217945 (RPL)/
BUILDING PERMIT
CONSTRUCTION ESTIMATEELECTRICAL
DEPARTMENT OF BUILDING & SAFET
COUNTY OF RIVERSIDE
FEES
FIELD OFFICE
PLUMBING FEES
1ST FL.
2ND FL.
POR.
GAR.
CAR P.
WCL
tV
/ Oa
APPLIANCE
SQ. FT. @
GARBAGE DISPOSAL
NO.
NO.
OUTLETS OG
SQ. FT. @ / i,w,- G Ute
PL. CK. FEE
SQ. FT. @ MOTOR 1 OR LESS H.P.
FIXTURE OR SOCKET
SQ. FT. @ MOTOR'5 OR LESS H.P.
PLUMBING FEE.
V
SQ. FT. @ MOTOR 20 OR LESS H.P.
DRAINAGE PIPING
SQ. FT. @
DRINKING FOUNTAIN
SQ. FT. @ I
.T
JURINAL
�O�YTjt's9 OK.W,UNITS I
WATER PIPING
ESTIMATED VALUATION $
AMPERES SERV. ENT.
SHOWER
1 pWIFLOOR
DRAIN Q CJ
SQ. FT.@
MECHANICAL FEES
INCINERATOR ❑ DOMESTIC ❑ INDUS. OR COMM.
I
IWATFrP C()FTFNFR
VENT SYSTEM ❑ FAN ❑ EVAP.COOL ❑ HOOD
SIGN
WASHER (AUTO) (DISH)
I PERMIT FEE
APPLIANCE
TRANSFORMER .=K.W.
GARBAGE DISPOSAL
I TOTAL FEES
�
FURNACE❑UNIT❑WALL❑FLOOR ❑SUSPENDED'
OUTLETS OG
LAUNDRY TRAY
PL. CK. FEE
AIR HANDLING UNIT CFM
FIXTURE OR SOCKET
KITCHEN SINK
PLUMBING FEE.
V
G -4S PIPE E] NATURAL ❑ L.P.G. ❑ OIL
CONST. SERV. ENTRANCE
WATER CLOSET '
�- - �
COMPRESSOR HP
POLE
LAVATORY
APPLIANCE VENT
AMPERES SERV. ENT.
SHOWER
ABSORPTION SYSTEM E:= B.T.U.
SQ. FT.@
BATH TUB
INCINERATOR ❑ DOMESTIC ❑ INDUS. OR COMM.
SQ. FT.@ a.
WATER HEATER
f
HEATING SYSTEM ❑ FORCED ❑ GRAVITY
SQ. FT. RESID. @ 1 (r
SEWAGE DISPOSAL
BOILER E:= B.T.U.
SQ. FT. GARAGE @ i Q
HO'O5'E ='P__ /
�® O U
PERMIT FEE
BALANCE OF MIN. FEE
% GAS PIPING
Q
MOBILEHOME HOOKUP FEE I$ I -I
I ' / IPERMIT FEE I
�I Of/' !
I PERMIT FEE
14,11
Q U
PERMIT NUMBER
I TOTAL FEES
�
I MOB. HOOK FEE
I HEAT & VENT FEE
DBL
PL. CK. FEE
I CONST, FEE
DBL ELEC. F E
DBL FEE
PLUMBING FEE.
V
'
DBL3.2
�, �� - 0/
�
�- - �
9
4
75
COMMUNITY .,.
DST
I UNITS�ROOM1VALUATION,,,,
SUPP. TO PERMIT
OFFICE
76
J F M A M J J A S O
N D
JOB ADDRESS
OWN. f
72
73
USE OF BUILDING
F.C.
DATE
PER IT N
17
5
74
�, �� - 0/
�
�- - �
9
4
75
COMMUNITY .,.
DST
I UNITS�ROOM1VALUATION,,,,
SUPP. TO PERMIT
OFFICE
76
�
��. U yj [G7
i
(00
F
MOBILEHOME
$
LEGAL DESCRIPTION
HOOKUP FEE
��C•� ��-- U — p0
DBL
SET BACK
LOT SIZE
ZONE
GRP
TYPE
CK Y
MECHANICAL FEE
$
JUSENO.
I
I
PLAN CHECK FEE
$
�0
BOND AMT.
PLAN NO.
PLAN CHECKER
FINA�T� INSPECTOR
��-.1,.3
CONSTRUCTION FEE
DBLNAME
$ n) q
OF CONST. LENDER
BRANCH OFFICE
NO LENDER INVOLV' O
/ U
c�
ELECTRICAL FEE
DBL
$
�
ADDRESS
CITY STATEt/
$
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 60 DAYS.
y}�
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
PLUMBING FEE
$
19TH
ORNIA. I ALSO AGREE TO CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES.
/ �
�,.
COMPLIANCE WITH THE LAWS OF THE STATE OF CALIFORNIA COVERING CONTRACTORS
IS ALSO GUARANTEED.
FI-
CATIDNSHEREBY HAS DONIFY E SOH NT THE INDIVIDUAL ACCORDANCE W THHSECT ON RED T07 T ENS SN SS AND
TOTAL FEES S G
�z
(7 `
—r
PROFESSIONS CODE OF THE STATE OF CALIFORNIA.
CASH ❑ CHECKoe M.O.❑ N.C.0
OWNER
�C °ONTTRACTbrA•
Received ByADDRESS
ADDRESS
! % i
Sewage System
T LL
P
CITY
CITY -
Trees Required Yes
No
'
/�
` /��14
INFORMATION
TEL. NO.
TEL. NO.
�,/ ,/I
�J / 'LICENSE
{/�
FORM 284-208 (REV. -4/71) V ►i/+'T4/(6/