239599 (RPL)BUILDING PERMIT
-DBL
DEPARTMENT OF BUILDING & SAFETY
COUNTY OF RIVERSIDE
CONSTRUCTION ESTIMATE
ELECTRICAL FEES
: 1 ST FL.,
SQ. FT.
Cia
NO. `
2ND FL.
SQ. FT.
Cia
POR.
SQ. FT.
@
MOTOR 1 OR LESS H.P.
GAR.
SQ:FT.
TYPE
MOTOR 5 OR LESS H.P.
CAR P.
SQ. FT.
@D
MOTOR 20 OR LESS H.P.
ALL
SQ.FT.
@
SQ. FT.
@a
PLAN CHECK FEE
ESTIMATED CONSTRUCTION VALUATION
KW.UNITS
NOTE: Not to be used as property tax valuation
MECHANICAL FEES
VENT SYSTEM ❑ FAN ` ❑ EVAP. COOL ❑ HOOD
'APPLIANCE
FURNACE ❑ UNIT ❑ WALL ❑FLOOR ❑SUSPENDED
AIR HANDLING UNIT CFM
GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
COMPRESSOR 0 HP
APPLIANCE VENT
ABSORPTION SYSTEM 0 B.T.U.
INCINERATOR ❑DOMESTIC 0, INDUS. OR COMM.
HEATING SYSTEM ❑ FORCED ❑ GRAVITY
BOILER 0 B.T.U.
PERMIT FEE
MOBILE HOME HOOKUP FEE I,$
PE MI O. TOTAL FEESMO8. HK. FEE MICRO FEE
,
/
M.H. HOOKUP FEE
i
SIGN
TRANS- O K.W.
FORMER
OUTLETS
FIXTURE OR SOCKET
CONST. SERV. ENTRANCE
POLE
AMPERES SERV. ENT.
SQ. FT. @ Q
SQ. FT. @
-,-wSQ. FT. RESID. @ 14
SO. FT. GARAGE @/24
BALANCE OF MIN. FEE
PERMIT FEE
,I IX_ 0I �
JOB ADDRESS _
7.9 ,V,FGl
USE OF BUILDING' y�-
FIELD OFFICE
PLUMBING FEES DST
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
FLOOR DRAIN
WATER SOFTENER
WASHER (AUTO) (DISH)
GARBAGE DISPOSAL
LAUNDRY TRAY
KITCHEN SINK
WATER CLOSET
LAVATORY
SHOWER
BATH TUB
WATER HEATER
SEWAGE DISPOSAL
HOUSE SEWER
GAS PIPING
PERMIT FEE ti
DBL. I ELECT. FEE I DBL. SMI FEE FEEPLUMB.FEE DBL.
7 ,j"v
•
OWNER ,
F.C. DA PER N
3,
ROOMS VALUATION SUPP. TO PERMIT OFFICE
-MECHANICAL FEE
-DBL
$
�Y 1t
&
SET BACK
LOT SIZE
ZONE
USE NO.
GRP
TYPE
CK BY
.. ..
}�r
,3
F zo S. • R
PLAN CHECK FEE
$
BOND AMT.
PLAN NO.
PLAN CHECKER FINAL DATE
INSPEC OR
CONSTRUCTION FEE
DBL
$
$&
NAME OF CONST. LENDER
BRANCH OFFICE .
NO LENDER IN41OLVED
kF
ELECTRICAL FEE
DBL
$
ADDRESS
CITY y
STATE -
SMI FEE
$
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 60 DAYS. CESSA-
TION OF WORK FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
FEE
$
I HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN AC.
CORDANCE WIYH 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.
1 HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND 5PECIFICATIQNS
$
TOTAL FEES
%%/
HAS DONE 50 IN ACCORDANCE WITH SECTION 5541 OF-11iE - NE F SIONS
OF
CODE OF THE TATE CALIFORNIA. /t'l
CASH ❑ .CHECKAr M.O.,❑' N.C. ❑'
OWNER,
C T X" OR
t
RECEIVED BY ADDRESS
SEWAGE SYSTEM TLL P
aTv.
TREES REQUIRED YES NO
INFORMATION TEL. NO.
FORM 284.208 ft . 11/72)
ADDRESS `
72 -,3
CITY
&A
TEL. NO. LICENSE