222823 (SATT)BUILDING PERMIT
DEPARTMENT OF BUILDING & SAFETY
WASHER (AUTO)ODISH)
COUNTY OF RIVERSIDE
CONSTRUCTION ESTIMATE.-.....,, ... ELECTRICAL FEES,.,.,
1 ST FL. SQ. FT. @
y ¢Q NO.
2ND FL. SQ. FT. @`
LAUNDRY TRAY
POR. SQ. FT. @
OJ MOTOR I OR LESS H.P.
GAR. SQ.FT. @
MOTOR 5 OR LESS H.P.
CAR P. SQ. FT. �D
r
MOTOR 20 OR LESS H.P.
WALL SQ.FT. @
POLE
I SQ. FT. @
APPLIANCE VENT
ESTIMATED CONSTRUCTION VALUATION
$ OK K.W. UNITS
NOTE: Not to be used as property tox voluation
SQ. FT. @ ¢
MECHANICAL FEES
INCINERATOR Cl DOMESTIC ❑ INDUS. OR COMM.
FIELD OFFICE
PLUMBING FEES DST. -
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
FLOOR DRAIN
WATER SOFTENER
VENTSYSTEMI,(P_,FAN ❑EVAP. COOL HOOD
SIGN
WASHER (AUTO)ODISH)
APPLIANCE
TRANS- K.W.
FORMER O
GARBAGE DISPOSAL
FURNACE ❑ UNIT ❑ WALL ❑FLOOR ❑SUSPENDED
OUTLETS
LAUNDRY TRAY
AIR HANDLING UNIT CFM
FIXTURE OR SOCKET
KITCHEN SINK
GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
CONST. SERV. ENTRANCE
WATER CLOSET
COMPRESSOR HP
POLE
::p LAVATORY
APPLIANCE VENT
AMPERES SERV. ENT.
SHOWER
ABSORPTION SYSTEM B.T.U.
SQ. FT. @ ¢
BATH TUB
INCINERATOR Cl DOMESTIC ❑ INDUS. OR COMM.
SQ. FT. @ Q
WATER HEATER
HEATING SYSTEM WORCED ❑GRAVITY
SQ. FT. RESID. @ I4
SEWAGE DISPOSAL
BOILER I B.T.U.
SQ. FT. GARAGE @ 1/2Q
HOUSE SEWER
PERMIT FEE lad
BALANCE OF MIN. FEE
GAS PIPING
MOBILE HOME HOOKUP FEE Is
PE@MIT O. TOTAL FEE$ MOB. HK.
222
J-1 F I M A I M 1 J I J A I S
73
74
75
M.H. HOOKUP FEE
JOD ADDRESS
USE OF BUIL
F'tKMll I-ttNtHMII I-tt
PL. CK. FEE CONST. FEE DBL. ELECT. FEE DBL. SMI FEE
j� J 3
P' fd
MICROFILM FEE
COPIES
$
NAME OF CONST. LENDER
LEGAL DERI ON
.NO LENDER INVOLVED
ELECTRICAL FEE
DBL
..
..
MECHANICAL FEE
ADDRESS
O,14,
DBL
$
SMI FEE
LOT SIZE
ZONE NO.�
GRP
TYPE
$
SETBACK
I HE AGREE �lAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN AC.
CORDANCE WITH THE TAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, I ALSO
AGREE TO CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLIANCE WITH
�. PLUMBING FEE
DBL
$
z:j
15V
F S R
THE LAWS OF THE STATE OF CALIFORNIA COVERING CONTRACTORS115 ALSO GUARANTEED.
1 HEREBY CERTIFY THAT THE INDIVIDUAL WHO PRE T LANS ND SPFIC IONS
J'USE
f.
PLAN CHECK FEE
$
+rJ
T F CALIFORNIA.
.
OWNER. CONTRACTOR N _
� ir.t� -- Dei U I �� Cort
CASH ❑ CHECK (�' M.O. ❑ N.C. ❑
GOND AMT. PLAN NO.
I
PLAN CHECKER FINAL DATE
INSPECTO
ADDRESS
o
SEWAGE SYSTEM
T
LL
P
KC
CONSTRUCTION FEE
DBL
$
CITY
TREES REQUIRED
YES
NO
q -I q
- j
S�
' I F®RMTION
FORM 284.2081Rev. 11/72)
I l PT 0
FEE DBL
3
NAME OF CONST. LENDER
BRANCH OFFICE
.NO LENDER INVOLVED
ELECTRICAL FEE
DBL
FTH
ADDRESS
O,14,
CITY -
`h?
STATE
SMI FEE
THIS. PERMIT SHALL BECOME OID IF WORK IS NOT COMMENCED WITHIN 60 DAYS. CESSA-'
TION OE WORK FORS O DAYS ALL ALSO CAUSE PERMIT TO BECOME VOID.
i FEE
$
I HE AGREE �lAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN AC.
CORDANCE WITH THE TAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, I ALSO
AGREE TO CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLIANCE WITH
�. PLUMBING FEE
DBL
$
G p
THE LAWS OF THE STATE OF CALIFORNIA COVERING CONTRACTORS115 ALSO GUARANTEED.
1 HEREBY CERTIFY THAT THE INDIVIDUAL WHO PRE T LANS ND SPFIC IONS
I $
TOTAL FEES
HAS DONE SO IN ACCORDANCE WITH SECTION 55 INE AND I NS
+rJ
T F CALIFORNIA.
.
OWNER. CONTRACTOR N _
� ir.t� -- Dei U I �� Cort
CASH ❑ CHECK (�' M.O. ❑ N.C. ❑
RECEIVED BY'
ADDRESS% ;
-4c'2 �
ADDRESS
o
SEWAGE SYSTEM
T
LL
P
KC
CITY
CITY
TREES REQUIRED
YES
NO
t
KC - 4?' � �(
- j
S�
' I F®RMTION
FORM 284.2081Rev. 11/72)
TEL. N0. `
• "'
TEL. LICENSE
-lNO.
�7 V