234740 (ELEC)BUILDING PERMIT
1 ST FL.
MOTOR I OR LESS H.P:
SQ. FT.
@
2ND FL.
MOTOR 5 OR LESS H.P.
SQ. FT.
@
POR.
MOTOR 20 OR LESS H.P.
SQ. FT.
@
GAR.
DST
SQ.FT.
@
CAR P.
SUPP. TO PERMIT
SQ. FT.
@
WALL
D K.W. UNITS
SQ.FT.
@
ZONE
USE NO.
SQ. FT.
@
DEPARTMENT OF BUILDING & SAFETY FIELD OFFICE
COUNTY OF RIVERSIDE
ELECTRICAL FEES.,,;;,,;,.- PLUMBING FEES DST
NO. NO. Ji
ESTIMATED CONSTRUCTION VALUATION $
NOTE: Not to be used as property tax valuation
MECHANICAL FEES
VENT SYSTEM ❑ FAN ❑EVAP. COOL O HOOD
APPLIANCE
FURNACE ❑ UNIT ❑ WALL ❑FLOOR ❑SUSPENDED
AIR HANDLING UNIT CFM
GAS PIPE ❑ NATURAL ❑ L. ❑ OIL
COMPRESSOR x—"� y HP
APPLIANCE VENT
ABSORPTION SYSTEM B.T.U.
INCINERATOR ❑ DOMESTIC ❑ INDUS. OR COMM.
HEATINGSYSTEM;Z K FORCED ❑GRAVITY
BOILER 0 B.T.U.
PERMIT FEE
MOBILE HOME HOOKUP FEE Is
2 3P8/M74 A TOTAL FEES M08 HK. FEE MICR
Jl {{//AyAy�, U S a..
J I F I M I A I M I J I J I A
73
74
75
M.H. HOOKUP FEE $
MICROFILM FEE COPIES $
MECHANICAL FEE
PLAN CHECK FEE
CONSTRUCTION FEE
ELECTRICAL FEE
SMI FEE
FEE
PLUMBING FEE
TOTAL FEES
CASH ❑ CHECK J
RECEIVED BY ��
SEWAGE SYSTEM
MOTOR I OR LESS H.P:
DBL $
MOTOR 5 OR LESS H.P.
F.C.
DATE
S
MOTOR 20 OR LESS H.P.
DRAINAGE PIPING
COMMUNITY
DST
DBL $
MECHANICAL FEE
PLAN CHECK FEE
CONSTRUCTION FEE
ELECTRICAL FEE
SMI FEE
FEE
PLUMBING FEE
TOTAL FEES
CASH ❑ CHECK J
RECEIVED BY ��
SEWAGE SYSTEM
DBL.
N D
MOTOR I OR LESS H.P:
OWNE
MOTOR 5 OR LESS H.P.
F.C.
DATE
PERM N
24740
MOTOR 20 OR LESS H.P.
DRAINAGE PIPING
COMMUNITY
DST
UNITS
DRINKING FOUNTAIN
VALUATION
SUPP. TO PERMIT
OFFICE
URINAL
LEGAL DESCRIPTION %� j
./T (+;r— — C116 / J'7' /` i/i�J1�Tjf (�4 / /„� "�•7 -3�" �J�i O
D K.W. UNITS
SETBACK
WATER PIPING
ZONE
USE NO.
GRP
FLOOR DRAIN
CK BY
WATER SOFTENER
SIGN
WASHER (AUTO) (DISH)
TRANS- K.W.
FORMER D
GARBAGE DISPOSAL
OUTLETS
LAUNDRY TRAY
FIXTURE OR SOCKET
KITCHEN SINK
CONST. SERV. ENTRANCE
WATER CLOSET
12
POLE
LAVATORY
AMPERES SERV. ENT.
SHOWER
SQ. FT. @ Q
BATH TUB
SQ. FT. @ Q
WATER HEATER
SO. FT. RESID. @ I
SEWAGE DISPOSAL
SQ. FT. GARAGE@112¢
HOUSE SEWER
3
BALANCE OF MIN. FEE
GAS PIPING
% PERMIT FEE
PERMIT FEE
MECH. FEE
OBL.
PL. CK;- FEE
I CONST. FEE
DBL.
E..ECT. FEE
DBL.
SMI FEE
FEE
DBL.
N D
J08 ADDRESS
OWNE
USE OF$U� IN %�� Jr1 F ,Lr� ��R',�(�
��Q��".�,;�uf,- 6�
F.C.
DATE
PERM N
24740
COMMUNITY
DST
UNITS
ROOMS
VALUATION
SUPP. TO PERMIT
OFFICE
LEGAL DESCRIPTION %� j
./T (+;r— — C116 / J'7' /` i/i�J1�Tjf (�4 / /„� "�•7 -3�" �J�i O
D�
SETBACK
LOT SIZE
ZONE
USE NO.
GRP
TYPE
CK BY
$ THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 60 DAYS. CESSA-
TION OF WORK FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO 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 ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS
CODE F THE STATE OF CALIFORNIA.
OWNER. CONTRACTOR•i1'
M.O. ❑ N.C. ❑
LL P CITY
TREES REQUIRED YES NO
INFORMATION TEL. NO.
Q(
: FORM 284.208 (Rev. 1) /721
k' • f ",Y (r r+ 0/ • I Ll
ADDRESS
/%%
IIY
1. NO. LICENSE