239594 (AR)BUILDING PERMIT
1STFL.
:r v
SO. FT.
@f����
2ND FL.
}
SO. FT.
@
POR.
RECEIVED BY
SQ. FT.
@
GAR.
DBL
SQ.FT.
@
CAR P.
SQ. FT.
@
WALL
DBL
SQ.FT.
@
284-208 (Re,
11/72)
SQ. FT.
@
ESTIMATED CONSTRUCTION VALUATION $
DEPARTMENT OF BUILDING I& SAFETY
COUNTY OF RIVERSIDE a
.ELECTRICAL FEES -
T<f'� NO.
MOTOR I OR LESS H.P.
MOTOR 5 OR LESS H.P.
MOTOR 20 OR LESS H.P.
NOTE: Not to be used os property tax vol Lotion .0
MECHANICAL FEES
VENT SYSTEM ❑ FAN ❑EVAP. COOL ❑ HOOD
APPLIANCE
FURNACE ❑UNIT ❑WALL ❑FLOOR ❑SUSPENDED
AIR HANDLING UNIT I CFM
GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
COMPRESSOR 0 HP
APPLIANCE VENT
ABSORPTION SYSTEM 0 B.T.U.
INCINERATOR ❑ DOMESTIC ❑ INDUS. OR COMM.
HEATING SYSTEM ❑ FORCED ❑GRAVITY
BOILER 0 B.T.U.
PERMIT FEE
MOBILE HOME HOOKUP FEE Is
23 PN L!'S MOB HK. FEE MICR
.......■
-.■■...■
MECHANICAL FEE
DBL
$
PLAN CHECK FEE
}
$
CASH
CHECK ( M.O. ❑ N.C. ❑
RECEIVED BY
SEWAGE SYSTEM
CONSTRUCTION FEE
DBL
$
P
TREES REQUIRED
9
�}}V
ELECTRICAL FEE
DBL
$
284-208 (Re,
11/72)
l
SMI FEE
$
3
$
• FEE
j PLUMBING FEE
DBL
$
K.W. UN
SIGN
TRANS- K W.
FORMER
OUTLETS
FIXTURE OR SOCKET
CONST. SERV. ENTRANCE
POLE
AMPERES SERV. ENT.
SQ. FT. @ Q
SQ. FT. @ Q
-w,;50. FT. RESID.@14
SO. FT. GARAGE @,1�2Q
BALAt4CE OF MIN. FEE
PERMIT FEE
MECH. FEE 1111L, I PL. CKf FEE CONST. FEE
Gti
r'
JOB ADDRESS
LEGAL DESCRIPTION
SETBACK LOT
FIELD OFFICE
PLUMBING FEES DST r
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
FLOOR DRAIN
WATER SOFTENER
WASHER (AUTO) (DISH)
GARBAGE DISPOSAL
LAUNDRY TRAY
KITCHEN SINK
WATER CLOSET
LAVATORY
SHOWER
BATH TUB
WATER HEATER
SEWAGE DISPOSAL
HOUSE SEWER
GAS PIPING
,00 1 PERMIT FEE
ELECT. FELE DBL. SMI FEE FEE PLUMB. FEE DBL.
��oc7�
k3
F.C. DATEPERMZ� � 5 9 4
".21 //- .fie 7.
15 I VALUATION UPP. TO PERMIT OFFICE
ONE USE NO. GRP I TYPE ICK BY
9—) A_. _ _
.NO LENDER INVOLVED
DDRESS I CITY I STATE
THIS PERMIT SHALL BECOME VOID 1F 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.
I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS
HAS DONE SO IN ACCDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS-
CODE
F THE STATE OF ALIFORNIA, e
WNER. �.!,}`f� / CONTRACTOR
DDRESS�J �r ��� f� @ ADDRESS
ITY f 4 ! CITY
EL. NO. TEL. NO. LICENSE
if