241066 (RPL)i BUILDING PERMIT
CONSTRUCTION ESTIMATE
1 ST FL. SQ.PT. @
2ND FL. SQ. FT. @
POR. SQ. FT. @
GAR. SQ. FT. @
CAR P. SQ.FT. @
64 U_ SQ. FT. @
✓fsiJF-td' SQ. FT. @
ESTIMATED CONSTRUCTION VALUATION $ j
NOTE: Not !o be used os property tax voluation
MECHANICAL FEES
VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD
DEPARTMENT OF BUILDING & SAFE'
COUNTY OF RIVERSIDE
NO. ELECTRICAL FEES
'go :—
MOBILEHOME SVC.
POWER OUTLET
SWIM POOL, PVT , .-5_ eo
SWIM POOL, COMM
SIGN
FIELD OFFICE
PLUMBING FEES
BOILER I I B.T.U.
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
FLOOR DRAIN
WATER SOFTENER
WASHER (AUTO) (DISH)
%I
FIA
APPLIANCE GARBAGE DISPOSAL
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED LAUNDRY TRAY
AIR HANDLING UNIT CFM IDLE METER KITCHEN SINK
ABSORPTION SYSTEM 0 B.T.U. TEMP USE PERM SVC WATER CLOSET
COMPRESSOR 0 HP POLE, TEMP/PERM LAVATORY
HEATING SYSTEM ❑ FORCED ❑ GRAVITY AMPERES SERV ENT SHOWER
SQ FT @ C BATH TUB
SQ FT @ a WATER HEATER
SQ FT RESID @ 1 a SEWAGE DISPOSAL
SQ FT GARAGE @ 'h¢ HOUSE SEWER
PERMIT FEE TEMP ELEC SVC ! GAS PIPING
MOBILE HOME PERMIT FEE Is
I I PERMIT FEE Jr el!�p f PERMIT FEE U v
P R
IT NO.
TOTAL FEES
MOB. HM. FEE
MICRO FEE
MECH. FEE
DBL.
PL. CK. FEE
CONST. FEE
DBL.
ELECT. FEE
DBL.
SMI nFEE
FEE PLUMB. FEE
DBL.
J I F I M A I M I J I J.. A I .5..1 Q - N ..D.
JOB Dq�RESSSS ,_ I _ _.—'�l'2_� ''.SP'NO�..
O " 1 .i./ Ar 1. (ia�J I
OW :� - ws�j r e:
If t) "A C+z 2).�/SI,
73
74
USE HERMIT
F.C.
J
DATE
PER T NO. �j
1A
75
M H PERMIT FEE
$
COM UNITY..
li C." YAiQ
DST
UNITS
ROOMS
VALUATION ISUPP.
TO PERMIT
OFFICE
MICROFILM FEE
COPIES
$
LEGAL DESCRIP.TIION % #J ff �}^ /
/�<✓"' `LJJJ✓TPFdf ty �y I 'pf�C�P3if
MECHANICAL FEE
DBL
$
SET BACK
LOT SIZE Z��O.j'NEEj
ji
(t
I
USE NO.
GRP
TYPE
CK BY
L
',�
F S RjC.#.�
PLAN CHECK FEE
$
BOND AMT.
PLAN NO.
PLAN CHECKER
FINAL DATE J
Oil INSWR
s-1 � 7
�a L��
CONSTRUCTION FEE
DBL
$
NAME OF CONST. LENDER BRANCH
OFFICE
NO LENDER INVOLVED
ELECTRICAL FEE
DBL
$
9
t7o
ADDRESS CITY
STATE
SMI FEE
$
J
,,fi�rr
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 12i51'J14YS. CESSA-
TION 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 ALSO
AGREE TO CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLIANCE WITH THE
LAWS OF THE STATE OF CALIFORNIA COVERING CONTRACTORS -IS ALSO GUARANTEED.
1 HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS
HAS DONE SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PR ftSSIONS CODE
OF THE STATE OF CALIFORNIA. J s
FEE
$
PLUMBING FEE
DBL
J$
tsy
549 .
TOTAL FEES
/
y/11V
OWNER/AGENT'S SIGNATURE
CONT✓R•A OR / - "�= ;,/„--' ��..--•
f J`
"
CASH ❑ CHECK ExM.O. ❑ N.C. ❑
ADDRESS
ADDRESS
RECEIVED BY
TREES REQUIRED
SEWAGE SYSTEM
/T
T
LL P
CITY ZIP CODE
CITY 01 ZIP CODE
/' �'l��� G04,
INFORMATION
FORM 284.208 (Rev. 9.731 05
TEL. NO.
` �
TEL. NO. j LICENSE
FIA