238344 (ELEC)BUILDING PERMIT
'DEPARTMENT OF BUILDING & SAFETY
COUNTY OF -RIVERSIDE
CONSTRUCTION ESTIMATE ELECTRICAL FEES
1 ST FL. SQ. FT. @ NO. N
2ND FL. SQ. FT. @*
POR. SQ. FT. @ MOTOR I OR LESS H.P.
GAR. SQ.FT. @
+ MOTOR 5 OR LESS H.P.
FIELD OFFICE
PLUMBING FEES KDs
CAR P. SQ. FT. @ MOTOR 20 OR LESS H.P. DRAINAGE PIPING ^;
WALL SOFT. @ DRINKING FOUNTAIN
SQ. FT. @ URINAL
ESTIMATED CONSTRUCTION VALUATION $ 0 K.W. UNITS WATER PIPING
NOTE: Not to be used as property tax valuation, FLOOR DRAIN
MECHANICAL FEES ei`o WATER SOFTENER
VENT SYSTEM Cl FAN ❑ EVAP. COOL ❑ HOOD SIGN 1 WASHER (AUTO) (DISH)
APPLIANCE TRANS-. K.W. GARBAGE DISPOSAL
FORMER
FURNACE ❑ UNIT ❑ WALL ❑FLOOR ❑SUSPENDED OUTLETS LAUNDRY TRAY j
AIR HANDLING UNIT CFM FIXTURE OR SOCKET KITCHEN SINK
GAS PIPE Cl NATURAL ❑ L.P.G. ❑ OIL CONST. SERV. ENTRANCE WATER CLOSET
COMPRESSOR HP V POLE + LAVATORY
APPLIANCE VENT AMPERES SERV. ENT. SHOWER 11
ABSORPTION SYSTEM l_.J B.T.U. SQ. FT..@ Q BATH TUB
INCINERATOR ❑ DOMESTIC ❑ INDUS. OR COMM. • SQ. FT. @ Q WATER HEATER
HEATING SYSTEM ❑ FORCED ❑ GRAVITY ESQ. FT. RESID: @1 4 SEWAGE DISPOSAL
BOILER 0 B.T.U. SQ. FT. GARAGE @/24 HOUSE SEWER
PERMIT FEE I . I BALA•NCE OF MIN. FEE GAS PIPING
MOBILE HOME'HOOKUP FEE ". $ J PERMIT FEE PERMIT FEE
P }
TOTAL FEES
MOB. HK, FEE MICRO FEE -
MECH. FEE
DBL.
PL. GWA.FEE
CONST. FEE
DBL.
ELECT. FEE
DBL.
SMI FEE-
FEE ..PLUMB. FEE
DBL. ,
2.3 934
4
�tj
� �
III
a
_ F_ M A M J' -� A S . O- N D•
JOB ADDD'RESS _/q.�-w. +-+- -
ie-)
s
OWNER --
-A—,o
73
4/I 4 om
• 74USE
OF BUILDIN
/1-7
F.C.
DATE
PERM NO
3 3 3 4
4
75
M.H. HOOKUP FEE
$
COMMUNITY . DST UNITS ROOMS VALUATION P. TO PERMIT - OFFICE
;
ISUP
AA �e
IA1
LEGAL DE CRIPa�TI//ON
MICROFILM FEE
COPIES
$
•
�j` q
' .Ii / L'J:CB''' .� �. �� L! '�F.:'l • �� ` (a4� / ^ e,` J� • C' Li S '1111
MECHANICAL FEE
'DBL -
$'
.. SETBACK
LOTSIZ_E
GRP
TYPE
BY
]ZONE
/ JUSENO.
<
ICK
PLAN CHECK FEE .$
BOND AMT. w.
,PLAN N0.
PLAN CHECKER ..
FINAL DATE
- ::.;
•
JINSPECTOR
%/ / a - 7 3
`
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 60 DAYS: CESSA-
TION 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 AC -
CORDANCE WITH.'THE LAWS OF RIVERSIDE COUNTY;AND THE STATE OF CALIFORNIA, I ALSO' 1,
PLUMBING FEE • •
DBL•
$
'
AGREE TO CARRY COMPENSATION INSURANCE UPON 'MY'.. EMPLOYEES. COMPLIANCE -WITH
`_THE LAWS OF THE STATE OF CALIFORNIA,COVERING CONTRACTORS IS ALSO GUARANTEED. 8
1 HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS I
•
$
�.
TOTAL FEES �,
1
'go
HAS DONE SO IN ACCORDANCE' WITH SECTION. 5541' OF THE BUSI AN PROFE ONS
- s
CODE F THE STATE OF CALIFORNIA.' ti _ = .-! /l _ L ; ,
CASH ❑ CHECK. M.O. ❑ - N.C.❑
OWNER, - _
CONTRACTOR f•�' - ' ' "E _
RECEIVED BY }rte-
ADDRESS
ADDRESS
i
♦. j
S'I sMLG if
SEWAGE SYSTEM
«. T
LL
P'
TREES REQUIRED
YES
NO'rA
CITY . c , - p
CITY'
s d1 4
INFORMATION ',
TEL. NO. ..
TEL. NO. - - LICENSE
pg�c P
FORM 284.208 (Re, 1)/721
-
f /,fes