241102 (SFD) Permit RenewalBUILDING PERMIT
DEPARTMENT OF BUILDING & SAFE
COUNTY OF RIVERSIDE
NO. ELECTRICAL FEES
UNITS
MOBILEHOME SVC.
POWER OUTLET
SWIM POOL, PVT
SWIM POOL, COMM
FIELD OFFICE
NO.I PLUMBING FEES
BOILER E
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
FLOOR DRAIN
WATER SOFTENER
// I
CONSTRUCTION ESTIMATE
1ST FL.
SQ.FT. @
i 2ND FL.
SQ. FT. @
POR.
SQ. FT. @
GAR.
SQ. FT. @
CAR P.
SQ.FT. @
WALL
SO. FT. @
SO. FT. @
ESTIMATED CONSTRUCTION VALUATION $
NOTE: Not !o be used as property tax valuation
MECHANICAL FEES
DEPARTMENT OF BUILDING & SAFE
COUNTY OF RIVERSIDE
NO. ELECTRICAL FEES
UNITS
MOBILEHOME SVC.
POWER OUTLET
SWIM POOL, PVT
SWIM POOL, COMM
FIELD OFFICE
NO.I PLUMBING FEES
BOILER E
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
FLOOR DRAIN
WATER SOFTENER
// I
VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD SIGN WASHER (AUTO) (DISH)
APPLIANCE GARBAGE DISPOSAL
FURNACE ❑ UNIT ❑ WALL Cl FLOOR ❑ SUSPENDED LAUNDRY TRAY
AIR HANDLING UNIT CFM IDLE METER KITCHEN SINK
ABSORPTION SYSTEM 0 B.T.U. TEMP USE PERM SVC WATER CLOSET
COMPRESSOR HP POLE, TEMP/PERM LAVATORY
HEATING SYSTEM ❑ FORCED ❑GRAVITY AMPERES SERV ENT SHOWER
SQ FT @ ¢ BATH TUB
SQ FT @ ¢ WATER HEATER
SQ FT RESID @ 1 ¢ SEWAGE DISPOSAL
SQ FT GARAGE @ '/r¢ HOUSESEWER
PERMIT FEE TEMP ELEC SVC GAS PIPING
MOBILE HOME PERMIT FEE Is
I PERMIT FEE PERMIT FEE
P R
IT O.
021
TOTAL FEES
MOB. HM. FEE
MICRO FEE
MECH. FEE
PL. CK. FEE
CONST. FEE
ELECT. FEE
9
D'E�
SMI FEE
FEE PLUMB. FEE
DEL
J I F I M A I M I J I J A I S 1 O 1 N D
JOB ADDRESS SP NO
�� - 3 ra Avr r� r �;.a,v�A I
0wI'*
,l N - 4 /Alit
73
74
U//SE OF PERMIT -1-2
i� �% ce ! /L �fl J- 1
F.C.
DATE ) �y !�
fJ� ` P` ;Z ` /
PERS T NO.
11-0.2
75
M H PERMIT FEE
$
COMMUNITY
,a 4&1A1 -1A
DST
U TS
ROOMS
VALUATION
SUPP. TO PERMIT OFFICE
9y2 r
MICROFILM FEE
COPIES
$
LEGAL DESCRIPTION
MECHANICAL FEE
D$Lr
$
SET BACK
LOT SIZEZONE
USE NO.
GRP
TYPE
CK BY
PLAN CHECK FEE
$
BOND AMT.
PLAN NO.
PLAN CHECKER
FINAL DATE /1,KP' ) �Ml INSPECTOR
CONSTRUCTION FEE
Qj
$
NAME OF CONST. LENDER /�tBRANCH
��
OFFICE
LENDER INVOLVED
ELECTRICAL FEE
gam+
$
ADDRESS CITY
STATTEEb
C..�4-
SMI FEE
$
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSA•
TION OF WORK FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
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
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
HAS DONE SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE
OF;HE;TEQFCALIF FNIA.
FEE
$
PLUMBING FEE
$
"
TOTAL FEES
$
�
04YNR IGN�? �'r `�-/ �.�—`
RY ' M
,g r
/AORr
CONTRACTOR
CASH ❑ CHECK M.O. ClN.C. ❑
ADDRESS
!; y cl, 1
�—y r ei� I• J i r
ADDRESS
RECEIVED BY G41!i
TREES REQUIRED
SEWAGE SYSTEM
T
LL
CITY i1 ! ZIP CODE
7,7
1'3
CITY ZIP CODE
INFORMATION E((((
�
f J
FORM 284-208 'Rev9731 Os
,..LNO.
TEL. NO.
TEL. NO. LICENSE