215617 (SATT)BUILDING PERMIT
CONSTRUCTION ESTIMA'
1ST FL.
SQ. FT. @f
2ND FL.
SQ. FT. @
POR.
SQ. FT. ;
GAR.
SQ. FT. @
CAR P.
SQ. FT. @
WALL
SQ. FT. @
PEj IT
SQ. FT. @
ESTIMATED VALUATION $
MECHANICAL FEES
DEPARTMENT OF BUILDING & SAFET
J&
COUNTY OF RIVERSIDE
E V1 ELECTRICAL FEES
L? 77--1 NO.
(f 7,� MOTOR 1 OR LESS H.P.
MOTOR 5 OR LESS H.P.TOR 5 OR LESS H.P
MOTOR 20 OR LESS H.P.
K.W.
FIELD OFFICE
PLUMBING FEES
DRAINAGE PIPING
DRINKING FOUNTA16
URINAL
WATER PIPING
FLOOR DRAIN
WATERSOFTENFR
VENT SYSTFJ&?JN FAN ❑ EVAP.COOLT?� HOOD 7&0
N D
SIGN
r
WASHER (AUT (DISH)
APPLIANCE 1 P
V
TRANSFORMER =K.W•
GARBAGE DISPOSAL
F.C.
FURNACE❑UNIT ❑WALL❑FLO(?t0SUSPENDED'
PEj IT
OUTLETS
74
LAUNDRY TRAY
Dw . Cond
AIR HANDLING UNITI CFM
4-25-72
FIXTURE OR SOCKET
!
KITCHEN SINK
GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
CONST. SERV. ENTRANCE
01
WATER CLOSETl600
'�L7
COMPRESSOR HP
:�
POLE
G�
LAVATORY
APPLIANCE VENT
AMPERES SERV. ENT.
SHOWER
C7
ABSORPTION SYSTEM B.T.U.
HOOKUP FEE
SQ, FT.@ Q
BATH TUB
O p
INCINERATOR ❑ DOMESTIC ❑ INDUS. OR COMM.
DBL
SQ. FT.@ Q.
WATER HEATER
ZONE
SYSTEM Z('�FORCED ❑ GRAVITY
TYPE
SQ. FT. RESID. @ 1 R
MECHANICAL FEE
SEWAGE DISPOSAL
O ,HEATING
BOILER B.T.U.
F R
SQ. FT. GARAGE @ i Q
S
HOUSE SEWER
PERMIT FEE
BALANCE OF MIN. FEE
GAS PIPING
MOBILEHOME HOOKUP FEE $ PERMIT FEE (� PERMIT FEE
PERMIT NUMBER TOTAL F MOB. 110011 FEE HEAT & VENT EE DBL PL. CK. a CONST. DBL EL EC. yE 6•a DBL PSE +` PLUMBING DBL
5 � 1 6 G C?�1� �-
J F M A M J J A S 0
N D
JOB ADDRESS
OWNER
72
78-062 Lago La Qginta Dr.
jZ
73
USE OF BUILDING
F.C.
DATE
PEj IT
N
74
Dw . Cond
1001
4-25-72
G 1
61
75
COMMUNITYST
UNITS�ROOMJVALUATION
SUPP. TO PERMIT
OFFICE
76
LaD
int
I 1
3SS c1a�
MOBILEHOME
$
LEGAL DESCRIPTION
HOOKUP FEE
t 14 a Tr-"lg
DBL
SET BACK LOT SIZE
ZONE
TYPE
CK BY
MECHANICAL FEE
$�
d 0
F R
JUSENO.RPG
IS 10
BOND AMT.
PLAN NO. PLAN CHECKER
FINAL DATE INSPECTOR
PLAN CHECK FEE
$
DBL
NAME OF CONST. LENDER
BRANCH OFFICE
NO LENDER INVOLVED
CONSTRUCTION FEE
1
I
R Desert
DBL
ADDRESS
CITY STATE
ELECTRICAL FEE
$
/
(A
$
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
y.6
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
�
ORNIA. I ALSO AGREE TO CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES.
COMPLIANCE WITH THE LAWS OF THE STATE OF CALIFORNIA COVERING CONTRACTORS
iv/
IS ALSO GUARANTEED.
I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THEPLANS ANDSPECIFI-
TOTAL FEES $
CATIONS HAS DONE SO IN ACCORDANCE WITH SE t, � JTV B SINESS AND
PROFESSIONS CODE OF THE STATE OF CALIFORNIA. (i(/{ic.xf
CASH ❑ CHECK � M.O. ❑ N.C. ❑
OWNER
CONTRACTOR
Received By
ADDRESS
A15
Sewage System
T LL
P
CITY
CITY
Trees Required Yes
No
INFORMATION
TEL. NO.
TEL. NO6[�(�2 LICENSE
22 (_ j•
FORM 284-208 (REV. 4/71)-R�