222935 (SFD)BUILDING PERMIT
DEPARTMENT OF BUILDING & SAFETY
• COUNTY OF RIVERSIDE '
•., . ELECTRICAL FEES,,..,
MOTOR I OR LESS H.P.
'S•p m� MOTOR 5 OR LESS H.P.
MOTOR 20 OR LESS H.P.
K.W. UNITS
F19LD OFFICE
PLUMBING FEES I D$Ty
N O. �/ m'•
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
FLOOR DRAIN
WATFD C0FTFNFD
CONSTRUCTION ESTIMATE.,,
I ST FL.
0 SQ. FT. Cia
2ND FL.
SQ. FT. @
POR.
SQ. FT. Cia
GAR.
/l Q SQ.FT.
CAR P.
SQ. FT. @
WALL
SQ.FT. V�a
„
SQ. FT..
ESTIMATED CONSTRUCTION VALUATION $
NOTE: Not to be used as property tax 'valuation
LAUNDRY TRAY
. ' MFCHANICAI FFFS
DEPARTMENT OF BUILDING & SAFETY
• COUNTY OF RIVERSIDE '
•., . ELECTRICAL FEES,,..,
MOTOR I OR LESS H.P.
'S•p m� MOTOR 5 OR LESS H.P.
MOTOR 20 OR LESS H.P.
K.W. UNITS
F19LD OFFICE
PLUMBING FEES I D$Ty
N O. �/ m'•
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
FLOOR DRAIN
WATFD C0FTFNFD
IuL�]YI1141:N]P.I4:LololAgl»R�B. U12:11
I 1 - I PFRMIT FFF _ 1 07 1 _� -
ERMIT O.
2,9
VENTSYSTEM.2"DEAN ❑EVAP. COOL HOOD
MOB. HK. FEE MICRO FEE
SIGN
WASHER (AUTO) (Dlb*
PL. CK: FEE
r{
-DBL. ELECT. FEE
APPLIANCE
O
FORMER D K'W
GARBAGE DISPOSAL
DBL.
tip
„
FURNACE ❑UNIT ❑WALL LOOR ❑SUSPENDED
73
OUTLETS
LAUNDRY TRAY
F.C.
dray.
DATE
- _ 3.
PERM N
2 9 $
AIR HANDLING UNIT CFM.
M.H. HOOKUP FEE
FIXTURE OR SOCKET
KITCHEN SINK
CoMMUNITY
y_
CAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
ROOMS
CONST. SERV. ENTRANCE
WATER CLOSET
OFFICE
S
COPIES
COMPRESSOR HP
Gp
POLE-
LAVATORY
DBL
j o
APPLIANCE VENT
LOTSIZE
AMPERES SERV. ENT. 00
SHOWER
GRP
TYPE
..
CK BY
R/YJN•'FZ.
ABSORPTION SYSTEM, B.T.U.
PLAN CHECK FEE
SO. FT. @ ¢
BATH TUB
BOND AMT. .
,.INCINERATOR ❑ DOME5.TIC ❑ INDUS. OR COMM.
PLAN CHECKER
- SQ. FT. @ ¢
WATER HEATER
CONSTRUCTION FEE'DBL
_ $ ' ' , -_ _
•}vy �1�,�
HEATING SYSTEM FORCED ❑ GRAVITY
b
SQ. F.T. RESID. (ail ¢ %
SEWAGE DISPOSAL
%O
DV
$
BOILER 0 B.T.U.
ADDRESS • CITY
-CAIrrV
SQ. FT. GARAGE @]�y¢ p, �5-0
HOUSE SEWER
SMI FEE
"
$
PERMIT FEE
y D
BALANCE OF. MIN. FEE
GAS PIPING
$
IuL�]YI1141:N]P.I4:LololAgl»R�B. U12:11
I 1 - I PFRMIT FFF _ 1 07 1 _� -
ERMIT O.
2,9
TOTAL FEES
MOB. HK. FEE MICRO FEE
MUCH. FEE
DBL
PL. CK: FEE
CONST. FEE
41
-DBL. ELECT. FEE
DBL.
SMI FEE
FEE
�PLMB. FEE
DBL.
-- -j.": r1 I: M.. `A ..- M ,. _7l`j.., ,,, -...,A.... �.y +O e NI',rD�l
JOB ADDRESS..1
OWN/E` %
73
74
USE OF BUILDING ..'
� �A
F.C.
dray.
DATE
- _ 3.
PERM N
2 9 $
75
M.H. HOOKUP FEE
$
CoMMUNITY
DST
UNITS
ROOMS
VALUATION
SUPP.TOPERMIT "
OFFICE
MICROFILM FEE
COPIES
$
LEGAL DESCRIPTION Re+97Wl_//A1—�
MECHANICAL FEE ' '
DBL
$'
SET BACK
LOTSIZE
ZONE JUSENO.
,�
GRP
TYPE
..
CK BY
R/YJN•'FZ.
F 6 S.-R.jt
PLAN CHECK FEE
- -
$ '
BOND AMT. .
PLAN NO.
PLAN CHECKER
FINAL DATE INSPECTOR
// Ic 3
4A r
CONSTRUCTION FEE'DBL
_ $ ' ' , -_ _
•}vy �1�,�
NAME OF CONST. LENDER - • BRANCH
OFFICE - ... ". J.NO
-
LENDER INVOLVED
ELECTRICAL FEE
DBL
$
ADDRESS • CITY
-CAIrrV
- STATE
,
SMI FEE
"
$
THIS•PERMITSHALL BECOME VOID IF, WORK IS NOT COMMENCED WITHIN 60 -DAYS. CESSA-
TION OF WORK FOR 120 DAYS SHALL ALSO, CAUSE PERMIT TO BECOME VOID.
I HEREBY AGREE THAT ALL WORK 1N 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 THE PLANS AND
,HAS DONE OR INF ACCORDANCE W TIH $ECT O 5'541 OF THEEBUSINESS AND PROFESSIONS,
ESSIONS,
STATE OF CALIFORNIA. ,✓ '
FEE
$
PLUMBING FEE
DBL
$
:'
TOTAL FEES
$ . l
CASH ❑ CHECK CX. M.O. ❑��� ' N:C. ❑,
OWNER.F"
may, --"" J}ery
CONTRACTOR'
.
_
RECEIVED BY
✓ t '+r'b
ADDRESS
ADDRESS
SEWAGE SYSTEM T
LL
TREES REQUIRED
YES
CITY .-
s
4���� ••,�
CITY _.. ..
' INFORMATION Ad r'r
FORM 284.2081Rev.11/721'
TEL. NO.
•- �, '� /
TEL. NO. LICENSE
•{
1