222827 (RIV CNTY PERMIT)BUILDING PERMIT DEPARTMENT OF BUILDING & SAFETY tr�"7� D 0 F4
COUNTY OF RIVERSIDE
CONSTRUCTION ESTIMATE. ELECTRICAL FEES- . -_ -- PLUMBING FEES DST A
1 ST FL. SQ. FT. '9"'CJ NO. NO.
2ND FL. SQ. FT. Cia
POR. SQ. FT. + MOTOR 1 OR LESS H P
GAR.
�� f @ ♦ ' MOTOR 5 OR LESS H P
SQ.FT.
CAR P. J SQ. FT_ Cia
MOTOR 20 OR LESS H -P. DRAINAGE PIPING I
WALL SQ.FT. @a DRINKING FOUNTAIN
SQ. FT.[a1 URINAL
ESTIMATED CONSTRUCTION VALUATION $ 6f 0 K.W" UNITS , WATER PIPING
NOTE: Not to be used as property tax valuation 'r FLOOR DRAIN
MECHANICAL FEES WATER SOFTENER
VENT SYSTEM FAN ❑EVAP. COOL W HOOD
SIGN
WASHER (AUT DISH)
f,LA1IT O.
APPLIANCE r'
.
> TRANS- -ORMER D K.W.
♦
GARBAGE DISPOSAL
Z
FURNACE El UNIT ❑WALL ❑FLO R ❑SUSPENDED
OUTLETS
.-1 S v
LAUNDRY TRAY
AIR HANDLING UNIT CFM
FIXTURE OR SOCKET
�
KITCHEN SINK
;
GAS PIPE ❑ NATURAL ❑ L.P.G ❑ OIL
CONST. SERV. ENTRANCE
JOB ADDRESS / OWNER
WATER CLOSET
LAr
COMPRESSOR HP -7 cam•
POLE
LAVATORY
APPLIANCE VENT y
AMPERES SERV. ENT, /
SHOWER
.r.
ABSORPTION SYSTEM B"T.0
SQ. FT, @ $
/
BATH TUB
USE OF BUILDING -
f,A
INCINERATOR ❑ DOMESTIC ❑ INDUS. OR COMM.
SQ. FT. @ Q
J
WATER HEATER
f
HEATING SYSTEM [FORCED ❑ GRAVITY 1y/ r
SQ" FT_ RESID. @ 14
/
SEWAGE DISPOSAL
fr
BOILER 0 B.T.U.
SQ, FT. GARAGE @1/20,
HOUSE SEWER
ROOMS VALUATION
PERMIT FEE
BALANCE OF MIN. FEE
GAS PIPING
MOBILE HOME HOOKUP FEE
Is
PtHM11 rtt I I'&'& PtHMI I I-tt
f,LA1IT O.
TOTAL FEES
MOB. I1K. FEE MICRO FEE
MECH. FEE DBL PL CK. FEE CONST. FEE DBL ELECT FEE DBL SMO FEE FEE PLUMB. FEE DBL
�
PE
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(�FGff�]► []r"
�
E I M A
M J J
A 1 S a
1,1 ❑
JOB ADDRESS / OWNER
73
74
USE OF BUILDING -
f,A
F C
/j !/j
,22827
75
M.H. HOOKUP FEE
$
IC&TIMUNITYDST
UNIT `
ROOMS VALUATION
UPh"10 PERM it
OFFICE
—� qj C u
MICROFILM FEE
COPIES
$
LEGAL SORPTION
y
!
MECHANICAL FEE
DBL
$
SET BACK
Lor SIZE
xoN
us v"
GRP
cRr
nae
CK sr
F S R
ep,BOND
+
PLAN CHECK FEE
$
MT
PL NO,
PLAN CHECKER
DATE INSPECTOR'"
6
CONSTRUCTION FEE
DBL
$
NAME OF CONST. LENDER BRANCH
OFFICE .NO
LENDER 174VOLVE0
1
ELECTRICAL FEE
DBL
$
A E 5
CITY STATE
+
f 7
/
SMI FEE
$
A2
J�zwg
1
�
THIS PERMIT SWUL BEC0�:1E 1/C�1 IF WORT- IS NOT COMMENCED V111THIN 60 DAYS. CESSA-
TION OF V,'ORIK FOR 120 DAYS SH ._ ALSO CAUSE PERI,AIT TO BECOME VOID.
FEE
$
I HERESY .AGREE THAT All \-VOPK IN OX -fl 1ECTION WITH THIS PERMIT WILL BE DONE IN AC.
CORD,,'NICE WITH TI �E Lr^,`�i'S OF RIVERSIDI= COUINTY AND THE STATE OF CALIFORNIA, I ALSO
PLUMBING FEE
DBL
$
AG^EE TO CARRY INSURANCE UPON N1\1' EMPLOYEES. COMPLIANCE WITH
QQ
THE LAYn'S OF "IHE S1ATE OF Cs\1_IFORiNIA COVEMNG CONTRACTORS IS ALSO GUARANTEED.
I HEF,EBY CERTIFY THAT THE IP!CIVIDUAL l'dH0 P TEON SA S" CIFICATIONS
TOTAL FEES
�r
HAS DOME SO IN ACCORDANCE BATH SECTION 41 i JeSS P ,OF IONS
C F hII
CASH ElCHECK [� MO ❑ N.C. [I
OWNER
CONTRACTOR 1
(J�
RECEIVED BY
ADDRESS
ADDRESS
SEWAGE SYSTEM
I
T
LL
P
-X
aTr
crTY
TREES REQUIRED
YES
NO
—
NO IIIIIII III IIIIIIII�I 66
r
' J
NF.]RMA�TEL
L N CENSE
FORM 284-2081R— 117721
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