258944 (BLCK)BUILDING PERMIT DEPARTMENT OF BUILDING & SAFETY FIELD OFFICE
Aft COUNTY OF RIVERSIDE
CONSTRUCTION ESTIMATE
1 ST FL.
SQ.FT. @
2ND FL.
SQ. FT. @
POR.
SQ. FT. @
GAR.
SQ. FT. @
CAR P.
SQ.FT. @
WALL
SQ. FT. @
400--D
SO. FT. @
ESTIMATED CONSTRUCTION
VALUATION $ �t
NOTE: Not to be used as property tax valuation
MECHANICAL FEES
VENT SYSTEM [I FAN ❑ EVAP. COOL ❑ HOOD
NO. I ELECTRICAL FEES
UNITS
MOBILEHOME SVC.
POWER OUTLET
SWIM POOL, PVT
SWIM POOL. COMM
SIGN
NO.] PLUMBING FEES
BOILER I 1 B.
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
FLOOR DRAIN
WATER SOFTENER
WASHER IAUTOI (DISH)
/I
APPLIANCE GARBAGE DISPOSAL
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED LAUNDRY TRAY
AIR HANDLING UNIT I CFM IDLE METER KITCHEN SINK
ABSORPTION SYSTEM OB.T.U. TEMP USE PERM SVC WATER CLOSET
COMPRESSOR 0 HP POLE, TEMP/PERM LAVATORY
HEATING SYSTEM ❑ FORCED ❑ GRAVITY AMPERES SERV ENT SHOWER
SQ FT @ a BATH TUB
SQ FT @ ¢ WATER HEATER
SQ FT RESID @ I a SEWAGE DISPOSAL
SQ FT GARAGE @ 'ha HOUSE SEWER
PERMIT FEE TEMP ELEC SVC GAS PIPING
MOBILE HOME PERMIT FEE Is
PERMIT FEE PERMIT FEE
RR
TOTALFEESMOB.
J-)
HM. FEE
MICRO FEE
MECH. FEE
DBL.
PL. CK. FEE
CONST. FEE
O
—
DBL.
ELECT. FEE
DBL.
SMI FEE
FEE PLUMB. FEE
DBL
J I F I M A I M I J I J A I 5 1 O 1 N D
JOB ADDRESS SP NO
5C7 G"1t wit 0 AL/MTS 1
olb fP T / ,Pl
N ! 1 f
73
74
USE PERMIT -
x; Qo t.00c)m> f E rvct
F.C.
DATE
-,7-i758944
P
75
M H PERMIT FEE
$
COMMUNITY }
fDST
UNITS I
ROOMS
VALUATION
SUPP. TO PERMIT
OFFICE
MICROFILM FEE
COPIES
$
LEGAL DESCRIPTION _
MECHANICAL FEE
DBL
$
IF
SET BACK
LOT SIE ZONE
USE NO,
GRP
TYPE CK
BY
15 IR
PLAN CHECK FEE
$
BOND AMT.
PLAN NO.
PLAN CHECKER
FINAL DATE INSPECTOR
r
CONSTRUCTION FEE
DBL
$
NAME OF CONST. LENDER BRANCH
OFFICE
NO LENDER INVOLVED
ELECTRICAL FEE
DBL
$
ADDRESS CITY
STATE
SMI FEE
$
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.
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
AGREE TO CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLIANCE WITH THE
LAWS OF THE STATE OF CALIFORNIA COVERING CONTRACTORS IS ALSO GUARANTEED.
1 HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS
HAS DONE SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE
OF THE STATE OF CALIFORNIA.
FEE
$
PLUMBING FEE
DBL
$
TOTAL FEES
$
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OWNER/AGENTjS SI ATURE fj
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CONTRACTOR
CAS ❑
CHECK ❑ M.Q. N.C. ❑
ADDRESS
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ADDRESS
RECEIVED BY 4a. _,, ...
TREES REQUIRED
I
E SYSTEM
SEWAG7
T
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CITY ZIP CODE
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CITY ZIP CODE
INFORMATION
FORM 284-208 (Rev 9.731 Os (ffJ4�frj'/�Q�f ,.�
TEL. NO.
-5 —
TEL. NO. LICENSE