226656 (SOTB)BUILDING PERMIT
fi�l
DEPARTMENT OF BUILDING & SAFETY
COUNTY OF RIVERSIDE .01
-
:ri i ELECTRICAL FEES--•
NO. I ' I I I NO.
MOTOR 1 OR LESS H.P.
MOTOR 5 OR LESS H.P.
MOTOR 20 OR LESS H.P.
K.W. UNITS
FIELD OFFICE
PLUMBING FEES
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
FLOOR DRAIN
WATFR SCIFTFNFR
CONSTRUCTION ESTIMATE --
I ST FL.
SQ. FT. @
2ND FL.
SQ. FT. @
POR.
SQ. FT. @
.GAR.
SQ.FT. @
CAR P.
SQ. FT. @
WALL
SQ.FT. @
FIAC iif
SQ. FT. @
ESTIMATED CONSTRUCTION VALUATION $
NOTE: Not to be used as property tax valuation
CONST. SERV. ENTRANCE
MFCHANICAI FFFS
DEPARTMENT OF BUILDING & SAFETY
COUNTY OF RIVERSIDE .01
-
:ri i ELECTRICAL FEES--•
NO. I ' I I I NO.
MOTOR 1 OR LESS H.P.
MOTOR 5 OR LESS H.P.
MOTOR 20 OR LESS H.P.
K.W. UNITS
FIELD OFFICE
PLUMBING FEES
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
FLOOR DRAIN
WATFR SCIFTFNFR
MOBILE HOME HOOKUP FEE I$ I 1 1 I PERMIT FEE I I 1 I PERMIT.FEE I I
22 P
966
VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD
SIGN
WASHER (AUTO) (DISH)
DBL.
APPLIANCE
TRANS-- =K.W.
FORMER
GARBAGE DISPOSAL
ELECT. FEE
FURNACE ❑ UNIT ❑ WALL ❑FLOOR ❑SUSPENDED
OUTLETS
LAUNDRY TRAY
FEE PLUMB. FEE
AIR HANDLING UNIT I = CFM
FIXTURE OR SOCKET
KITCHEN SINK
OWNEERR^
GAS PIPE ❑ NATURAL ❑ L.P.G. Cl OIL
CONST. SERV. ENTRANCE
WATER CLOSET
_
COMPRESSOR 0 HP
POLE
LAVATORY
APPLIANCE VENT
AMPERES SERV. ENT.
SHOWER
UNITS
ABSORPTION SYSTEM 0 B.T.U.
SO. FT. @ Q
BATH TUB
_
INCINERATOR ❑ DOMESTIC ❑ INDUS. OR COMM.
SQ. FT. @ Q
WATER HEATER
,t
HEATING SYSTEM ❑ FORCED ❑ GRAVITY
SQ. FT. RESID. @ I
SEWAGE DISPOSAL
_
BOILER 0 B.T.U.
SQ. FT. GARAGE @/2Q
HOUSE SEWER
COPIES
PERMIT FEE
BALANCE OF MIN. FEE
GAS PIPING
MOBILE HOME HOOKUP FEE I$ I 1 1 I PERMIT FEE I I 1 I PERMIT.FEE I I
22 P
966
TOTAL FEES
.149 or
MOB. HK. FEE MICRO FEE.
MECH. FEE
DBL.
PL. CK. FEE
CONST. FEE
119o�
DBL.
ELECT. FEE
DBL.
SMI F
-.
FEE PLUMB. FEE
DBL:
.J I F I M A M .I ) A I S 1 O 1 N I D
JOB ADDRESS - -
OWNEERR^
73
74 -
USE OF BUILDINGTT,�. F.C.
1RF 0 21;44/ '9
DATE
r l a—
PERMLi Nj
e 6J 5 E
75
M.H. HOOKUP FEE
$
COMMUNITY DST
UNITS
ROOMS
VALUATION
UPP. TO PERMIT
OFFICE
,t
A I
I
I
MICROFILM FEE
COPIES
$
LEGAL DESCRIPTION
}
MECHANICAL FEE
DBL
$
"
SETBACK LOT SIZE ZONE
F 5 R /8
(
—i
USE NO. ��p
rA � 0-
GRP
TYPE
CK BY
�•'
PLAN CHECK FEE � �
$ �
BOND AMT.
PLAN NO. PLAN CHECKER
FINAL DATE IN
P CTOR
CONSTRUCTION FEE .:
DBL
$
NAME OF CONST. LENDER' - BRANCH
OFFICE .
LENDER INVOLVED -
-�
J.NO
ELECTRICAL FEE .
DBL
$
ADDRESS . CITY
STATE
r
SMI FEE .., ..
$
f�'p
/
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 60 DAYS. CESSA=
TION 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 IN A1C"
CORDANCE WITH THE LAWSOFRIVERSIDE COUNTY AND THE STATE OF. CALIFORNIA, I ALSO
AGREE TO CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLIANCE WITH
PLUMBING FEE
DBL
$
THE LAWS OF THE STATE OF CALIFORNIA COVERING CONTRACTORS IS ALSO GUARANTEED.
IHEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS
HAS DONE SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS -
OF THE STATE OF CALIFORNIA.
TOTAL FEES
$
�s�
J
`^CODE
-
1
CASH ClCHECK M.O. 01. N.C. ❑ .
OWNER,
CONTRACTOR
��i�C.�..l`S' Y jJ`•�sAdR`t'a �:�C.-�
'
RECEIVED BY
ADDRESS
ADDRESS
F
SEWAGE SYSTEM T
LL
P
TREES REQUIRED
YES
NO
CITY
cl�
��
' INFORMATION -
FORM 284.2081Rm 11/72)
TEL. NO.
TEL. NO. {{p� LICENSE -