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259221 (BLCK)
BUILDING PERMIT CONSTRUCTION ESTIMATE 1 ST FL. SQ.FT. @ 2ND FL. SQ. FT. @ POR. SQ. FT. @ GAR. SQ. FT. @ CAR P. SQ.FT. @ WALL j��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 MOBILEHOME SVC. POWER OUTLET SWIM POOL, PVT SWIM POOL, COMM SIGN FIELD 'OFFICE NO.I PLUMBING FEES BOILER I I B.T.U. BAR SINK ROOF DRAINS DRAINAGE PIPING DRINKING FOUNTAIN URINAL WATER PIPING FLOOR DRAIN WATERSOFTENER WASHER (AUTO) (DISH) DST 1; APPLIANCE GARBAGE DISPOSAL FURNACE O 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 O FORCED ❑GRAVITY AMPERES SERV ENT SHOWER SQ FT @ a BATH TUB SQ FT @ ¢ WATER HEATER SQ FT RESID @ la SEWAGE DISPOSAL SQ FT GARAGE @ 'ha HOUSE SEWER PERMIT FEE TEMP ELEC SVC GAS PIPING MOBILE HOME PERMIT FEE $ PERMIT FEE PERMIT FEE PERMIT NO. ``TOTAL FEES t� UU -�.._ MOB. HM. FEE MICRO FEE MECH. FEE DBL. PL. CK. FEE /CONST. FEE d -- DBL. ELECT. FEE DBL. SMI FEE FEE PLUMB. FEE JDBL. J I F I M A I M J I ! I A I S O 1 ND !oB DRE�55/ SP NO- "/. (. /�jt• � ✓4A14 I OWNER y! 1/ ii� C.� fJ/Oa 73 74 USE OF PERMIT ' .." ffld F.C. DATE PNO (d(JJ, 75 M H PERMIT FEE $ COMMUNITY DST UNITS ROOMS I VALUATION � Q SUPP. TO PERMIT OFFICE MICROFILM FEE COPIES $ LEGAL DESCRIPTION 7-- MECHANICAL FEE DBL $ SETBACK LOT SIZE ZONE IUSENO. GRP TYPE �% CKyBY a,A F 5 R PLAN CHECK FEE $ BOND AMT. PLAN NO. PLAN CHECKER FINAL DATE (INSPECTOR CONSTRUCTION FEE DBL $ 00 NAME OF CONST. LENDER BRANCH OFFICE NO LENDER INVOLV D 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. 1 HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA. FEE $ PLUMBING FEE DBL $ TOTAL FEES DD U/lGENT'$ SIGNATURE. r.. CONTRACTOR CASH CHECK ❑ M.O. ❑ N.C. ❑UIJ ADDRESSADDRESS r P '!! A � �/�ic}/t/A- RECEIVED BY ��.t..�l. TREES REQUIRED SEWAGE SYSTEM T LL P CITY ZIP CODE � CITY ZIP CODE - INFORMATION FORN� 284-208 (Rev. 9.73) ©s TEL. NO. TEL. No. LICENSE