215670 (SATT)BUILDING PERMIT
DEPARTMENT OF BUILDING & SAFET
COUNTY OF RIVERSIDE is
FIELD OFFICE
VENT SYSTEM;2jn FAN ❑ EVAP. COOL "HOOD
CONSTRUCTION ESTIMATE
ELECTRICAL FEES
%
PLUMBING FEES
]"
1ST FL.
2ND FL.
POR.
GAR.
CAR P.
WALL
d
SQ. FT. @ r4CP 1ZNO.
I GARBAGE DISPOSAL
NO.
FURNACE❑UNIT ❑WALL❑FLOO4ED SUSPENDED
DATE
SQ. FT. @
SQ. FT. (a i�%// MOTOR 1 OR LESS H.P.
74
SQ. FT. @ �Lf� MOTOR 5 OR LESS H.P. / A / yl
S?�
SQ. FT. @ MOTOR 20 OR LESS H.P. DRAINAGE PIPING
ar'-..�1r- 7z.
SQ. FT. @ DRINKING FOUNTAIN
SQ. FT. @ URINAL
75
OK.W.UNITS WATER PIPING
vim
ESTIMATED VALUATION Is a
UN
COMPRESSOR "® HP
FLOOR DRAIN
POLE
OFFICE
MECHANICAL FEES
APPLIANCE VENT
IWATFR SOFTFNFR
AMPERES SERV. ENT. S
VENT SYSTEM;2jn FAN ❑ EVAP. COOL "HOOD
a
SIGN
%
WASHER (AUTO ISH)
OC%
APPLIANCE y r
d
TRANSFORMER OK•W•
I GARBAGE DISPOSAL
USE OF BUILDING
FURNACE❑UNIT ❑WALL❑FLOO4ED SUSPENDED
DATE
OUTLETS
LAUNDRY TRAY
74
AIR HANDLING UNITI I CFM
phda a► c-
FIXTURE OR SOCKET
ar'-..�1r- 7z.
KITCHEN SINKZ%
GAS PIPE C) NATURAL Cl L.P.G. ❑ OIL
75
CONST. SERV. ENTRANCE
COMMUNITY-�...�
WATER CLOSET
UN
COMPRESSOR "® HP
p
POLE
OFFICE
LAVATORY
APPLIANCE VENT
AMPERES SERV. ENT. S
�ROOMJVALUATION
SHOWER
QCJ
ABSORPTION SYSTEM B.T.U.
MOBILEHOME
SQ. FT.@ (r
$
BATH TUB
U fi
INCINERATOR ❑ DOMESTIC ❑INDUS. OR COMM.
SQ. FT.@ (r.
WATER HEATER
%
HEATING SYSTEM FORCED ❑ GRAVITY
d
SQ. FT. RESIO. @ i It7h
%
SEWAGE DISPOSAL
d
BOILER E::� B.T.U.
GRP
SQ. FT. GARAGE @ z'Q
BY
HOUSE SEWER
PERMIT FEE
V
BALANCE OF MIN. FEE I I
fl
GAS PIPING
.S"U
MOBILEHOME HOOKUP FEE $ PERMIT FEE -7 U PERMIT FEE ;2101 U
PERMIT
NUMBER TOTAL FE OB. HOOK FEE
77
HEAT & VENT F
DBl
PL. CK. F CONST. F
T
'0
DBL ELEC. F Bl
FEE
PLUMBING .
DBL
J F M A M J J A S O
N D
JOB ADDRESS
OWNER
�j
73
USE OF BUILDING
F.C.
DATE
PEgM
74
phda a► c-
&&/1
ar'-..�1r- 7z.
G 15670
75
COMMUNITY-�...�
DST
UN
ISUPP.TOPERMIT
OFFICE
76
I
�ROOMJVALUATION
MOBILEHOME
$
LEGAL DESCRIPTION
HOOKUP FEE
J -0-y- 1A y
DBL
SET BACK
LOT SIZE
ZONE
USE NO.
GRP
TYPE CK
BY
MECHANICAL FEE
$ (,
J
jV15,70
-R f
/7 '^FINAL
1/Anj j)�
s (� R re)
BOND AMT.
PLAN NO.
PLAN CHECKER
DATE INSPECTOR
PLAN CHECK FEE
••�jr
$ .r,�
O
�
/� �
�-/�/ ��
CONSTRUCTION FEE
DBL
NAME OF CONST. LENDER
BRANCH OFFICE
-;:31
NO LENDER INVOLVED
p
c 67 N 4
;: !
DBL
ADDRESS
CITY STATE
ELECTRICAL FEE
$
$
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 60tDAYS.
G�
CESSATION OF WORK FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
FEE
1 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
ORNIA. I ALSO AGREE TO CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES.
.[fO
42
25
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 SPECIFI-
TOTAL FEES $
CATIONS HAS DONE SO IN ACCORDANCE WITH SECTIq 5541x0 THE B IN.E S AND
`C
PROFESSIONS CODE OF THE STATE OF CALIFORNIA. ,L
CASH F� CHECK C!5- M.O. ❑ N.C. Q
OWNER
CONTRACTOR
Received By
ADDRESS
ADDRESS
Sewage System
T
t
P
CITY
CITY _
Trees Required
Yes
No
' �
INFORMATION
TEL. NO.
TEL. NO. LICENSE
}
FORM 284-208 (REV. 4/711