260608 (PLBG)FIELD OFFICE
BUILDING PERMIT DEPARTMENT OF BUILDING & SAFETY
COUNTY OF RIVERSIDE r
CONSTRUCTION ESTIMATE
I ST FL. SO.FT. @
2ND FL. SQ. FT. @
POR. SQ. FT. @
GAR. SO. FT. @
CAR P. SQ.FT. @
WALLSO. FT. @
SO. FT. @
ESTIMATED CONSTRUCTION VALUATION $
NOTE: Not to be used as property tax valuotion
MECHANICAL FEES
VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD
NO. I ELECTRICAL FEES
UNITS
MOBILEHOME SVC.
POWER OUTLET
SWIM POOL, PVT
SWIM POOL. COMM
SIGN
NO. I PLUMBING FEES
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
FLOOR DRAIN
WATER SOFTENER
WASHER IAUT01 (DISH)
�l
APPLIANCE
J,OB ADDRESS � �� SP NO
c[.�� t
OWNER
GARBAGE DISPOSAL
/ •�- /
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
75
LAUNDRY TRAY
F.C. JDATE
AIR HANDLING UNIT
CFM
IDLE METER
KITCHEN SINK
a :� — 1 15
ABSORPTION SYSTEM
� B.T.U.
TEMP USE PERM SVC
WATER CLOSET
COMMUNITY
COMPRESSOR O
HP
POLE, TEMP/PERM
LAVATORY
SUPP. TO PERMIT
HEATING SYSTEM ❑ FORCED ❑ GRAVITY
AMPERES SERV ENT
SHOWER
BOILER O B.T.U.
t�')/�3r
SQ FT @ ¢
BATH TUB
=�a
SQ FT @ ¢
WATER HEATER
COPIES
$
SOFT RESID @ 1 ¢
SEWAGE DISPOSAL
fits
SQ FT GARAGE @ 'h¢
HOUSE SEWER
DBL
PERMIT FEE
SET BACK
GAS PIPING
MOBILE HOME PERMIT FEE
$
TYPE
PERMIT FEE
PERMIT FEE
?�
PERMIT NO,
26060
TOTAL FEES
:--
MOB. HM.FEE
MICRO FEE
MECH. FEE
DBL.
PL. CK. FEE
CONST. FEE
DBL.
ELECT. FEE
DBL.
SMI FEE
FEE
PLUMB. FEE
1,�00
DBL.
J f M A M J J A S O N D
J,OB ADDRESS � �� SP NO
c[.�� t
OWNER
/ •�- /
75
USE OF PERMIT
F.C. JDATE
PERMIT NO.
260608
76
�L.
E?! �w r31 C ta: c 0 5f i 7
a :� — 1 15
M H PERMIT FEE
$
COMMUNITY
r ST
UNITS
ROOMSVALUATION
SUPP. TO PERMIT
OFFICE
t�')/�3r
=�a
MICROFILM FEE
COPIES
$
LEGAL DESCRIPTION
.le 7 or
MECHANICAL FEE
DBL
$
SET BACK
LOT SIZE ZONE
USE NO.
GRP
TYPE
BY
_
--L,>
R
F S R
PLAN CHECK FEE
$
BOND AMT.
PLAN NO.
PLAN CHECKER
FINAL DATE
INSPECTOR
%U 'e, 7S-
�
EOL-c�.Y._Q ,f2
CONSTRUCTION FEE
DBL
$
NAME OF CONST. LENDER BRANCH
OFFICE
NO LENDER INVOLVED
ELECTRICAL FEE
DBL
$
ADDRESS CITY
STATE
i
STRONG MOTION
$
OWNER/AGENT'S SIGNATURE
CONTRACTOR
INSTRUMENTATION FEE
,--v
r%c-5 1y-.9 6.! it A-
$
$
ADDRESS
ADDRESS -
f
FEE12A7
11:1
PLUMBING FEE
DBL
$
CITY_✓ ZIP CODE
CITY ZIP CODE
fJ
,L
TOTAL FEES
$
� .,.''O^-
f,J �
TEL. NO.
TEL. NO. LICENSE
CASH ❑ CHECK M.O. ❑ N.C. ❑
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSA
ION OF WORK FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID. r
Y� /1�TR
RECEIVED BEES REQUIRED
"' I HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN AC
,✓
SEWAGE SYSTEM
CORDANCE WITH THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA,' I ALSC
T//.1//h LL
P�S .Y/=I
AGREE TO CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLIANCE WITH THI
I I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPAREDTHEPLANS AND SPECIFICATIONS
FORM 284-208 (Rev. 10-74) @L HAS DONE SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE
OF THE STATE OF CALIFORNIA.