260616 (ELEC)BUILDING PERMIT
DEPARTMENT OF BUILDING & SAFETY=
COUNTY OF RIVERSIDE
CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES
1 ST FL. SQ.FT. @ UNITS
2ND FL. SQ. FT. @
POR. SQ. FT. @ MOBILEHOME SVC.
GAR. SQ. FT. @ POWER OUTLET
CAR P. SQ.FI. @
WALLSQ. FT. @
SQ. FT. @
ESTIMATED CONSTRUCTION VALUATION $
NOTE: Not to be used as property tax valuation
MECHANICAL FEES
VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD
APPLIANCE
SWIM POOL. PVT
SWIM POOL. COMM
SIGN
FIELD OFFICE
O. PLUMBING FEES
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
FLOOR DRAIN
WATER SOFTENER
WASHER IAUTOI IDISHI
GARBAGE DISPOSAL
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
-TOB ADDRESS - SP NO
�'ICI
OWNER' - -
/ j
LAUNDRY TRAY
AIR HANDLING UNIT
CFM
IDLE METER
USE OF P RMIT
KITCHEN SINK
ABSORPTION SYSTEM
0 B.T.U.
TEMP USE PERM SVC
_tc, -/
WATER CLOSET
COMPRESSOR 0
HP
POLE, TEMP/P{Rrir^
LAVATORY
HEATING SYSTEM ❑ FORCED "❑ GRAVITY
AMPERES SERV ENT
-DST ,
SHOWER
'BOILER 0 B.T.U.
VALUATION
SQ FT @ ¢
OFFICE
BATH TUB
SQ FT @ ¢
A4 A
WATER HEATER
SQ FT RESID @ 1 ¢
SEWAGE DISPOSAL
MICROFILM FEE
COPIES
SQ FT GARAGE @ 'h¢
HOUSE SEWER
PERMIT FEE
GAS PIPING
MOBILE HOME PERMIT FEE
$
$
PERMIT FEE
SET BACK LOT SIZE ZONE
PERMIT FEE
PERMIT NO.
260616
TOTAL FEESMOB.
�°
HM.FEE
MICRO FEE
MECH. FEE
DBL.
PL. CK. FEE
CONST. FEE
DBL.
ELECT. FEE
442
DBL.
SMI FEE
FEE
PLUMB. FEE
DBL.
J I F I M A I M I J I J A 1 S 1 OT N D.
-TOB ADDRESS - SP NO
�'ICI
OWNER' - -
/ j
74
7.0 .� riQ J1/ .l G::. ,00 J
s ; K// ITC %
75
USE OF P RMIT
F, C.
DATE
�D--3-7�--
PERMIT NO.
260616'
76
_tc, -/
M H PERMIT FEE
$
COMMUNITY
-DST ,
UNITS
ROOMS
VALUATION
SUPP. TO PERMIT
OFFICE
A4 A
MICROFILM FEE
COPIES
$
LEGAL DESCRIPTION
MECHANICAL FEE
DBL
$
SET BACK LOT SIZE ZONE
USE NO.
GRP
TYPE
CK BY
F S R
PLAN CHECK FEE
$
BOND AMT.
PLAN NO. PLAN CHECKER
FINAL DA
INSPECTOR
CONSTRUCTION FEE
DBL
$
NAME OF CONST. LENDER BRANCH
OFFICE
NO LENDER INVOLVED
ELECTRICAL FEE
DBL
$
ADDRESS CITY
STATE
p
STRONG MOTION
INSTRUMENTATION FEE
$
OWNER/AGENT'S SIGNATURE
CONTRACTOR
FEE
$
ADDRESS
-1-17
/, t93 ,As—
ADDRESS -
PLU MBI NG FEE
DBL
$
CITY ZIP CODE
CITY ZIP CODE
TOTAL FEES
$
U�
TEL. Nq - -
/
/(
TEL. NO. - LICENSE
CASH CHECK ❑ M.O. O N.C. ❑
THIS PERMIT SHALL BECOME VOID IFWORK IS NOT COMMENCED WITHIN 120 DAYS. CESSA
(yFION OF WORK FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID. r
RECEIVED BY
TREES REQUIRED
y Q" I HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN AC
WITH THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, I ALSC
SEWAGE SYSTEMCORDANCE
T
LL
p loft
AGREE TO CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLIANCE WITH THI
r CT Tr — r — , n—J-1ni!--i Tn A`r-T is A i — r i i A n A niTr
I HEREBY CERTIFY•THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS
FORM 284-208 (Rev. 10-74) OP L HAS DONE 50 IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE
OF THE STATE OF CALIFORNIA.