230126 (SATT)BUILDING PERMIT
DEPARTMENT OF BUILDING & SAFETY
' COUNTY OF RIVERSIDE '
re – ELECTRICAL FEES.—
MOTOR I OR LESS H.P.
MOTOR 5 OR LESS H.P.
MOTOR 20 OR LESS H.P.
K.W. UNITS
FIELD OFFICE
11 PLUMBING FEES I DST
INO.1 -t
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
FLOOR DRAIN
WATFD C(1FTFNFR
CONSTRUCTION -ESTIMATE
1 ST FL. '
SQ. FT. Cia r _.
2ND FL.
SQ. FT. @
POR.
SQ. FT. (sJ24 Q
GAR.
SQ.FT. t1a ;
CAR P.
SQ. FT. @
WALL
SQ.FT. @a
LAUNDRY TRAY
SQ. FT.
ESTIMATED CONSTRUCTION VALUATION
NOTE: Not to be used as property tax valuation
DEPARTMENT OF BUILDING & SAFETY
' COUNTY OF RIVERSIDE '
re – ELECTRICAL FEES.—
MOTOR I OR LESS H.P.
MOTOR 5 OR LESS H.P.
MOTOR 20 OR LESS H.P.
K.W. UNITS
FIELD OFFICE
11 PLUMBING FEES I DST
INO.1 -t
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
FLOOR DRAIN
WATFD C(1FTFNFR
IuC�III��:Nlul�:[�Z�L"t91i��E'�—�I '•�frlrlrll
(* pyP$f�MJaj N
6
VENT SYSTEh FAN ❑EVAP. COOL ,HOOD
SIGN
ME� EE DBL1,,PLCK.;�,�
WASHER (AUTWDISH) 7!3
EL T. FEE
APPLIANCE 'tea
rORMER D K.W.
FEE ' PLUMB. FEE
GARBAGE DISPOSAL
f'/6y�J[U I-2
FURNACE ❑ UNIT ❑ WALL ❑FL OR ❑SUSPENDED
OUTLETS
LAUNDRY TRAY
AIR HANDLING UNIT I CFM
FIXTURE OR SOCKET
KITCHEN SINK
GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
CONST. SERV. ENTRANCE
A I S 1 O N I D
WATER CLOSET
_
COMPRESSOR HP 47
POLE
LAVATORY
APPLIANCE VENT
AMPERES SERV. ENL
.2
SHOWER
_
ABSORPTION SYSTEM B.T.U.
SO. FT. Q° Q
M.H. HOOKUP FEE
BATH TUB
INCINERATOR ❑ DOMESTIC ❑ INDUS. OR COMM.
SQ. FT. @
`
WATER HEATER
DST
HEATING SYSTEM FORCED ❑GRAVITY
�^ SQ. FT. RESID. Q° 14
VALUATION
SEWAGE DISPOSAL O
_
BOILER 0 B.T.U.
SQ. FT. GARAGE @a 124 .
'
HOUSE SEWER
PERMIT FEE
BALANCE OF MIN. FEE
111
GAS PIPING
IuC�III��:Nlul�:[�Z�L"t91i��E'�—�I '•�frlrlrll
(* pyP$f�MJaj N
6
TOTAL EES-
MOB. HK. FEE MICRO FEE
ME� EE DBL1,,PLCK.;�,�
CON�FEEE DBL
EL T. FEE
DBL. SMI FEE
�7/�
FEE ' PLUMB. FEE
DBL.,
f'/6y�J[U I-2
COf
ssS!✓
_ --J I _F_ M..
A I M I J I J
A I S 1 O N I D
JOB ADDRESS
LgZaTxQulyttg nr.
OWNER
P
73
74
USE OF BUILDING . /
Cond.Dw is>;.'Act;f e1mwe
F.C.
00'1
DATE
6-4-73�V1
PERM N
j�
26
75
M.H. HOOKUP FEE
$
COMMUNITY
DST
UNITS
ROOMS
VALUATION
SUPP. TO PERMIT
OFFICE
Laints
111
I 1
35.095.00
MICROFILM FEE
COPIES
$.
LEGAL DESCRIPTION
1.ct-16.up Ti.3941
MECHANICAL FEE
DBL
$
SETBACK
LOT SIZE ZONE
USE NO.
GRP
TYPE
CK BY
.PLAN
R-1
Ta
nlM
CHECK FEE$
DAMT.PLA
to
N NO.
PLAN CHECKER
DATE^ JINSPE
— %
TOR
CONSTRUCTION FEE
DBL
$.
NAME OF CONST. LENDER BRANCH
n
OFFICE J.NO
LENDER INVOLVED" '
ELECTRICAL FEE
. ..
DBL
$
�y
7?
A ESS - " -
CI '"• STATE
J,
YI
SMI FEE
$
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 60 DAYS. CESSAA
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 AC.
CORDANCE WITH'THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, I ALSO
PLUMBING FEE
DBL
$
.,
AGREE TO CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLIANCE WITH
THE LAWS OF THE STATE OF CALIFORNIA COVERING CONTRACTORS IS ALSO GUARANTEED.
1 HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS PND SP CIFI TIONS
$
TOTAL
FEES
HAS DOCODENNE CCORDAONNEAWITH SECTION 554 F I PR _ SIONS
/
HEOSTAIN TE
CASH ❑
CHECK M.O. ❑ ,
N.C. ❑
OWNER,
CONTRACTOR
`
RECEIVED BYr
ADDRESS
V
SEWAGE SYSTEM
T LL
P
nano m
CIN
REQUIRED
YES
NO
Yae_
Palo Desert
dTREES
INFORMATION
TEL. NO.
i
TEL. NO.LICENSE
3/
F0ARM 284-2081Rev.11/721
346-6002 22556$