158854 (SATT)DEPARTMENT OF BUILDING & SAFETY
SET BACK
LOT SIZE
USE #
FIELD OFFICE
COUNTY OF RIVERSIDE
_7R
JOWNER-
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•
PLAN CHECK FEE
ZONE
`1
t f
-
F F BUM 'DING t
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t_ .� G, k to F^- 411 � 1 4.. ,-
DATE
'
CHEC KE{DfJ BY,
C•OMMl1NlT '
DISTRICT° F.Cr pp
Wi TS
CONSTRUCTION ESTIMATE
ELECTRICAL FEES
MECHANICAL FEES•N
PLUMBING FEES
't
A
1st Fl. .t`,,
,.
Sq. Ft. @ f <� ":.% �.'f, di
NO.
GROUP
TYPE
NO.
P•�R8IT NU R
'
Sq. Ft. @
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'
2nd FI.
Sq. Ft. @"
! rf _ate E'. c I'
ll
/F
ELECTRICAL* FEE e..w.•.
Par. t:�f' 2
�s � � � �,�� � -
-
,
PLAN CHECKER
BOND $
BOND
CASH
PLAN FILE #
FINAL DATE
INSPECTOR
Sq. 'Ft. @
JPOLES
�8
QC.
/ /•j'
Sq, Ft, eQ / jG•
SIGNS
•
. DRAINAGE PIPING
7
/Gar. r
' Car P. Lf.'=•
T
".Sq. Ft. @
TRANS. AND/
OR T. CLK.
WITHIN 60 DAYS. CESSATION OF WORK FOR 120 DAYS SHALL ALSO
CAUSE PERMIT TO BECOME VOID.
I HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS
CASH CHECK M.O. -N.C.
,.
DRINKING FOUNTAIN
rc
Wall
Sq. Ft. @
MOTOR H. P.
;
R _e
T
URINAL
P
CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLI-
ANCE WITH LAWS OF THE STATE OF CALIFORNIA COVERING CON-
TRACTORS IS ALSO GUARANTEED.
'�"� _ INFORMATION
MOTOR H. P.
OWNER
WATER PIPING
i0
• .. ..
ESTIMATED VALUATION $t'a.'
MOTOR H. P.
v 21 �G.
FLOOR DRAIN
ADDRESS
'
MECHANICAL FEES T
MOTOR" H. P.
TEL. NO.
WATER SOFTENER
1
VENT SYSTEM 13FAN ❑ EVAP. COOL 11HOOD „
MOTOR - H. P.
7V "e14�fyjf//
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i APPLIANCE
FIXTURES
I14-208 11/87
__
-�.
GARBAGE DISPOSAL
> FURNACE ❑ UNIT ❑ WALL 11 FLOOR ❑ SUSPENDED
J
OUTLETS
LAUNDRY TRAY'
Z" AIR HANDLING UNIT
0
SUB-PAMEL
KITCHEN SINK
f M,
-
-.J GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
•A
WATER CLOSET.
U COMPRESSOR D MP
RANGE AND/OR OVEN
LAVATORY
t nJ}
7- 7
D APPLIANCEVENT -
'
WATER HEATER
SHOWER
,
tf j
21-1
- ABSORPTION SYSTEM B.T.U.
SPACE HEATER
t
BATH TUB
_
' V INCINERATOR DOMESTIC ❑ INDUS. ❑COMM. ��
� C ON STRUCTION POLE
".# '.
�
WATER HEATER
.i. 3 a
HEATING SYSTEM ❑.FORCED ❑ GRAVITY
SERVICE ENTRANCE
?.J la
SEWAGE DISPOSAL
BOILER B.T.U.
F RESID. 1Q SO. FT.
' '.. 4�
HOUSE SEWER
RESIDEN TAL FEE SQ. FT.
.ryr°- GARAGE iC SO. FT.
GAS PIPING
PERMIT FEE
j PERMIT FEE
�',r (-.-
1
- PERMIT FEE'
''
I;``
'ERMITREN.
�1
B854
DBL.
TOTAL FEES
HEAT $ VENT FEE
PLN. CK. FEE
CONST. 'FEE
ELEC. F
VIPLVMB.
FEE
`
.
J - F, M A M
J J A
SET BACK
LOT SIZE
USE #
JOB ADDRESjS�
_7R
JOWNER-
" t9 a' f A: C�. i n''
•
PLAN CHECK FEE
ZONE
`1
t f
-
F F BUM 'DING t
�*/mss . • ...
t_ .� G, k to F^- 411 � 1 4.. ,-
DATE
'
CHEC KE{DfJ BY,
C•OMMl1NlT '
DISTRICT° F.Cr pp
Wi TS
VALUATION
OF;F(I CE
MECHANICAL FEES•N
'}
WIT
't
A
E i•�f_ •*
'ew
.CONSTRUCTION
GROUP
TYPE
LEGAL DE �'
�
P•�R8IT NU R
'
FEE i
rc" •..: ,
'
SPEC. INS. .
-
SUPP. TO PERMIT
ll
/F
ELECTRICAL* FEE e..w.•.
�s � � � �,�� � -
-
•
'9$
PLAN CHECKER
BOND $
BOND
CASH
PLAN FILE #
FINAL DATE
INSPECTOR
PLUMBING FEE ti '•
�8
QC.
i
TOTAL FEES
$
•
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.
I HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS
CASH CHECK M.O. -N.C.
1=CEIVED BY
SEWAGE SYSTEM
rc
PERMIT WILL BE DONE IN ACCORDANCE WITH THE LAWS OF RIVER-
SIDE COUNTY AND THE STATE OF CALIFORNIA. I ALSO AGREE TO
;
R _e
T
LL
P
CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLI-
ANCE WITH LAWS OF THE STATE OF CALIFORNIA COVERING CON-
TRACTORS IS ALSO GUARANTEED.
'�"� _ INFORMATION
OWNER
CONTRACTOR
v 21 �G.
ADDRESS
ADDRESS
'
b
TEL. NO.
TEL. NO.. '•}
7V "e14�fyjf//
.. -
LICENSE NO.
I14-208 11/87
__