242989 (PLBG)BUILDING PERMIT
CONSTRUCTION ESTIMATE
1 ST FL.
SQ.FT. @
2ND FL.
SQ. FT. @
POR.
SQ. FT. @
GAR.
SQ. FT. @
CAR P.
SQ.FT. @
WALL
SQ. FT. @
HEATING SYSTEM ❑ FORCED ❑GRAVITY AMPERES SERV ENT ' SHOWER f r�
SQ. FT. @
ESTIMATED CONSTRUCTION
VALUATION $
NOTE: Not !o be used as property tax valuation
MECHANICAL F -EES
DEPARTMENT OF BUILDING & SAFE
11 COUNTY OF RIVERSIDE
F
NO. I ELECTRICAL FEES
MOBILEHOME SVC.
POWER OUTLET
SWIM POOL. PVT
SWIM POOL, COMM
FIELD OFFICE
NO.1•- PLUMBING FEES
BOILER I
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
FLOOR DRAIN
WATER SOFTENER
VENT SYSTEM FAN ❑ EVAP. COOL ❑ HOOD yL . ao SIGN WASHER (AUTO) (DISH)
APPLIANCE GARBAGE DISPOSAL
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED LAUNDRY TRAY
AIR HANDLING UNIT r_ CFM IDLE METER KITCHEN SINK
ABSORPTION SYSTEM OB.T.U. TEMP USE PERM SVC WATER CLOSET
COMPRESSOR 0 HP POLE, TEMP/PERM LAVATORY
HEATING SYSTEM ❑ FORCED ❑GRAVITY AMPERES SERV ENT ' SHOWER f r�
SQ FT @ ¢ BATH TUB
SQ FT @ a WATER HEATER
SQ FT RESID @ 1 a SEWAGE DISPOSAL
SQ FT GARAGE @ 'ha HOUSE SEWER
-
PERMIT FEE TEMP ELEC SVC GAS PIPING
MOBILE HOME PERMIT FEE $
PERMIT FEE f PERMIT FEE oz
PERMIT NO.
2A�q8qj
TOTAL FEES
MOB. HM. FEE
MICRO FEE
MECH. FEE
DBL
PL. CK. FEE-
CONST. FEE
DBL.
ELECT. FEE
DBL:
SMI FEE
FEE - PLUMB. FEE
DBL.
A M •J J A S O N D 'JOB
ADDRESS �q I SP NO
.� `,.j' sa? t)%'r Zdt`!=(r G. Rf I
O NER ,, t
{�1 i_i' #,/V ` !_ C/7 T"•
73
74
USE OF PERMIT
F.C.
DATE
PMIT NO_ .
qQ®q�
.75
M H PERMIT FEE
$
COMMUNITY
DST UNITS.
Rooms
UATION L ISUPP..TO
PERMIT
OFFICEL
MICROFILM FEE
COPIES
$
LEGAL DESCRIPTION
MECHANICAL FEE
DBL
$
oe
SET BACK
LOT SIZE ZONE
USE NO.
GRP
TYPE
CK BY '
PLAN CHECK FEE
$
BOND AMT.
PLAN NO.
PLAN CHECKER
IFINALIATE. INSP
C
CONSTRUCTION FEE
DBL
$
NAME OF CONST: LENDER BRANCH
OF E
NO LENDER INVOLVED. -
ELECTRICAL FEE
DBL
$
ADDRESS CITY.
STATE
SMI FEE
$
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT -COMMENCED WITHIN 120 DAYS. CESSA°
TION OF WORK FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
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 CONTRACTORS IS ALSO GUARANTEED. -
I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS
HAS DONE SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE
OF THE STATE OF CAUF�1 .
FEE
$
PLUMBING FEE '
DBL
$
G �✓
TOTAL FEES
^
ESC3
OWNER/AGEV'S Sl N, t.
�p Azl
CONTRACTOR
CASH ❑ CHECK'. M.O. ❑ N.C. ❑
ADDRESS
ADDRESS
RECEIVED BY
TREES REQUIRED
SEWAGE SYSTEM
T /�J` �'
LL I P!�
CITY ZIP CODE
C
✓ �l�/N%r�9
CITY ..ZIP CODE
INFORMATION - •.
FORE¢ ^.84-208 (Rev. 9-731 05 d:a..
r.i1�
TEL. NO. t
•
TEL. NO. LICENSE
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