230127 (SATT)BUILDING PERMIT
�D
DRAINAGE PIPING
DEPARTMENT OF BUILDING & SAFETY
DRINKING FOUNTAIN
DBL.
URINAL
COUNTY OF RIVERSIDE
WATER PIPING
CONSTRUCTION ESTIMATE��.�,.. ELECTRICAL
I ST FL.
g23 71
*SO. FT.
NO.
2ND FL.
GARBAGE DISPOSAL
SQ. FT.
�a
+
POR.
<_
SQ. FT.
J I F I M A I M I J I J A I S 1 O 1 N D
MOTOR.J OR LESS H.P.
GAR.
SHOWER
SQ.FT.
@
�✓ 44/ ++ MOTOR 5 OR LESS H.P.
CAR P
! (,? I
SQ FT
�j
MOTOR 20 OR LESS H.P.
WALL SQ.FT. 1@
SQ. FT.
ESTIMATED CONSTRUCTION VALUATION $
NOTE: Not to be used. as property tax valuation
MECHANICAL FEES
VENT SYSTEM Q.FAN ❑EVAP. COOL ®,HOOD
APPLIANCE
FURNACE ❑ UNIT ❑ WALL ❑FLOOR ❑S SPENDED
AIR HANDLING UNIT 1 7= CFM
GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
COMPRESSOR HP
APPLIANCE VENT
ABSORPTION SYSTEM 0 B.T.U. .
INCINERATOR ❑ DOMESTIC ❑ INDUS. OR COMM.
_ HEATING SYSTEM FORCED ❑ GRAVITY
_ BOILER 0 B.T.U.
PERMIT FEE
Y�MOBILE HOME HOOKUP FEE $
K.W. UNI
SIGN
TRANS-_ K W
FORMER D
OUTLETS
FIXTURE OR SOCKET
CONST. SERV. ENTRANCE
POLE
AMPERES SERV. ENT.
SO. FT. @ Q
SQ. FT. @
• SQ. FT. RESID. @I Q
SQ. FT. GARAGE@1/,Q
BALANCE OF MIN. FEE
% PERMIT FEE
FIELD OFFICE
PLUMBING FEES DST
r70-11111111
ITNO
DRAINAGE PIPING
.TOTAL FEES MOR, HK. FEE MICRO FEE MECH. FEE
DRINKING FOUNTAIN
DBL.
URINAL
DBL.
WATER PIPING
FLOOR DRAIN
WATER SOFTENER
WASHER (AUTO}(DISH)
/
GARBAGE DISPOSAL
�
LAUNDRY TRAY
KITCHEN SINK
� �
WATER CLOSET
J I F I M A I M I J I J A I S 1 O 1 N D
LAVATORY
OWNER M
SHOWER
74 -
BATH TUB
F.
WATER HEATER
! (,? I
SEWAGE DISPOSAL
�j
HOUSE SEWER
%
GAS PIPING
!S i
PERMIT FEE
r70-11111111
ITNO
.TOTAL FEES MOR, HK. FEE MICRO FEE MECH. FEE
DBL. FEE CONST. FEE
DBL.
ELECT. FEE
DBL.
SMI FEE
FEE PLUMB. FEEDBL.1912.277
[;�CK.�
�
� �
J I F I M A I M I J I J A I S 1 O 1 N D
JOB ADDRESS
78-097 Imo i is
OWNER M
73
74 -
USE OF BUILDING
F.
C. DATE
PERM Nsl
� �
O 12
�j
75
Card tt ara
t 01,
6-4- 3
M.H. HOOKUP FEE
$
COMMUNITY
DST
` UNITS
ROOMS
VALUATION
SUPP. TO PERMIT
OFFICE
-
MICROFILM FEE
COPIES
$
LEGALDES RIPTION
+
'MECHANICAL FEE
DBL$
SETBACK
LOT SIZE ZONE
USE NO.
GRPTYPE
CK BY
/y
I i
PLAN CHECK FEE
$
BOND AMT.
PLAN NO.
PLAN CHECKER
FINAL DATE INSPE-
_
yJ
/
CONSTRUCTION_FEE
DBL
$
•
i
/
NAME OF CONST. LENDER BRANCH
• ,�
OFFICE .NO
LENDER NVOLVED
I
ELECTRICAL FEE
DBL
$
•
AD E5 —' '" CITY
'�� STATE
'
G/ .
#
' y
SMI FEE
$
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 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
tS_44
THE LAWS OF THE STATE OF CALIFORNIA COVERING CONTRACTORS IS AL 50 GUARANTEED,
I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREP ED TH L S 5 IFI IONS
$
TOTAL FEES
HAS DONE SO IN ACCORDANCE WITH SECTION 55C91F IONS
nDF F THE STATE OF CALIFORNIA.
CASH CI CHECK 9$00" M.0. ❑ , N.C. ❑
OWNER.
CONTRACTOR -
t
.RECEIVED BYn
ADDRESS
AD 3 +
SEWAGE SYSTEMT
LL
P
CITY _
CIYY r
REQUIRED
YES
NO
p�(TREES
'1f
V INFORMATION
TEL. NO.
_
TE O. "— LICENSE
FORM 284-208 (Rev. 1 1 /721
• e
346-6002 22x358