222826 (RIV CNTY PERMIT)BUILDING PERMIT
DEPARTMENT OF BUILDING & SAFETY
COUNTY OF RIVERSIDE
WASHER (AUTO ISH)
CONSTRUCTION ESTIMATE
- ELECTRICAL FEES
PLUMBING FEES DST
1 ST FL.
2ND FL.
POR. �✓
GAR.
CAR P.
WALL
ESTIMATED CONSTRUCTION VALUATION
SQ. FT.NO.
FURNACE ❑ UNIT ❑ WALL ❑FLOOR SUSPENDED
NO.
SQ. FT. [7n
v^�
SQ. FT- � MOTOR 1 OR LESS H.P.
FIXTURE OR SOCKET
MOTOR 5 OR LESS H -P.
SOFT.
Tr
SQ, FT, (al MOTOR 20 OR LESS H.P,
DRAINAGE PIPING i
SQ.FT. Cai
DRINKING FOUNTAIN
SQ. FT, @
URINAL I
$ ^ 'a 0 K W UNITS
WATER PIPING
NOTE: Not to be used as property tax valuation
AMPERES SERV. ENT
FLOOR DRAIN
MFC'HANICAI FFFS
ABSORPTION SYSTEM 0 B.T.U.
WATER SOFTENER
VENT SYSTE FAN ❑EVAP. COOL HOOD
SIGN
WASHER (AUTO ISH)
3
APPLIANCE i
r ypMFR 0 K W
GARBAGE DISPOSAL
FEE R,,F�tEUE CBL
FURNACE ❑ UNIT ❑ WALL ❑FLOOR SUSPENDED
OUTLETS
LAUNDRY TRAY
v^�
AIR HANDLING UNIT CFM
FIXTURE OR SOCKET
KITCHEN SINK
Tr
GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
CONST. SERV. ENTRANCEWATER
CLOSET
COMPRESSOR HP
POLE
, LAVATORY
JOB ADDRESS
9 r. /
APPLIANCE VENT
AMPERES SERV. ENT
/ SHOWER
/5-0
ABSORPTION SYSTEM 0 B.T.U.
SO. FT. @ ¢
BATH TUB
f
INCINERATOR ❑ DOMESTIC ❑ INDUS- OR COMM-
SQ. FT. @
WATER HEATER
�/ -
HEATING SYSTEM FORCED ❑ GRAVITY
SO. FT. RESID- @
SEWAGE DISPOSAL
$
BOILER B.T.U.
SQ FT- GARAGE �ia 1/2Q
HOUSE SEWER
UNITS!
PERMIT FEE
BALANCE OF MIN. FEE
GAS PIPING
MOBILE MOMS HOVKUP Ftt rCKMH rCC rCrtrvui "I C -e 1
TOTAL FEES
MOB- HK FEE MICRU iEE hIECH. FEE DBL
M00-
PL C%. FEE CORST-- FEE
DBL ELEL7 FEL
DBL 5#S1 FrEE
FEE R,,F�tEUE CBL
^/Jyp
�I�
v^�
a
1,;;Lll>.i
-
�
Tr
V .2
1
C�� ?:
J F M A 1 1VL I J I. J I A S 1 r] 1 N I D
JOB ADDRESS
9 r. /
OWNER
J
73
74
USEOF BUILUING
F C,
P M[S NLI.
�` Q
e.L1
75
J
�/ -
A826
M.H. HOOKUP FEE
$
COMMUNITY /
DST
UNITS!
ROOMS
VALUATION SU PP -TO PERMIT
OFFICE
I
MICROFILM FEE
COPIES
$
LEGAL D PTION
- —
MECHANICAL FEE
DBL
$`�
SET BACK
LOT SIZE
ZONE USE NO
GRP
TIPS
CK BY
'� S
PLAN CHECK FEE
$
BOND AMTPLAN
NO.
PLAN CHECKER
FINAL DATE INSPECTOR
CONSTRUCTION FEE
DBL
$
NAME OF CONST. LENDER BRANCH
OFFICE -NO
LENDER INVOLVED
,�
ELECTRICAL FEE
DBL
$
,:2
17
/
7
AB rt-- CITY
T "
STATE f
— -k
SMI FEE
$
ry�
THIS PERI;AIT SHALL BFCO 'E V D IF %,YORK IS NOT COMMENCED 1A11THIN 60 DAYS. CES�fiA-
T101v1 01,11'OPK, FOR 120 DP,i S SHALL ALSO CAUSE PERMIT TO BECOME VOID.
$
FEE
I HE!cB`( :GREE THAT ALL V,/'' -IRK IN CONNECTIC)N bo'ITH THIS PERMIT WILL BE DONE IN
COrPAN,CE WITH THE LAI`'/S OF RIVERSIDE COL"INTY AND THE STATE OF CALIFORNIA, I ALSO �
PLUMBING FEE
DBL
$
AGREE TO CARRY 0DNWEP15AT10NI IPJ: U0Ar,10E UFO''N P:1`l Eis�PLOYEES. COMPLIANCE FYI T H
.22
-7 -4 -/
THE LAV!3' OF THE STATE OF C,'v1_I1'OR.NIA COVERING CONTPACTOPz IS ALSO GUARANTEED.
1 HERESY CERTIFY THAT THE INDIVIDUAL WHO F F' THE P NS ANIJ SPECIFICATIONS
$
TOTAL FEES
7
NS
HAS DONE SO IN_ACCORDANCE WITH SECTION F BU J 'D PRO BIONS
&r;
I FO RN IA
OWNER CONTRACTOR
CASH ❑ CHECK Lem' M ❑ N C. ❑
-O
�
f p'
RECEIVED BY
ADDRESS
ADDRESS
r
�`f
h
SEWAGE SYSTEM
T
LL
P
CITY CITY
TREES REQUIRED
YES
NO
{E{{{ { j
TEL NO TF.. NO LICENSE
I VIII III � IIIIIIII IIII 65 �
11
N�i51 N
}k+J1
1F I
II
IE ��� �
FORM 284-208 (Rev. 111721