222839 (SATT)BUILDING PERMIT DEPARTMENT OF BUILDING & SAFETY
• COUNTY OF RIVERSIDE •
FIELD OFFICE
CONSTRUCTION ESTIMATE _
ELECTRICAL FEES , .
PLUMBING FEES DST
1 ST FL.
2ND FL.
POR.
GAR.
CAR P.
WALL
ESTIMATED CONSTRUCTION VALUATION
SQ. FT. @
NO:
NO.lz
SQ. FT. @
FIXTURE OR SOCKET
SQ. FT. @ '� $ MOTOR I OR LESS H.P.
GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
fa MOTOR 5 OR LESS H.P.
SQ.FT. @ L
SQ. FT. @ MOTOR 20 OR LESS H.P.
DRAINAGE PIPING
SQ.FT. @
DRINKING FOUNTAIN
SQ. FT. @
URINAL
$ K.W. UNITS
WATER PIPING
NOTE: Not to be used as property tax voluotion
SO. FT. @ Q
FLOOR DRAIN
MFCHANICAL FFFS
SQ. FT. @
WATFR SOFTFNFR
VENT SYSTEM - FAN ❑EVAP. COOL WOOD
SIGN
WASHER (AUTO)IPISH)
APPLIANCETRANS-
FORMER K W
GARBAGE DISPOSAL
FURNACE ❑ UNIT ❑ WALL ❑FLOOR jb SUSPENDED
OUTLETS
LAUNDRY TRAY
AIR HANDLING UNIT I = CFM
FIXTURE OR SOCKET
KITCHEN SINK
GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
CONST. SERV. ENTRANCE
WATER CLOSET
COMPRESSOR HP
POLE
LAVATORY
_
APPLIANCE VENT
AMPERES SERV, ENT.
7 SHOWER ri
+ ABSORPTION SYSTEM B.T.U.
SO. FT. @ Q
f BATH TUB
INCINERATOR ❑ DOMESTIC ❑ INDUS. OR COMM.
SQ. FT. @
WATER HEATER
HEATING SYSTEM WORCED ❑ GRAVITY
SQ. FT. RESID. @) 4
SEWAGE DISPOSAL <
BOILER 0 B.T.U.
SQ. FT. GARAGE @1/2¢
HOUSE SEWER
PERMIT FEE
BALANCE OF MIN. FEE
GAS PIPING
MOBILE HOME HOOKUP FEE 1$ 1 1 1 t 1 PtRMI I t-tt I W In n 1 L I PERMIT FEE • 1 "? I w d7
E IT NO.
TOTAL FEES
B. HK. FEE MICRO FEE
MECH. FEE
DBL.
PL. CK. FEE
CONST. FEE
OBL. ELECT.
SMI FEE
FEE PLUMB. FEE DBL.
,,
2? 8 32
4;BL.
I
J I F I M
7 r
A -I PA I J I J- -A 1 S 1
O 1 .N I D.
JOB ADDRESS. - -
41 %at
OWNER _
73
74
USE OF BU DIN F.C.
►
E
PERM Q, a
�G►283
7$
M.H. HOOKUP FEE
$
COMMUNITY
DST
UNI!S
ROOMS
VALUATION SUPP. TO PERMIT
OFFICE
r .
% e
`
MICROFILM FEE
COPIES
$
LEGAL nMCRIPTION
.. �..
MECHANICAL FEE
DBL
$
LOT
SETBACK
SIZE
ZONE
SE NO.
GRP
TYPE
CK BY
!
F r..
S Z. 4t
$
PLAN CHECK FEE
OND AMT. PAN NO.
PLAN CHECKER
FINAL ATE INSPECTOR
' C Li 3�L
V,
CONSTRUCTION FEE
DBL
$
NAME OF CONST. LENDER BRANCH
OFFICE .NO
LENDER INVOLVED t
Lr
ELECTRICAL FEE
DBL
$
w'ADDRESS
- CITY
STATE
;
SMI FEE
$
THIS PERMIT SHALL BECOME V ID IF WORK IS NOT COMMENCED WITHIN 60 DAYS. CESSA-
TION OF WORK FOR 120 DAYS S� LL 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 W.4TH
Cela
THE LAWS OF THE STATE OF CALIFORNIA COVERING CONTRACTORS IS ALSO GUARANTEED.
1 HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED -THE S AND SPECIFICATIONS
$
TOTAL
FEES
HAS DONE SO IN ACCORDANCE WITH SECTION 55P7 1pd f"6-
BUST ESS A P FESSIONS
STATEO CALIFORNIA. 10 _
CASH ❑
CHECK (3./
M.O. ❑ ,
N.C. ❑
OWNER.
CON RACTOR
3 OF
RECEIVED BY/
ADDRESS
ADDRES
SEWAGE SYSTEM
T
LL
P
CITY -
CITY -
TREES REQUIRED
YES
NO
^
r
4TOLNO.
'
INF�MATI
TEL. NO.
LICENSE
FORM 284.2081Rm 11/72)
I