224615 (BLCK)BUIl:DING PERMIT
NOTE: Not to be used as property tax valuation
DEPARTMENT OF BUILDING & SAFETY
• COUNTY OF RIVERSIDE •
fes-^ ,- ELECTRICAL FEES—:-^---
MOTOR I OR LESS H.P.
MOTOR 5 OR LESS H.P.
MOTOR 20 OR LESS H.P,
$ I I OK W. UN
MECHANICAL FEES
VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD
APPLIANCE
FURNACE ❑ UNIT ❑ WALL ❑FLOOR ❑SUSPENDED
AIR HANDLING UNIT CFM
GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
_ COMPRESSOR 0 HP
APPLIANCE VENT
ABSORPTION SYSTEM B.T.U.
INCINERATOR ❑ DOMESTIC ❑ INDUS. OR COMM.
HEATING SYSTEM ❑ FORCED ❑GRAVITY
_ BOILER 0 B.T.U.
PERMIT FEE
MOBILE HOME HOOKUP FEE is
29EGIT O. MI
TOTAL FEES MOB. HK. FEE CRO FEE
Jj F I M A I M I J I J A I S 1 O 1 N I D
73
74
75
M.H. HOOKUP FEE $
MICROFILM FEE
CONSTRUCTION ESTIMA
' 1 ST FL.:
GARBAGE DISPOSAL
SQ. FT.
@
2ND FL.
KITCHEN SINK
SQ. FT.
@
POR.
50
SQ. FT.
@
GAR.
SQ. FT. @ Q WATER HEATER
SQ.FT.
@
CAR P.
GAS PIPING
SQ.•FT.
@
WALLAA,
fT
SOFT.
@
DBL.
ELECT. FEE
SQ. FT.
@
ESTIMATED CONSTRUCTION VALUATION
NOTE: Not to be used as property tax valuation
DEPARTMENT OF BUILDING & SAFETY
• COUNTY OF RIVERSIDE •
fes-^ ,- ELECTRICAL FEES—:-^---
MOTOR I OR LESS H.P.
MOTOR 5 OR LESS H.P.
MOTOR 20 OR LESS H.P,
$ I I OK W. UN
MECHANICAL FEES
VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD
APPLIANCE
FURNACE ❑ UNIT ❑ WALL ❑FLOOR ❑SUSPENDED
AIR HANDLING UNIT CFM
GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
_ COMPRESSOR 0 HP
APPLIANCE VENT
ABSORPTION SYSTEM B.T.U.
INCINERATOR ❑ DOMESTIC ❑ INDUS. OR COMM.
HEATING SYSTEM ❑ FORCED ❑GRAVITY
_ BOILER 0 B.T.U.
PERMIT FEE
MOBILE HOME HOOKUP FEE is
29EGIT O. MI
TOTAL FEES MOB. HK. FEE CRO FEE
Jj F I M A I M I J I J A I S 1 O 1 N I D
73
74
75
M.H. HOOKUP FEE $
MICROFILM FEE
COPIES
$
GARBAGE DISPOSAL
MECHANICAL FEE
DBL
$
KITCHEN SINK
PLAN CHECK FEE
WATER CLOSET
$ /
r
50
CONSTRUCTION FEE
DBL
$
SQ. FT. @ Q WATER HEATER
ELECTRICAL FEE
DBL
$
GAS PIPING
SMI FEE
PERMIT FEE
$
DBL
FEE
CONST.
'
DBL.
ELECT. FEE
PLUMBING FEE
DBL
$
PLUMB. FEE
CASH U
RECEIVED BY
TOTAL FEES $'3'f 1-.5-
CHECK M.O. ❑ ' N.C. ❑
SEWAGE SYSTEM T LL P
r,fEES REQUIRED YES N
INFORMATION �T✓`
FORM 284-208 (Rev. 11/721
FIELD OFFICE
PLUMBING FEES DST
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
FLOOR DRAIN
WATER SOFTENER
SIGN
WASHER (AUTO) (DISH)
TRANS- K.W.
FORMER D
GARBAGE DISPOSAL
OUTLETS
LAUNDRY TRAY
FIXTURE OR SOCKET
KITCHEN SINK
CONST. SERV. ENTRANCE
WATER CLOSET
POLE
LAVATORY
AMPERES SERV. ENT.
SHOWER
SO. FT. @ , Q BATH TUB
SQ. FT. @ Q WATER HEATER
SQ. FT. RESID. @I Q SEWAGE DISPOSAL
SQ. FT. GARAGE @1/24 HOUSE SEWER
BALANCE OF MIN. FEE
GAS PIPING
PERMIT FEE . ��
PERMIT FEE
MECH.FEE
DBL
PL.CK.LU%
/.
CONST.
'
DBL.
ELECT. FEE
DBL.
SMI FEE
FEE
PLUMB. FEE
JpBL,
JO A DRESS
,3c3
O -
USE OF BUILDING
F.C.
DATE PERM
-31
N
24,1
COMMUNITY
*4Af �v_,w4ll
DST
UNITS
ROOMS
VALUATION
SUPP. TO PERMIT
OFFICE
LEGAL DESCRIPTION
SET BACK LOT SIZE
7__T7_ R.
ZJO/'NNEE
/
i♦
. —
USE NO.
GRP
TYPE C Y
ITE CAC Vt cL
/-I - 71-?
THIS PERMIT SHALL BECOME VOID -IF. WORK IS NOT COMMENCED WITHIN 60 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.
I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS
HAS DONE O IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS
CODE QFSTATE OF CAf.IFO�RNIA...�...++
OWNER'. $� , Ie ��„� y/ �( �� CONTRACTOR r
J� f/
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CITY
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