260898 (RPL)BUILDING PERMIT
DEPARTMENT OF BUILDING &SAFETY
COUNTY OF RIVERSIDE
CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES
1 ST FL. SQ.FT. @ UNITS
2ND FL. --SO. FT. @
POR. SO. FT. @ MOBILEHOMESVC.
GAR. POWER OUTLET
CAR P. SO.FI. @
WALL SO. FT. @
SO. FT. @
ESTIMATED CONSTRUCTION VALUATION $
NOTE: Not to be used os property tax voluotion
MECHANICAL FEES
VENT SYSTEM Cl FAN ❑ EVAP. COOL ❑ HOOD
SWIM POOL, PVT
SWIM POOL, COMM
SIGN
FIELD OFFICE
APPLIANCE
D/ST
LWREk
NO. PLUMBING FEES
FURNACE ❑ UNIT ❑ WALL Cl FLOOR ❑ SUSPENDED
YARD SPKLR SYSTEM
LAUNDRY TRAY
BAR SINK
AIR HANDLING UNIT
ROOF DRAINS
IDLE METER
DRAINAGE PIPING
DRINKING FOUNTAIN
B.T.U.
URINAL
WATER CLOSET
WATER PIPING
COMPRESSOR, 0
FLOOR DRAIN
POLE, TEMP/PERM
WATER SOFTENER
WASHER IAI ITC)1 IDISHI
AMPERES SERV ENT
APPLIANCE
JOB ADDRESS —..._ . _ __ _� .�.�..... 'SP NO`-.
LWREk
GARBAGE DISPOSAL
FURNACE ❑ UNIT ❑ WALL Cl FLOOR ❑ SUSPENDED
7rj
LAUNDRY TRAY
F.C. JDATEP
AIR HANDLING UNIT
CFM
IDLE METER
KITCHEN SINK
ABSORPTION SYSTEM
B.T.U.
TEMP USE PERM SVC
WATER CLOSET
UNITS
COMPRESSOR, 0
HP
POLE, TEMP/PERM
LAVATORY -
HEATING SYSTEM Cl FORCED ❑ GRAVITY
AMPERES SERV ENT
SHOWER
BOILER 0 B.T.U.
SQ FT @ a
BATH TUB
MICROFILM FEE
SQ FT @ ¢
WATER HEATER
LEGAL D SCRIPTION
SQ FT RESID @ 1¢
SEWAGE DISPOSAL
MECHANICAL FEE
SQ FT GARAGE @ '/2a
HOUSE SEWER '
PERMIT FEE
LOT SIZE ZONE
GAS PIPING
GRP
MOBILE HOME PERMIT FEE
Is4
1 1PERMIT FEE
PERMIT FEE'
PERMIT NO.
260898
TOTAL FE�r
�0 1
MOB. HM.FEE
MICRO FEE
MECH. FEE
DBL-
PL. CK. FEE,
%
CONST, FEE
DBL.
ELECT. FEE
DBL.
SMI FEE
FEE
PLUMB. FEE
DBL.
.iom `J f I M - A M I J I J -_ A S • _O N_ D -
JOB ADDRESS —..._ . _ __ _� .�.�..... 'SP NO`-.
LWREk
7rj
USE OF PERMIT - _
F.C. JDATEP
ERMIT NO.
M H PERMIT FEE
$
COMMUNITY
DST
UNITS
ROOMS
VALUATION
UPP. TO PERMITFFICE
O
MICROFILM FEE
COPIES
$
LEGAL D SCRIPTION
MECHANICAL FEE
DBL
$
SETBACK
LOT SIZE ZONE
USE NO.
GRP
TYPE
CK BY,
I,%.�
.�.. •?i�
F f S 1 R
PLAN CHECK FEE
$
4 C7
BOND AMT.
PAN NO.
PLAN CHECKER
FI Dtf JINSPECTOR
CONSTRUCTION FEE
DBL
$
NAME OF CONST. LENDER BRANCH
OFFICE
NO LENDER INVOLVED
ELECTRICAL FEE
DBL
$
ADDRESS CITY
STATE
STRONG MOTION
INSTRUMENTATION FEE
$�j
3
OWNER/AGENT'S SIGNATURE j
CONTRACTOR j, f
J
`+
✓ t
; , A—•`t'
FEE
$
-
ADDRESS
ADDRESS r
PLUMBING FEE
DBL
$
�
CITY ZIP CODE
CITY ZIP, CODE
TOTAL FEES
$ (�
7J
TEL. NO. �'
TEL.'CENSE
/ NO. LICENSE
CASH ❑ CHECK M.O. ❑ N.C. ❑
THIS PERMLT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSA
rON-OF WORK FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
RECEIVED B �R f2 %t!�
TREES REQUIRED
� 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 ALSC
SEWAGE SYSTEM
"'
r(\,
T LL
P l!
AGREE TO CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLIANCE WITH THI
I I HEREBY CERTIFY THAT THE -INDIVIDUAL WHO PREPARED THE,PLANS AND SPECIFICATIONS
FORM 284-208 (Rev. 10-74) @L HAS DONE SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE
OF THE STATE OF CALfFORNIA.