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245816 (AR)
BUILDING PERMIT CONSTRUCTION ESTIMATE ' 1 ST FL. �r� SQ.FT. @ 2ND FL. SQ. FT. @ POR. SQ. FT. @ GAR. SQ. FT. @ CAR P. SQ.FT. @ WALL SQ. FT. @ SQ. FT. @ ESTIMATED CONSTRUCTION VALUATION $ NOTE: Not to be used as property tax valuation MECHANICAL FEES VENT SYSTEM. n FAN EVAP. COOL ❑ HOOD DEPARTMENT OF BUILDING & SAFETY 1 COUNTY OF RIVERSIDE A NO. ELECTRICAL FEES UNITS MOBILEHOME SVC. POWER OUTLET SWIM POOL, PVT SWIM POOL, COMM SIGN FIELD OFFICE NO.I PLUMBING FEES BOILER I I B.T.U. BAR SINK ROOF DRAINS DRAINAGE PIPING DRINKING FOUNTAIN - URINAL WATER PIPING FLOOR DRAIN WATER SOFTENER WASHER (AUTOI (DISH) LIA APPLIANCE GARBAGE DISPOSAL FURNACE ❑ UNIT ❑ WALL ❑ FLOOR Cl SUSPENDED LAUNDRY TRAY AIR HANDLING UNIT - CFM IDLE METER KITCHEN SINK ABSORPTION SYSTEM ] B.T.U. TEMP USE PERM SVC WATER CLOSET COMPRESSOR 0 HP POLE, TEMP/PERM LAVATORY HEATING SYSTEM ❑ FORCED ❑GRAVITY AMPERES SERV ENT SHOWER SQ FT @ C BATH TUB SQ FT @ ¢ WATER HEATER SQFTRESID @ 1¢ j�' SEWAGE_DISPOSAL SQ FT GARAGE @ V c HOUSE SEWER PERMIT FEE � �%C TEMP ELEC SVC GAS PIPING MOBILE HOME PERMIT FEE $ PERMIT FEE f,3� PERMIT FEE 4R5110. TOTAL FEES G'Ci MOfi-. HM. FEE /ItCRO fEE MECH. FEE r�f'rT DBL. PL. CK. FEE `` to P? CONST. FEE P6J DBL. ELECT.F " DBL. SMI FEE p+,f FEE PLUMB. FEE DBL J F I M A M I ) I J A I S 1 O N D JOB ADDRESS_ O SP NO fi.S�yrc'Ir£�4/ OW R 7s/—C7'/rhe 74 USE OF PERMIT :' a9.�(� r�+ > . f�u:+!;s F.C. DATE S— fit/ P I Q 11 •� '[ 6 7s,c)./f�Ji M H PERMIT- FEE $ COMMUNITY DST I UNIT ROOMS I VALUATION ISUPP. TO PERMIT 7FFICE MICROFILM FEE COPIES $ LEGAL DESCRIPTION " V rl, T.4 l ^ :l%.9eUlai� Uf i MECHANICAL FEE DBL $ .(i SET BACK LOT SIZE ZONEu5E A" NO, GRP TYPE CK BY F s_ 3� Rl� PLAN CHECK FEE $ �a BOND AMT. PLAN NO, PLAN CHECKER FINAL DATE - INSPECT c;�-j6- CONSTRUCTION FEE DBL $ NAME OF CONST. LENDER BRANCH OFFICE NO LENDER INVOLVED - ELECTRICAL FEE DBL $ ADDRESS CITY STATE SMI FEE $ THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 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 LAWS OF THE STATE OF CALIFORNIA COVERING CONTRACTORS IS ALSO GUARANTEED. 1 HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA. FEE $ PLUMBING FEE DBL $ TOTAL FEES Jam, V OWNER/AGENT'S SIGNATURE • y e• CONTRACTOR CASH CHECK Cl M.O. ❑ N.C. ❑' ADDRESS C�. i ��,.�i 3 /� ' •�i+�.�:► ��{ �. ������ ADDRESS RECEIVED BY TREES REQUIRED `CITY SEWAGE SYSTEM LL P ZIP CODE � /lam'/f21l.�a � C�" CITY ZIP CODE INFORMATION FORM 264-2081Rev.9731 ©s TEL... Ne+++OO.., TEL. NO. LICENSE LIA