222934 (SFD)BUILDING PERMIT
DEPARTMENT OF BUILDING 8, SAFETY
COUNTY•OF RIVERSIDE '
:•I. _ . ELECTRICAL FEES:
NO..
MOTOR I OR LESS H.P.
MOTOR 5 OR LESS H.P.
MOTOR 20 OR LESS H.P.
tSY' i!/ 0 K.W. UNITS
FIELD OFFICE
r ,
j;
PLUMBING FEES DST,
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
FLOOR DRAIN
WATFR SnFTFNFP
CONSTRUCTION ESTIMATE -
1 ST FL.
it'
SQ. FT. @ 43
2ND FL.
SQ. FT. @a
POR.
SQ. FT. @a
GAR.
SQ.FT. @�
CAR P.
SQ. FT. @
WALL
SQ.FT. Cal
�7�
SQ. FT. @
ESTIMATED CONSTRUCTION VALUATION
$
NOTE: Not to be used as property tax valuation
DEPARTMENT OF BUILDING 8, SAFETY
COUNTY•OF RIVERSIDE '
:•I. _ . ELECTRICAL FEES:
NO..
MOTOR I OR LESS H.P.
MOTOR 5 OR LESS H.P.
MOTOR 20 OR LESS H.P.
tSY' i!/ 0 K.W. UNITS
FIELD OFFICE
r ,
j;
PLUMBING FEES DST,
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
FLOOR DRAIN
WATFR SnFTFNFP
VENT SYSTEM ❑ FAN ❑EVAP. COOL OOD
0SIGN
MECH. FEE
' ��
WASHER (AUTO) (94"
�
f'V
DBL. ELECT. FEE
APPLIANCE r
.SMI FEE
TRANS --
FORMER 0 K W
GARBAGE DISPOSALS
DBL
'
�7�
FURNACE ❑ UNIT ❑ WALL ❑FLO R ❑SUSPENDED
OUTLETS
LAUNDRY TRAY
�i�a
Aq��
•
AIR HANDLING UNIT CFM
FIXTURE OR SOCKET
KITCHEN SINK
J I FI M'I A -I M I J I A 4- .q- .g. 1-0,1 N 1 !D
JcIIADDRESS- max., «. tea._. ,e�y• _.-� -_ a
u
GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
73
CONST. SERV. ENTRANCE
WATER CLOSET
A
r
COMPRESSOR HP
DATE ..
-
POLE
LAVATORY
M. H. HOOKUP FEE
pO
a
APPLIANCE VENT
COMMUNITY
AMPERES SERV. ENT. yT
SHOWER
ROOMS
VALUATION
SUPP. TO PERMIT OFFICE
ABSORPTION SYSTEM B.T.U.
SQ. FT. @ Q
i BATH TUB
j
3 tZ
�-
INCINERATOR ❑ DOMESTIC• ❑ INDUS. OR COMM.
^. SQ. FT. Q° Q
WATER HEATER
COPIES
$
`HEATING SYSTEM WFORCED ❑GRAVIN
! [°Gp
SQ. FT. RESID..@I� a
SEWAGE DISPOSAL
p
:�y}
• _~
BOILER 0 B.T.U.
SO. FT. GARAGE @a 1�2¢�'
HOUSE SEWER
USE NO.
GRP
TYPES
PERMIT FEE
&0
BALANCE OF MIN. FEE,
GAS PIPING
/
I:d•111�a:L•L.I�:NI•L'417�Ra�aE>�aa���aaaaa aalrJlITMaaal/a97:ml, Iayyaa ar7-rim
P
22PZ93�
TOTAL FEES
�y
MOB. HK. FEE MICRO FEE
MECH. FEE
' ��
DBLe
PL. CK. FEE
.CONST. FEE
DBL. ELECT. FEE
DBL.
.SMI FEE
FEE
PLUMB. FEE
�
DBL
�7�
��,�
�i�a
Aq��
1��
J I FI M'I A -I M I J I A 4- .q- .g. 1-0,1 N 1 !D
JcIIADDRESS- max., «. tea._. ,e�y• _.-� -_ a
O:VNE
73
74
USE OF BUILDING - .
.e11 - . A
F.C.
DATE ..
-
PERM T N '
2934
75
M. H. HOOKUP FEE
$
COMMUNITY
DST
UNITS
ROOMS
VALUATION
SUPP. TO PERMIT OFFICE
MICROFILM FEE
COPIES
$
LEGAL DESCRIPTION
MECHANICAL FEE
DBL
.SET BACK LOT SIZE - ZONE
USE NO.
GRP
TYPES
BY
/
ICK
PLAN CHECK FEE -
$
}
�,. ✓
BOND AMT. PLAN NO. PLAN CHECKER
FINAL DATE C%.TiNQLp �' INSPECTOR
-
CONSTRUCTION FEE
DBL
NAME OF CONST. LENDER . BRANCH
OFFICE
LENDER INVOLVED
-
J.NO
ELECTRICAL.FEE
DBL
$
-
y
J9
ADDRESS - CITY
�� f -
STATE
%/y � gJ
4T4
SMI FEE
$
.-THIS.•PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 60 DAYS. CESSA-
$
FEE
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•
WITH:THE *LAWS OF RIVERSIDE COUNTY AND'THE STATE OF CALIFORNIA, I ALSO "
PLUMBING FEE-
DBL
$
''CORDfiNCE
i --AGREE
.TO CARRY COMPENSATION INSURANCE UPON' MY EMPLOYEES. COMPLIANCE WITH
THE LAWS OF THE STATE O_ F CALIFORNIA COVERING CONTRACTORS IS ALSO GUARANTEED.
I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS
t
$
TOTAL FEES .;
<
•'"HAS
DONE S& -IN ACCORDANCE •,WITI I SECTION 5541 OF THE BUSINESS AND PROFESSIONS
,
CODE F THE STATE OF CALIFORNIA.
CASH CHECK M.O.❑\- N.C.❑
OWNER, /` R !
CONTRACTOR,+•
-...--•^^�"r�Ga�";LJ�`�v�!r�
Y
_. - °
- !
_ _ .
RECEIVED BY •
ADDRESS
�J1 ti
ADDRESS
j
;�
SEWAGE SYSTEM T
_
LL
P
t
.-
TREES REQUIRED
YES +
NO
CITY +i
CITY
-} INFORMATIONj,j'40 q
TEL. NO. -•
TEL. NO. • LICENSE
+!`f,•r
3 /f
-
FORM 284-2081ReV. 11/721
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