272548 (AR)BUILDING PERMIT DEPARTMENT 'OF BUILDING $ SAFETY
COUNTY OF RIVERSIDE
CONSTRUCTION ESTIMATE , , NO. ELECTRICAL FEES
1 CT El FT
F ///Cr •. r_, ."L 'l ;112 I IUNITS
MOBILEHOME SVC.
POWER OUTLET
SWIM POOL, PVT
SWIM POOL, COMM
SIGN
FIELD OFFICE
NO.I PLUMBING FEES
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
• URINAL
WATER PIPING
FLOOR DRAIN
WATER SOFTENER
WASHER (AUTO) (DISH)
DST
/1
APPLIANCE
1011 ADDRESS SP NO
OWNER
2ND FL.
GARBAGE DISPOSAL
SQ. FT. @
POR.
USE OF PERMIT els ��/✓L li t J-�j+ �f /�
SO. FT. @
GAR.
CFM
SO. FT. @
CAR P.
KITCHEN SINK
SQ.FT. @
WALL
TEMP USE PERM SVC
SQ. FT. @
WATER CLOSET
COMPRESSOR
HP
SQ. FT. @
ESTIMATED CONSTRUCTION VALUATION $-
NOTE: Not to be used os property tax valuation
HEATING SYSTEM ❑ FORCED O GRAVITY
MECHANICAL FEES
VENT SYSTEM
❑ FAN O EVAP. COOL ❑ HOOD
MOBILEHOME SVC.
POWER OUTLET
SWIM POOL, PVT
SWIM POOL, COMM
SIGN
FIELD OFFICE
NO.I PLUMBING FEES
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
• URINAL
WATER PIPING
FLOOR DRAIN
WATER SOFTENER
WASHER (AUTO) (DISH)
DST
/1
APPLIANCE
1011 ADDRESS SP NO
OWNER
74 1 1J;
GARBAGE DISPOSAL
FURNACE O UNIT O WALL O FLOOR O SUSPENDED
75
USE OF PERMIT els ��/✓L li t J-�j+ �f /�
LAUNDRY TRAY
AIR HANDLING UNIT
CFM
IDLE METER
DwA �i/�lr ra/
KITCHEN SINK
ABSORPTION SYSTEM
0 B.T.U.
TEMP USE PERM SVC
WATER CLOSET
COMPRESSOR
HP
POLE, TEMP/PERM
UNITS
LAVATORY
HEATING SYSTEM ❑ FORCED O GRAVITY
AMPERES SERV ENT
SHOWER
BOILER 0 B.T.U.
SQ FT @ a
BATH TUB
I
SQ FT @ ¢
WATER HEATER
MICROFILM FEE
COPIES
tly SQ FT RESID @/3-4J
SEWAGE DISPOSAL
SQ FT GARAGE @ IF,a
HOUSE SEWER
PERMIT FEE
DBL
$
GAS PIPING
MOBILE HOME PERMIT FEE
5
USE NO.
/ PERMIT FEE
PO
PERMIT FEE
2R1T jJQ.4
TOTAL F�EyES
MOB. HM FEE
MICRO FEE
MECH. FEE
DBL.
�L CK. FEE
CONST FEE
PBL.
ELE/CT. FEE
DBL.
S/MI FEE
FEE
PLUMB FEE
DBL.
J
J I F I M A I M IJ J A S Q N D
1011 ADDRESS SP NO
OWNER
74 1 1J;
-11,/e, ,#ue ��F_/'1: r +C'
75
USE OF PERMIT els ��/✓L li t J-�j+ �f /�
F.C.
DATE
PE I O.
76
DwA �i/�lr ra/
;-,�0
272548
M H PERMIT FEE
$
COMMUNITY
DST
UNITS
ROOMS
VALUATION
SUPP. TO PERMITOFFICE
I
I
MICROFILM FEE
COPIES
$
LEGAL DESCRIPTION
PAI - %gy-,g "-X/ - 01 t i -/ - f',1- .9 !. -If Af7-4 Prlr r+
MECHANICAL FEE
DBL
$
SET)BACK
LOT SIZE ZONE
USE NO.
GRP
TYPE
CK BY
DIS
PLAN CHECK FEE
$
BOND AMT.
PLAN NO.
PLAN CHECKER
FINAL DATE
f
JINSPECTOR
CONSTRUCTION FEE
DBL
$
NAME OF CONST. LENDER BRANCH
OFFICE
NO LENDER INVOLVED
a. y
40
/---
ELECTRICAL FEE
DBL
$
ADDRESS CITY
�' ��
STATE
STRONG MOTION
$
OWNER/AGENT'S SIGNATURE
CONTRACTOR
INSTRUMENTATION FEE
Iq
d
FEE
$
ADDRESS
ADDRESS
PLUMBING FEE
DBL
$
CITY ZIP CODE
CITY ZIP CODE
,(}
TOTAL FEES
$
/� U
TEL. NO.
TEL.NO. LICENSE
I—/ 7 --, / f / d t ' L�
—i 7
CASH O CHECK, M.O. ❑ N.C. O
y� THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSA•
y[;PON OF WORK FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
RECEIVED BY
TREES REQUIRED 1
J 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, I ALSC
SEWAGE SYSTEM
T
LL
P �,
AGREE TO CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLIANCE WITH THE
A1C—TUC CTArC—(-Aii n —1--T—C Ic Al cry—IAD-1 C,
I I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS
FORM 284-208 (Rev. 10-74) O► L HAS DONE SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE
OF THE STATE OF CALIFORNIA.