232178 (AR)BUILDING PERMIT DEPARTMENT OF BUILDING & SAFETY
COUNTY OF RIVERSIDE
CONSTRUCTION ESTIMATE,_ - . ELECTRICAL FEES --
I ST FL. a 9' SQ. FT. @1J -� �c° �Q� _ NO.
2ND FL. SQ. FT.
POR SQ. FT.
MOTOR I OR LESS H.P.
GAR. SQ.FT.
MOTOR 5 OR LESS H.P.
CAR P. SQ. FT. Cai MOTOR 20 OR LESS H.P.
WALL SOFT. Ca
SQ. FT.
ESTIMATED CONSTRUCTION VALUATION $ & IF
NOTE: Not to be used as property tax valuation
MECHANICAL FEES
VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD
APPLIANCE
FURNACE ❑ UNIT ❑ WALL ❑FLOOR ❑SUSPENDED
AIR HANDLING UNIT I CFM
GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
COMPRESSOR HP
APPLIANCE VENT
ABSORPTION SYSTEM B.T.U.
INCINERATOR ❑ DOMESTIC ❑ INDUS. OR COMM.
HEATING SYSTEM ❑ FORCED ❑ GRAVITY
BOILER 0 B.T.U.
PERMIT FEE
MOBILE HOME HOOKUP FEE Is
I — 1 K.W. UNITS
SIGN
TRANS- K W
FORMER
OUTLETS
FIXTURE OR SOCKET
CONST. SERV. ENTRANCE
POLE
AMPERES SERV. ENT.
SO, FT, U° Q
SO. FT. @ a
SQ. FT. RESID. Cat 1 a
SQ. FT. GARAGE Cia I�,Q
BALANCE OF MIN. FEE
PERMIT FEE
FIELD OFFICE
PLUMBING FEES DsT
N O.
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
FLOOR DRAIN
WATER SOFTENER
WASHER (AUTO) (DISH)
GARBAGE DISPOSAL
LAUNDRY TRAY
KITCHEN SINK
J WATER CLOSET
LAVATORY
SHOWER
BATH TUB
WATER HEATER
SEWAGE DISPOSAL
HOUSE SEWER
GAS PIPING
f PERMIT FEE
P
237178
N
TOTAL FEES
7o 40 --�'
MOB. HK. FEE MICRO FEE
MECH. FEE
DBL
PL. CK. FEE
f =
CONST. FEE
�- �
DBL.
ELECT EE
�
DBL. SMI FEE
�
FEE
PLUMB. FEE
�V
DBL.'
J F I M A M J I J A I S Q 1 N I D
JOB ADDRESSt / 1'
OWNE ;
73
74
USE OF BUILDING �j
00,Sal' T �t/h'.Sr 1?v0AI
.C.
��F
ATE y
% 7 /57-/
PERM75
� �21
7 8
W. H. HOOKUP FEE
$
COMMUNITY
IX l?,wra
DST
P
UNITS
ROOMS
I VALUATION
6 Sal °=
SUPP. TO PERMIT
OFFICE
r
MICROFILM FEE
COPIES
$
LEGAL DESCRIPTION
MECHANICAL FEE
DBL
$
SET BACK
LOT SIZE ZONEUSE
NO.
GRP
TYPE
CK BY
F ab S a Ra �-
P'
PLAN CHECK FEE
$
j
BOND AMT.
PLAN NO.
PLAN CHECKER
I FINAL DATE
CONSTRUCTION FEE
DBL
$
3 "
NAME OF CONST. LENDER BRANCH
OFFICE
NO LENDER INVOLVED
ELECTRICAL FEE
DBL
$J}
q
♦
_/l
S+'
ADDRESS CITY
STATE
SMI FEE _
$
t,0
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.
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
F WE STATE OF CALIFORNIA.
FEE
$
PLUMBING FEE
DBL
$
C)
TOTAL FEES
$
.7
l
0<F
CASH ❑ CHECK M.O. ❑' N.C. ❑
OWNSRR/� ? r✓';. [ , w /•�,. = +-
C6 TRACTOR '
RECEIVED BY f
ADDRESS
f p - z i�5- 6 /k �� •�
ADDRESS
SEWAGE SYSTEM T
LL
P
TREES REQUIRED
YES
NO
CITY
Af YYY �U f e Jvr4 7
CITY
INFORMATION
31't
FORM 284-2081Rev. 111721
TEL. NO.
y rE'1•—
TEL. NO. LICENSE
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