242983 (RPL)BUILDING PERMIT
CONSTRUCTION ESTIMATE
I ST FL.
SOFT. @
21ND FL.
SQ. FT. @
POR.
SQ. FT. @
GAR.
SQ. FT. @
CAR P.
SQ.FT. @
WALL
SQ. FT. @
J 0 yl4j Ean
SQ. FT. @
ESTIMATED CONSTRUCTION
VALUATION j
NOTE: Not to be used as property tax valuation
MECHANICAL FEES
PERMIT FEE TEMP ELEC SVC GAS PIPING
VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD
PERMIT FEE ,�! d13 PERMIT FEE
APPLIANCE
DEPARTMENT OF BUILDING St SAFE'
COUNTY OF RIVERSIDE
NO. ELECTRICAL FEES
UNITS
Q0
MOBILEHOME SVC.
POWER OUTLET
SWIM POOL, PVT 3"
SWIM POOL, COMM
SIGN
FIELD OFFICE
NO.I PLUMBING FEES
BOILER I I B.
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
FLOOR DRAIN
WATER SOFTENER
WASHER (AUTO) tDISHI
GARBAGE DISPOSAL
S�>
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED LAUNDRY TRAY
AIR HANDLING UNIT CFM IDLE METER KITCHEN SINK
ABSORPTION SYSTEM 0 B.T.U. TEMP USE PERM SVC WATER CLOSET
COMPRESSOR 0 HP POLE, TEMP/PERM LAVATORY
HEATING SYSTEM ❑ FORCED ❑GRAVITY AMPERES SERV ENT SHOWER
SOFT @ ¢ BATH TUB
SQ FT @ a WATER HEATER ti
SQ FT RESID @ 1¢ SEWAGE DISPOSAL
SQ FT GARAGE @ 'h¢ HOUSESEWER
PERMIT FEE TEMP ELEC SVC GAS PIPING
MOBILE HOME PERMIT FEE $
PERMIT FEE ,�! d13 PERMIT FEE
PERMIT NO.
TOTAL FEES
%+j
MOB. HM. FEE
MICRO FEE
MECH. FEE
DBL.
PL. CK. FEE
CONST. FEE
nr�
DBL,
ELECT. FEE
UFt
DBL.
SMI FEE
FEE FEE
✓�
177.PLUMB.
31
17
�r�6r
J F M A I M I J I i A I S 1 O 1 N D
1011 ADDRESS �("'"' �g'7 _ i ,SP NO
P"A14•.$
o-NEY
73
7 . � 715TI I
74
USE OF PERMIT /
ar, tots/ 402-
F.C.
DATE
�g0 �-�/-7
P
75
M H PERMIT FEE
$
COMMUNITY
DST
UNITSROOMS
VALUATION
SUPP. TO PERMIT OFFICE
MICROFILM FEE
COPIES
$
LEGAL DESCRIPTION
44 # / C' 61;
ter /r 4<9e STS -
MECHANICAL FEE
DBL
$
SET BACK LOT SIZE ZONE
USE NO.
GRP
TYPE
CK BY
F I_ S " R f ,o
�{
}
T
i
PLAN CHECK FEE
$
BOND AMT.
PLAN NO. PLAN CHECKER
FINAL DAT INSP
O ;
/
_ f c7—
y
CONSTRUCTION FEE
DBL
$
NAME OF CONST. LENDER BRANCH
OFFICE
NO LENDER INVOLVED
j/yam`
ELECTRICAL FEE
DBL
$
ADDRESS CITY
STATE
9
49L9
SMI FEE
S
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.
$
FEE
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.
PLUMBING FEE
DBL
$
I 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.
$
OWNER/AGENT'S SIGNATURE
CONTRACT OR
TOTAL FEES
r'L7
CASH ❑ CIH ECK M.O. ❑ N.C. ❑
ADDRESS
ADDRESS
RECEIVED BY
��,�C
TREES REQUIRED
!
CITY ZIP CODE
CITY ZIP COOL
$
SEWAGE SYSTEM
T
LL P
� {
r ✓ 41el rO
INFORMATION
TEL. NO.
TEL. LICENSE
NORM 2840.?OB (Rev. 9731 OPs
.NNO.