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268392 (SPIN)FIELD OFFICE BUILDING PERMIT DEPARTMENT OF BUILDING & SAFETY r COUNTY OF RIVERSIDE ldd!1111116� NO' I ' ELECTRICAL FEES UNITS MOBILEHOME SVC. POWER OUTLET SWIM POOL. PVT SWIM POOL, COMM IDST NO. PLUMBING FEES I lil; YARD SPKLR SYSTEM BAR SINK ROOF DRAINS DRAINAGE PIPING DRINKING FOUNTAIN URINAL WATER PIPING FLOOR DRAIN WATER SOFTENER VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD CONSTRUCTION ESTIMATE I,ST FL. SQ.FT. @ 2ND FL. SQ. FT. @ POR. SQ. FT. @ GAR. SQ. FT. @ CAR P. SQ.FT. @ WALLSQ. FT. @ WATER CLOSET SQ. FT. @ ESTIMATED CONSTRUCTION VALUATION $ NOTE: Not to be used os property tax voluotion AMPERES SERV ENT MECHANICAL FEES NO' I ' ELECTRICAL FEES UNITS MOBILEHOME SVC. POWER OUTLET SWIM POOL. PVT SWIM POOL, COMM IDST NO. PLUMBING FEES I lil; YARD SPKLR SYSTEM BAR SINK ROOF DRAINS DRAINAGE PIPING DRINKING FOUNTAIN URINAL WATER PIPING FLOOR DRAIN WATER SOFTENER VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD SIGN WASHER (AUTO) IDISHI APPLIANCE _ cn IP PP I GARBAGE DISPOSAL FURNACE ❑ UNIT 0 WALL ❑ FLOOR ❑ SUSPENDED USE OF PERMIT LAUNDRY TRAY AIR HANDLING UNIT CFM IDLE METER KITCHEN SINK ABSORPTION SYSTEM 0 B.T.U. TEMP USE PERM SVC WATER CLOSET COMPRESSOR 0 HP POLE, TEMP/PERM LAVATORY HEATING SYSTEM ❑ FORCED ❑ GRAVITY AMPERES SERV ENT SHOWER BOILER 0 B.T.U. SQ FT @ a BATH TUB SO FT @ ¢ WATER HEATER UNITS SQ FT RES1D @ 1 ¢ SEWAGE DISPOSAL SU PP. TO PERMIT SQ FT GARAGE @ I/]a HOUSE SEWER PERMIT FEE $ GAS PIPING MOBILE HOME PERMIT FEE Is MECHANICAL FEE PERMIT FEE PERMIT FEE PERMIT NO. 268392 TOTAL FEES lo� MOB. HM.FEE MICRO FEE MECH. FEE DBL. Pl. CK. FEE CONST. FEE DBL. ELECT. FEE DBL. SMI FEE ��° FEE PLUMB. FEE DBL. J F M A M J A S Q N D JOB ADDRESS SP NO OWNER 74 _ cn IP PP I 75 USE OF PERMIT F.C. DATE PE$MIT N 226 8 3 9 2 76 •U I_ _ M H PERMIT FEE $ Co IST UNITS ROOMS VALUATION SU PP. TO PERMIT OFFICE MICROFILM FEE COPIES $ LEG ES R PTION z Tr- 1114R MECHANICAL FEE DBL $ SET BACK LOT SIZE ZONE USE NO. GRP TYPE CK BY R_q Avera F S R PLAN CHECK FEE $ BOND AMT. PLAN NO. PLAN CHECKER FINAL DATE OR4`'� JINECTSe I CONSTRUCTION FEE DBL $ NAME OF CONST. LENDER BRANCH OFFICE NO LENDER INVOLVED ELECTRICAL FEE DBL $ ADDRESS CITY STATE STRONG MOTION $ OWNER/AGENT'S SIGNATURE CONTRACTOR !(Gf ^• I: INSTRUMENTATION FEE lc /II rIz. l ADDRESS AD s ��TEE PLUMBING FEE DBL $ CITY ZIP CODE CITY ZIP CODE Dir5cia TOTAL FEES $ TEL. NO. TEL. LICENSE �Q p L�-.l,Q© 2. X �f_-(f t CASH ❑ CHECKM.O. ❑ N.C. ❑ THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSA ION OF WORK FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID. PT RECEIVED BY TREES REQUIRED 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, 1 ALSC SEWAGE SYSTEM J I T LL P AGREE TO CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLIANCE WITH THI IA%A/C/CTUC CTATC/C(Al ICl DKIIA /'!1\/CDIAir l- KITDA/T—C IC AI — — IAnAAIT— I I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS FORM 284-208 (Rem. 10.74) OO L HAS DONE SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA.