236220 (MECH)BUILDING PERMIT DEPARTMENT OF BUILDING I& SAFETY
COUNTY OF RIVERSIDE
CONSTRUCTION ESTIMATE,ELECTRICAL FEES.4
1 ST FL.
SQ. FT. @ NO.,
SQ. FT. @
2ND FL.
SQ. FT. @ MOTOR I OR LESS H.P.
POR.
GAR.
MOTOR 5 OR LESS H.P.
SQ.FT. @
CAR P.
SQ. FT. @ MOTOR 20 OR LESS H.P.
WALL
SQ.FT. @
SQ. FT. @
$ F__________jK W. UNITS
E2f'*
STIMA ED CONSTRUCTION VALUATION
NOTE: Not to be used as property tax valuation
MECHANICAL FEES
VENT SYSTEM ❑ FAN ❑EVAP. COOL ❑ HOOD
APPLIANCE
FURNACE ❑UNIT ❑WALL ❑FLOOR ❑SUSPENDED
AIR HANDLING UNIT CFM
GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
COMPRESSOR 0 HP
APPLIANCE VENT
ABSORPTION SYSTEM O B.T.U.
INCINERATOR ❑ DOMESTIC ❑ INDUS. OR COMM.
HEATING SYSTEM ❑ FORCED ❑GRAVITY
BOILER 0 B.T.U.
PERMIT FEE
MOBILE HOME HOOKUP FEE Is
2 3PEJ� 2 o OTAL � 11 MOB. HK. FEE MICRO FEE
J I f I M I A I M
73
74
75
M.H. HOOKUP FEE
MICROFILM FEE
MECHANICAL FEE
PLAN CHECK FEE
CONSTRUCTION FEE
ELECTRICAL FEE
SMI FEE
FEE
PLUMBING FEE
1
JA J V 1 N I V
JOB ADDRESS
/ f�
7 - 7��-
USE OF BUILDING
/ I t
$
COMMUNITY
w
COPIES
$
LEGAL OE I ON -
DBL
$
SET BACK
F �201S r-
$
BO D AMT.
PLAN
DBL
$
NAME OF CONST. LENDE
SIGN
TRANS- K W
FORMER
OUTLETS
FIXTURE OR SOCKET
CONST. SERV. ENTRANCE
POLE
AMPERES SERV. ENT.
SQ. FT. @ Q
SO. FT..@ Q
—SQ. FT, RESID. @ 14
SQ. FT. GARAGE @ /24
BALANCE OF MIN. FEE
PERMIT FEE
PL. CKrFEE CONST. FEE
. J jw
FIELD OFFICE
PLUMBING FEES DST
NO.1 Tit
OWNER /
t• T
F. C. DATE
T�u
SNIT$ ROOMS VALUATION
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
FLOOR DRAIN
WATER SOFTENER
WASHER (AUTO) (DISH)
GARBAGE DISPOSAL
LAUNDRY TRAY
KITCHEN SINK
WATER CLOSET
LAVATORY
SHOWER
BATH TUB
WATER HEATER
SEWAGE DISPOSAL
HOUSE SEWER
GAS PIPING
PERMIT FEE
SMIFEE, FEE
TO PERMIT
3
0 LENDER VOLVED
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.
$ I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS
TOTAL FEESHAS DONE SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS
tCODE OFTHE STATE OF CALIFORNIA.
OWN P,R' CONTRACTOR
CASH ❑ CHECK M.O. ❑ N.C. ❑
RECEIVED BY ADDRESS t! j ADDRESS
SEWAGE SYSTEM T LL P
CI
TREES REQUIRED YES NO
INFORMATION
FORM 284-208 (Rev. 11 /721 'V""'
TEL. NO.