230128 (SATT)BUILDING PERMIT DEPARTMENT OF BUILDING & SAFETY
COUNTY OF RIVERSIDE
MOB. HK. FEE MICRO FEE
FIELD OFFICE
CONSTRUCTION ESTIMATE .,�;,: -
3 r ,. ELECTRICAL FEES:,,a, ;
,.
PLUMBING FEES
DST,
@, 0
1ST FL. SQ. FT.Of
2ND FL. SQ. FT. @
$-a i
POR.7 SQ. FT. n
GAR. SQ.FT. @ °
CAR P. SQ. FT. @
WALL SQ.FT. @
SQ. FT. @
ESTIMATED CONSTRUCTION VALUATION
NO. J
MOTOR I OR LESS H.P.
MOTOR 5 OR LESS H.P.
MOTOR 20 OR LESS H.P.
W0 K.W. UNITS
NO.
-
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
" NOTE: Not to be used as property tax valuation
JOBADDRESS i
$% i.O,Tt4i23 ota Iii.
OWNER .-
mj3w. CORP
FLOOR DRAIN
74
MECHANICAL FEES
F.C.
001
DATE
6-4-73
WATER SOFTENER
-
2 8
VENT SYSTEAFAN ❑EVAP. COOL ,&HOOD
1&PjSIGN
WASHER (AUTOYADISH)
C7
APPLIANCE p
HiQ FORMER E= K•W •
UNITS
GARBAGE DISPOSAL
SUPP. TO PERMIT
FURNACE ❑ UNIT ❑ WALL ❑FLOOR SUSPENDED
OUTLETS
COPIES
LAUNDRY TRAY
AIR HANDLING UNIT CFM
FIXTURE OR SOCKET
DBL.'
KITCHEN SINK
GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
CONST. SERV. ENTRANCE
USE NO.
ar-1034
WATER CLOSET
TYPE
COMPRESSOR HP
POLE
LAVATORY
APPLIANCE VENT
AMPERES SERV. ENT.
CONSTRUCTION FEE
SHOWER
ABSORPTION SYSTEM O B.T.U.
SQ. FT. @ Q
OFFICE .NO
BATH TUB
ELECTRICAL FEE
INCINERATOR ❑ DOMESTIC ❑ INDUS. OR COMM.
SQ. FT. @
/
WATER HEATER
- STATE
f HEATING SYSTEM.,i® FORCED ❑ GRAVITY
Q SQ. FT. RESO. @ 14
,
SEWAGE DISPOSAL
6
BOILER 0 B.T.U.
SQ. FT. GARAGE @1�2Q
HOUSE SEWER
$
PERMIT FEE
Q BALANCE OF MIN. FEE
DBL
GAS PIPING
MOBILE HOME HOOKUP FEE $
/ PERMIT FEE% ®d
j
PERMIT FEE. M
.i n t1
23 P N TOTAL FE 1
�� !
MOB. HK. FEE MICRO FEE
MECH. FEE
DBL.
PL. CK. FEE �
-�
CONST. FEE
��lfl r
DBL.
EL/ECf T. FEE
V
DBL.
sMI�FE/E_
�
FEE PLUMB. FEE .
JF..-�
G�
DBL.
J F M A M J J A S. -O N -0
JOBADDRESS i
$% i.O,Tt4i23 ota Iii.
OWNER .-
mj3w. CORP
73
74
USE OF BUILDING
Cgnd & Ate ara
F.C.
001
DATE
6-4-73
�
PERM N 0128
0 1
-
2 8
75
M.H. HOOKUP FEE
$
COMMUNITY
to
DST
UNITS
ROOMS VALUATION
3 a UEl
SUPP. TO PERMIT
OFF ICE
.+ I
MICROFILM FEE
COPIES
$
LEGAL DESCRIPTION
-0 -18,`1<"r 1$
MECHANICAL FEE'
DBL.'
$L
-t
SET BACK • LOT SIZE
F } s.. R
ZONE
it
USE NO.
ar-1034
GRP
TYPE
CK BY "
jY -
PLAN CHECK FEE
$
BOND AMT. PLAN NO. PLAN CHECKER FINAL DATE INSPECTOR
CONSTRUCTION FEE
DBL
�: (f
NAME OF CONST. LENDER BRANCH
�.• .
OFFICE .NO
LENDER INVOLVED ;
#
ELECTRICAL FEE
DBL
-
$too
40-
ADD ESS -- - CITY
- STATE
SMI FEE
$
6
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. d
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
AGREE TO CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLIANCE WITH
THE LAWS OF THE STATE OF CALIFORNIA COVERING CONIRACTORS IS ALSO GUARANTEED.
1 HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPUED THE PL�NSIFIC IONS
HAS DONE SO IN ACCORDANCE WITH SECTION 554QF IAB 'OF IONS
CODE OF HE STATE OF CALIFORNIA. `�- f- '
FEE
$
PLUMBING FEE ..
DBL
$
TOTAL FEES
$•
'*"
CASH ❑ CHECK 9�1 M.O. ❑ , N.C. ❑
OWNER,
CONTRACTOR - -
RECEIVED BY
ADDRESS
ADOR
SEWAGE SYSTEM T
LL
P
TREES REQUIRED YES
NO
CITY
CITY -
womaw INFORMATION
284 2081Rev. 11/721 �c..�
TEL. NO.
TEL. NO.
/ t LICENSE ,
34 4-6001 225368