN X EVAP. COOL X HOOD
SWIM POOL, PVT
SWIM POOL, COMM
SIGN
FIELD OFFICE
NO. PLUMBING FEES
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
FLOOR DRAIN
WATER SOFTENER
VYACHFa IAI ITnI IrMWr
71
APPLIANCE
108 ADDRESS /� r i SP NO
ve
OWNER
J
75
GARBAGE DISPOSAL
/ JDATE(.%
FURNACE ❑ UNIT Q WALL ❑ FLOOR ❑ SUSPENDED
P 'go
0870
76
AT
i t VF . (i
LAUNDRY TRAY
I Y!
AIR HANDLING UNIT CFM
IDLE METER
$
KITCHEN SINK
COMMUN Y
Lo.
ABSORPTION SYSTEM 0 B.T,U.
TEMP USE PERM SVC
'2,
WATER CLOSET
TO PERMIT
COMPRESSOR HP
POLE, TEMP/PERM
LAVATORY
Ar
HEATING SYSTEM*—NUTORCED O GRAVITY
AMPERES SERV ENT
SHOWER
BOILER � B.T.U.
SO FT @ ¢
$ /
• /
f
BATH TUB
Q
DBL
SO FT @ ¢
��.1
!
WATER HEATER
USE NO.
GRP
Cl SO FT RESID @ ¢
C!C
SEWAGE DISPOSAL
p� 9'1 /' SO FT GARAGE @p
HOUSE SEWER
PERMIT FEE
PLAN CHECK FEE
$
GAS PIPING
BOND AMT.
MOBILE HOME PERMIT FEE $
F�INA, L DATE_ /J
PERMIT FEE
�
PERMIT FEE
2 EERfjdlT fl0.7
lJMOB.;E�HM.FEE
M,: .'�E
CONSTRUCTION FEE
DBL.
PL. CK FEE
/NST.E
DBL.
ELECT. FEE `
DBL.
SM FEE
FEE
PLS
DBL.
J I F I M A I M J I J A I S 1 O 1 N D
74
108 ADDRESS /� r i SP NO
ve
OWNER
J
75
USE OF PERMI
��L/1r � e
/ JDATE(.%
/
P 'go
0870
76
AT
i t VF . (i
I Y!
L
M H PERMIT FEE
$
COMMUN Y
Lo.
DST
UNITS
ROOMS
I VALUATION ,SUPP.
% A
TO PERMIT
O:GtGL
711 A
MICROFILM FEE
COP IE
$ /
• /
�
1.10)(11DE IRIPTON �( le I1 /} // 1� �(
769- 13.E iJ /1,Yp I>r-sek1 �/Ub nr `^'i A)
MECHANICAL FEE
DBL
$
��.1
SET BACK LOTS E 20y�
tf'7f l
FA/ S�
USE NO.
GRP
TYPE
C!C
l
S 2S' JRVI
'
PLAN CHECK FEE
$
BOND AMT.
PLAN NO. PLAN CHECKER
F�INA, L DATE_ /J
INSPECTOR
�
CONSTRUCTION FEE
DBL
$
lad
NAME OF CONST. LENDER BRANCH
OFFICE
NO LENDS NVOLVED
ELECTRICAL FEE
DBL
$�
ADDRESS CITY
STATE
STRONG MOTION
INSTRUMENTATION FEEes
$
�✓
OWNER/A6EaT7S SIGNATU E'
CONTRACTOR
iezgA M
FEE
$
ADDRESS
?f` qs / [ 1.j� p 5-1` i -
ADDRESS
PLUMBING FEE
DBL
$
CITY ZIP CODE
fir l o
CITY ZIP CODE
TOTAL FEES *0
$ ! /"•�C 1
S
TEL. NO.
-�!�
TEL. NO. LICENSE
CASH Q CHECK M.O. ❑ N.�. ❑ r
ff THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSA
TION 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 AC
CORDANCE WITH THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, I ALSC
RECEIVED B r�j�r�
TREES REQUIRED n
SEWAGE SYSTEM
6 �
T4140LL
P n v
AGREE TO CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLIANCE WITH THE
I HEREBY OFICALIFORNIA-
ERTIFY THAT THE INDIVIDUAL WHO PREPAREDTHEPLANS AND SPECIFICATIONS
FORM 284-208 (Rev. 10-74) OIL HAS DOVE SON ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE
1 - OF THE STATE