219830 (RPL)BUILDING PERMIT DEPARTMENT OF BUILDING & SAFET FIELD OFFICE
0 COUNTY OF RIVERSIDE (a
CONSTRUCTION ESTIMATE ELECTRICAL FEES PLUMBING FEES
1ST FL.
SQ. FT. @ NO.
2ND FL.
SQ. FT. @
POR.
SQ. FT. @
GAR.
SQ. FT.
CAR P.
SO. FT.
WALL
SQ. FT. @
ZV I M% IIA/ j
CONST. SERV. ENTRANCE
/-; n EG
SQ. FT. @
ESTIMATED VALUATION $ ,2
MECHANICAL FEES
MOTOR 1 OR LESS H.P.
MOTOR 5 OR LESS H.P.
MOTOR 20 OR LESS H.P.
K.W. L
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
FLOOR DRAIN
WATFR SOPTFNFR
VENT SYSTEM ❑ FAN ❑ EVAP.COOL ❑ HOOD
SIGN
WASHER (AUTO) (DISH)
APPLIANCE
TRANSFORMER =K.W.
GARBAGE DISPOSAL
FURNACE❑UNIT ❑WALL❑FLOOR ❑SUSPENDED
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
LAVATORY
APPLIANCE VENT
AMPERES SERV. ENT.
SHOWER
ABSORPTION SYSTEM E:= B.T.U.
SQ. FT.@ ¢
BATH TUB
INCINERATOR ❑ DOMESTIC ❑ INDUS. OR COMM.
SQ. FT.@ ¢.
WATER HEATER
HEATING SYSTEM ❑ FORCED ❑ GRAVITY
SQ. FT. RESID. @ 1 Q
SEWAGE DISPOSAL
BOILER E:= B.T.U.
SQ. FT. GAR AGE IT z'
HOUSE SEWER
PERMIT FEE
BALANCE OF MIN. FEE
GAS PIPING
MOBILEHOME HOOKUP FEE
I$ I 11 •I _ I (PERMIT FEE 4p
"r—I I PERMIT FEE
4x -
PERMIT NUMBER 4.kTAfMES
MOB. HOOK FEE
HEAT & VENT FEE
DBL
PPCK. E
C�
DBL LE�
DBL F:EE
PL U�FEE
�,�r
,� sem, �., .
,fly(/fJ�
75COMMUNITY
,
DST
UNITS
OOM
VALUATION �O
D13 �'
SUPP. TO PERMIT
OFF( E
•J F M A M J J A S O N D
JOB AD RESs
� «P
OWNER
ST"�
72
74
USE'OF BUILDING
.G.C.
vV�
DATE
PERMIT
219
NO.
8 30
�,�r
,� sem, �., .
75COMMUNITY
DST
UNITS
OOM
VALUATION �O
D13 �'
SUPP. TO PERMIT
OFF( E
76
of )v 7,4�
MOBILEHOME
$
LE AL DESCRIPTION / .�j /
� �� l �(p 7
HOOKUP FEE
/ %. f .G�/
DBL
SET BACK
LOT SIZE
IN
USE NO.
GRP
TYPE ICKBY
MECHANICAL FEE
$
F sf R
/tr/y
ow
BOND AMT.
PLAN NO.
PLAN CHECKER
FINAL DATE IN
PECTOR
PLAN CHECK FEE�—
CONSTRUCTION FEE
DBL
NAME OF CONST. LENDER
BRANCH OFFICE
NO LENDER INVOLVED
v
ELECTRICAL FEE
DBL
no
V
$7
ADDRESS
CITY STATE
1
$
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 60 DAYS.
�(�
CESSATION 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 ACCORDANCE WITH THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIF -
ORNIA. 1 ALSO AGREE TO CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES.
DBL
/
PLUMBING FEE
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 SPECIFI-
CATIONS HAS DONE SO IN ACCORDANCE WITH SECTI.0).N>55Y OF THE ,B6S'I1 A
Oq
TOTAL FEES $
(�Y /
PROFESSIONS CODE OF THE STATE OF CALIF 0RNIA.�J� fir+
CASH ❑ CHECKX M.O. � N.C. D
OWNER
CONTRACTOR
Received By
ADDRESS
ADDRESS
00 -7 11461 Y
Sewage System
T
LL
P
CITY
CITY
Trees Required
Yes
No
1,4100
INFORMATION
TEL. NO.
TEL. NO. LICENSE
�/�
/�
974
FORM 284-208 (REV. 4171 Ig v