204533 (SFD)DEPARTMENT OF BUILDING & SAFETY
• COUNTY OF RIVERSIDE •
CONSTRUCTION ESTIMATE ELECTRICAL FEES`
1 ST FL. SQ. FT.
2ND FL. SQ. FT. @
POR. SQ.. FT. @
GAR. a SQ.FT. @✓ t�
CAR P. SQ. FT. @
WALL SQ.FT. @
SQ. FT. @
ESTIMATED VALUATION Is ,L
MECHANICAL FEES
VENT SYSTEM 19 -FAN ❑ EVAP. COOL Q'HOOD
APPLIANCE .T , K
FURNACE ❑ UNIT ❑ WALL ❑ FLOgR ❑ SUSPENDED
AIR HANDLING UNIT I CFM
GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
COMPRESSOR HP
APPLIANCE VENT
ABSORPTION SYSTEM O B.T.U.
INCINERATOR ❑ DOMESTIC ❑ INDUS, OR COMM.
HEATING SYSTEM a FORCED ❑ GRAVITY
BOILER B.T.U.
PERMIT FEE
TRAILER ISSUANCE FEE -PERMIT FEE
2103
FIEtD OFFICE
PLUMBING FEES
NO.
PER2
4533
TOTAL FEE Sr REN. TRAILER FEE HEAT @ VENT. FEE
PL. CK. FEE CONST.
FEE
MOTOR I OR LESS H.P.
ELEC. FEE BL.
SPEC. INSP. FEE
PLUMBING FEE
DBL
MOTOR 5 OR LESS H.P.
MOTOR 20 OR LESS H.P.
DRAINAGE PIPING
DRINKING FOUNTAIN
A
..M J.,_ _ .. J _ —..A.-_... - .. S -
M J J A S
O N ...D
'
O N D
URINAL
E::� K W. UNITS
SIZE
USE #
WATER PIPING
OWNER
FLOOR DRAIN
WATER SOFTENER
)
SIGN
WASHER (AUTOY(DISH)
FORMER O K.W.
USE OF BUILDING
DATE
GARBAGE DISPOSAL
J
OUTLETS
LAUNDRY TRAY
f
)1y
FIXTURE OR SOCKET
f
-
KITCHEN SINK
f
CONST. SERV. ENTRANCE
F.C.
WATER CLOSET
VALUATION OFF CE
POLE
LAVATORY
AMPERES SERV. ENT,
j
I oo
SHOWER
SQ. FT. @ 3
%
BATH TUB
SQ. FT. @ d
LEGAL D SCRI PTION ,.
NU 8
WATER HEATER
SO. FT. RESID. @ 14
? t2
q
SEWAGE DISPOSAL
4
SQ. FT. GARAGE @112¢
HOUSE SEWER
fFS
BALANCE OF MIN. FEE
yI
GAS PIPING
DBL
i PERMIT FEE
As,
I
PFRMIT FFF
:1
PER2
4533
TOTAL FEE Sr REN. TRAILER FEE HEAT @ VENT. FEE
PL. CK. FEE CONST.
FEE
DBL.
ELEC. FEE BL.
SPEC. INSP. FEE
PLUMBING FEE
DBL
- _ _ .^ _ w _ ►�
J F M
AM
A
..M J.,_ _ .. J _ —..A.-_... - .. S -
M J J A S
O N ...D
'
O N D
SET BACK
LOT
SIZE
USE #
JOB ADDRESS -
OWNER
)
ZONE
USE OF BUILDING
DATE
PLAN CHECK FEE
. /
tA-jto '
f
)1y
f
-
CHECKED BY
COMMUNITY .0 DISTRICT
F.C.
UNITS
VALUATION OFF CE
MECHANICAL FEE
I oo
DBL
$
R
GP 'TYPE
LEGAL D SCRI PTION ,.
NU 8
CONSTRUCTION FEE '
�2E4T533
q
4
fFS
t- 0
DBL
PLAN CHECKER
SUPP. TO PERMI-
ELECTRICAL FEE
DBL
BOND s
BOND
CASH
PLAN FILE # FINAL
DATE
,
PLUMBING FEE
$
4'
I
JINSPECTOR
TRAILER PERMIT
NAME OF• CONSTRUCTION LENDER
>; °[-E+7 •� -
BRANCH OFFICE
LENDCR
ISSUANCE FEE
f
�'
.r r .S
IND
INVOLV EI•
ADORES 5
CITY -
STATE
FEE
$
TOTAL FEES.
$
^"
THIS PERMIT SHALL BECOME vowl F WORK IS NOT COMMENCED WITHIN 60 DAYS. CESSATION
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 ACCOR-
CASH CHECK M.O. N.C.
❑
❑
DANCE WITH THE LAWS OF RIVERSIDE COUNTY AND T.H.E STATE OF CALIFORNIA. I ALSO AGREE TO
CARRY. COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLIANCE WITH THE LAWS OF THE STATE
RECEIVED BY SEWAGE SYSTEM
7
_
OF CALIFORNIA COVERING CONTRACTORS IS ALSO GUARANTEED.
111'op_�e_APT
LL P
IHEREBY CERTIFY THAT THE INDIVIDUALWHOPREPARED THE PLANS AND SPECIFICATIONS HAS DONE
SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE
INFORMATION
OF CALIFORNIA, ~
OWNER /�•�f •,e/��f
CONTRACTOR
ADDR! S -
r
.M+
ADDRESS
TEL. NO.
TEL. NO.
LICENSE -NO.
FORM 284 208 REV 170 Qh
S