232271 (SFD)BUILDING PERMIT DEPARTMENT OF BUILDING & SAFETY FIELD OFFICE
COUNTY OF RIVERSIDE
CONSTRUCT ION. EST IMAT,:Ea -moi,.�„,..-
..
ELECTRICAL FEES,;... - - PLUMBING FEES
1 ST FL. f ' SQ. FT. y. `3
AP -NO , NO.
.2ND FL. SQ. FT. Cia
POR. SQ. FT. ,
`. MOTOR I OR LESS H.P.
GAR. 1-10 14 SQ.FT. d °
MOTOR 5 OR LESS H.P.
"• CAR P. SQ. FT. @
b MOTOR 20 OR LESS H.P. DRAINAGE PIPING
WALL SQ.FT• @
DRINKING FOUNTAIN
SQ. FT. @
URINAL
ESTIMATED CONSTRUCTION VALUATION' W 0 OK K.W. UNITS f WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM -]•FAN ❑EVAP. COOL AD,HOOD
ej C SIGN WASHER (AUTOP.(DISH) Q (�
APPLIANCE ,
TRANS -, K W f GARBAGE DISPOSAL f
YJ FORMER
FURNACE ❑ UNIT ❑ WALL ❑FLOO ❑SUSPENDED
OUTLETS LAUNDRY TRAY
AIR HANDLING UNIT I CFM
FIXTURE OR SOCKET KITCHEN SINK
GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
CONST. SERV. ENTRANCE WATER CLOSET 9
COMPRESSOR HP
POLE LAVATORY
APPLIANCE VENT
AMPERES SERV. ENT. SHOWER r
ABSORPTION SYSTEM B.T.U.
SQ. FT. @ Q f BATH TUB 0 P
INCINERATOR ❑ DOMESTIC ❑ INDUS. OR COMM.
SQ. FT. @ Q / WATER HEATER
HEATING SYSTEM -J93 FORCED ❑ GRAVITY
-SQ. FT. RESID:.@ I ” (j SEWAGE DISPOSAL
BOILER 0 B.T.U.
SO. FT. GARAGE @1/24 — HOUSE SEWER
PERMIT FEE
( BALANCE OF MIN. FEE j GAS PIPING
MOBILE HOME HOOKUP FEE Is
'. PERMIT FEE 'y U PERMIT FEE 12J
PE217
TOTAL FEES
M08. HK. FEE MICRO FEE
MECH. FEE
DBI.
PL. CK. FEE _
CONST. FEE
DBL. ELECT. E DBL'.
SMI FeE-E�
FEE PLUMS. FEE
OBL:
_ J F I M. A. M I J I J A I S 1 O 1 N D
JOB ADDRESS, ~
s
OWNER
I r
73
USE OF BUILDING
/
DA E
ER
%
75
M.H. HOOKUP FEE
$
COMMUNITY'
DST NITS
ROOMS
VALUATION
SUPP.?O PERMIT
OFFICE>
I
�a
�. _.-
MICROFILM FEE
COPIES
$
LEGAL DESCRIPTION
MECHANICAL FEE
DBL...
$,
SET BACK LOT SIZEZONE
SE NO.
GRP
TYPE
CK BY
..
J
s /�' R*r
I .Y
/I
TPLAN CHECK FEE..
$ -
BOND AMT. PLAN NO. ° PLAN CHECKER -
FINAL DATE. - INSPE
TOR r
+�gr
��
7ej
-
C / -
3 ate- 5�
.� CONSTRUCTION FEE " ,..
- DBL
$ ./.
NAME OF CONST. LENDER BRANCH
OFFICE .NO
LENDER INV • LVED.
1
<1
J
ELECTRICAL FEE •
DBL
•, --• "+�ADDRESS
' CITY
STATE
_wl ' v f!
SMI FEE
$-
PERMIT -SHALL BECOME VOID IF WORK IS NOT., OMMENCED WITHIN 60 DAYS, CESSA-
TION OF WORK FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO'BECOME VOID.
FEE
$et2THIS
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 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 PRRFL.T E P NS D SP CIF,I/TIONS
$
TOTAL FEES
SIN A RO SSIONS
HAS DONE SO IN ACCORDANCE WITH SECTION �....
•�
CODE OF THE STATE OF CALIFORNIA.
i -OWNER,.
CASH" ❑ CHECK,M.O' ❑ N.C. ❑
CONTRACTOR
,b
®..f f - 1
RECEIVED BY
ADDRESS -.-
. ..
ADDRESS Y
..1.'
SEWAGE SYSTEM T
..
LL- -
P _ ..
CITY . . ,
y
—,
CRY -.
TREES_REQUIRED YES
NO
`•
INFORMATION '
TEL. NO.
TEL. NO. I LICENSE
FORM 284-208 (Rev. 11/721
.9�1 .-