155600 (SPIN)SET
BACK
DEPARTMENT OF BUILDING & SAFETY
FIELD OFFICE
in
COUNTY OF RIVERSIDE
j
PLddN CHECK FEE
CONSTRUCTION ESTIMAT9W
ELECTRICAL FEES
PLUMBING FEES
' 1st FI.
Sq. Ft. @
NO.
NO.
2nd FI.
Sq. Ft.
Por.
Sq. Ft. (i
Gar.
Sql Ft.
POLES
Car P.
Sq. Ft.
SIGNS
DRAINAGE PIPING
TRANS
Wall
Sq. Ft.
OR CLK.D/
DRINKING FOUNTAIN
{�
I,/ �GI al
Sq• Ft.
MOTOR H.P.
URINAL
s
MOTOR H.P.
WATER PIPING
ES IMATED VALUATION $
MOTOR H. P.
FLOOR DRAIN
NO. MECHANICAL FEES
MOTOR H.P.
WATER SOFTENER
HEAT APPLIANCE
MOTOR H.P.
WASHER (AUTO) (DISH)
INLETS - OUTLETS
FIXTURES
GARBAGE DISPOSAL
M. SO. FT. - UNIT HEATER
OUTLETS
LAUNDRY TRAY
M. SO. FT. - PERF. CEILINGMAT.
SUB -PANEL
KITCHEN SINK
APPLIANCE VENT
WATER CLOSET
GAS PIPE
RANGE AND/OR OVEN
LAVATORY
REPAIR OR ALTER
WATER HEATER
SHOWER
VENT SYSTEM ❑ HOOD ❑ EVAP. COOL ❑
SPACE HEATER
BATH TUB
COMPRESSOR
CONSTRUCTION POLE
WATER HEATER
i
COMPRESSOR
SERVICE ENTRANCE
SEWAGE DISPOSAL
COMPRESSOR
RESID. 10 SQ. FT.
HOUSE SEWER
GARAGE iQ SO. FT.
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
rPE
Mg M E
REN
DBL
PLN CHK
FEE
CONSTR. FEE
HEAT & VENT
ELECT. FEE
PLUMB. FEE
TOTAL FEES
PLAN CHECKER
Li
J F M A
M J J A
S
0 N D
J F M A
M J J A
S
O N D
BUILDING INFORMATION
JOB ADDRESS
OWNER
WOOD
CONCRETE
FIREPLACEe
f
CONCRETE
PIERS
MEMBRANE
USE OF BUILDING
dDATE
BLOCK I FRAME STUCCO
BRICK CONC. METAL
OTHER
�'#
_
COIiAMUNITY
DISTRICT
F.C.
VALUATION
OFFICE
'
PLASTER DRY WALL
ROOF COVERING
11313. RMS.
1.a
JUNITS
LEGAL D S RIPTION
PE
I N
R
ZO/N�E'� ZONING CHECKED BY
PERMIT USE NO.
Jif J •-.�..j __A ��
SUPPLEMENT TO PERMIT
SET
BACK
FRONT S
REAR
j
PLddN CHECK FEE
MECHANICAL FEE
CONSTRUCTION FEE
LOT SIZE
FINALED DATE SP CTOR� GROUP TYPE BOND BOND CASH
$ /,% Z-617 h � t� $
6f CONTRACTOR /I/ T" RELEASE BOND
LICENSE -TYPE DATE
In accordance with Sec. 302-D of the Uniform Building Code, this permit Shot[
expire if work is not commenced within 60 days. If work is suspended or aban-
doned for a period of 120 days, this permit shat[ automatically became null
and void.
This permit is issued, and shall continue in effect, pursuant to the terms and
conditions of Sec. 3800 of the Business and Professions Code and as a condi-
tion of the issuance hereof the following certificate is executed.
OWNER -BUILDER CONTRACTOR
I hereby certify that in performance I hereby certify that in performance
of the work for which this permit is of the work for which this permit is
!7�} issued I shall not employ any person issued I hove complied with Title 8,
in any manner whatsoever as to be- Article 3, Sec. 3800 of the Labor
N c come subject to the Workmen's Com- Code, and a certificate or certified
pensation Lows of the State of copy is on file with the Riverside
Calif. ia. County Building Deportment.
Owner Contractor
SEEPAGE PIT
Address, Address
GAL. Telephone 1 4, A,Tel. Lic. #
44 t;.' Jc
ELECTRICAL FEE
$
PLUMBING FEE
TOTAL FEE $
CASH CHECK i M.O.
,RECEIVED PLAN FILE
•W
ATERIVOLUME SEPTIC TANK LEACH LINE
GAL. SO. FT
LETTER F-1 FILE