236460 (SFD)BUILDING PERMIT
DEPARTMENT OF BUILDING & SAFETY
COUNTY OF RIVERSIDE
FIELD OFFICE
CONSTRUCTION ESTIMATE.
_
ELECTRICAL FEES_,..-
PLUMBING FEES DST.
IST FL.
2ND FL.
POR. .4 12 0
h
GAR. �
CAR P.
WALL
ESTIMATED CONSTRUCTION
SQ. FT. (
SQ. FT. Cia
NO.
NO. f /
SQ. FT. a =—gyp a'e MOTOR I OR LESS H.P.
� ! ���� MOTOR 5 OR LESS H.P.
SQ.FT.
OO '*
SQ. FT. @ MOTOR 20 OR LESS H.P.
DRAINAGE PIPING
SQ.FT. @a
DRINKING FOUNTAIN
SQ. FT. @
URINAL
VALUATION iiD " OK W. UNITS
/ WATER PIPING v
NOTE: Not to be used os property tox voluotion
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN ❑EVAP. COOL HOOD
p SIGN
WASHER (AUTO)4&eH)
APPLIANCE
? (? FORMER O KK.W.j
GARBAGE DISPOSAL d
FURNACE ❑ UNIT ❑ WALL ❑FL OR ❑SUSPENDED
OUTLETS
LAUNDRY TRAY
AIR HANDLING UNIT
CFM
FIXTURE OR SOCKET '^ KITCHEN SINK ) o
GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
CONST. SERV. ENTRA
WATER CLOSET (j
COMPRESSOR HP
POLE
LAVATORY '� p
APPLIANCE VENT
AMPERES SERV, ENT. SHOWER j
ABSORPTION SYSTEM B.T.U.
SO. FT. @ ¢
l BATH TUB f �O
INCINERATOR Cl DOMESTIC ❑ INDUS. OR COMM.
50. FT. @ d
WATER HEATER 4�
HEATING SYSTEM FORCED ❑ GRAVITY
40e al> • :50. FT. RESID. @ 1 ¢ 14
SEWAGE DISPOSAL d (�
BOILER �_� B.T.U.
SQ. FT. GARAGE @.1/,4D
` HOUSE SEWER
PERMIT FEE
V BALANCE OF MIN. FEE
GAS PIPING /
MOBILE HOME HOOKUP FEE $
PERMIT FEE
PERMIT FEE O
2 P 1 N
3 T 6 0
TOTAL FEES
a/ Jr, R��,o
�OB. HK. FEE MICRO FEE
MECH. FEE
DBL
PL. CKrfEE
s�
CONST. FEE
g �o
DBL.
ELECT. FEE
DBL.
SMI FEE
FEE PLUMB. FEE JDBL.
R fpp
J I F I M A I M I J I J I A I S 1 Q 1
N I D
JOB ^ADDRESS
J 397 lr ��RR-4�
OWNER �j'�r
01)/;r ed gg1V1.' �
73
74
USE OF BUILDING
k-# 6�Aoq,-z
F.
C. DATEPERM
i
N
75
M.H. HOOKUP FEE
$COMMUVITY
DST
I UNITS
I ROOMS
I VALUATION
a
SUPP. TO PERMIT
OFFICE
MICROFILM FEE
COPIES
$
LEGAL DESCRIPTION
/v%' rm t ,E 'S�I1 -S9a1?.4 C.;o tf cs_ TA
MECHANICAL FEE
DBL
$
SETBACK
LOT SIZE WE%
USE NO.
GRP
TYPE
CK BY
F O S
PLAN CHECK FEE
$
BOND AMT.
PLAN NO.
PLAN CHECKER
I FINAL DATE INSPECTOR
' �J
CONSTRUCTION FEE
DBL
$
?-91111
L/yV)
NAME OF CONST. LENDER BRANCH
OFFICE
.NO
LENDER INVOLVED
ELECTRICAL FEE
DBL
$
v (J
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.
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.
1 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 F THE STATE OF CALIFORNIA.
FEE
$
PLUMBING FEE
DBL
$
! TOTAL FEES
$
r
�P
CASH ❑ CHECK] M.O. ❑ N.C. O
OWNER,
CONTRACTOR
1 _ ' /'' f
RECEIVED BY
SEWAGE SYSTEM T LL P
TREES REQUIRED YES NO
I
INFORMATION
FORM 284-208 Wev. 11 /721 Q►./J�n�
AUTYRESSSrS
CITY
r
rEL. NO. LIC NSE