230117 (SATT)BUILDING PERMIT. DEPARTMENT OF BUILDING & SAFETY •
O.
'
FIELD OFFICE
MOB. HK. FEE MICRO FEE MECH. FEE
COUNTY OF RIVERSIDE
PL. CK. FEE
1i
CONST. FEE
.� "�
DBL.J;CT./S
�. CONSTRUCTION .EST.IMATE,,. . , -
rELECTRICAL..EEESo.,,.,,_.,,_,,,„t__l
_ ..
PLUMBING FEES, .. Ds
1ST FL. a. SQ. FT. (Q
NO.
NO.
JOB ADDRESS
_ fl
OWNER
�
2ND FL. SQ. FT. Cia
74
USE Of BUILDING
F.C.
DATE
_11.71
POR. SQ. FT.
�- MOTOR I OR LESS H.P.
M.H. HOOKUP FEE
$
�f
GAR. SQ.FT. @k
MOTOR 5 OR LESS H.P.
ST NITS
r
I VALUATION
1 t
CAR P. SQ. FT. Cat
MOTOR 20 OR LESS H.P.
MICROFILM FEE
DRAINAGE PIPING
$
WALL SQ.FT.
LEGAL DESCRIPTION
t
MECHANICAL FEE
DRINKING FOUNTAIN
$
SQ. FT. Cai
'SET BACK
LOT SIZE ZONE
.
URINAL
USE NO.
_
ESTIMATED CONSTRUCTION VALUATION '
0 K.W. UNITS
ICK BY
WATER PIPING
!
NOTE: Not to be used as property tox voluotion
$
FLOOR DRAIN
PLAN CHECKER
MECHANICAL FEES
PECTOR
CONSTRUCTION FEE
WATER SOFTENER
$
fto
VENT SYSTEO19 FAN ❑ EVAP. COOL ® HOOD
00 SIGN
/
WASHER (AUTOVDISH)
;5P 40 lj
APPLIANCE f
ei FORMER [� K'W
GARBAGE DISPOSAL
"(y
FURNACE ❑ UNIT ❑ WALL ❑FLOOR ❑ SPENDED
OUTLETS
LAUNDRY TRAY
AIR HANDLING UNIT I CFM
FIXTURE OR SOCKET
�%
KITCHEN SINK
GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
CONST. SERV. ENTRANCE
$ .
WATER CLOSET
TOTAL FEES
COMPRESSORHP
jr0 POLE
LAVATORY
v
APPLIANCE VENT
AMPERES SERV. ENT.
ADDRESS
SHOWER
SEWAGE SYSTEM T
ABSORPTION SYSTEM 0 B.T.U.
SO. FT. @ Q
TREES REQUIRED YES
BATH TUB
-
INCINERATOR ❑ DOMESTIC ❑ INDUS. OR COMM.
SQ. FT. @ d
TEL. NO. -
WATER HEATER
_ HEATING SYSTEM,2K FORCED ❑GRAVITY
(a SQ. FT. RESID. Cat) G
SEWAGE DISPOSAL
_ BOILER 0 B.T.U.
SO. FT. GARAGE Cia 112Q
HOUSE SEWER
PERMIT FEE
BALANCE OF MIN. FEE
GAS PIPING
TMOBILE HOME HOOKUP FEE Is I I
/ I PERMIT FEE (1p
/
PERMIT FEE _ ry
,..2
s fff
O.
'
TOTAL FEES
9t1
MOB. HK. FEE MICRO FEE MECH. FEE
DBL
PL. CK. FEE
1i
CONST. FEE
.� "�
DBL.J;CT./S
FEE
DBL.
r
SMI FEE
€'
.FEE
PLUMB. FEE
t� . -9
DBL.
J I F I M A I M I J I J A I S 1 O 1 N D
JOB ADDRESS
_ fl
OWNER
�
73
74
USE Of BUILDING
F.C.
DATE
_11.71
PERMZ3 17
75
M.H. HOOKUP FEE
$
COMMUNITY
,a
ST NITS
ROOMS
I VALUATION
1 t
SUPP. TO PERMIT
OFFICE
MICROFILM FEE
COPIES
$
LEGAL DESCRIPTION
t
MECHANICAL FEE
DBL -
$
q
'SET BACK
LOT SIZE ZONE
.
��
USE NO.
_
GRP
►
TYPE
ICK BY
F S R
PLAN CHECK FEE
-
$
BOND AMT. PLAN NO. -
PLAN CHECKER
FINAL DATE IN
PECTOR
CONSTRUCTION FEE
DBL
$
fto
NAME OF CONST. LENDER BRANCH
OFFICE .NO
LENDER INVOLVED -
I
ELECTRICAL FEE
DBL
$
V
y
.. wa
A EP `- - '""` CITY
STATE
z
SMI FEE
$
1,2
THIS PERMIT SHALL BECOME VOID IF WORK ISNOT COMMENCED: WITHIN 60 DAYS. CESSA-.
TION OF WORK FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME -VOID.
I HERERY 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 PLA AND SP IFICATIONS
HAS DONE SO IN ACCORDANCE WITH SECTION 55 FST ND ROFESSIONS
CODF F F STATE OF CALIFORNIA. `.- "--f,—
FEE
$
PLUMBING FEE.
DBL
$ .
TOTAL FEES
$
'
CASH ❑ CHECK [�"� M❑' ` N.C. ❑
OWNER,
d
CONTRACTOR.O. 1
RECEIVED'BY
ADDRESS
ADD • " "• •
SEWAGE SYSTEM T
LL
P
TREES REQUIRED YES
NO
CITY.
CIT . -
r INFORMATION
FORM 284.208(Rev.11/72)
TEL. NO. -
TEL. NO. LICENSE
345«6002 225368 ,