236427 (SFD)BUILDING PERMIT
NOTE: Not to be used as property tax valuation
DEPARTMENT OF BUILDING & SAFETY
COUNTY OF RIVERSIDE a
ELECTRICAL -FEES
NO.
ro MOTOR I OR LESS H.P.
MOTOR 5 OR LESS H.P.
61
MOTOR 20 OR LESS H.P.
K.W. UNITS
MECHANICAL FEES_
VENT SYSTEM,0 FAN O EVAP. COOL HOOD
APPLIANCE
FURNACE O UNIT O WALL ❑FLOOR USPENDED
AIR HANDLING UNIT CFM
GAS PIPE Cl NATURAL O L.P.G. Cl OIL
COMPRESSOR HP
APPLIANCE VENT
ABSORPTION SYSTEM 0 B.T.U.
INCINERATOR O DOMESTIC O INDUS. OR COMM.
HEATING SYSTEM FORCED ❑GRAVITY
BOILER 0 B.T.U.
PERMIT FEE
MOBILE HOME HOOKUP FEE $
fWITNO^. F4 TOTAL FEE$ .' MOB. HK. FEF MICRO FEE. -12
FIELD OFFICE
PLUMBING FEES DST__.-•
INO.1 - J
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
FLOOR DRAIN
MECH.
CONSTRUCTION ESTIMA
n I ST FL.
SQ. FT.
g(7
2ND FL.
TRANS-. K,W,
FORMER D
SQ. FT.
Cia
POR.
OUTLETS
SQ. FT.
LAUNDRY TRAY
GAR.
FIXTURE OR SOCKET
SQ.FT.
KITCHEN SINK
CAR P.
CONST. SERV. ENTRANCE
SQ. FT.
�a
WALL
POLE
SQ.FT.
Cai_
LEGAL PTION ,
AMPERES SERV. ENT.
SQ. FT.
SHOWER
ESTIMATED CONSTRUCTION VALUATION
SQ. FT. @
NOTE: Not to be used as property tax valuation
DEPARTMENT OF BUILDING & SAFETY
COUNTY OF RIVERSIDE a
ELECTRICAL -FEES
NO.
ro MOTOR I OR LESS H.P.
MOTOR 5 OR LESS H.P.
61
MOTOR 20 OR LESS H.P.
K.W. UNITS
MECHANICAL FEES_
VENT SYSTEM,0 FAN O EVAP. COOL HOOD
APPLIANCE
FURNACE O UNIT O WALL ❑FLOOR USPENDED
AIR HANDLING UNIT CFM
GAS PIPE Cl NATURAL O L.P.G. Cl OIL
COMPRESSOR HP
APPLIANCE VENT
ABSORPTION SYSTEM 0 B.T.U.
INCINERATOR O DOMESTIC O INDUS. OR COMM.
HEATING SYSTEM FORCED ❑GRAVITY
BOILER 0 B.T.U.
PERMIT FEE
MOBILE HOME HOOKUP FEE $
fWITNO^. F4 TOTAL FEE$ .' MOB. HK. FEF MICRO FEE. -12
FIELD OFFICE
PLUMBING FEES DST__.-•
INO.1 - J
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
FLOOR DRAIN
MECH.
WATER SOFTENER
SIGN
S
WASHER (AUT (DISH)
TRANS-. K,W,
FORMER D
V LU TION' ,.
GARBAGE DISPOSAL
OFFICE
OUTLETS
LAUNDRY TRAY
a
FIXTURE OR SOCKET
1��
KITCHEN SINK
e
CONST. SERV. ENTRANCE
WATER CLOSET
y
POLE
r
LAVATORY
LEGAL PTION ,
AMPERES SERV. ENT.
SHOWER
SQ. FT. @
BATH -TUB
r
SQ. FT. @ 3
V
WATER HEATER
DBL
-SQ. FT. RESID. @ (d ?r
SEWAGE DISPOSAL
SETBACK
SQ. FT. GARAGE @1�2Q
HOUSE SEWER
0 BALAtICE OF MIN. FEE
PERMIT FEE
/
%
GAS PIPING ,
PERMIT FEE
FEE=DBL.
Y
PL:,CK#FEE
i
CONST. FELE
DBL:
ELECT. FrEE DBL.
SMI FEE
FEE
sa
PLUMB. -FEE DBL. ".
13
ADDRESS .�.�r-,.-._�,� a._
»
...•_„r.
_OWNER.....,,.._.. -
�• "'
OF BU DI G -
f SPEC OR
F.C. f
DATE
P@R
N
4�2q
M.H. HOOKUP FEE
$
'CO M NI
S
UNITS
ROOMS
V LU TION' ,.
SUPP. TO PERMIT
OFFICE
1��
MICROFILM FEE
COPIES
$
LEGAL PTION ,
V
'MECHANICAL FEE
DBL
$
'
SETBACK
Lo a� ' zo E
GRP
BY
!
[USEMO.
J.TY
S
PLAN CHECK FEE'
BOND AMT: >
PLAN NO
PLAN CHECKER�-
FINAL DATE -
f SPEC OR
_
Jt� '.,' — •
`i -
CONSTRUCTION FEE
DBL
$;F'
-
NAME OF CONST. LENDER BRANCH
OFFICE
LENDERINVOLVED -
!
J.NO
4,
ELECTRICAL FEE
DBL
$
'
-
LL
-ADDRESS .+'• -
CITY - -
STATE -
SMI FEE'
$
c✓%
r
+ 1
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 CALIFORNIA, I ALSO
PLUMBING FEE
DBL
$
,,
.AGREE JO CARRY" COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLIANCE
o
Q
,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
$
TOTAL FEES
'
-HAS DONE'SO IN ACCORDANCE WITH'.SECTION 5541 OF THE BUSINESS AND PROFESSIONS'
r
*CODE
OF THE STATE OF CALIFORNIA.
CASH ❑ CHECK O'• M.O. 0' N.C. O
OWNER �/•• . -
CONTRACTOR
RECEIVED BY+,`.s.
�•"�
ADDRESS .. -
ADDRESS
SEWAGE SYSTEM T
LL
P
Cl 1
cm
TREES REQUIRED YES
NO/
%/�
INFORMATION
r T Rs
TEL. NO. f'
TEL. NO. t LICENSE
91
- FORM 284.208 (Rev. 11 /721
" -t .