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280658 (BLCK)iI APPLIANCE JOB ADDRESS SP NO GARBAGE DISPOSAL FIELD OFFICE BUILDING PERMIT DEPARTMENT OF BUILDING & SAFETY LAUNDRY TRAY USE OF PERMIT /.6oXs r W s�,ti y AIR HANDLING UNIT I CFM COUNTY OF RIVERSIDE KITCHEN SINK CONSTRUCTION ESTIMATE ABSORPTION SYSTEM D B.T.U. NO. ELECTRICAL FEES NO. PLUMBING FEES I ST FL. SQ.FT. @ POLE, TEMP/PERM UNITS SQ. FT. @ AMPERES SERV ENT SHOWER YARD SPKLR SYSTEM 2ND FL. SQ. FT. @ BATH TUB MOBILEHOME SVC. BAR SINK POR. 5Q. FT. @ w Q,I�,a�� , POWER OUTLET ROOF DRAINS GAR. SOFT. @ SQ FT GARAGE @ 'ha DRAINAGE PIPING CAR P. WALL 50. FT. @ w' MECHANICAL FEE DRINKING FOUNTAIN 50. FT. @ PERMIT FEE PERMIT FEE URINAL ESTIMATED CONSTRUCTION VALUATION $ - a(}, : -• MOB. HM.FEE WATER PIPING jNOTE: Not to be used os property tax valuation DBL. SWIM POOL, PVT FLOOR DRAIN MECHANICAL FEES ELECT. FEE SWIM POOL, COMM WATERSOFTENER FEE VENT SYSTEM ❑ FAN ❑ EVAP. COOL Cl HOOD SIGN WASHER (AUTO) (DISH) iI APPLIANCE JOB ADDRESS SP NO GARBAGE DISPOSAL FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED LAUNDRY TRAY USE OF PERMIT /.6oXs r W s�,ti y AIR HANDLING UNIT I CFM IDLE METER KITCHEN SINK 76 ABSORPTION SYSTEM D B.T.U. TEMP USE PERM SVC WATER CLOSET COMPRESSOR HP POLE, TEMP/PERM LAVATORY HEATING SYSTEM ❑ FORCED ❑ GRAVITY AMPERES SERV ENT SHOWER ROOMS BOILER � B.T.U. SQ FT @ a BATH TUB SQ FT @ a WATER HEATER w Q,I�,a�� , SQ FT RESID @ la SEWAGE DISPOSAL a©, SQ FT GARAGE @ 'ha HOUSESEWER COPIES PERMIT FEE GAS PIPING MECHANICAL FEE MOBILE HOME PERMIT FEE Is $ PERMIT FEE PERMIT FEE LOT SIZE Z/ONE 2 _PEgMIT NO� 8PRO01, sAL FEES MOB. HM.FEE MICRO FEE MECH. FEE DBL. PL. CK. FEE ON;T� DBL. ELECT. FEE DBL. SMI FEE FEE P�Bo:�toD.l J F M A M J A S Q N D JOB ADDRESS SP NO OWNER B %5 USE OF PERMIT /.6oXs r W s�,ti y F.C. DATE 76 P M �N 0 6 5 8 76 w.�//crus L. A is M H PERMIT FEE $ COMMUNITY, DST if UNITS ROOMS VALUATION Q / �... SUPP. TO PERMIT OFFICE w Q,I�,a�� , a©, MICROFILM FEE COPIES $ LEGAL DESCRIPTION FV !07- 61{ xj4) 36-t5 k'7e MECHANICAL FEE DBL $ SETBACK LOT SIZE Z/ONE USE NO. GRP TYPE CK Y • i �� G/// F S R PLAN CHECK FEE $ BOND AMT. PLAN NO. PLAN CHECKER FIN^^ VE I IN E OR d 17 ' 7 CONSTRUCTION FEE DBL $ NAME OF CONST. LENDER BRANCH OFFICE NO LENDER VOLVED ELECTRICAL FEE DBL $ ADDRESS CITY STATE STRONG MOTION $ OWNER/AGENT'S SIGNATURE CONTRACTOR INSTRUMENTATION FEE S fZ,yts JQ(�NQ` h��j FEE $ ADDRESS ADDRESS ]j l:GJ &A N r Cl C N S eCl PLUMBING FEE DBL $ CITY ZIP CODE CITY ZIP CODE Poo � <1 -s 1 G 12 �?' TOTAL FEES $ TEL. NO. t TEL. NO. LICENSE �j� cJ _ f -714510 CASH ❑ CHECKX M.O. ❑ N.C. ❑ 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. RECEIVED BY B-3 9z TREES REQUIRED I1 �� 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 SEWAGE SYSTEM T LL P AGREE TO CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLIANCE WITH THI I A—C (1C TUC CTATC A1C rAI IC! 0111A !' UrDIIAI(- rnNITDArT(1DC IC AI Cn /-1 IA DANITCCr1 I I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS FORM 284-208 (Rev. 10 -74) ©L HAS DONE SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA.