215834 (SATT)BUILDING PERMIT DEPARTMENT OF BUILDING & SAFET
J&
is COUNTY OF RIVERSIDE
FIELD OFFICE
VENT sys-rEMft FAN ❑ EVAP. COOL ❑ HOOD
CONSTRUCTION ESTIMATE
ELECTRICAL FEES
PLUMBING FEES A
1ST FL.
2ND FL,
POR.
GAR.
CAR P.
WALL
23*
SQ. FT. @ l3w4CI31 1,
NO.
NO.
SQ. FT. Co)
FIXTURE OR SOCKET
SQ. FT. @ L• MOTOR 1 OR LESS H.P.
GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
SQ. FT. @ MOTOR 5 OR LESS H.P.
WATER CLOSET
SQ. FT. @ MOTOR 20 OR LESS H.P.
DRAINAGE PIPING
SQ. FT. @
DRINKING FOUNTAIN
SQ. FT. Ca
URINAL
OK.W.UNITS
WATER PIPING
ESTIMATED VALUATION $
INCINERATOR ❑ DOMESTIC ❑ INDUS. OR COMM.
FLOOR DRAIN
WATER HEATER
MECHANICAL FEES
SQ. FT. RESID. @ 1 Q
WATER SOFTENER
VENT sys-rEMft FAN ❑ EVAP. COOL ❑ HOOD
SIGN
WASHER (AUT (DISH)
APPLIANCE DrylT 3
TRANSFORMER =K.W.
GARBAGE DISPOSAL
FURNACE❑UNIT ❑WALL❑FLOOR ❑SUSPENDED
OUTLETS
LAUNDRY TRAY
AIR HANDLING UNITI CFM
FIXTURE OR SOCKET
KITCHEN SINK
GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
CONST. SERV. ENTRANCE
WATER CLOSET
COMPRESSOR Z E=j= HP
POLE
LAVATORY
APPLIANCE VENT
AMPERES SERV. ENT.
SHOWER
ABSORPTION SYSTEM E== B.T.U.
SQ. FT. @ Q
BATH TUB
INCINERATOR ❑ DOMESTIC ❑ INDUS. OR COMM.
SQ. FT.@ Q.
WATER HEATER
HEATING SYSTEM2 be FORCED ❑ GRAVITY R Inn
SQ. FT. RESID. @ 1 Q
SEWAGE DISPOSAL
BOILER B.T.U.
SQ. FT.GARAGE @ ''z
HOUSE SEWER
PERMIT FEE 31MI
1 BALANCE OF MIN. FEE
GAS PIPING
MOBILEHOME HOOKUP FEE
$
PERMIT FEE
72
PERMIT FEE
PERMIT NUMBER
TOTAL FEES
MOB. HOOK FEE
NEAT B VENT FEE
74
PL. CK. FEE
CONST. FEE
DBL ELEC. FEE
DBL
FEE
PLUMBING FEE
DBL
MOBILEHOME $
•
LEGAL ESCRIPTION
HOOKUP FEE
JDBL�
J
S BA ""-MT
J
J F M A M J J A S O
N D
.JOB ADDRESS OWNER
72
n
73 1 1
US LD NG �;�F DA - PERMIT NO.
215834
74
fa�.G
75
COMMUNITY DST UNITS OOj'VALLTA_-hZM SUPP. TO PERMIT OFFICE
76
MOBILEHOME $
LEGAL ESCRIPTION
HOOKUP FEE
DBL
S BA ""-MT
SIZE ZONE TYPE CK BY
MECHANICAL FEE
$
JUSENO. JGRIP
1
F S R 011,111%
BO AM . LAN
PLAN CHECKER DATE IN,S'�ECTOR -
PLAN CHECK FEE
$
�,NAL
_� U ` 3 N -V. -
DBL
NAME OF CONST. LENDER
BRANCH OFFICE NO LENDER INVOLVED
-
CONSTRUCTION FEE
$
116
50
T RANK
DBL
S
CI STATE
ELECTRICAL FEE
$
$
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 60 DAYS.
CESSATION OF WORK FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
FEE
I HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE
ACCORDANCE WITH THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIF -
DBLIN
PLUMBING FEE
ORNIA. 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 ANDSPECIFI-
TOTAL FEES $
CATIONS HAS DONE SO IN ACCORDANCE WITH SECN41 p( i(HEUSI ESS AND
PROFESSIONS CODE OF THE STATE OF CALIFORNIA.
CASH ❑ CHECK U�K M.O. ❑ N.C.-El
OWNER
CONTRACTOR
Received ByC4 .e_
ADDRESS
+ ��
Sewage System T
LL
P
CITY
Y
Trees Required
Yes
No
TEL. NO.
LICENSE
ft23 a INFORMATION
vJ+s lY
FORM 284-208 (REV. 4/71)