222837 (SFD)BUILDING PERMIT DEPARTMENT OF BUILDING & SAFETY FIELD OFFICE
• COUNTY OF RIVERSIDE •
CONSTRUCTION' ESTIMATE -
1 ST FL.
SQ. FL @
2ND FL.
SQ. FT. @
POR.
SQ. FT. @� 251
GAR.
SQ.FT. @ 77
CAR P.
SQ. IT, @
WALL
SQ.FT. @
SQ. FT. @
ESTIMATED CONSTRUCTION VALUATION
$ '�
NOTE: Not to be used as property tax valuation
MFCHANICAL FEES
ELECTRICAL FEES . -x
MOTOR I OR LESS H.P.
MOTOR 5 OR LESS H.P.
MOTOR 20 OR LESS H.P.
O K.W. UNITS
PLUMBING FEES
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
FLOOR DRAIN
WATER SOFTENER
MOBILE HOME HOOKUP FEE 11 1 1 1 . I PtHM11 Ftt I -A!I A fJ 1 A I PtRMII FEE 1 7 1 A ei
IT NO
PE IT NO.
VENTSYSTEM FAN ❑EVAP. COOL {HOOD q
SIGN
DBL.
WASHER (AUTO .ISH)
CONST. FaEREE DBL. ELECT. DBL.
APPLIANCE
TRANS- K.W.
FORMER
FEE PLUMB.
GARBAGE DISPOSAL
/77
FURNACE ❑ UNIT ❑ WALL ❑FLOOR ❑ tSPENDED
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
&I
LAVATORY
_
APPLIANCE VENT
AMPERES SERV, ENT.
F.C.
SHOWER
PERM N
ABSORPTION SYSTEM j B.T.U.
SQ. FT. @
*j
I
BATH TUB
-283
INCINERATOR ❑ DOMESTIC ❑ INDUS. OR COMM.
SQ. FT. @ 4
/
WATER HEATER
HEATING SYSTEM FORCED ❑ GRAVITY
SQ. FT. RESID. @14
ROOMS
SEWAGE DISPOSAL
_
BOILER 0 B.T.U.
SQ. FT. GARAGE @1�s4
HOUSE SEWER
_
PERMIT FEE
BALANCE OF MIN. FEE
/
GAS PIPING
MOBILE HOME HOOKUP FEE 11 1 1 1 . I PtHM11 Ftt I -A!I A fJ 1 A I PtRMII FEE 1 7 1 A ei
IT NO
PE IT NO.
TOTALFEES OB. HK. FEE MICRO FEE
MECH. F
DBL.
PL. CK. FEE
CONST. FaEREE DBL. ELECT. DBL.
SMI��,
FEE PLUMB.
2
/77
JDBL.
J I F I M I A.1 M.!'J I J I A 1 S 1 O -I N.1 D
JOB ADDRESS
f _ tJ►
OWNER
A
73
74E
OF BUILDING
F.C.
ATE
PERM N
75
0
-283
M.H. HOOKUP FEE
$
TOMMUNITY
S
ROOMS
VALUATION SUPP. TO PERMIT
OFFICE
_Jrr
I
1-7
"`7
1
MICROFILM FEE
COPIES
$
LEGALDESCRIPTION
MECHANICAL FEE
DBL
$
SET BACK OT SIZE.Z.O{�,,
if
US o. GRP+
TYPE
CK BY
^y
r
F. 01 s R
o —
+� �j
f'. i/1
PLAN CHECK FEE
$
BOND AMT.
PLAN NO. .PLAN CHECKER
FINAL DATE INSPECTOR
-9-(o--?
r
CONSTRUCTION FEE
DBL
$
NAME OF CONST. LENDER
BRANCH OFFICE .NO
LENDER INVOLVED
.
ELECTRICAL FEE
DBL
$11,
ADDRESS
CrTY STATE
a
SMI FEE
$�
•
THIS PERMIT SHALL BECOME JI) IF WORK IS NOT COMMENCED WITHIN 60 DAYS. CESSg-
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
$
asAGREE
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 PR ARED THE ANS AND SPECIFICATIONS
LL�7
TOTAL FEES
HAS DONE SO IN ACCORDANCE WITH SECTION 5 - 1 B INES PROFESSIONS
T F CALIFORNIA.
CASH ❑ CHECK @9-' M.O. O • N.C. ❑
OWNER. ,
CO TRACTOR
Alp
RECEIVED BY
ADDRESS
ADDRESS
~ -
SEWAGE SYSTEM t T
LL
P
ary
c v -
TREES REQUIRED
YES
NO
t
INF ATI
TEL. NO.
TEL. NO. LICENSE
`
�� ���
FORM 284-208 (Rev. 11/721