274270 (RPL)BUILDING PERMIT
CONSTRUCTION ESTIMATE
I ST FL. L SQ.FT. @
2N SO. FT. @
PQt�R.. �{� I SO. FT. @
GaR. R SO. FT: @
DEPARTMENT OF BUILDING & SAFETY
COUNTY OF RIVERSIDE
NO. ELECTRICAL FEES INO
UNITS
CAR it b v SQ.FT. @
WALL SO. FT. @
SQ. FT. @
ESTIMATED CONSTRUCTION VALUATION $
NOTE: Not to be used os property tax voluotion
MECHANICAL FEES
VENT SYSTEM O FAN Cl EVAP. COOL ❑ HOOD
MOBILEHOME SVC.
POWER OUTLET
SWIM POOL, PVT
SWIM POOL. COMM
SIGN
,FIELD OFFICE
PLUMBING FEES
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
FLOOR DRAIN
WATER SOFTENER
WASHER (AUTO) (DISH)
APPLIANCE
JOBB ADDRESS SP NO
. 3 4/'
OWNER
GARBAGE DISPOSAL
USE OAPERMIT
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
4270
LAUNDRY TRAY
AIR HANDLING UNIT I CFM
IDLE METER
KITCHEN SINK
•ABSORPTION SYSTEM 0 B.T.U.
TEMP USE PERM SVC
COf4PUPnTY � f
WATER CLOSET
UNITS
COMPRESSOR 0 HP
POLE, TEMP/PERM
SUPP. TO PERMIT
LAVATORY
MICROFILM FEE
HEATING SYSTEM ❑ FORCED ❑ GRAVITY
AMPERES SERV ENT
SHOWER
BOILER � B.T.U.
SQ FT @ a
BATHTUB
MECHANICAL FEE
DBL
SQ FT @ ¢
WATER HEATER
LOT SIZE ZOtIEU
SQ FT RESID @ 1 ¢
GRP
SEWAGE DISPOSAL
CK BY
SQ FT GARAGE @ 'h¢
HOUSE SEWER
PERMIT FEE
GAS PIPING
ov.
MOBILE HOME PERMIT FEE $ .
PLAN CHECK FEE
PERMIT FEE
ray
PERMIT FEE
EJ a f.
2 IRM1T f10.�
��� FE5E 5yyt
HM.FEE
ti RO FEE
MECH. FEE
DBL.
COLJSTnF
DBL.
�CT
DBL.
SMI F
FEE
MB
DBL.
J I F I M A I M I J I J A S I O' N I D
74 XT-
JOBB ADDRESS SP NO
. 3 4/'
OWNER
75
USE OAPERMIT
F.0 jl),�
4270
MH PERMIT FEE
$
COf4PUPnTY � f
DST
UNITS
ROOMS
I VALUATI.NND A
SUPP. TO PERMIT
O55yyKC�
MICROFILM FEE
COPIES
$
LEGAL DESCRIPTION -
- off
L -j i,
MECHANICAL FEE
DBL
$
SETBACK
LOT SIZE ZOtIEU
SE NO.
GRP
TYPE
CK BY
v
�{7
PLAN CHECK FEE
$
BOND AMT.
PLAN NO.
PLAN CHECKER
FINAL DA
INSPECTOR
�NO
CONSTRUCTION FEE
DBL
$ 7�J
NAME OF CONST. LENDER BRANCH
OFFICE
LENDER I OLVED
ELECTRICAL FEE
DBL
$
ADDRESS CITY
STATE
STRONG MOTION
$
OWNER AGENT S SIGNAT E !
CONTRACTOR
INSTRUMENTATION FEE
$
ADDRESS
ADDRESS f
FEE
PLUMBING FEE
DBL
$ 9
CITY ZIP CODE
CITY f ZIP CODE
TOTAL FEES
$ 76
TEL. NO.
TEL. No.. _ LICENSE
CASH ❑ CHECK M.O. ❑ N.C. ❑
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSA
TION OF WORK FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
RECEIVED BY r
TREES REQUIRED
f
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 ALSC
��
SEWAGE SYSTEM
TT
LL
P
AGREE TO CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLIANCE WITH THI
A%A/C nC TUC CTATC nC rAl ICn DAIIA rnVCDIAI(1 rnKITDArrn DC IC Al Cn rl IA DAAITGGr\
I I HEREBY CERTIFY THAI THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS
FORM 284-208 (Rem. 10-74) QP L HAS DONE SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE
OF THE STATE OF CALIFORNIA.