258238 (PLBG)E
BUILDING PERMIT
VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD
DEPARTMENT OF BUILDING & SAFETY
COUNTY OF;-RIVERSIDE-
NO.
F-. RIVERSIDE
NO. I ELECTRICAL FEES
UNITS
MOBILEHOME SVC.
POWER OUTLET
SWIM POOL, PVT
SWIM POOL. COMM
SIGN
PLUMBING FEES
BOILER 0 B
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
FLOOR DRAIN
WATERSOFTENER
WASHER (AUTO) (DISH)
// I
CONSTRUCTION ESTIMATE
I ST FL.
SQ..FT.
2ND FL.
SQ. FT.
POR.
SQ. FT.
GAR.
SQ. FT.
CAR P.
SO -FT.
WALL
SQ. FT. ®.
SQ. FT.
ESTIMATED CONSTRUCTION VALUATION $
NOTE: Not
to be used as property tax valuation
VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD
DEPARTMENT OF BUILDING & SAFETY
COUNTY OF;-RIVERSIDE-
NO.
F-. RIVERSIDE
NO. I ELECTRICAL FEES
UNITS
MOBILEHOME SVC.
POWER OUTLET
SWIM POOL, PVT
SWIM POOL. COMM
SIGN
PLUMBING FEES
BOILER 0 B
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
FLOOR DRAIN
WATERSOFTENER
WASHER (AUTO) (DISH)
// I
APPLIANCE GARBAGE DISPOSAL
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED LAUNDRY TRAY
AIR HANDLING'UNIT I CFM IDLEMETERKITCHEN SINK
ABSORPTION SYSTEM O B.T.U. TEMP USE PERMSVC WATER CLOSET
COMPRESSOR 0 HP POLE, TEMP/PERM LAVATORY
HEATING.SYSTEM ❑ FORCED ❑GRAVITY AMPERESSERV ENT SHOWER
SQ FT ¢ BATH TUB
SO FT (d ¢ WATER HEATER
SQFT RES1D @ 1C SEWAGE. DISPOSAL
SQ FT GARAGE ® 'ht HOUSESEWER.
PERMIT FEE TEMP ELEC SVC GAS PIPING.
MOBILE HOME PERMIT. FEE $
PERMITTEE PERMIT FEE
R
2
TO TrEES -
MOB. HM..FEE::C�FEEMECH.
FEE
DBL,
PL. CK. FEE
- CONST. FEE
DBL
ELECT. FEE
DBL.
$MIiIFEE
FEE
E/!•� �j V
DBL
J F I M A I M I J I A 1.S 1 O 1 N I D
73
JOB ADDRESS, 1 ,SP NO
'..1 %' 7, ' I
OWNER'
;91a�'fij
USE OF PERM -P.C.:
C.
O%^
i/V
PlyL74
2 A
M H PIERMIT FEE
$
''COMMUNITY
Ctlf�rq
DST -
//
UNITS
ROOMS
VALUATION
3 c?
SUPP. TO;PERMIT
OFFICE
.�
MICROFILM FEE
COPIES
$
LEGAL DESCRIPTION
GoT/-J7 SAj 7A' A L17A /f773. 0cs �ar�
MECHANICAL FEE
DBL
$
SET BACK
LOT'SIZF IZONE
USE NO.
GRP
TYPE
FK BY
F 9' ft
PLAN CHECK FEE
$
'BOND
AMT.
PLAN NO.
'PLAN'CHECKER -
FINALOATE - INSPECTOR,
CONSTRUCTION FEE
DBL
$
'NAME
OF CONST. LENDER BRANCH
OFFICE
NO LENDERINVOLVED'
ELECTRICAL FEE
DBL
$
ADDRESS CITY
STATE
SMI FEE
$
THIS PERMIT SHALL BECOME VOID IF WORK fS NOT COMMENCED WITHIN 120 DAYS, CESSA-
TION OF WORK. FOR 1.20 DAYS SHALL ALSO CAUSE PERMITTO BECOME VOID.
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 ALSO
AGREE TO CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLIANCE WITH THE
LAWS OF THE STATE OF CALIFORNIA COVERING CONTRACTORS IS ALSO GUARANTEED.
1 HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS
HAS DONE SO'IN AC90RDANCE WITH S�CTI.ON 55A I OF THE BUSINESS AND PROFESSIONS CODE
OF THESTATE ":QRNIA.
_TOTAL
FEE
PLUMBING FEE
DBL
$ !
5G
:�]O
FEES
$
NAD.'4
CONTRACTOR
�"CAS CHE ❑ M:O. ❑ N.RESS
ADDRESS_
RECEIVED BY
TREES REQUIRED
SEWAGE SYSTEM
T
LC FP
CITY ZIP CODE
tif4iiF� 1 ,{� L
CITY ZIP CODE
INFORMATION
'FaORl��2820BIRev. 9-T31 .IFJS �
TEL N/O.�
-
TEL. NO. 'LICENSE