221258 (BLDG)BUILDING PERMIT DEPARTMENT OF BUILDING & SAFETY
COUNTY OF RIVERSIDE '
CONSTRUCTION ESTIMATE, -,ELECTRICAL FEES
1 ST FL.
SIGN
SQ. FT.
(a)
2ND Fl.
GARBAGE DISPOSAL
SQ. FT.
Cia
POR.
AIR HANDLING UNIT I CFM
SQ. FT.
@
GAR.
CONST. SERV. ENTRANCE
SQ.FT.
COMPRESSOR HP
CAR P.
LAVATORY
SQ. FT.
l7a
W Lff;�, (J
ABSORPTION SYSTEM B.T.U.
SQ.FT.
(7a
��jjf
SQ. FT. @ Q
SQ. FT.
Cal
EMP;TED CONSTRUCTION
VALUATION
BOILER 0 B.T.U.
NOTE: Not to be used os property tax voluotion
HOUSE SEWER
MFCHANICAI FFFS
NO.
MOTOR I OR LESS H.P.
MOTOR 5 OR LESS H.P.
MOTOR 20 OR LESS H.P.
K.W. UNITS
FIELD OFFICE
PLUMBING FEES
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
FLOOR DRAIN
WATFR',OPTFNFR
VENT SYSTEM O FAN ❑ EVAP. COOL ❑ HOOD
SIGN
WASHER (AUTO) (DISH)
APPLIANCE
TRANS- K.W.
FORMER D
GARBAGE DISPOSAL
FURNACE ❑ UNIT ❑ WALL OFLOOR ❑SUSPENDED
OUTLETS
LAUNDRY TRAY
AIR HANDLING UNIT I CFM
FIXTURE OR SOCKET
KITCHEN SINK
GAS PIPE ❑ NATURAL O L.P.G. O OIL
CONST. SERV. ENTRANCE
WATER CLOSET
COMPRESSOR HP
POLE
LAVATORY
APPLIANCE VENT
AMPERES SERV. ENT.
SHOWER
ABSORPTION SYSTEM B.T.U.
SQ. FT. @ ¢
BATH TUB
INCINERATOR ❑ DOMESTIC O INDUS. OR COMM.
SQ. FT. @ Q
WATER HEATER
HEATING SYSTEM ❑ FORCED ❑ GRAVITY
SQ. FT. RESID. @ 1 ¢
SEWAGE DISPOSAL
BOILER 0 B.T.U.
SQ. FT. GARAGE @l�y¢
HOUSE SEWER
PERMIT FEE
BALANCE OF MIN. FEE
GAS PIPING
MOBILE HOME HOOKUP FEE 1$ 1 1 I I PERMIT FEE I I 1 I PERMIT FEE I
TOTAL FEE
MOB. HK. FEE MICRO FEE
MECH. FEE
DBL.
PL. CK. FEE
CONST.
DBL.
ELECT. FEE
DBL.
SMI FEE
.FEE
PLUMB. FEE
DBL.
YP
,
J I F I M A I M I
J I J
A I
$ 1 O 1 N D
JOB ADDRESS
OWNER
73
74
USE OF BUILDING F.
!p
C. DATE i ' I
�'
PERM`�L�✓�N (^''
ea Gael
75
M.H. HOOKUP FEE
$
'COMMUNITY
1
S
UNITS
ROOMS
VALUATION SUPP. TO PERMIT
JFFICE
I
MICROFILM FEE
COPIES
$
LEGAL DESCRIPTION
Ei i
MECHANICAL FEE
DBL
$
SET BACK
LOT SIZE ZONE
USE NO.
GRP
TYPE
'
F S R
"
$
PLAN CHECK FEE
BOND AMT.
PLAN NO.
PLAN CHECKER
FINAL DATE INSPECTOR
CONSTRUCTION FEE
DBL
$
NAME OF CONST. LENDER BRANCH
OFFICE .NO
LENDER INVOLVED
��
k
V
ELECTRICAL EEE
DBL
$
-
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.
FEE
$
I HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN PC -
CORDANCE WITH THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, I ALSO
PLUMBING FEE
DBL
$
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
_TH'E
$
TOTAL FEES
HA$^D NE SO IN ACCORB NCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS
CODE OF STATE OF CALIFORNIA.
CASH Cl�- CHECK ❑
M.Q. ❑
' N.C. ❑
OWNER. f / r`
CONTRACTOR
RECEIVED BY
Y6—" � S
ADDRESS
SEWAGE SYSTEM
T
LL
P
..a/i s ' •j '9
CITY
clTv
TREES REQUIRED
YES
NO
INFORMATION
TEL. NO.
TEL. NO. LICENSE
FORM 284.208 IR.v.' 11/721
(7 e..
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