RPL (223012)BUILDING PERMIT
DEPARTMENT OF BUILDING & SAFETY
COUNTY OF RIVERSIDE .
ELECTRICAL FEES..,,:
MOTOR I OR LESS H.P.
MOTOR 5 OR LESS H.P.
MOTOR 20 OR LESS H.P.
W. UNITS
FIELD OFFICE
PLUMBING FEES
NO.
DRAIVGE PIPING
DRINKING FOUNTAIN
URINAL.'
WATER PIPING
FLOOR DRAIN
WATFD InrTP MFR
DST"
f/ '',
CONSTRUCTION ESTIMATE••x,
1 ST FL.-
SQ. FT. @
2ND FL.*
SQ. FT. @
POR.
SQ: FT. @
GAR.
SQ.FT. @
CAR P.
SQ. FT. @
WALL
SOFT. Cal
.4,W4',11 J� '0182oZZSQ.
FT. @
ESTIMATED CONSTRUCTION VALUATION $
NOTE: Not to be used as property tax valuation
CONST. SERV. ENTRANCE
MECHANICAL FEES
DEPARTMENT OF BUILDING & SAFETY
COUNTY OF RIVERSIDE .
ELECTRICAL FEES..,,:
MOTOR I OR LESS H.P.
MOTOR 5 OR LESS H.P.
MOTOR 20 OR LESS H.P.
W. UNITS
FIELD OFFICE
PLUMBING FEES
NO.
DRAIVGE PIPING
DRINKING FOUNTAIN
URINAL.'
WATER PIPING
FLOOR DRAIN
WATFD InrTP MFR
DST"
f/ '',
MOBILE -HOME HOOKUP FEE • 1$ 1 - 11
1 /,I PtRMI I I-tt , I ifl v' 1 / I PERMIT FEE 1 11 &401
P€R O
VENT SYSTEM ❑ FAN O EVAP. COOL ❑ HOOD
SIGN
WASHER (AUTO) (DISH)
MECH. FEE
APPLIANCE
TRANS-. K.W.
FORMER D
GARBAGE DISPOSAL
'
FURNACE ❑ UNIT ❑ WALL ❑FLOOR❑SUSPENDED
OUTLETS
_ LAUNDRY TRAY
.PLUMB. FEE DBL. �
AIR HANDLING UNIT CFM
FIXTURE OR SOCKET
011, 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
OWNER4.
i'Y lC S /.Ao
ABSORPTION SYSTEM 0 B.T.U.
SQ. FT, lrin Q
BATH TUB
F. C.
INCINERATOR ❑ DOMESTIC ❑ INDUS. OR COMM.
SQ. FT. @ d
WATER HEATER r.
75
HEATING SYSTEM ❑ FORCED ❑ GRAVITY
SQ. FT. RESID. @
SEWAGE DISPOSAL
BOILER 0 B.T.U.
SQ. FT. GARAGE Cia 1/2¢
HOUSE SEWER
ROOMS
PERMIT FEE
BALANCE OF MIN. FEE
GAS PIPING
MOBILE -HOME HOOKUP FEE • 1$ 1 - 11
1 /,I PtRMI I I-tt , I ifl v' 1 / I PERMIT FEE 1 11 &401
P€R O
• TOTAL -FEES
MOB. HK. FEE MICRO FEE
MECH. FEE
DBL.
PL. CK. FEE
CONST. FEE
DBL. ELECT. FEE
-DBL.
SMI FEE
" FEE
.PLUMB. FEE DBL. �
--A... -AA I J- -J.-1 A_I_. S 1 .0,.. -W I- D-
JOB ADDRESS
OWNER4.
i'Y lC S /.Ao
73
74
USE OF BUILDING -
F. C.
DATE ,g� _
PERM NO
H
'
12
75
M. H. HOOKUP FEE
$, �`
COMMUNITY'
DDSSTT
UNITS'
ROOMS
VALUATION '-
SUPP. TO PERMIT
OFFICE .
+ ,
�,,
MICROFILM FEE
COPIES
$
LEGAL D CRIPTION'
MECHANICAL.FEE - .
`DBL
$
SET BACK
OT SIZE
ZONE
USE NO.GRP'
-
JT.YPE, LY
PLAN CHECK FEE
$
•'146
Vv
BOND AMT.PLAN NO. .
PLAN CHECKER
FINAL DATE INSPECTOR
CONSTRUCTION. FEE '
DBL
$
���
NAME OF CONST. LENDER BRANCH
s
OFFICE - J.NO
LENDER INVOLVED' -
�.
-ELECTRICAL FEE
,DBL
$
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 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 P AN A D SPE TIONS
$
�Cs
TOTAL FEES-
�.
/
rv'i
i
--.
HAS DONE SO IN ACCORDANCE WITH SECTION 5541 OF S NS
CODE OF THE STATE OF CALIFORNIA.
'
CASH O CHECK M.O. ❑' - N.C. ❑
OWNER,
CONTRACTOR
RECEIVED BY -v •. .a.
ADDRESS
ADDRESS - ..
SEWAGE SYSTEM
T
LL -
P
TREES REQUIRED
YES
No
CITY. -
CITYy ,
- - INFORMATIONTEL.
V49
NO.
TEL. NO. - LICENSE
�
.0"CA11-14
.•+
3 7'�a•/
FORM 284-208 (Re, 1)/721 ( b+cf
_ ' { -..j40