AR (222767)53200 Avenida Martinez
222767
BUILDING PERMIT DEPARTMENT OF BUILDING & SAFETY
• COUNTY OF RIVERSIDE •
CONSTRUCTION ESTIMA.TE..-,
ELECTRICAL FEE-.S,. -.
'1 Si FL. '
2ND FL.
POR.
GAR.
CAR P.
AAy
SQ.
Y f'fTMAT D CONSTRUCTION VALUATION
SQ. FT. @
SO. FT. Cal
NO. NO.
SQ. FT. @
MOTOR 1 OR LESS H.P.
SO.Fi. @
SQ, IT, Cal
MOTOR 5 OR LESS H.P.
MOTOR 20 OR LESS H.P.
SQ.FT. @
LAUNDRY TRAY
FT. @
AIR HANDLING UNIT CFM
$Z
K.W. UNITS
NOTE: Not to be used as property tax valuation
GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
MFCHANICAI FFFS
WATER CLOSET
FIELD OFFICE
PLUMBING FEES
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
FLOOR DRAIN
WATFR SOFTFNFR
MOBILE HOME HOOKUP FEE Is I I I # I PERMIT FEE I _7 I:t/.II I PERMIT FEE I I
E) vtIZjY0. - P
292.7
VENT SYSTEM ❑ FAN ❑EVAP. COOL ❑ HOOD
SIGN
WASHER (AUTO) (DISH)
DBL
APPLIANCE
TRANS-, K.W.
FORMERGARBAGE
DISPOSAL
DBL.
FURNACE ❑ UNIT ❑ WALL ❑FLOOR ❑SUSPENDED
OUTLETS
LAUNDRY TRAY
J.., J. FN I M I A'I M I J -1 J I A S 1 O. I N I D
AIR HANDLING UNIT CFM
FIXTURE OR SOCKET
KITCHEN SINK
~
GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
CONST. SERV. ENTRANCE
WATER CLOSET
75
COMPRESSOR 0 HP
POLE
LAVATORY
APPLIANCE VENT
AMPERES SERV. ENT.
SHOWER
VALUATION '
ABSORPTION SYSTEM B.T.U.
SO. FT. @ ¢
BATH TUB
Y
INCINERATOR ❑ DOMESTIC ❑ INDUS. OR COMM.
SO. FT. @ ¢
WATER HEATER
HEATING SYSTEM ❑ FORCED ❑ GRAVITY
SQ. FT. RESID. @ I ¢
SEWAGE DISPOSAL
_
BOILER 0 B.T.U.
SQ. FT. GARAGE @ /2¢
HOUSE SEWER
PERMIT FEE
BALANCE OF MIN. FEE
GAS PIPING
MOBILE HOME HOOKUP FEE Is I I I # I PERMIT FEE I _7 I:t/.II I PERMIT FEE I I
E) vtIZjY0. - P
292.7
TOTAL FEE
MOB. HK. FEE MICRO FEE
. MECH. FEE
DBL
L. CK. FEE
CONST. F
DBL. ELEC E
DBL.
SMI FEE
ka?
FEE PLUMB. FEE
DBL..
J.., J. FN I M I A'I M I J -1 J I A S 1 O. I N I D
JOB ADDRESS --
OVJN'c j
f ! f"
73
74
USE O BU i G -F.
e /
ATE
N
PER222767
75
M.H. HOOKUP FEE
$
oM I
D$f UNITS
ROOMS
VALUATION '
SUP P iO PERMIT
OFFICE
MICROFILM FEE
COPIES
$
t -r
LEGA E NZcj
_ _
'MECHANICAL FEE
DBL
$
SET BACK
L 512E
ZatY
USE N
GRP
TYPE
Y
ICK
f
F S R
PLAN CHECK FEE
-'
$
00
BOND A.T. TPLA. NO.
PLAN CHECKER
FI AL DATE IN
CONSTRUCTION' FEE
DBL
$
NAME OF CONST. LENDER - BRANCH
OFFICE J.NO
LENDER INVOLVED
ELECTRICAL FEE
DBL
$
•
✓l
ADDRESS CITY
- STATE
'
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 PERMIT TO BECOME VOID.
FEE
$
I HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN AC.
CORDANCE WITH THE LAWS OF',R4VERSIDE 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 FEESHAS
.,.
DONE SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS
CALIFORNIA.
CASH ❑ CHECK M.O. ❑ ' N.C. ❑
OWNER.
J ! ' Wi.Aci
CONTRACTOR
RECEIVED BY
ADDRESS
4
ADDRESS
SEWAGE SYSTEM,
. T
LL
P
clrY
CITY
REQUIRED
YES
NO
' INFORMATION
1y
ORM 284-208 (Re, 11/721
EL. NO. 1
/ / -
TEL. NO. LICENSE