AR (260916)BUILDING PERMIT DEPARTMENT OF BUILDING & SAFETY
i. COUNTY OF RIVERSIDE i
CONSTRUCTION ESTIMATE
1 ST FL. -S'O SQ.FT. @�-
2ND FL. SQ. FT. @
POR.r�A 3AQ SQ. FT. @ OG3 O OQ
GAR. SQ. FT. @
CAR P. SQ.FT. @
WALLSQ. FT. @
----lSQ. FT. @
ESTIMATED CONSTRUCTION VALUATION $ C3 Q
NOTE: Not to be used as property tax valuation
MECHANICAL FEES
VENT SYSTEM O FAN O EVAP. COOL ❑ HOOD
APPLIANCE
FURNACE ❑ UNIT O WALL O FLOOR ❑ SUSPENDED
NO. I ELECTRICAL FEES
UNITS
MOBILEHOME SVC.
POWER OUTLET
SWIM POOL, PVT
SWIM POOL, COMM
SIGN
FIELD OFFICE
NO. PLUMBING FEES
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
FLOOR DRAIN
WATER SOFTENER
WASHER (AUTO) (DISH)
GARBAGE DISPOSAL
LAUNDRY TRAY
AIR HANDLING UNIT
CFM
IDLE METER
KITCHEN SINK
�i,�
NEIN Y//. 6-l�/i h
ABSORPTION SYSTEM
0 B.T.U.
TEMP USE PERM SVC
WATER CLOSET
PERMIT NO.
COMPRESSOR 0
HP
POLE, TEMP/PERM
LAVATORY
/
(;
HEATING SYSTEM ❑ FORCED ❑ GRAVITY
AMPERES SERV ENT
SHOWER
COMMUNITY
L
BOILER B.T.U.
ROOMS
SQ FT @ ¢
BATH TUB
OFFICE
SQ FT @ a
WATER HEATER
J/
/
/05/o
SQ FT RESID @ I¢
SEWAGE DISPOSAL
MICROFILM FEE
COPIES
$
SQ FT GARAGE @ 1/2(1
/ HOUSE SEWER
DBL
PERMIT FEE
SETBACK
GAS PIPING
NO.
MOBILE HOME PERMIT FEE
$
—
PERMIT FEE
PERMIT FEE
(90
2 6I/PLUMB.
01916
TOTAL FEES
MOB. HM.FEE
MICRO FEE
MECH. FEE
DBL.
� C�EE
C. 0��
DBL. E� . FSE
DBL.
SMI
` FEE
EE
DBL.
J I F M A M J J q S O N D
JOB AODRES5 'SP NOOWNER
3/- FYI /Arm
74
�i,�
NEIN Y//. 6-l�/i h
75
US OF PERMIT.1F.C.
JDATE
PERMIT NO.
76 —
�'auv rii S1agov r- ro 134m 0A/
//-/,0-7-5`1260916
M H PERMIT FEE
$
COMMUNITY
DST
I UNITS
ROOMS
I VALUATIONSUPP.
as
TO PERMIT
OFFICE
)A QvIN7A
J/
/
/05/o
r
MICROFILM FEE
COPIES
$
LEGAL DESCRIPTION
�CA-17,3-/0� -- on.z. • �b%-13�-/�(� �NT�1� .171�/r,.�. 2��
MECHANICAL FEE
DBL
$
SETBACK
LOT SIZE ZONEUSE
NO.
GRP
TYPE I
�„
4CKY
F ry S R/O
PLAN CHECK FEE
$
BOND AMT.
PLAN NO.
PLAN CHECKER
FINAL DA — ... 1.
NSPEC OR
7
.S-0
� .a
I���
L,
CONSTRUCTION FEE
DBL
$
NAME OF CONST. LENDER BRANCH
OFFICE
NO LENDE/ INVOLVED
ELECTRICAL FEE
DBL
$
ADDRESS CITY
STATE
STRONG MOTION
$
/0
OWNE AG T'S SIGNATURE ,r
"/ `
CONTRACTOR
INSTRUMENTATION FEE
t-
$
ADDRESS
ADDRESS
FEE
�j
J"/"'/�%%1' Avrs I%N 41,Z
PLUMBING FEE
DBL
$
CITY ZIP CODE
CITY ZIP CODE
/I}
TOTAL FEES
$TEL.
�/ a
NO.
TEL. NO. LICENSE
CASH ❑ CHECK M.O. O N.C. ❑
THIS PERMITT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSA
ION OF WORK FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
AT
RECEIVED BY �
TREES REQUIRED ��4
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 ALSC
SEWAGE SYSTEM
ILL
T
P
AGREE TO CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLIANCE WITH THI
I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS
FORM 284•208 (Rev. 10-74) pL HAS DONE SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE
OF THE STATE OF CALIFORNIA.