BLCK (226547)51453 Avenida Martinez
226547
BUILDING PERMIT
DEPARTMENT OF BUILDING & SAFETY
SIGN
COUNTY OF RIVERSIDE
CONSTRUCTION ESTIMATE --a --ELEGTRICAL FEES_ , --
1 ST FL. SQ. FT. @
NO. NO.
2ND FL. SQ. FT. @
DBL.
POR. SQ. FT. @
MOTOR I OR LESS H.P.
GAR. SQ.FT. @
MOTOR 5 OR LESS H.P.
CAR P'. ' SQ. FT. @
MOTOR 20 OR LESS H.P.
/
-
WALL t9JAM SQ.FT. @
CONST. SERV. ENTRANCE
SQ. FT. @
_
ESTIMATED CONSTRUCTION VALUATION
$ K.W. UNITS
NOTE: Not to be used as property tax valuation
FIELD OFFICE
PLUMBING FEES ,-13
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
FLOOR DRAIN
WATFR r0FTFNFR'
MOBILE HOME HOOKUP FEE $ PtRMII t-tt PERMIT FEE
VENT SYSTEM ❑ FAN ❑EVAP. COOL ❑ HOOD
SIGN
WASHER (AUTO) (DISH)
MEC., FEE
APPLIANCE
TRANS-. K.W.
FORMER O
GARBAGE DISPOSAL
DBL.
FURNACE O UNIT ❑ WALL ❑FLOOR ❑SUSPENDED
OUTLETS
LAUNDRY TRAY
AIR HANDLING UNIT I CFM
FIXTURE OR SOCKET
KITCHEN SINK
-
GAS PIPE ❑ NATURAL ❑ L.P.G: ❑ OIL
CONST. SERV. ENTRANCE
WATER CLOSET
_
COMPRESSOR 0 HP
POLE
LAVATORY
APPLIANCE VENT
AMPERES SERV. ENT.
SHOWER
ABSORPTION SYSTEM B.T.U.
SO. FT. @ ¢
BATH TUB
INCINERATOR ❑ DOMESTIC ❑ INDUS. OR COMM.
SQ. FT. @ ¢
WATER HEATER
DATE
HEATING SYSTEM ❑ FORCED ❑ GRAVITY
SQ. FT. RESID. @ ) ¢
SEWAGE DISPOSAL
_
_
BOILER. 0 B.T.U.,
SO. FT. GARAGE Cally¢
HOUSE SEWER
OST
PERMIT FEE
BALANCE OF MIN. FEE
GAS PIPING
MOBILE HOME HOOKUP FEE $ PtRMII t-tt PERMIT FEE
PE I O.
TOTAL FEES
MOB. HK. FEE MICRO FEE
MEC., FEE
DBL.
PL."CK.-FEE
CONST. FEE
DBL.
ELECT. FEE
DBL.
SMI FEE
FEE PLUMS. FEE
DBL
22'
J I F I M A I M I J I J A I 5 1 O 1 N D
JOB ADDRESS+,
OWNER
74
USE OF BUILDING ..
F.C.
DATE
PERM T N
6 5 4
75
M.H. HOOKUP FEE
$
COMMUNITY
OST
UNITS
ROOMS
VAL ATION
SUPP. TO PERMIT
OFFICE
li7-rel
I
MICROFILM FEE
COPIES'
$
LEGAL DESCRIPTION
- •G.raQ `
MECHANICAL FEE-
'
DBL
$
SETBACK
LOT SIZE ZONE
USE NO.
GRP
TYPE CK. BBY
r
J
" PLAN -CHECK FEE
$
BOND AMT.
PLAN NO.-
PLANCHECKER
FINAL DATE - SPECTOR
'
•
t
x-15'
CONSTRUCTION FEE
DBL
$_
NAME OF CONST. LENDER ' BRANCH
OFFICE J.NO
LENDER INVOLVED
✓^'
ELECTRICAL FEE
DBL
$
ADDRESS CITY
STATE
N
SMI FEE
$
°
THIS PERMIT SHALL BECOME VOID _IF WORK IS NOT.COMMENCED WITHIN "60 DAYS. CESSA-
TION OF WORK FOR 120 DAYS SHALL ALSO CAUSE PERMITTO BECOME VOID.
FEE
$
s
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
PLUMBING FEE
DBL
$
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
TOTAL FEES .
HAS DONE SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS
_'CODF
OF THESTATE OF CALIFORNIA.
CASH CHECK ❑i M.O. ❑, : N.C. ❑
OWNER" -OL bk
a
F a`
CONTRACTOR -
RECEIVED BY `
A,D +DRESS
T
ADDRESS -
SEWAGE SYSTEM T
LL
P
0 Jul—*
TREES REQUIRED YES
NO
cl
'41
CITY
'
INFORMATION
TEL. NO. (
TEL. NO. LICENSE
f1
FORM 284-2081Rev. 11/721