222833 (SFD)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.�
GAR.
SQ.FT.
CAR P.
SQ. FT. @
WALL
SQ.FT. @
OUTLETS
SQ. FT. @
ESTIMATED CONSTRUCTION VALUATION
3
NOTE: Not to be used as property tax valuation
MFCHANICAI FFFS
r
MOTOR 1 OR LESS H.P.
MOTOR 5 OR LESS H.P.
MOTOR 20 OR LESS H.P.
K.W. UNITS
FIELD OFFICE
PLUMBING FEES DST
NO.
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
FLOOR DRAIN
WATFR SOFTFNFR
MOBILE HOME HOOKUP FEE 1I I 1 1 I rtrcrvHl rtt I .-�f 1(1+•71 t I FtHMlI rtt 1 __7 I A.4
PE IT NO
VENT SYSTEM FAN ❑EVAP. COOL OOD 4
1 SIGN
MECH. FEE
WASHER (AUT DISH)
Py. CK. FEE
APPLIANCE
FORMER D K.W.GARBAGE
DISPOSAL w
PLUMB. F
FURNACE Cl UNIT ❑ WALL ❑FLOOR SUSPENDED
OUTLETS
LAUNDRY TRAY
3
AIR HANDLING UNIT CFM
FIXTURE OR SOCKET
�is�
KITCHEN SINK
GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
CONST. SERV. ENTRANCEWATER
CLOSET
0-I N D
COMPRESSOR HP
POLE
73
LAVATORY
_
.r
APPLIANCE VENT
AMPERES SERV. ENT.
F.C.
SHOWER
ER
M22283'
ABSORPTION SYSTEM B.T.U.
SQ. FT. Cla Q
`
BATH TUB
INCINERATOR ❑ DOMESTIC ❑ INDUS. OR COMM.
SQ. FT. @ Q
�/
WATER HEATER
HEATING SYSTEM FORCED ❑ GRAVITY 41 ari
SQ. FT. RESID. @ 14
t'
SEWAGE DISPOSAL
COMMUNITY t r DST UNITS ROOMSVALUATION SUPP. TO PERMIT OFFICE
BOILER 0 B.T.U.
SQ. FT. GARAGE @1/2¢/
HOUSE SEWER
PERMIT FEE
BALANCE OF MIN. FEE'
.MICROFILM FEE
GAS PIPING
4 5M2
MOBILE HOME HOOKUP FEE 1I I 1 1 I rtrcrvHl rtt I .-�f 1(1+•71 t I FtHMlI rtt 1 __7 I A.4
PE IT NO
TOTAL FEE
MOB. HK. FEE MICRO FEE
MECH. FEE
DBL.
Py. CK. FEE
CONST. FESS DBL.
ELECT. FEE' DBL.��IF�EEFEE
PLUMB. F
DBL.
22 3�
3
�is�
4Tf
J I F-1 M- -A I M I J I J. A I $
0-I N D
JOB ADDRESS �v-
OWNER
7
73
7
USEOFBULDI G
F.C.
DATE
-
ER
M22283'
5
�
M.H. HOOKUP FEE
$
COMMUNITY t r DST UNITS ROOMSVALUATION SUPP. TO PERMIT OFFICE
3.
LEGAL IOf�
.MICROFILM FEE
COPIES
$
MECHANICAL FEE
DBL
$
SET BACK
LOT SIZE
USE NO.
GRP
TYPE
CK BY
y
�NE'
J
F 5LLENDER
PLAN CHECK FEE - -
$
OND AMT.PLAN
CHECKER
FINAL DATE INSPECTOR
-
��rr
CONSTRUCTION FEE
DBL
$,
-
NAME OF CO
lZA
BRANCH OFFICE .NO
LENDER INVOLVED
ELECTRICAL FEE
DBL
$
ADDRE SCITY
STATE
+
SMI FEE
$ r
''
THIS PERMIT SHALL BECOME V ID IF WORK IS NOT COMMENCED WITHIN 60 DAYS. CESSA-
TION OF WORK FOR 120 DAYS S ALL ALSO CAUSE PERMIT TO BECOME VOID.
FEE
$
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
PLUMBING FEE.
DBL
$ _
AGREE TO CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLIANCE WITH
Uti
THE LAWS OF F THE STATE OF CALIFORNIA COVERING CONTRACTORS IS ALSO GUARANTEED.
i HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREWQD THE PLA ND SPECIFICATIONS
$
TOTAL FEESHAS
�s
..CODE
DONE+SO IN ACCORDANCE WITH SECTION 554 SINE A P FESSIONS
—2-
'
OF THE STATE OF CALIFORNIA.
CASH ❑ CHECK [,
M.O. ❑
N.C. ❑
OWNER.
CONT ACTOR/
"
RECEIVED BY
YYY�
ADDRESS
gDORES
� •
�
SEWAGE SYSTEMT
LL
P
- �-
CITY -
CITY
TREES REQUIRED
YES
NO
f a
+ INF,MATI N
TEL. NO.
.•
TEL. NO. j LICENSE
FORM 284-208 Mm 1 17721
•^
k �