230123 (SATT)BUILDING PERMIT DEPARTMENT OF BUILDING & SAFETY
COUNTY OF RIVERSIDE
CONSTRUCTION ESTIMATE_ I . ELECTRICAL FEES,
1 ST FL. SQ. FT.
2ND FL. SQ, FT.
POR. SQ. FT.
^* �..Se
GAR. SQ.FT. @-
CAR P. SQ. FT. I@
WALL SQ.FT. @
SQ. FT.
ESTIMATED CONSTRUCTION VALUATION
NOTE: Not to be used as property tax valuation
MECHANICAL FEES
VENT SYSTEMORTAN ❑EVAP. COOL B HOOD
APPLIANCE
FURNACE ❑ UNIT ❑ WALL ❑FLOOR JbSUSPENDED
AIR HANDLING UNIT CFM
GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
COMPRESSOR HP
APPLIANCE VENT
ABSORPTION SYSTEM j B.T.U.
INCINERATOR ❑ DOMESTIC ❑ INDUS. OR COMM.
_ HEATING SYSTEN�,®, FORCED ❑ GRAVITY
_ BOILER BT.U.
PERMIT FEE
MOBILE HOME HOOKUP FEE. S"
NO.
FIELD OFFICE
PLUMBING FEES
MOTOR 1 OR LESS H.P.
TOTAL.FEES
MOB. HK. FEE MICRO FEE' MECH. FEE
-
MOTOR 5 OR LESS H.P.
PL. CK. FEE
9
CONST. FEE
MOTOR 20 OR LESS H.P.
ELECT. FEE DBL.
DRAINAGE PIPING
FEE PLUMB. FEE
DRINKING FOUNTAIN
J I F I M A I M I J I J A I $ 1 Q 1 N I D
JOBADDRESS- --
Li a i re I 4z
URINAL
0 K.W. UNITS
74
WATER PIPING
F.C.
fit?
DATE :
b -G-73
FLOOR DRAIN
01
6 23
WATER SOFTENER
SIGN
WASHER (AUTOgbISH)
TRANS- K.W.
FORMER O
COMMUNITY DST
£)uinta Y3
GARBAGE DISPOSAL
OUTLETS
VALUATION,
35,149.00
LAUNDRY TRAY
FIXTURE OR SOCKET
MICROFILM FEE
KITCHEN SINK
CONST. SERV. ENTRANCE
WATER CLOSET
POLE
+L '
LAVATORY
AMPERES SERV. ENT.
SETBACK
SHOWER
SO. FT. @ d
/
BATH TUB
SQ. FT. @ d
CK BY i
t
Donle
WATER HEATER
SQ. FT. RESID. Cai) d _
PLAN CHECK FEE
SEWAGE DISPOSAL
SQ. FT. GARAGE @1120 'Tj
HOUSE SEWER
BALANCE OF MIN. FEE
PLAN CHECKER FINAL DATE INSPE
—
GAS PIPING
PERMIT FEE AA
1
PERMIT FFF
DST
MITIN O
22.-
TOTAL.FEES
MOB. HK. FEE MICRO FEE' MECH. FEE
-
DBL.
PL. CK. FEE
9
CONST. FEE
DBL.
ELECT. FEE DBL.
SMI FEE-
;2
FEE PLUMB. FEE
DBL."
J I F I M A I M I J I J A I $ 1 Q 1 N I D
JOBADDRESS- --
Li a i re I 4z
OWNER-
WNER-73
R -P
73
74
USE OF BUILDING -
Ondl Aw .& Att/ ersge
F.C.
fit?
DATE :
b -G-73
N PERM
� �
01
6 23
75
M.H. HOOKUP FEE
$
COMMUNITY DST
£)uinta Y3
UNITS
ROOMS
VALUATION,
35,149.00
ISUPP. TO PERMIT
OFFICE '
I
MICROFILM FEE
COPIES
$
LEGAL DESCRIPTION
cIt_1 1
MECHANICAL FEE• '
DBL
$
�n�r�
'ce 4�
SETBACK
LOT SIZE ZONE
-1 I
USE NO.
Var-1 34
JGRP
'
TYPE
CK BY i
t
Donle
F 5
R
PLAN CHECK FEE
$ ..
BOND AMT.
PLAN NO.
PLAN CHECKER FINAL DATE INSPE
—
OR
CONSTRUCTION FEE
DBL
$ell
L
NAME OF CONST. LENDER BRANCH
.wn
OFFICEJ,NOLENDER
INVOLVED -
ELECTRICAL FEE
DBL
$
.
-'va
ADDRESS CITY
/r_5 STT
_ 41 � / ✓ �.' /L: S 4✓%�
TT
, k
SMI FEE
$
V4
THS 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 LAVVS•OF THE STATE OF CALIFORNIA COVERING CONTRACTORS IS ALSO GUARANTEED.
I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS D SPECIFXATIONS
HAS DONE SO IN ACCORDANCE WITH SECTION 5540F SBU S PRSBFESSIONS
r.ODF OF THE STATE TE OF CALIFORNIA.
FEE
$
PLUMBING FEE
DBL
$
00
TOTAL FEES
$
/� t.
CASH ❑ CHECK @P" M.O: ❑' N.C. ❑
OWNER,
CONTRACTOR
RECEIVED BY
ADDRESS
ADD SS'
LOBOx-164
SEWAGE SYSTEM T
LL
P
TREES REQUIRED
YES
NO
CITY -
CITY - -
'Palmt
INFORMATION
RM 284.2081Revr11/721 0
TEL. NO.
TEL. NO. LICENSE
346-6flt}2 225368