215618 (SATT)BUILDING PERMIT
SIGN
DEPARTMENT OF BUILDING & SAFET
COUNTY OF RIVERSIDE
WASHER(AUTO&DISH)
FIELD OFFICE
APPLIANCE
ESTIMATE
ELECTRICAL FEES
GARBAGE DISPOSAL
PLUMBING FEES
1ST FL.
2ND FL.
POR.
GAR.
CAR P.
WALL
��CIIONSTRUCTION
2311.
424
SQ. FT. P13,40
31,771.40NO.
741001Dm.
NO.
FIXTURE OR SOCKET
SQ. FT. @
KITCHEN SINK
SQ. FT. @ MOTOR 1 OR LESS H.P.
GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
SQ. FT. @ 6 25 MOTOR 5 OR LESS H.P. 1
Ear Sink 150
SQ. FT. @ MOTOR 20 OR LESS H.P.
DRAINAGE PIPING
SQ. FT. @
DRINKING FOUNTAIN
SQ. FT. @
URINAL
OK.W.UNITS
WATER PIPING I So
ESTIMATED VALUATION Is
2
SHOWER
FLOOR DRAIN
SQ. FT.@ Q
MECHANICAL FEES
BATH TUB
00
INCINERATOR ❑ DOMESTIC ❑ INDUS. OR COMM.
werro Gf1CTCAICO
VENT SYSTEM FAN ❑ EVAP.COOL HOOD
SIGN
I
WASHER(AUTO&DISH)
3. 00
APPLIANCE
TRANSFORMER =K•W
GARBAGE DISPOSAL
1,50
FURNACE❑UNIT❑WALL❑FLOOR❑SUSPEND ED
OUTLETS
DATE
LAUNDRY TRAY
741001Dm.
AIR HANDLING UNITI I CFM
FIXTURE OR SOCKET
I
KITCHEN SINK
1.50
GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
CONST. SERV. ENTRANCE
3
WATER CLOSET
11, rM
COMPRESSOR HP
POLE
4
LAVATORY
AlAn
APPLIANCE VENT
AMPERES SERV. ENT.
2
SHOWER
ABSORPTION SYSTEM O B.T.U.
SQ. FT.@ Q
2
BATH TUB
00
INCINERATOR ❑ DOMESTIC ❑ INDUS. OR COMM.
SQ. FT.@ q
I
WATER HEATER
HEATING SYSTEM 5 FORCED ❑ GRAVITY
SQ. FT. RESID. @1 q ll
7n ISEWAGE
DISPOSAL
DBL
BOILER B.T.U.
SQ. FT. GARAGE @ z q 9
Art
HOUSE SEWER
NO.
PERMIT FEE
BALANCE OF•MIN.FEE
CK BY
GAS PIPING
gn
MOBILEHOME HOOKUP FEE I$ I 1 I I IPERMIT FEE 13 1(M I I PERMIT FEE I 2 IO0
PERMIT NUMBER I TOTAL FEES I MOB. HOOK- FEE I HEAT B VENT FEE IDBLI PL. CK. FEE I CONST. FEE JOBLI ELEC. FEE IDBLI FEE FPLUMBING FEE IDBL
J F M A M J I J A S O
N D
JOB ADDRESS
OWNER
72
78-074 Lago La Quint&
73
USE OF BUILDING
F.C.
DATE
PERMIT NO.
215 618
741001Dm.
9-2S-72
75
COMMUNITY
DST
UNITSOOM
VALUATION
SUPP. TO PERMIT
OFFICE
76
f t>et:
I
�S / DU
0,5/
MOBILEHOME
$
LEGAL DESCRIPTION
HOOKUP FEE
Lot 15 4w Tr -"18
DBL
SET BACK LOT SIZE
ZONE
NO.
GRP
TYPE
CK BY
MECHANICAL FEE
$
JUSE
24
�
F s OIR In_
BOND AMT.
PLAN NO. PLAN CHECKER
FINAL DATE INSPECTOR
PLAN CHECK FEE
$
1
V j n
1
\_
59.25
7�
�
DBL
NAME OF CONST. LENDER
BRANCH OFFICE NO LENDER INVOLVED
CONSTRUCTION FEE
116.50
DBL
Alft RESS
CITY STATE
ELECTRICAL FEE
$ 30.160
$
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
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
46
ORNIA. I ALSO AGREE TO CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES.
�0COMPLIANCE
50
WITH THE LAWS OF THE STATE OF CALIFORNIA COVERING CONTRACTORS
IS ALSO GUARANTEED.
I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS ANQ SPECIFI-
TOTAL FEES $
PROFONS HAS DONE ACCORDANCE WARN SE 41 OF; .H US1 ESS AND
SOT I ��
277.3
ESSIONS CODE STATE
np;2
CASH M CHECK 0' M.O. ❑ N.C. 0
OWNER
CONTRACTOR
Received By
ADDRESS
A
Pmnr 164
Sewage System��,
P
CITY
CITY
Trees Required
Yes
No
INFORMATION
TEL. NO.
TEL. NO. LICENSE
346-5002 -,L S-*:) t0 y P. I
FORM 284-208 (REV. 4/71)
i