200243 (RIV CNTY PERMIT)i
11111111 Jill 53 DEPARTMENT OF BUILDING $SAFETY
• COUNTY OF RIVERSIDE -
CONSTRUCTION ESTIMATE ELECTRICAL FEES
FURNACE ❑ UNIT ❑ WALL ❑'s OOR ❑ SUSPENDED
FIELD.OFFICE
PLUMBING FEES
I ST FL.�
2ND FL.
POR.
GAR.
CAR P.
WALL
FIXTURE OR SOCKET' KITCHEN. SINK
SQ. FT.
NO.
NO.
POLE LAVATORY]
SQ. FT. @
AMPERES SERV, ENT. ,�j SHOWER
SQ. FT. @ MOTOR I OR LESS H.P.
SQ. FT. Ca Q BATH TUB
SQ.FT. @ " MOTOR 5 OR LESS H.P.
%
SQ. FT. @ MOTOR 20 OR LESS H.P.
DRAINAGE PIPING
SQ.FT. @
DRINKING FOUNTAIN
SQ. FT. @
URINAL
OK W. UNITS
WATER PIPING wD
ESTIMATED VALUATION $"
,
TOTAL FEES+� REN. TRAILER FEE HE E
`SII
FLOOR DRAIN
oel.
MECHANICAL FEES
111L.ISPEC.
INSP. FEE PLUM BIN�F�€
WATER SOFTENER
VENT SYSTEM
�6 FAN ❑ EVAP. COOL t] HOOD SIGN
WASHER (AUT(5)e(DISH)
APPLIANCE Y Ac 9+'
4 FOR E R 0 K•W• GARBAGE DISPOSAL T)
FURNACE ❑ UNIT ❑ WALL ❑'s OOR ❑ SUSPENDED
OUTLETS LAUNDRY TRAY
AIR HANDLING UNIT CFM
FIXTURE OR SOCKET' KITCHEN. SINK
GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
CONST. SERV. ENTRANCE WATER CLOSET
COMPRESSOR C HP
POLE LAVATORY]
APPLIANCE VENT
AMPERES SERV, ENT. ,�j SHOWER
ABSORPTION SYSTEM • 0 B.T.U.
SQ. FT. Ca Q BATH TUB
INCINERATOR ❑ DOMESTIC ❑ INDUS. OR COMM.
SQ. FT. @ d WATER HEATER 5-0
HEATING SYSTEM Al FORCED ❑ GRAVITY
60 SQ. FT. RESID. @j � •� / SEWAGE DISPOSAL
BOILER B.T.U.
SQ. FT. GARAGE @/24 HOUSE SEWER
PERMIT FEE
'3 BALANCE OF MIN. FEE GAS PIPING
TRAILER ISSUANCE FEE PERMIT FEE
PERMIT FEE �' PERMIT FEE 4
PER
2
0 2 4 3
TOTAL FEES+� REN. TRAILER FEE HE E
`SII
PL. CK.��SGE�fy., CONST. F 6,
vGw:w J-�''"i!
oel.
ELEC. FkE_,
111L.ISPEC.
INSP. FEE PLUM BIN�F�€
DBL.
a
3�/
J ._.. i M A " M
J ..J A S O
10
N D
SET 11 A
LOT SIZE
USE j/JOB
ADDRESS • ly 0 NER
- d f W-• R
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ti !7 '9PJ 4J� .7 ,: ~ .
S �:3
R t
ZONE
USE OF BUILDING -
DATE
PLAN CHECK FEE
$
y� `
-
�7 -
�
CHECKED BY
COMMUNITY - 6_1i4IC
y`?
Ew
-.C:
�U a
{
V U{� 0 F
T'��
OFFICE
MECHANICAL FEE
$
,
-�1
ev
�^''
- DBLGslQ
P
TYPE
LEGAL DESCR TION - .e
ERMIT NUM ER '
CONSTRUCTION FEE
$ .
-1/, _ e * .2
2
02 3
DBL
PLAN CHECKER
SUPP. TO PERMIT
ELECTRICAL FEE
{j
DBL
BOND $
BOND
CASX
PLAN FILE'p FINAL
DATE
INSPECTOR
$ �
§--//- -),-
)rNAME
PLUMBING FEE
i
NAMEOF, CONSTRUCTION
LENDER
BRANCH OFFICE
E NDER
TRAILER PERMIT
ISSUANCE FEE
$
add,
INO/L
IN OLVED
ADDRESS
-
CITY
STATE
FEE
$
C51`
i . . 9
TOTAL FEES
1
$
THIS PERMIT SHALL COME VOID IF WORK IS NOT COMMENCED WITHIN 60 DAYS. CESSATION
7
OF WORK FOR 120 DAY SHALL ALSO CAUSE PERMIT TO BECOME VOID. �
I HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCOR-
DANCE WITH THE LAWS OF RIVERSIDE COUNTY AND T,H,E STATE OF CALIFORNIA. I ALSO AGREE TO
CARRY. COMPENSATION INSURANCE UPON.MY EMPLOYEES. COMPLIANCE WITH THE LAWS OF THE STATE
RECEIVED BY SEWAGE SYSTEM
OF CALIFORNIA COVERING CONTRACTORS IS ALSO GUARANTEED.
fr T 1t%B� LL P /
IHEREBY CERTIFY THAT THE INDIVIDUALWHOPREPARED T PLANS,_ ND SPECIFICATIONS HAS DONE
SO IN ACCORDANCE WITH SECTION 5541 OF THE B SI SS >1 PR FESSIO S , ODE OF THE STATE
f INFORMATION
OF CAIFORNIA. I
OWNER
C TRACT
-
'i,11 G e
ADDRESS
A 0 /FE�SS j
V k
• -
Y? Gn I; a
t
TEL. NO.
TEL. NO.
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a(R) W V-, 0
a
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FORM 284-208 (REV. 1,0)
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