232274 (SFD)BUILDING PERMIT DEPARTMENT OF BUILDING & SAFETY FIELD OFFICE
COUNTY OF RIVERSIDE
CONSTRUCTION ESTIMATE. �� f.;
D
'. d , ELECTRICAL FEES r. PLUMBING FEES DST
Cc Cj w 1
1 ST FL. SQ. FT. (yY
°--- NO. N O.
2ND FL. SQ. FT. @
POR. SQ. FT.
{^' MOTOR.I OR LESS H.P.
MOTOR 5 OR LESS H.P. .
GAR. 0 SQ.FT.
CAR P. SQ. F.T. @°
MOTOR 20 OR LESS H.P. DRAINAGE PIPING
WALL SQ.FT. @DRINKING
FOUNTAIN
SQ. FT. @
:URINAL
ESTIMATED CONSTRUCTION VALUATION eln
az/ d' K.W. UNITS /- WATER PIPING /' "v
NOTE: Not to be used as property tax valuation.
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER '
VENT SYSTEM ;® FAN ❑ EVAP. COOL -0 HOOD
15r, 00 SIGN WASHER (AUTa(DISH) 00
APPLIANCETRANS-.
J ♦ �+
K.W.GARBAGE DISPOSAL
FORMER O 'z
FURNACE Cl UNIT ❑ WALL [:)FLOG ❑SUSPENDED
OUTLETS LAUNDRY TRAY
AIR HANDLING UNIT CFM
FIXTURE OR SOCKET KITCHEN SINK
GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
CONST. SERV. ENTRANCE WATER CLOSET
COMPRESSOR ' HP
POLE LAVATORY
APPLIANCE VENT
AMPERES SERV. ENT. { SHOWER
' ABSORPTION SYSTEM B.T.U.
SO. FT. @ Q BATH TUB
INCINERATOR ❑ DOMESTIC ❑ INDUS. OR COMM.
SQ. FT. @ WATER HEATER U ,
HEATING SYSTEM 'A FORCED ❑ GRAVITY
'—SO. FT. RESID. @ 14 i SEWAGE DISPOSAL.
BOILER 0 B.T.U.
SO. FT. GARAGE @1�2Q 4 HOUSE SEWER
_
PERMIT FEE
BALANCE OF MIN. FEE l GAS PIPING
MOBILE HOME HOOKUP FEE $
PERMIT FEE I ly 100- PERMIT FEE M !d
3P�.!
FE
MOB. HK. FEE MICRO FEE.
MECH:FCE
DBL.
CK.3E_
!r`
CONST. FEE_.
DB EL
EC .FEE .DBL.
SM E
FEE�PLUMB.�
DBL`
WAOTAL
_J..:. ... F. M A I M -I -J I .J.—.. A -I S -1_Q -...N D
Jag ADDRESS. :; _ ..'.'-
OrW3101NER_
74 -
s
USEOF BUILDINF.C.
B'
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DATEG
-3
E M N
'
2 27�"s2l7S
_
M.H. HOOKUP FEE
$
COMMUNITY
DST
UNITS
ROOMS
VALUATION
SUPP. TO'PERMIT OFFICE ;
MICROFILM FEE
COPIES
$
LEGAL DESCRIPTION
7 51' Ali
MECHANICAL FEE
DBL
$ .. ..La7
i
SET BACK LOT SIZE ZONE
USE NO.
GRP .
TYPE
C j�Y y
.� s . - ..
Y,s<af
$
PLAN CHECK FEE • _
BOND AMT. •
PLAN NO. PLAN CHECKER
FINAL DATE INSPE
TOR -
—w r
CONSTRUCTION FEE ' .
DBL
$
NAME OF CONST. LENDER' : BRANCH
OFFICE - .NO
LENDER I VOLVED
•
�,
ELECTRICAL F,EE
DBL
$
- .
ADDRESS CITY
- STATE
.SMI FEE
$
5'
-THIS PERMIT SHALL BECOME VOID IF WORK IS NOT OMMENCED WITHIN 60 DAYS: CESSA-
TION OF, WORK FOR 120 DAYS SHALL ALSO CAUSE PE IT TO BECOME VOID.
FEE
$
I HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN AC.
COROANCE 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 SO GUARANTEED.
I HEREBY CERTIFY THAT THE INDIVIDUAL WHO FR�� ED P NS D SPECIA TIONS
$
TOTAL FEES: `'
OCODE
HAS DONE SO IN ACCORDANCE WITH SECTION- 5��.`'� PRO SSIONS
w
OF'THE STATE'OF CALIFORNIA.
CASH ❑ CHECK &r., M.O. ❑) .N.C. ❑
OWNER.
CONTRACTOR i
I -
RECEIVED BY
ADDRESS
ADDRESS `.
SEWAGE SYSTEM.°-%
T
LL'
P'-
CITY-
CIT
TREES REQUIRED
YES
N.'
f
' • -INFORMATION '- -
TEL. NO. ` ,
TEL NO. _ - F LICENSE -
FORM 284-208 (Rev. 1 1 /721 �,,,/.
- - • '�,� "'tA
y
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