206024 (SPIN)z 'DEPARTMENT OF BUILDING & SAFET FIELD'OFFICE ^
BUILDING' PERMIT r' -
;COUNTY OF RIVERSIDE
CONSTRUCTION ESTIMATE EL'ECTRICAL•FEES` PLUMBING FEES
"NO. NO.
1ST'FLi FT.'@
2ND FL.
POR.: � �
.'GAR.--
'CAR P.
yWALL
2. ''
SO. FT. @'
APPLIANCE' ' '>
TRANSFORMER OK.W.
MOTOR OR;LESS H.P.
SO. FT: @' 1
'
SO. FT. @ ' : MOTOR 5 OR LESS H.P.
LAUNDRY. TRAY
SO FT: Co) ' MOTOR 20 OR LESS H:P.
DRAINAGE PIPING '
SO..FT: Ca) , " `_ •
DRINKING FOUNTAIN.
SO. FT. @
URINAL - c
OK.W.UNITS
WATER PIPING
ESTIMATED VALUATION $
'
FLOOR DRAIN
'
MECHANICAL'FEES ..
SQ. FT.@- ¢
WATER SOFTENER .�
VENT, SYSTEM ❑'FAN •❑ EVAP.COOL❑ HOOD
SIGN
WASHER (AUTO) (DISH)'
APPLIANCE' ' '>
TRANSFORMER OK.W.
, GARBAGE, DISPOSAL
FURNACE❑UNIT ❑WALL❑FLOOR ❑SUSPENDED
OUTLETS .'
LAUNDRY. TRAY
AIR HANDLING�UNIT ' z CFM'
FIXTURE OR SOCKET'
KITCHEN SINK
GAS PIPE ❑ NATURAL. ❑ L.P.G.. , ❑ OIL
CONST. SERV. ENTRANCE
WATER CLOSET %
COMPRESSOR HP*
POLE
LAVATORY
APPLIANCE VENT
AMPERES SERV: ENT..
SHOWER
ABSORPTION SYSTEM 0} B.T.U.
SQ. FT.@- ¢
BATH TUB
INCINERATOR ❑ DOMESTIC ❑INDUS. OR COMM. -; *
SQ. FT.@.. it:
WATER* HEATER.
.HEATING SYSTEM, ❑ FORCED ❑ GRAVITY,
SQ. FT. RESID. @ 1 (r
SEWAGE DISPOSAL
BOILER B.T.U. f
SQ. FT. GARAGE '@ z a
HOUSE SEWER
PERMIT FEE- `x
BALANCE OF MIN. FEE
GAS PIPING' .
MOBILE HOME HOOKUP FEE .'I$ . I I - I �� (PERMIT FEE I` 'I I PERMIT FEE I .�
--------------
PERMIT NUMBER TOTAL FEES MOB. NOOK FEE .HEAT 8 VENT FEE DBL PL. CK. FEE CONST. FEE DBL EL EC.FEE IDBLI�aF FS•�. PIVMBING FEE DBL
'J F M A M 'J J�j A. 'S O
N. D
JOB:ADDRESS. "
'
OWNER
,72
I !a �% 6;5 Yi
/ f�
73
USE.OF BUILDING , _
F.C.
DATE _
PERMIT NO.
206024-,
741,=.�-��
75 `
C.OMMUNITV JJDS.;T;•
.UNITS
OOM
VALUATION -.SUPP.
TO PERMIT
OFFICE .
:,'j
MOBILE HOME
$
LEGAL DESCRIPTION
' HOOKUP FEE
?
DBL_
�.
a `'SET BACK
LOT SIZE•
ZONE
USE NO.
GRP
TYPE
CK BY`�-
_MECHANICAL' FEE
l
_
F t. S ` R
- yc
M
BOND AMT.;
PLAN'NO.q
PLAN CHECKER.•`
FINAL DATE INSPECTOR
'
PLAN CHECK FEE'
$
,?
p ,-7 r
:DBL
-
.NAME OF CONST. LENDER "
BRANCH OFFICES
LVED
NO LENDER INVOLVED.
CONSTFUCTION FEE
$'
?
-
.
' '-DBL
-
ADDRESS - - p .,
CITY' -
ATE
ELECTRICAL FE•E
$ A .y
y"
_ST
• '
THIS PERMIT, SHALL BECOME VOID IF,WORK IS NOT COMMENCED;WITHIN 60'DAYS.
"
&FEE,
CESSATION 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`.
"
.PL'UMBING
,
ORNIA. 1 ALSO AGREE TO CARRY -COMPENSATION INSURANCE UPON. MY.EMPLOYEES.
FEE ...
COMPLIANCE'WITH THE -LAWS OF THE STATE.OF CALIFORNIA COVER ING'CONTRACTORS
R
IS ALSO GUARANTEED. "` r
1 HEREBY,CERTIFY THATpTHEINDIVIDUAL WHO_PREPARED'THE PLANS AND SPECIFI-
t
-TOTAL' FEES'S
�"�
IN qr TION.5541 OF THE BUSINESS AND
'OF CE W
;CAT.F6SS10,NS ODE OFOTHE.,+TA, C RNiA.
CASH CHECK M.O. ❑ N.( (�
own R ' ' �" =fit. -
COri RA OR �!
A
Received By . a
ADDRESS £,4 c e AD -DR ESS>
'Trees Required
Yes No
n
+• � � { t 'LICENSE �;�, t�
FORM 284-208 (REV. 4/71)•H " (j .��. _ S• �V`�