268510 (SFD)BUILDING PERMIT
CONSTRUCTION ESTIMATE
I ST FL. SOFT. @ f
2ND FL. SO. FT. @
POR. 02 SO. FT. @
GAR.SO. FT. @
CAR P. SO.FT. @
WALL SQ. FT. @
SQ. FT. @
ESTIMATED CONSTRUCTION VALUATION $
NOTE: Not to be used os property tax voluotion
MECHANICAL FEE!
VENT SYSTEM ❑ FAN ❑ EVAP. COOL
DEPARTMENT OF BUILDING & SAFETY
COUNTY OF RIVERSIDE .18
FIELD OFFICE
2A Y'c2
02 NO. ELECTRICAL FEES
NO. PLUMBING FEES
,,
E x
UNITS
USE OF PERMIT
� '� � C� �pQgeT 601
F.C.
DATE
�'s - %�
YARD SPKLR SYSTEM
76
- MOBILEHOME SVC.
BAR SINK
LAUNDRY TRAY
POWER OUTLET
ROOF DRAINS
D
J
DRAINAGE PIPING
COMMU IT
4Oiv
IDLE METER
DRINKING FOUNTAIN
KITCHEN SINK
VALUATION Nn
iia
URINAL
OFFICE
,9 --
WATER PIPING
SWIM POOL. PVT
FLOOR DRAIN
WATER CLOSET
SWIM POOL. COMM
WATER SOFTENER
HOOD
SIGN
WASHER (AUT(*DISH)
DST
I/.
J F M A M J J A S O N D
APPLIANCE
2A Y'c2
00
ij u� /�fFNDU.�
,,
E x
GARBAGE DISPOSAL
USE OF PERMIT
� '� � C� �pQgeT 601
F.C.
DATE
�'s - %�
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR SUSPENDED
76
,
LAUNDRY TRAY
M H PERMIT FEE
AIR HANDLING UNIT
CFM
COMMU IT
4Oiv
IDLE METER
UNITS
KITCHEN SINK
VALUATION Nn
iia
(�
OFFICE
ABSORPTION SYSTEM
0 B.T.U.
-TEMP USE PERM SVC
I Al
WATER CLOSET
7
b
;LI /o
COMPRESSOR
HP
l3fJ
POLE, TEMP/PERM
$
LAVATORY
O
HEATING SYSTEM FORCED ❑ GRAVITY
D
SD AMPERES SERV ENT
00
SHOWER
iii
$
17
BOILER � B.T.U.
SET BACK
LOT SIZE ZO
SQ FT @ ¢
USE NO.
BATH TUB
Gt'J
5
SQ FT @ a
XD �3
WATER HEATER
O
PLAN CHECK FEE
.
SQ FT RESID
$
y
SEWAGE DISPOSAL
D
PLAN NO.
PLAN CHECKER
FINAL DATE
I ECTOR
,?90 SQ FT GARAGE @ ¢
.7
HOUSE SEWER
PERMIT FEE
aQ
CONSTRUCTION FEE
r----'.....
$
GAS PIPING
NAME OF CONST. LENDER BRANCH
OFFICE
MOBILE HOME PERMIT FEE
$
1 a p
040
3 19DI
PERMIT FEE
'.
10
2 PER6L0.1
E�j
/FT?
MOB. HM.FEE
MICRO FEE
M�'p FnE
IDBL.lWtol
� OONS .FbE
a to
DBL
ELECT. €fj
;27
DBL.
� MI F,F�
FEE;L�U�Q.F3E
STRONG MOTION
INSTRUMENTATION FEE
DBL.
J F M A M J J A S O N D
.IOB ADDRESS 1� SP NO
�•�~l3 �D
OWN
7a
ij u� /�fFNDU.�
,,
E x
7rj
USE OF PERMIT
� '� � C� �pQgeT 601
F.C.
DATE
�'s - %�
PE IT O.
� 8 510
76
,
M H PERMIT FEE
$
COMMU IT
4Oiv
DST ,
/l
UNITS
ROOMS
VALUATION Nn
iia
SUPP. TO PERMIT
OFFICE
I Al
/
;LI /o
MICROFILM FEE
COPIES
$
LEGAL DESCRIPTION
MECHANICAL FEE
DBL
$
17
Ov
SET BACK
LOT SIZE ZO
E
-/
USE NO.
GRP
TYPE BY
5
XD �3
PLAN CHECK FEE
.
ADo
$
y
av
BOND AMT.
PLAN NO.
PLAN CHECKER
FINAL DATE
I ECTOR
aQ
CONSTRUCTION FEE
DBL
$
NAME OF CONST. LENDER BRANCH
OFFICE
NO LENDER INVOLVED
1 a p
040
'.
ELECTRICAL FEE
DBL
$
ADDRESS CITY
STATE
a7
1y
STRONG MOTION
INSTRUMENTATION FEE
$
/
J
OWNER/AGENT'S SIGNATURE
CONTRACTOR
J'
$
ADDRESS��
ADDRESS
FEE
111 — V I 'Q //A--- A _,OWE
PLUMBING FEE
DBL
$
CITYCODE
/%w t
CIT v ZIP CODE
TOTAL FEES
$
TEL NO.
TEL. NO. LICENSE
CASH ❑ C ECK M.O. ❑ N.C. ❑
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSA
AN OF WORK FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
RECEIVED BY
TREES REQUIRED (3
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
/(J� t�
TP �X )Y
T
LL
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) @L HAS DONE SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS. CODE
J
OF THE STATE OF CALIFORNIA.