206071 (AR)BUILDING PERMIT DEPARTMENT OF BUILDING & SAFET
0 COUNTY OF RIVERSIDE
FIELD OFFICE
VENT SYSTEM ❑ FAN ❑ EVAP.COOL ❑ HOOD
CONSTRUCTION ESTIMATE
ELECTRICAL FEES
PLUMBING FEES
1ST FL.
2ND FL.
POR.
GAR.
CAR P.
WALL
��
SQ. FT. @
NO.
NO.
SQ. FT. @
FIXTURE OR SOCKET
SQ. FT. @ 12 f j J,:?5�=MOTOR 1 OR LESS H.P.
GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
SQ. FT. Co) 0 MOTOR 5 OR LESS H.P.
WATER CLOSET
SQ. FT. @ MOTOR 20 OR LESS H.P.
DRAINAGE PIPING
SQ. FT. Co)
DRINKING FOUNTAIN
SQ. FT. @
URINAL
OK.W.UNITS
WATER PIPING
ESTIMATED VALUATION Is
INCINERATOR ❑ DOMESTIC ❑INDUS. OR COMM.
FLOOR DRAIN
WATER HEATER
MECHANICAL FEES
SQ. FT. RESID. @ 1 4
WATFR SOFTFNFR
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 CFM
FIXTURE OR SOCKET
KITCHEN SINK
GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
CONST. SERV. ENTRANCE
WATER CLOSET
COMPRESSOR E== HP
POLE
LAVATORY
APPLIANCE VENT
AMPERES SERV. ENT.
SHOWER
ABSORPTION SYSTEM O B.T.U.
SQ. FT. @ (r
BATH TUB
INCINERATOR ❑ DOMESTIC ❑INDUS. OR COMM.
SQ. FT.@ C.
WATER HEATER
HEATING SYSTEM ❑ FORCED ❑ GRAVITY
SQ. FT. RESID. @ 1 4
SEWAGE DISPOSAL
BOILER E== B.T.U.
SQ. FT. GAR AGE @
HOUSE SEWER
PERMIT FEE
BALANCE OF MIN. FEE
GAS PIPING
MOBILEHOME HOOKUP FEE
I$ I I
I I IPERMIT FEE
I PERMIT FEE
PERMIT NUMBER
TOTAL FEES
MOB. HOOK FEE
HEAT 8 VENT FEE
DBL
PL. CK. FEE
CONST. FEE
OBL EC. EE,
FEE PLUMBING FEE
DBL
74
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F.C. DATE
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PER206071
NO
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LEGAL DESCRIPTION '
HOOKUP FEE
"r C- %% -3 — a,—
DBL
SET BACK
LOT SIZE
ZONE
USE NO.
GRP
TYPE
CK BY
MECHANICAL FEE
$
)
t '
F. S R
�/
BOND AMT.
PLAN NO.
PLAN CHECKER
FINAL DATE INSP
CTOR
PLAN CHECK FEE
$
I J
I
DBL
O
NAME OF CONST. LENDER
BRANCH OFFICE
NO LENDER INVO PED
CONSTRUCTION FEE
1/--
DBL
G
ADDRESS
CITY STATE
ELECTRICAL FEE
$
$
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 60 DAYS.
Z
CESSATION OF WORK FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
SN!FEE
..
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
PLUMBING FEE
ORNIA. I ALSO AGREE TO CA�IRY COMPENSATION INSURANCE UPON MY EMPLOYEES.
COMPLIANCE WITH THE LAW$ OF THE STATE OF CALIFORNIA COVERING CONTRACTORS
IS ALSO GUARANTEED.
I HEREBY CERTIFY TH THEl114D1 DUAL WHO PREPARED THE PLANS AND SPECIFI-
TOTAL FEES $ ! I
CATIONS HAS D NE SC,4N APCOR NCE IT ECTION 5541 OF THE BUSINESS AND
�7
PROFES5' E OF AT F O IA.
CASH F-1 CHECK O) M.O. Fl N,C, 0
OWN
ONTRACTOR
op
/
Received B Y
ADDR _$S ADDRESS _
d
Sewage System
T
LL
P
_
CITY----�-�''' CITY' •�•,: •,`.. X�%.r5
Trees Required
Yes
No
/O�
TEL(O.TEL. NO. LICENSE
FORM 284-208 (REV. 4/711 (� 3 \