280127 (ELEC)} f '
BUILDING PERMIT
e
DEPARTMENT OF BUILDING & SAFETY
COUNTY OF RIVERSIDE
CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES
ST FL SQ FT @ UNITS
2ND FL.
SO. FT. @
POR.
SQ. FT..
GAR.
SQ. FT. @`
CAR P.
SOFT. @
WALL
SQ. FT. @
CFM
SQ. FT. @
ESTIMATED CONSTRUCTION VALUATION $
NOTE: Not to be used as property tax valuation
ABSORPTION SYSTEM
MECHANICAL FEES
VENT SYSTEM
❑ FAN ❑ EVAP. COOL ❑ HOOD
MOBILEHOME SVC.
POWER OUTLET
SWIM POOL, PVT
SWIM POOL, COMM
SIGN
FIELD OFFICE
D
NO. PLUMBING FEES
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
y DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
FLOOR DRAIN
WATER SOFTENER
WASHFR MI ITnl InISHI
APPLIANCE
JOB ADDRESS SP NO
OWNER
74
GARBAGE DISPOSAL
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
75
76
USE OF PERMIT r
�Af,. �;/tef �� -7--y,
LAUNDRY TRAY
AIR HANDLING UNIT
CFM
IDLE METER
KITCHEN SINK
ABSORPTION SYSTEM
0 B.T.U.
TEMP USE PERM SVC
UNITS
WATER CLOSET
COMPRESSOR
HP
POLE, TEMP/PERM
LAVATORY
HEATING SYSTEM ❑ FORCED ❑ GRAVITY
AMPERES SERV ENT
mg
"A ej�t ff At�
SHOWER
BOILER B.T.U.
SQ FT @ a
BATH TUB
MICROFILM FEE
COPIES
SQ FT @ a.
WATER HEATER
SQ FT RESID @ 1¢
SEWAGE DISPOSAL
MECHANICAL FEE
DBL
SQ FT GARAGE @ 'h4
HOUSESEWER
PERMIT FEE
USE NO.
GRP
GAS PIPING
MOBILE HOME PERMIT FEE
$
_
PERMIT FEE
p Ep I
PERMIT FEE
PE MIT NO.
2 8 612 7
TOTAL FEES
M 08. HM.FEE
MICRO FEE
MECH. FEE
DBL.
PL: CK. FEE
CONST. FEE
DBL.
ELECT. FEE
DBL.
SMI FEE107
fEE
PLUMB. FEE
J I F I M A I M I J I J A I S Q 1 N I D
JOB ADDRESS SP NO
OWNER
74
�f f "° �� � ��
�Vts.:W AX4
75
76
USE OF PERMIT r
�Af,. �;/tef �� -7--y,
F.C.
DATE
-: � _7
P M N
b 127
M H PERMIT FEE
$
COMMUNITY
5/T f
UNITS
ROOMS
VALUATION
SUPP. TO PERMIT
OFFICE
mg
"A ej�t ff At�
/ j
w
MICROFILM FEE
COPIES
$
LEGAL DESCRIPTION 9z- 0 r—,,;- Al -
MECHANICAL FEE
DBL
$
SETBACK
LOT SIZE ZONE
USE NO.
GRP
TYPE
CK BY
4
F IS IR
/
'
PLAN CHECK FEE
$
BOND AMT.
PLAN NO.
PLAN CHECKER
FINAL DATE
INSPECTOR
-11 )h
CONSTRUCTION FEE
DBL
$
NAME OF CONST. LENDER BRANCH
OFFICE
NO LENDER INVOLVED
ELECTRICAL FEE
DBL
$
ADDRESS CITY
STATE
STRONG MOTION
INSTRUMENTATION FEE
$
OWNER/APE N SIGN U
�F
CONTRACTOR
J
�j`f
' ,9 �i '
yL
- �/ sF. L't.� % Jam!' L- % ✓C....�
/ 7 G V
$
ADDRESS
ADDRESS
FEE
PLUMBING FEE
DBL
$
CITY ZIP CODE
CITY ZIP CODE
TOTAL FEES
$
�'
��'
TEL. NO.
TEL. NO. .8 LICENSE
31:1 - /5 -561-5-61 /b
CASH ❑ CHECK Ik— M.O. ❑ N.C. ❑
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSA
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 ALSC
RECEIV
BEES REQUIREDkTION
SEWAG SYSTEM
/�'m
LL
p Ly
AGREE TO CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLIANCE WITH THE
I I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPAREDTHEPLANS AND SPECIFICATIONS
FORM 284-208 (Rev. 10-74) @L HAS DONE SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE
L OF THE STATE OF CALIFORNIA.