230134 (SATT)BUILDING PERMIT
CONSTRUCTION ESTIMA.-T
l ST F.L.
SQ. FT. (gy�
2ND FL.
SQ. FT. Ci0
POR. '
SQ. FT.
GAR.
SQ.FT.
CAR P.
SQ. FT. t7a
WALL
SQ.FT.
40�
SQ. FT. Cia
ESTIMATED CONSTRUCTION VALUATION
NOTE: Not to be used as property tax valuation
MFC'HANIC-AI FFFS
DEPARTMENT OF BUILDING & SAFETY
COUNTY OF RIVERSIDE 18 ,
,, ,.ELECTRICAL FEES ,,,- .
v/ 7'7/4M NO. I NO.
MOTOR I OR LESS H.P.
B MOTOR 5 OR LESS H.P.
MOTOR 20 OR LESS H.P.
D K.W. UNITS
FIELD OFFICE
PLUMBING FEES
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
FLOOR DRAIN
WATFR SOFTFNFR
DST _
MOBILE MOMS MUUKUP htt 11 . I 1 1 ? I HtKMI I rtt I ---ff I ff 6v 1 6 I HtHMn I-tt I ;/ 14 a
P N
VENT SYSTE . "i�'FAN ❑ EVAP. COOL '9HOOD
MOB. HK. FEE MICRO FEE MECH. FEE -.198L.
SIGN
CONST. FEE
WASHER (AUTOPDISH)
go 0
SMI FEE
APPLIANCE
®
FORMER O K.W.
GARBAGE DISPOSAL
40�
FURNACE ❑ UNIT ❑ WALL ❑FLOOR ❑ USPENDED
OUTLETS
-
LAUNDRY TRAY
AIR HANDLING UNIT = -I CFM
JOB ADDRESS
-7r— 4
FIXTURE OR SOCKET
73
KITCHEN SINK
USE OF BUILDINGDATE
i.'
GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
PE�tN 0134 134
CONST. SERV. ENTRANCE
7 5
WATER CLOSET
yl5v
$
COMPRESSOR HP
COMMUNITY
POLE
ROOMS
LAVATORY
�'f3
APPLIANCE VENT
AMPERES SERV. ENT.
SHOWER.
I
—6 ...o
ABSORPTION SYSTEM 0 B.T.U.
MICROFILM FEE
SQ. F.T. @ ¢
7
BATH TUB
8 <
INCINERATOR ❑ DOMESTIC ❑ INDUS. OR COMM.
SO. FT. @
.-.
v �� 6 m
WATER HEATER
DBL
$
HEATING SYSTE FORCED ❑GRAVITY
SETBACK
f SQ. FT. RESID. @
1
SEWAGE DISPOSAL
AO d
TYPE
BOILER 0 B.T.U.
SQ. FT. GARAGE @/2
HOUSE SEWER
PERMIT FEE
BALANCE OF MIN. FEE
GAS PIPING
s R
MOBILE MOMS MUUKUP htt 11 . I 1 1 ? I HtKMI I rtt I ---ff I ff 6v 1 6 I HtHMn I-tt I ;/ 14 a
P N
TOTAL FE
MOB. HK. FEE MICRO FEE MECH. FEE -.198L.
PL. CK. F!4.5[
CONST. FEE
DBL.
ELECT. FEE DBL.
SMI FEE
FEE PLUMB. FEE
DBL.
40�
-
G
J I F I M' A I M I J I J- A I S 1 O 1 N D
JOB ADDRESS
-7r— 4
OWNER-
+ ;r
73
74
USE OF BUILDINGDATE
i.'
y 4-1- 7
PE�tN 0134 134
7 5
M.H. HOOKUP FEE
$
COMMUNITY
DST UNITS
ROOMS
VALUATION - SUPP. TO PERMIT
OFFICE
I
—6 ...o
MICROFILM FEE
CIOPIES
$
LEGAL D P 10
.-.
v �� 6 m
MECHANICAL FEE
DBL
$
SETBACK
.LOT SIZE zoffE
USt NO.
GRP
TYPE
Z1.
-
s R
PLAN CHECK FEE.
$F
BOND AMT.
PLAN NO.
PLAN CHECKER -
FINAL DATE INSPECTOR
l/i]
AN
— a ^ %
' -
"
�.-
CONSTRUCTION FEE
DBL
$,
NAME OF CONST. LENDER BRANCH
Ile.f -94 jM
OFFICE .NO
LENDER INVOLVED t "
ELECTRICAL FEE
DBL
$
ADDRESSCITY
�fJ j/ jj ISTATE�
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 AC -
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
6
THE LAWS OF THE STATE OF CALIFORNIA COVERING CONTRACTORS IS ALSO GUARANTEED:
I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPLA S SP CIFIC NS
$
TOTAL FEES *',27
7
HAS DONE SO IN ACCORDANCE WITH SECTION 5541 A PROF IONS
CODE OF THE STATE OF CALIFORNIA.
CASH ❑ CHECK 9- M.O.'O, N.C. ❑.
OWNER,
CONTRACTOR
RECEIVED BY
ADDRESS.
ADDRESS
SEWAGE SYSTEM T
LL
P
CITY
CITY•
TREES REQUIRED
YES
NO
�... p
INFORMATIONT
TEL. NO.
TEL. NO. LICENSE
FOR4.2081Rev.IT/721