242911 (ELEC)BUILDING PERMIT
DEPARTMENT OF BUILDING & SAFETY
kl
COUNTY OF RIVERSIDE
-4
NO. ELECTRICAL FEES
UNITS '
MOSILEHOME SVC.
POWER OUTLET
SWIM POOL, PVT .
SWIM POOL, COMM
FIELD OFFICE
NO.1 PLUMBING FEES
T
BOILER I I B.T.U.
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
FLOOR DRAIN
WATER SOFTENER
CONSTRUCTION ESTIMATE
1 ST FL.
SQ.FT. @
2ND FL.
SQ. FT. @
POR.
SQ. FT. @
GAR.
SQ. FT. @
CAR P.
SQ.FT. @
WALL
SQ. FT.• @
SQ. FT. @
ESTIMATED CONSTRUCTION VALUATION $
NOTE: Not to be used as property tax valuation
MECHANICAL FEES
DEPARTMENT OF BUILDING & SAFETY
kl
COUNTY OF RIVERSIDE
-4
NO. ELECTRICAL FEES
UNITS '
MOSILEHOME SVC.
POWER OUTLET
SWIM POOL, PVT .
SWIM POOL, COMM
FIELD OFFICE
NO.1 PLUMBING FEES
T
BOILER I I B.T.U.
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
FLOOR DRAIN
WATER SOFTENER
VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD SIGN WASHER (AUTO) (DISH)
APPLIANCE GARBAGE DISPOSAL
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED LAUNDRY TRAY
AIR HANDLING UNIT CFM IDLE METER KITCHEN SINK
ABSORPTION SYSTEM OB.T.U. TEMP USE PERM SVC WATER CLOSET
COMPRESSOR 0 HP POLE, T' ?ff/PERM L3 C3 LAVATORY
HEATING SYSTEM ❑ FORCED ❑GRAVITY AMPERES SERV ENT SHOWER
SOFT @ a BATH TUB
SQ FT @ a WATER HEATER
SQ FT RESID @ la SEWAGE DISPOSAL
SQ FT GARAGE @ Vvz HOUSE SEWER
PERMIT FEE TEMP ELEC SVC GAS PIPING
MOBILE HOME PERMIT FEE
PERMIT FEE . 414) PERMIT FEE
PERMIT NO.
24291
TOTAL FEES
9
MOB. HM. FEE
MICRO FEE
MECH. FEE
DHL.
PL. CK. FEE
I CONST. FEE
DBL.
ELECT. FEE
DBL.
I SMI FEE
I
FEE PLUMB. FEE
DBL.
.I.—I .F I..M, •-.4.. I,M. ..J...I —J.. J - A ->.$. O N - D.
1011ADDRE55..:_/�- /. % ..��.�..r�^�r-,-v....-y+.��r.5P N0...
7 ?.� �� i G•k� //L 25 G �L• I
OWNyERyI.Sy..-..•��. ..-..
f / S G .twjv . 1t Fe f4 %r
V
73
74
USE OF PERMITS .
F.C.
DAT�E/'
PMI O. '
M H PERMIT FEE
COMMUNITY
1, etsv,117'.4.,
DST
UNITS
ROOMS
I VALUATION
SUPP. TO PERMIT
OFFICE
MICROFILM FEE
COPIES
. $
LEGAL DESCRIPTION
MECHANICAL FEE
DBL
$
1
SET BACK
LOT SIZE ZONEUSE
ll
NO. -
GRP
TYPE
jcKBy
F/ 0 S R
PLAN CHECK.FEE
$
BOND AMT.
PLAN NO.
PLAN CHECKER
I FINAL DATE JINSPE
CONSTRUCTION FEE
DBL
$
NAME OF CONST. LENDER BRANCH
OFFICE
NOLENDER 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 STA;E 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 PROCESSIONS CODE
OF THE STATE OF CALIFORNIA. ..-..,.- _2 �,
'-'
FEE
$
PLUMBING FEE
DBL
$
TOTAL FEES
$
OWNER/AGENT'S SIGNATURE
?NTRACTOR � r%S✓Ns'
� -
{� R
CASH ❑ CHECK M.O. ❑ N.C. ❑
ADDRESS I..
ADDRESS
C�' „ �•-T k� j..�3 / % l.,r .�
RECEIVED BY .Lix� �dlfi
TREES REQUIRED
SEWAGE SYSTEM
CITY ZIP CODE
CITY - —• '- - ZIP CODE
p o 1
- INFORMATION
FORM 284 208 (Re, 9.73) 05 C.-
TEL. NO. -
TEL. NO. .. "+ LICENSE ?
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