AR (239694)77511 Calle Madrid
239694
BUILDING PERMIT DEPARTMENT OF BUILDING & SAFETY FIELD OFFICE
Am COUNTY OF RIVERSIDE Am
ESTIMATED CONSTRUCTION VALUATION Is
NOTE: Not to be used as property tax valuation
MECHANICAL FEES
VENT SYSTEM ❑ FAN ❑EVAP. COOL ❑ HOOD
APPLIANCE
FURNACE ❑UNIT ❑WALL ❑FLOOR ❑SUSPENDED
AIR HANDLING UNIT CFM
GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
COMPRESSOR ' 0 HP
APPLIANCE VENT
ABSORPTION SYSTEM 0 B.T.U.
INCINERATOR ❑ DOMESTIC ❑ INDUS. OR COMM.
HEATING SYSTEM ❑ FORCED ❑GRAVITY
BOILER 0 B.T.U.
PERMIT FEE
MOBILE HOME 9 1HOOKUP FEE $
2 91P,FgM q •1 kT S MOB HK FEE MICRO FEE
J I F I M A I M I^J I J A I S-1 O 1 N -I D
73
74
75
M.H. HOOKUP FEE $
CONSTRUCTION ESTIMATE
1 ST FL.
MICROFILM FEE
SQ. FT.
@°
2ND FL.
DBL
SQ. FT.
@
POR.
$
SQ. FT.
CSO.
GAR.
ELECTRICAL FEE
SQ.FT.
@
CAR P.
SQ. FT.
@
WALL
VALUATION
SQ.FT.
@°
&%,"('
TOTAL FEES
SQ. FT.
CASH ❑ CHECK [ M.O. ❑'
ESTIMATED CONSTRUCTION VALUATION Is
NOTE: Not to be used as property tax valuation
MECHANICAL FEES
VENT SYSTEM ❑ FAN ❑EVAP. COOL ❑ HOOD
APPLIANCE
FURNACE ❑UNIT ❑WALL ❑FLOOR ❑SUSPENDED
AIR HANDLING UNIT CFM
GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
COMPRESSOR ' 0 HP
APPLIANCE VENT
ABSORPTION SYSTEM 0 B.T.U.
INCINERATOR ❑ DOMESTIC ❑ INDUS. OR COMM.
HEATING SYSTEM ❑ FORCED ❑GRAVITY
BOILER 0 B.T.U.
PERMIT FEE
MOBILE HOME 9 1HOOKUP FEE $
2 91P,FgM q •1 kT S MOB HK FEE MICRO FEE
J I F I M A I M I^J I J A I S-1 O 1 N -I D
73
74
75
M.H. HOOKUP FEE $
ELECTRICAL FEES --
NO.
MOTOR I OR LESS H.P.
MOTOR 5 OR LESS H.P.
MOTOR 20 OR LESS H.P.
K.W. UNITS
SIGN
TRANS- K W
FORMER
MICROFILM FEE
COPIES
$
MECHANICAL FEE
DBL
' $
PLAN CHECK FEE
POLE
$
CONSTRUCTION FEE
.DBL '
$
ELECTRICAL FEE
aot"
$
SMI FEE
$
FEE
BALA=NCE OF MIN. FEE
VALUATION
PLUMBING FEE
DBL
$
TOTAL FEES
I
CASH ❑ CHECK [ M.O. ❑'
RECEIVED BY `
SEWAGE SYSTEM
JOB ADDRESS - - .
17 s ,/
LL
TREES REQUIRED
YES
INFORMATION
FORM 284.208IRm 11/72)
ELECTRICAL FEES --
NO.
MOTOR I OR LESS H.P.
MOTOR 5 OR LESS H.P.
MOTOR 20 OR LESS H.P.
K.W. UNITS
SIGN
TRANS- K W
FORMER
OUTLETS
FIXTURE OR SOCKET
psi ' '
CONST. SERV. ENTRANCE
DATE
POLE
PERMIT NO ' '
AMPERES SERV. ENT.
I ^"
!S' SQ. FT. U° Q
`
SQ. FT. ea
cJ
-IrSQ. FT. RESID. @ 1
SQ. FT. GARAGE @1 2¢
UNITS
BALA=NCE OF MIN. FEE
VALUATION
PERMIT FEE
SU-P`P. TO PERMIT
MECH: FEE
1108L.
I
IU;L
3 v 2
ELECT. FEE
GG.'
Ae
JOB ADDRESS - - .
17 s ,/
?
PLUMBING FEES I DST
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
FLOOR DRAIN
WATER SOFTENER
WASHER (AUTO) (DISH)
GARBAGE DISPOSAL
LAUNDRY TRAY
KITCHEN SINK
WATER CLOSET
LAVATORY
SHOWER
BATH TUB
WATER HEATER
SEWAGE DISPOSAL
HOUSE SEWER
GAS PIPING
PERMIT FEE
- SMI FEE FEE
ADDRESS CITY STATE
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 60 DAYS. CESSA-
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-
CORDANCE WITH THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, I ALSO
AGREE TO CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLIANCE WITH
THE LAWS OF THE STATE OF CALIFORNIA COVERING CONTRACTORS IS ALSO GUARANTEED.
I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS
t HAS DONE SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS
L F TWE STATE OF CAL ORNIA
OWN CONTRACTOR
N.C. ❑ j
P
NO
— _P/(
WIT
LICENSE
iE OF BUILDING
psi ' '
F.C.
F.C.
DATE
PERMIT NO ' '
-A,0`4)
I ^"
`
cJ
MMUNITY
UNITS
ROOMS
VALUATION
SU-P`P. TO PERMIT
lf 41hIA1722'
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{DIST
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SENT BACK
LOT SIZE
ZONE
USE NO.
GRP
TYPE C
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IZ S
J
)NO AMT.
PLAN NO.
PLAN CHECKER
FINAL
DATE
INSPECTOR
IME OF CONST.
LENDER
I BRANCH OFFICE
I.NO LENDER
INVOLVED
ADDRESS CITY STATE
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 60 DAYS. CESSA-
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-
CORDANCE WITH THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, I ALSO
AGREE TO CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLIANCE WITH
THE LAWS OF THE STATE OF CALIFORNIA COVERING CONTRACTORS IS ALSO GUARANTEED.
I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS
t HAS DONE SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS
L F TWE STATE OF CAL ORNIA
OWN CONTRACTOR
N.C. ❑ j
P
NO
— _P/(
WIT
LICENSE