222668 (MECH)BUILDING PERMIT
CONSTRUCTION ESTIMA
I ST FL.
SQ. FT. l-
2ND
2ND FL.
SQ. FT. @—
POR.
SQ. FT. @—
GAR.
SQ.FT. @_
CAR P.
SQ. FT. @_
WALL
SQ.FT. @_
AIR HANDLING UNIT ` CFM
SQ. FT. @_
ESTIMATED CONSTRUCTION VALUATION
NOTE: Not to be used as property tax valuation
MFCHANICAL FEE
DEPARTMENT OF BUILDING &SAFETY
• COUNTY OF RIVERSIDE t
v =t ELECTRICAL FEES.,,,,,-,
NO.
e
MOTOR I OR LESS H.P.
MOTOR 5 OR LESS H.P.
MOTOR'20 OR LESS H.P.
K.W. UN
FIELD OFFICE -
PLUMBING FEES •, ..,osT,
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
FLOOR DRAIN
WATFR SOFTFNFR
MOBILE HOME HOOKUP FEE Is I 1 1 1 PERMI I I-tt I I - 1 / 1 PERMIT FEE 1 vj I_
/yP .1lT�•1
VENT SYSTEM ❑ FAN ❑EVAP. COOL ❑ HOOD
SIGN
WASHER (AUTO) (DISH)
DBL.
APPLIANCE
TRANS". K.W.
FORMER 0
GARBAGE DISPOSAL
ELECT... FEE
FURNACE ❑UNIT ❑WALL ❑FLOOR ❑SUSPENDED
OUTLETS
LAUNDRY TRAY _
FEE PLUMB. FEE
AIR HANDLING UNIT ` CFM
FIXTURE OR SOCKET
.KITCHEN SINK
GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
CONST. SERV. ENTRANCE
WATER CLOSET -
COMPRESSOR 0 HP
POLEr
LAVATORY
APPLIANCE VENT
AMPERES SERV. ENT.
SHOWER
_J,. "F- M -A-1, M —J. J A' - S -1 O 1 D
ABSORPTION SYSTEM 0 B.T.U.
SQ. FT. @ ¢
BATH TUB '
74
INCINERATOR ❑ DOMESTIC ❑ INDUS. OR COMM.
SO. FT. @ d
WATER HEATER
^
EATING SYSTEM ❑ _FORCED .❑ GRAVITY
`SQ. FT. RESID. @ 1 ¢
SEWAGE DISPOSAL
,.
BOILER 0 B.T.U.
SQ. FT. GARAGE Lally¢
HOUSE SEWER
VALUATION_
PERMIT FEE _
BALANCE OF MIN. FEE"
GAS PIPING '
MOBILE HOME HOOKUP FEE Is I 1 1 1 PERMI I I-tt I I - 1 / 1 PERMIT FEE 1 vj I_
/yP .1lT�•1
TOTAL FEEpS�'
MOB. HK. FEE MICRO FEE
ECH.FEE
DBL.
PL. CK. FEE
CONST. FEE
DBL.
ELECT... FEE
DBL.
SMI FEE
FEE PLUMB. FEE
DBL`
6 8
_J,. "F- M -A-1, M —J. J A' - S -1 O 1 D
JOB ADDRESS
OWNER--, .-�'C-`- :.w••.� ^ .
73
74
USE OF BUILDI ;,F.C..
L � F3Tiwe ve A
DATE
/ ^ � � �
PERM NO� �y
L.t � V � �
75
M.H. HOOKUP FEE
$
COMMUN S
DST
UNITS ROOMS
VALUATION_
SUPP. TO PERMIT OFFICE
L
f C! <
A
MICROFILM FEE
COPIES
$
LEGAL DESICRIPTION
It of / . • 4s J e ej; 46f - :7.349- 0/
MECHANICAL FEE
DBL
$ '
2-4
SET BACK
LOT SIZE ZONE
USE NO.
GRP
TYPE -
CK BY
> /
.
F DLJ T. R
PLAN CHECK FEE
$
BOND AMT.
PLAN NO.
PLAN CHECKER
FINAL DATE INSPECTOR
-
73
CONSTRUCTION FEE
DBL _
$
NAME OF CONST. LENDER -
^
BRANCH OFFICE _. .NO
LENDER INVOLVE
"
ELECTRICAL FEE
DBL
$
ADDRESS-. - -
CITY - STATE
SMI FEE
$
THIS PERMIT SHALL.BECOME VOID IF WORK IS NOT COMMENCED WITHIN 60 DAYS. CESSA-
TION 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 AC.
'CORDANCE WITH THE',LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNfA,•I ALSO _
PLUMBING FEE
DBL
$
r
49
AGREE TO CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLIANCE WITH
THE LAWS OF THE STATE OF CALIFORNIA COVERING CONTRACTORS IS ALSO GUARANTEED.
I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS t
$
TOTAL FEES
.��
�-CODETATE
HAS DONE SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS_ AND PROFESSIONS'
OF CALIFORNIA.
CASH CHECK ❑ M.O. Cl' '• N.C. ❑
OWNER. -
- • -
- CONTRACTOR '
� - •
,•-
RECEIVED BY
ADDRESS
ADDRESS
i �=�AP
SEWAGE SYSTEM
T LL -
P
%
_
CITY. .-. ....
CITY
t
TREES REQUIRED YES
NO
-
Js� Jr,✓ j a
r '•T
INFORMATION __ _ j •
TEL. NO.
TEL. NO. LICENSE /
'
4
e.'36 ♦yrs (,
�: " ��-7��0
FORM 284-2081Rev. 11/721
- >..
�f . 7 i