206155 (ELEC)BUILDING PERMIT DEPARTMENT OF BUILDING & SAFET
0 COUNTY OF RIVERSIDE
CONSTRUCTION ESTIMATE
IST FL.
SQ. FT. Co)
2ND FL.
SQ. FT. @
POR.
SQ. FT. @
GAR.
SQ. FT. @
CAR P.
SQ. FT. @
WALL
SQ. FT. @
SQ. FT. @
ESTIMATED VALUATION is
MECHANICAL FEES
m
ELECTRICAL FEES
MOTOR 1 OR LESS H.P.
MOTOR 5 OR LESS H.P.
MOTOR 20 OR LESS H.P.
K.W. UN
FIELD OFFICE
PLUMBING FEES
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
FLOOR DRAIN
W4TFG Cr1CT{ Kj9rp
VENT SYSTEM ❑ FAN ❑ EVAP.COOL ❑ HOOD
SIGN
WASHER (AUTO) (DISH)
APPLIANCE
TRANSFORMER OK.W.
GARBAGE DISPOSAL
FURNACE ❑ UNITE) 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 S
WATER CLOSET
COMPRESSOR HP
POLE
LAVATORY
APPLIANCE VENT
AMPERES SERV. ENT.
SHOWER
ABSORPTION SYSTEM O B.T.U.
SQ. FT.@ Q
BATH TUB
INCINERATOR ❑ DOMESTIC E] INDUS. OR COMM.
SQ. FT.@ 4.
WATER HEATER
HEATING SYSTEM ❑ FORCED ❑ GRAVITY
SQ. FT. RESID. @ 1 (r
SEWAGE DISPOSAL
BOILER � B.T.U.
SQ. FT.GARAGE @ z Q
HOUSE SEWER
PERMIT FEE
BALANCE OF MIN. FEE
GAS PIPING
MOBILEHOME HOOKUP FEE $ PERMIT FEE 3— PERMIT FEE
PERMIT NUMBER I TOTAL FEES IMOB, HOOK FEE I HEAT & VENT FEE DBl PL. CK. FEE I CONST. FEE DBL ELEC. , DBL FEE PLUMBING FEE DBL
ngi
J F M A M J J A S O
N D
JOB ADDRESS
df e 6,-lfV %<a9
OWNER
/-H Oe.
72
c`3G7CJ 5
QU//vT� r� efc
73
USE OJF BUILDING
F.C.
DATE
IT
PER206155
NO
74
,�-1 ���� �r
3-12-72-1
75
COMMUNITY
DST
UNITS
DOM
VALUATION
SUgPP. TO PERMIT
OFFICE
76
d
2 /
MOBILEHOME
$
L/EGAL%�ESCRIRIPTION �✓ ^- 7- ��"
HOOKUP FEE
f Q %. C< / -.,y•� lj"�/i/%'r�I <5G/L T
DBL
SET BACK
LOT SIZE
ZONE
USE NO.
GRP
TYPE
BY
MECHANICAL FEE
$
�
ICK
O tl--\
F s R
PLAN CHECK FEE
$
BOND AMT.
PLAN NO.
PLAN CHECKER
FINAL DATE INSPECTOR
� -1
};',
12'1'
DBL
NAME OF CONST. LENDER
BRANCH OFFICE
NO LENDER INVO ED
CONSTRUCTION FEE
ELECTRICAL FEE
DBL
$ r,
'>
ADDRESS
CITY STATE
$
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-
DBL
ORNIA. I ALSO AGREE TO CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES.
COMPLIANCE WITH THE LAWS OF THE STATE OF CALIFORNIA OVERING CONTRACTORS
IS ALSO GUARANTEED.
I HEREBY CERTIFY THAT THE INDIVIDUAL PPRE THE P gNDSPECIFI-
CATIONS HAS DONE SO IN ACCORDANCE WIT E5 �E USE US AND
TOTAL FEES $�
PROFESSIONS CODE OF THE STATE OF CALI FOR IA.
r
CASH ❑ CHECK �• M.O. ❑ N.C.'
O ER
/�
(�
CO TRACTOR
, I ,I� f� �
f
Received By �� GaJ6«
A DRESSY
`✓�����,��f
ADDRE 5'i
�±t,/f f f
'�i/
,- -�
Sewage System
T
L
P
lTvp
Trees Required
Yes
No
INFORMATION
/
TEL.
TEL. NO.r
* LICENSE
FORM 284-208 (REV. 4/71) �7 0
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