222838 (SATT)BUILDING PERMIT
CONSTRUCTION ESTIMATE
1 ST FL.
SQ. FT.
2ND FL.
SQ. FT. @
POR.
$q. FT. @ Lr
GAR.
SQ.FT. Cia-7'--�
CAR P.
SQ. FT. @
I WALL
SQ.FT. @
CONST. SERV. ENTRANCE
SQ. FT. @
ESTIMATED CONSTRUCTION VALUATION
POLE
NOTE: Not to be used as property tax valuation
DEPARTMENT OF BUILDING & SAFETY
COUNTY OF RIVERSIDE
ELECTRICAL FEES.
a n &/,:i'3 NO.
MOl,OR I OR LESS H.P.
MOTOR 5 OR LESS H.P.
MOTOR 20 OR LESS H.P.
K.W. UNITS
FIELD OFFICE
PLUMBING FEES
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
FLOOR DRAIN
WATER SOFTENER
VENT SYSTEM FAN ❑EVAP. COOL RHOOD
IVSIGN
WASHER (AUTO)9PISH)
APPLIANCE
TRANS- K.W.
f-ORMER 0
GARBAGE DISPOSAL
FURNACE ❑ UNIT ❑ WALL ❑FLOOR ❑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 t
COMPRESSOR—► HP
POLE
LAVATORY
_
APPLIANCE VENT
AMPERES SERV. ENT.
SHOWER
ABSORPTION SYSTEM B.T.U.
SQ. FT. @ Q
J BATH TUB
INCINERATOR ❑ DOMESTIC ❑ INDUS. OR COMM.
SO. FT. @
WATER HEATER
HEATING SYSTEM E5KFORCED ❑ GRAVITYL/j(j
SQ. FT. RESID. @) Q
SEWAGE DISPOSAL
BOILER 0 B.T.U.
SQ. FT. GARAGE Cia 1/2d
HOUSE SEWER
PERMIT FEE
BALANCE OF MIN. FEE
GAS PIPING
MOBILE HOME HOOKUP FEE Is I 1 1 i I PtRMn Ftt I %f I A t31 j I PLRMI I Fitt I J IA /J
PZ
293
8102
TOTAL FEES
&5� P"i
MOB. HK. FEE17,
MECH. FEE
DBL
PL. CK. FEE CONST. FEE
J//
DBL.
i
ELECT. FEE DBL.
J.
SMI FEE
FEE
PLUMB. FEE DBL.
1 I F I M
A I M I J I J
A 1 $ 1 O N I D
JOB ADDRESS �+ 1—
r. T7 A :/:2,,
OWNER -
J s�Y
73
74
USE OF BUTLDING �
F.C.
DATE
PERMV, N�
75
M.H. HOOKUP FEE
$
OMMUNITY
'DST
' UNI
ROOMS
VALUATION SUPP. TO PERMIT OFFICE
I
MICROFILM FEE
COPIES
$
-LEGAL DRI TION
.. O j
MECHANICAL FEE
DBL
$
SET BACK
LOT SIZE
USE NO.
GRP
TYPE
CK BY
1;?/NE
/
F S� R
PLAN CHECK FEE
$
4
BONO AMT.
PLAN NO.
PLAN CHECKER
FINAL EFATE INSPECTOR
q-6,-)3
- L,
CONSTRUCTION FEE
DBL
$
NAME OF CONST. LENDER BRANCH
OFFICE .NO
LENDER INVOLVED
rU, Old.
{
ELECTRICAL FEE
DBL
$
ADDRESS CITY
STATE
__1761
s
l
SMI FEE
$
THIS PERMIT SHALL BECOME V IF WORK IS NOT COMMENCED WITHIN 60 DAYS. CESS4A-
TION OF WORK FOR 120 DAYS SHALL 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
$
D G
AGREE TO CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLIANCE WITH
THE LAWS OF THE STATE OF CALIFORNIA COVERING CONTRACTORS IS ALSO GUARANTEED.
I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE P, NS AND SPECIFICATIONS
$
TOTAL FEES
HAS DONE SO IN ACCORDANCE WITH SECTION 5 BUS ESS PROFESSIONS
CODE F THE STATE OF CALIFORNIA.
CASH ClCHECK
M.O. ❑
N.C. ❑
OWNER.
CONAC OR
RECEIVED BY
ADDRESS
ADDRESS
SEWAGE SYSTEM
T
LL
P
CITY.
CITY
TREES REQUIRED
YES
NO
INFRMATION
TEL. NO.
TEL. NO. LICENSE
FORM 284.2081Rev.Il/721