215402 (SFD)BUILDING PERMIT
'SIGN
WASHER (AUTO)(D�ISH)
DEPARTMENT OF BUILDING & SAFET
COUNTY OF RIVERSIDE,
O
FIELD OFFICE
�Q9,N§1BUCTION
ESTIMATE
ELECTRICAL FEES
PLUMBING FEES
1ST FL.
2ND FL:
POR.
GAR.
CAR P.
WALL
SQ, FT. @
9
� NO.
NO.
SQ. FT. @
COMPRESSOR HP
SQ. FT. @ .... MOTOR 1 OR,LESS H.P.
LAVATORY
SQ. FT. @ MOTOR 5 OR LESS H. P.
AMPERES SERV. ENT.
SQ. FT. @ MOTOR 20 OR LESS H.P.
DRAINAGE PIPING
SQ. FT. @
DRINKING FOUNTAIN
SQ. FT. @
URINAL
OK.W.UNITS
WATER PIPING
I
ESTIMATED VALUATION is
SEWAGE DISPOSAL •+��
�'•
FLOOR DRAIN
MECHANICAL FEES
PERMIT FEE
I
I IWATER SOFTENER
VENT SYSTEM ❑ FAN ❑ EVAP. COOL n HOOD
'SIGN
WASHER (AUTO)(D�ISH)
APPLIANCE
TRANSFORMER OK•W•
GARBAGE DISPOSAL
FURNACE❑UNIT ❑WALL❑FLOO El SUSPENDED
OUTLETS.
LAUNDRY TRAY
AIR HANDLING UNIT CFM
FIXTURE OR SOCKET
KITCHEN SINK r -�
GAS PIPE ❑ NATURA ❑ L.P.G. ❑ OIL
CONST. SERV. ENTRANCE
WATER CLOSET
COMPRESSOR HP
POLE
LAVATORY
APPLIANCE VENT
AMPERES SERV. ENT.
SHOWER
ABSORPTION SYSTEM B.T.U.
SQ. FT.@ ¢
BATH TUB
INCINERATOR ❑ DOMESTIC ❑INDUS. OR COMM..
SQ. FT.@ ¢:
WATER HEATER
HEATING SYSTEM FORCED ❑GRAVITY
"� SQ. FT. RESIO. @ 1 ¢. ry ,
SEWAGE DISPOSAL •+��
BOILER E== B.T.U.
SQ. FT. GAR AGE @ z ¢
HOUSE.SEWER
PERMIT FEE
BALANCE OF MIN. FEE
GAS PIPING
MOBILEHOME HOOKUR FEE -I$ I _ I.
I I IPERMIT
FEE I
.1I -"' I / I PERMIT FEE
I _I
PERMIT NUMBER
TOTAL V •
MOB. HOOK' FEE
HEAT /&'/VENT_ FEE
DBL
PL. CK. FEE
3 Vier
CONST.
o
��!/yS1.:
DBL EL�EEC. EF,E,
I
BL FEE
PLUM BINSyf`1E DBL
.
f 'VAnV�7"']�M
COMMUNITY'
DST
DST
UNITS�OOM
r+�~Y/ T
J F M A M J J A S O
N D
JOB ADDRESS
�i6 ✓r L
OWNER � ,
i�✓� i�
72
J J���(ly ,.I -
tif��/✓NL�
79
OF BUILDING
USE -1DW,6,44iN�
F C.
r
DA TE
�-�-�.�
PERMIT NO .
215402.
74
76
COMMUNITY'
DST
DST
UNITS�OOM
VALUATION
SU PP. TO PERMIT
OFFICE
76,
h� V% MrAl
r
3 �P
MOBILE.HOME$
LEGAL DESCRIPTION I/Q
•'�'. 7
HOOKUPFEE
l��,JjJ��N�/1
40 041eI2 41e /I.. L/Y%l �i- 77
MECHANICAL FEE
DBL
$ 7
(%
�—
SET BACK
LOT SIZE
ZONE
USE NO.
�GRPYPE
XCKY
PLAN CHECK FEE
$ "%
u„y�
BOND AMT.
PLAN NO.
PLAN CHECKER
FIN JINSPECTOR
. ,
/
s
,
CONSTRUCTION FEE
DBL
NAME OF CONST. LENDER
BRANCH OFFICE
NO LENDERG INVOLVED
--
' 1/. 51inv. /L v.► N
ELECTRICAL FEE$
DBL
/
i
�J
'ADDRESS
C '" STATE
W/1.�'��".
5ty%
$
THIS PERMIT SHALL BECOME VOID IF. WORK IS NOT COMMENCED WITHIN 60 DAYS.
CESSATION OF WORK FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
FEE
'r'""
I HEREBY AGREE THAT WORKAN PERMIT
ALL CONNECTION WITH THIS WILL BE DONE
IN ACCORDANCE'WITH THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIF-
DBL
ORNIA. I ALSO AGREE TO CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES.
.r-
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 SPECIFI-
CATIONS HAS DONE SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND
/
PROFESSIONS CODE OF THE STATE OF CALIFORNIA.
CASH 0 CHECK M.O. ED N.C.
OWNER
EDis%i4 .ZA J. SEN .E
CONTRACTOR ,
,%/•��'
,Received
By
A/D�D/R'ESS/
ADDRESS
i�G i�� •' ��1"/
% �""'�• �f�� b�/V
Sewage SystemT
.S'ri
LL
PaX/�
CITY
CIT
Trees Required
Yes
No
PES -RoT L56�
1
INFORMATION
TEL. NO. 1
TEL. NO.. LIC.KNSE
FORM 284-208 (REV. 4/71)0 s�t,
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