236402 (ELEC)BUILDING PERMIT
SQ. FT. @
DEPARTMENT OF BUILDING & SAFETY
COUNTY OF RIVERSIDE
ELECTRICAL FEES
NO. NO.
MOTOR I OR LESS H.P.
MOTOR 5 OR LESS H.P.
ESTIMATED CONSTRUCTION VALUATION Is
NOTE: Not to be used as property tax voluotion
MECHANICAL FEES
VENT SYSTEM ❑ FAN Cl EVAP. COOL Cl 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 0 B.T.U.
INCINERATOR ❑ DOMESTIC ❑ INDUS. OR COMM.
HEATING SYSTEM ❑ FORCED ❑ GRAVITY
BOILER 0 B.T.U.
PERMIT FEE
MOBILE HOME HOOKUP FEE Is
3PRO 2 TOTAL FEES MOB. HK. FEE MICRO FEE
L J I F I M A I M I J I J A I S 1 O N I D
73
74
75
M.H. HOOKUP FEE $
L
JOB ADDRESS
FIELD OFFICE
PLUMBING FEES I DST
MOTOR 20 OR LESS H.P. I DRAINAGE PIPING
CONSTRUCTION ESTIMA
I ST FL.
— /
SQ. FT.
@
2ND FL.
ROOMS
SQ. FT.
FINAL DATE
POR.
FLOOR DRAIN
SQ. FT.
@
GAR.
SIGN
SQ.FT.
@
CAR P.
DE CRIPTION
SQ. FT.
@
f. WALL
LAUNDRY TRAY
SQ.FT.
Cia
SQ. FT. @
DEPARTMENT OF BUILDING & SAFETY
COUNTY OF RIVERSIDE
ELECTRICAL FEES
NO. NO.
MOTOR I OR LESS H.P.
MOTOR 5 OR LESS H.P.
ESTIMATED CONSTRUCTION VALUATION Is
NOTE: Not to be used as property tax voluotion
MECHANICAL FEES
VENT SYSTEM ❑ FAN Cl EVAP. COOL Cl 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 0 B.T.U.
INCINERATOR ❑ DOMESTIC ❑ INDUS. OR COMM.
HEATING SYSTEM ❑ FORCED ❑ GRAVITY
BOILER 0 B.T.U.
PERMIT FEE
MOBILE HOME HOOKUP FEE Is
3PRO 2 TOTAL FEES MOB. HK. FEE MICRO FEE
L J I F I M A I M I J I J A I S 1 O N I D
73
74
75
M.H. HOOKUP FEE $
L
JOB ADDRESS
FIELD OFFICE
PLUMBING FEES I DST
MOTOR 20 OR LESS H.P. I DRAINAGE PIPING
/ l
DRINKING FOUNTAIN
— /
UN
URINAL
K.W. UNITS
ROOMS
WATER PIPING
FINAL DATE
J SPECTOR
FLOOR DRAIN
I
p
WATER SOFTENER
SIGN
WASHER (AUTO) (DISH)
'RA NS -R K.W.
FORMEO
DE CRIPTION
GARBAGE DISPOSAL
OUTLETS
$
LAUNDRY TRAY
FIXTURE OR SOCKET
SET BACK
KITCHEN SINK
CONST. SERV. ENTRANCE
WATER CLOSET
POLE
5 R
LAVATORY
AMPERES SERV. ENT.
SHOWER
SO. FT. @ Q
BATH TUB
SQ. FT. @ 4
CITY
WATER HEATER
— SQ. FT. RESID. @) 4
SEWAGE DISPOSAL
SO. FT. GARAGE @/24
HOUSE SEWER
BALANCE OF MIN. FEE
GAS PIPING
PERMIT FEE
i/ 0
PERMIT FEE
PL CKnFEE
I CONST. FEE
I DBL.
I ELECT. FEE
9.4a
DBL.
SMI FEE
FEE
PLUMB.
/ l
/t
— /
UN
- DST
UNITS
ROOMS
VALUATION '
FINAL DATE
J SPECTOR
I
I
DE CRIPTION
CONSTRUCTION FEE
DBL
$
•� tt
NAME OF CONST. LENDER
SET BACK
LOT SIZE
ZONE
USE NO.
5 R
DBL
$
GRP ITYPE ICK BY
PLAN CHECK FEE
$
1
t 1 /
BOND AMT.
PLAN NO.
PLAN CHECKER
FINAL DATE
J SPECTOR
CONSTRUCTION FEE
DBL
$
NAME OF CONST. LENDER
BRANCH OFFICE
.NO LENDER INVOLVED
I--
ELECTRICAL FEE
DBL
$
G
ADDRESS
CITY
STATE
j 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.
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
�' . FEE
$
PLUMBING FEE
DBL
$
THE LAWS OF THE STATE OF CALIFORNIA COVERING CONTRACTORS IS ALSO GUARANTEED.
I HEREBY CERTIFY THAT THE INDIVIDUALWH EP D TH ANSA SPECIFICATIONS
$
TOTAL FEES
01
C7
Q
HAS DONE SO IN ACCORDANCE WITH SECTION O E B SI S ND PR. ESSIONS
OF THE STATE OF CALIFORNIA.
CASH ❑ CHECKeC' M.O. ❑ N.C. ❑
OWNER,
A TOR
r _
Ofd
RECEIVED BY
ADDRESS I
AfDDRRESS
j
�!r �` "`� '7f�`7���
SEWAGE SYSTEM T
LL
P/
TREES REQUIRED
YES
NO
CITY
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Jar ! .
Cm
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INFORMATION
FORM 284-208 (Re, 11/721 aAdd OIL
TEL. NO. )j
TEL. NO. LICENSE