245548 (BLCK)BUILDING PERMIT
CONSTRUCTION ESTIMATE
I ST FL. SQ.FT. @
2ND FL. SQ. FT. @
POR. SQ. FT. @
GAR. SQ. FT. @
CAR P. SQ.FT. @
WALL A&5zM'P!V SQ. FT. @
SQ. FT. @
ESTIMATED CONSTRUCTION VALUATION $
NOTE: Not to be used as property tax valuation
MECHANICAL FEES
VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD
DEPARTMENT OF BUILDING & SAFETY
COUNTY OF RIVERSIDE
NO. ELECTRICAL FEES
UNITS
MOBILEHOME SVC.
POWER OUTLET
SWIM POOL, PVT
SWIM POOL, COMM
SIGN
FIELD OFFICE
NO.I PLUMBING FEES
BOILER I i B.T.U.
BARSINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
FLOOR DRAIN
WATER SOFTENER
WASHER IAUTOI (DISH)
I
APPLIANCE GARBAGE DISPOSAL
FURNACE O UNIT ❑ WALL ❑ FLOOR 0 SUSPENDED LAUNDRY TRAY
AIR HANDLING UNIT CFM IDLE METERKITCHEN SINK
ABSORPTION SYSTEM 0 B.T.U. TEMP USE PERM SVC WATER CLOSET
COMPRESSOR 0 HP POLE, TEMP/PERM LAVATORY
HEATING SYSTEM O FORCED 0GRAVITY AMPERES SERV ENT SHOWER
SQ FT @ a BATH TUB
SQ FT @ a WATER HEATER
SQ FT RESID @ I a SEWAGE DISPOSAL
SQ FT GARAGE @ 'ha HOUSE SEWER
PERMIT FEE TEMP ELEC SVC GAS PIPING
MOBILE HOME PERMIT FEE Is
PERMIT FEE PERMIT FEE
24R5
lA' T)OT)AL FEES
e
MHM. FEE h11CR0
FEE
MECH. FEE
DBL.
PL. CK. FEE
CjONST. FE�
i08.
ate!
DBL.
ELECT. FEE
DBL.
SMI FEE
FEE PLUMB. FEE
JDBL.
J I F I M A I M I J IJI A I S- Q 1 N D
JOB ADDRESS i I SP NO
OWNERS ,h,.
73
74
USE OF PERMIT j
F.C.
DA,T[�j
P� I
548
M H PERMIT FEE
$
COMMUNITY
DST
I UNITS
ROOMS
VALUATIONSUPP.
n`
TO PERMIT OFFICE
MICROFILM FEE
COPIES
$
LEGAL DESCRIPTION
�s7 1ti A ci`4 1.410 f i`. �,� f 1� (��� SCJ " 04
MECHANICAL FEE
DBL
$
SETBACK
LOT SIZE ZONE;
Y
+
+
USE NO. JGRP
TYPE
144fo
F S R
PLAN CHECK FEE
$
BOND AMT.
PLAN NO.
PLAN CHECKER
FINAL DATE ✓ n) 'CLINSPECTOR
J
CONSTRUCTION FEE
DBL
$
NAME OF CONST. LENDER BRANCH
OFFICE
NO LENDER INVOLVED
ELECTRICAL FEE
DBL
$
ADDRESS CITY
STATE
SMI FEE
$
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. 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.
I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS
HAS DONE SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PR ESSI6NS C DE
OF THE STATE OF CALIFORNIA.
FEE
$
PLUMBING FEE
DBL
$
TOTAL FEES
OWNER/AGENT'S SIGNATURE
CONTRACTbR"
"
9 t .4jV1/
CASH ❑ CHECK [ � M.Q. ❑ N.C. ❑
ADDRESS
ADDRESS �9
I -a � �' { J,�g JAr/< U 0179
RECEIVED BY
TREES REQUIRED
SEWAGE SYSTEM
T
LL P
CITY, ZIP CODE
CITY ZIP CODE
_ h
INFORMATION
L,,//
OR 284.208 (Rev. 9-731 �s
TEL. NO.
TEL. NO.. ` . p LICENSE l
+�/ '� w e,7 . 2 r. 1 /
I