200244 (RIV CNTY PERMIT)EA
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DEPARTMENT OF BUILDING & SAFETY
COUNTY OF RIVERSIDE •
TOTAL-FEE9'r..%K
'7iri!
FIELD OFFICE
PL. CK. F E& CONST.
CONSTRUCTION ESTIMATE
ELECTRICAL FEES
ELEC. F E(�.
PLUMBING FEES
SPEC. INSP.: FEE
I ST FL.
2ND FL.
POR.
GAR.
CAR P.
WALL
SQ. FT: @' �sI NO
NO.
GJ
SQ. FT. @ '
SQ. FT. @ MOTOR I OR LESS H.P.
SQ.FT. @ '` MOTOR 5 OR LESS H.P.
SQ. FT. @ MOTOR 20 OR LESS H.P. DRAINAGE PIPING
SQ.FT. @ DRINKING FOUNTAIN
_
_ J w - F
SQ. FT. @ URINAL
A M J _ J_ A 5- - O
A• M J .J A 5 0
- K w. UNITS WATER PIPING
O
ESTIMATED VALUATION $ ,;"' `f 4
-LOT SIZE
FLOOR.DRAIN
USE #
JOB ADDRESS
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM -eFAN ❑EVAP. COOL XHOOD
SIGN
r/
WASHER (AUTO`J�DISH)
?
%
APPLIANCE
FORMER O K.W.
GARBAGE DISPOSAL
,'5-73
DATE
FURNACE ❑ UNIT ❑ WALL ❑ JOOR ❑ SUSPENDED
OUTLETS
a
LAUNDRY TRAY
A-yE,i x '
,. -
16
AIR HANDLING UNIT I CFM
FIXTURE OR SOCKET
KITCHEN SINK
COMMUNITY �
/ �
GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
CONST. SERV. ENTRANCE
VALUATION
WATER CLOSET
MECHANICAL FEE
'
COMPRESSOR HP
POLE
C
LAVATORY"
A(� ,
APPLIANCE VENT
AMPERES SERV. ENT., `
DBL
SHOWER
(�
ABSORPTION SYSTEM B.T.U.
SQ. FT. @ ¢
/
BATH TUB
UM ER
CONSTRUCTION FEE
INCINERATOR ❑ DOMESTIC ❑ INDUS. OR COMM.
SQ. FT. @ Q
WATER HEATER
�f"" • drM „
HEATING SYSTEM A& FORCED ❑ GRAVITY d
SQ. FT. RESID. @ I
DBL
SEWAGE DISPOSAL
BOILER B.T.U.
SQ. FT. GARAGE @112¢
HOUSE SEWER
ELECTRICAL FEE./
PERMIT FEE
BALANCE OF MIN. FEE
GAS PIPING
TRAILER ISSUANCE FEE -PERMITFEEI I
PERMIT FEE [Y
Ji
PFRMIT FFF
,=t
fa
EA
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n
TOTAL-FEE9'r..%K
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`RE N. TRAILER FEE HEAT @ VE�
PL. CK. F E& CONST.
FkE
oeL.
ELEC. F E(�.
oBL.
SPEC. INSP.: FEE
PLUMBING FEE_
DBL.
GJ
_
_ J w - F
M..._
M
A M J _ J_ A 5- - O
A• M J .J A 5 0
N D
N D .�....- _
-LOT SIZE
USE #
JOB ADDRESS
J_R
{�OWNERSEX
%
ZONE -
USE OF BUILDING/
DATE
PLAN CHECK FEE
$ x,j` fa
a
f "
A-yE,i x '
,. -
16
CHECKED BY
COMMUNITY �
/ �
F�IC�
UN1p
T"�'hLf
VALUATION
O30 FFICE
MECHANICAL FEE
rD�BICT
E�
DBL
`GR
TYPE
LEGAL DESCRI TION � �
ER IT
UM ER
CONSTRUCTION FEE
$
�f"" • drM „
2'
4
DBL
PLAN CHECKER
SUPP. TO PERMIT
ELECTRICAL FEE./
$
Q
DBL
BOND $
BOND
'CASH
PLAN FILE {� FINAL
DATE
INSPECTOR
PLUMBING FEE m
�i
�f
-I/' 7T"
TRAILER PERMIT
$
NAME OF, CONSTRUCTION LENDER -
BRANCH OFFICE
NO LENDER
N.OLVED
ISSUANCE FEE'
"�
ADDRESS
CITY
STATE
FEE
$
.�•
TOTAL FEES
$.!t
THIS PERMIT SHALL fEjOME VOID IF WORK IS NOT COMMENCED WITHIN 60 DAYS. CESSATION
OF WORK FOR 120 DAYS ALL ALSO CAUSE PERMIT TO BECOME VOID.
1 HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCOR-
N.C.
CASH Q CHECK
M.O. Q
DANCE WITH THE LAWS OF RIVERSIDE COUNTY AND T.H,E STATE OF CALIFORNIA. I ALSO AGREE TO
CARRY. COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLIANCE WITH THE LAWS OF THE STATE
RECEIVED BY SEWAGE SYSTEM
OF CALIFORNIA COVERING CONTRACTORS IS ALSO GUARANTEED.
�r rL��®
I HEREBY CERTIFY THATTHE INDIVIDUALWHO PREP DTH PLANS A D SPECIFICATIONS HAS DONE
SO IN ACCORDANCE WITH SECTION 5541 OF THE BU I SS ° t` SSIO E OF THE STATE
I��T=
INFORMATION
OF CALIFORNIA
OWNER .
C NTRACTOR
Off^
ADDRESS
ADDRESS
..
t� Ci
TEL. NO. -
TEL. NO.
LIC Et{$
FORM 284-208 (REV. 1-701 @