215667 (SATT)BUILDING PERMIT
_ CONSTRUCTION ESTI fF
1ST F. f
SQ. FT. @19
2ND FL.
SQ. FT. @
POR.
SQ. FT.
GAR.
_
SO. FT. @ V "^
CAR P.
SQ. FT. @
WALL
SQ. FT.
OUTLETS
SQ. FT. @
ESTIMATED VALUATION $
MECHANICAL FEES
DEPARTMENT OF BUILDING & SAFET
J&
I COUNTY OF RIVERSIDE
E t�/ ,, ELECTRICAL FEES
I tO' , 1 a N0. I I I I NO.
MOTOR 1 OR LESS H.P.
MOTOR 5 OR LESS H.P.
MOTOR 20 OR LESS H.P.
177__� K.W. UNITE
FIELD OFFICE
PLUMBING FEES
3>' a t vs A
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
FLOOR DRAIN
WATFR eOFTFNFR
VENT SYSTE FAN ❑ EVAP.COOL [�lj HOOD E%V
SIGN
PERMIT FEE
c014001
j WASHER(AUTO)ISH)
OC9
APPLIANCE 1
TRANSFORMER OK•W•
TOTAL FEE
OB. HOQK FEE HEAT & VENT F.EE
�.!/
GARBAGE DISPOSAL
PL. CK.-iy F.E+^
FURNACE❑UNIT ❑WALL❑FLOO ❑SUSPENDED'
OUTLETS
BL
FEE^'f
LAUNDRY TRAY
DBL
AIR HANDLING UNIT CFM
FIXTURE OR SOCKET
a
/
KITCHEN SINK
55667
GAS PIPE E) NATURAL ❑ L.P.G. ❑ OIL
CONST. SERV. ENTRANCE
���
WATER CLOSET
DST
COMPRESSOR HP
POLE
- SUPP. TO PERMIT
LAVATORY
(p' !i(9
APPLIANCE VENT
AMPERES SERV. ENT.
yis
02
SHOWER
, Q
ABSORPTION SYSTEM �.B.T.U.
SQ.FT.@ (t
BATH. TUB
d0
INCINERATOR ❑ DOMESTIC ❑ INDUS.OR•COMM.
SQ. FT.@ Q:
MOBILEHOME
WATER HEATER
i
HEATING SYSTEM FORCED ❑ GRAVITY
SQ. FT. RESID. @ 1
®
SEWAGE DISPOSAL
BOILER B.T.U.
SQ. FT. GAR AGE@ i a
DBL
HOUSE SEWER
PERMIT FEE
BALANCE OF MIN. FEE
ZONE
USE NO.
GAS PIPING
CK SY
MOBILEHOME HOOKUP FEE
$ f
PERMIT FEE
c014001
PERMIT FEE
7 1
PERMIT NUMBER
5667
TOTAL FEE
OB. HOQK FEE HEAT & VENT F.EE
�.!/
DBL
PL. CK.-iy F.E+^
CONST. F
DBL ELEC. F
BL
FEE^'f
PLUMBING-,,.E,EF
5+/4Yrj
DBL
. ..V11VF%BUILDING �_�,�,-
. gC% dY�4
a
��7�
G-
55667
���
COMMUNITY
DST
UNy1
- SUPP. TO PERMIT
OFFICE
76
�OOMJVALUATION
I
J F MIA M J J A S O
N D
JOB ADDRESS l`
+ �D�
OWNER /
72
7 1
� � Y
73
USE O,y
F.Ct.
DATE
Ritf�
74
. ..V11VF%BUILDING �_�,�,-
. gC% dY�4
a
—
G-
55667
75
COMMUNITY
DST
UNy1
- SUPP. TO PERMIT
OFFICE
76
�OOMJVALUATION
I
MOBILEHOME
$
'LEGAL DESCRIPTION
HOOKUP FEE
a -",r
DBL
SET BACK
LOT SIZE
ZONE
USE NO.
GRP TYPE
CK SY
MECHANICAL FEE
$
BOND AMT.
PLAN NO.
PLAN CHECKER
FINAL DATE
IM PEC TORT
PLAN CHECK FEE
$
:5.17
g
_// .�
1I !
DBL
NAME OF CONST. LENDER
BRANCH OFFICE
NO LENDER INVOLVED
CONSTRUCTION FEE
$�,�
G.
Z�o
b'!
DBL
-
ADDRESS
CITU
STATE
ELECTRICAL FEE
$
��
�Q
ca
$
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. d
FEE
I HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE
IN ACCORDANCE WITH THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIF -
DBL
PLUMBING FEE
I ALSO AGREE TO CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES.
jORNIA.
V
COMPLIANCE WITH THE LAWS OF THE STATE OF CALIFORNIA COVERING CONTRACTORS
IS ALSO GUARANTEED.
1 HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLA AND SP CIFI-
CATIONS HAS DONE SO IN ACCORDANCE WITH SECT 55 OF T%I l'NE,5AND
TOTAL FEES $
7
fF�
PROFESSIONS CODE OF THE STATE OF
CALIFORNIA.• p
CASH 0 CHECK grIll, M.O. 0 N.C. O
OWNER
CONTRACTOR
ra c
Received By
ADDRESS
DDRESS
Sewage System
7 LL
P
CITY
CITY
Trees Required Yes
No
f
` /
INFORMATION
TEL. NO.
TEL. NO.. LICENSE
FORM 284-208 (REV. 4/71)