238431 (RPL)BUILDING PERMIT DEPARTMENT OF BUILDING & SAFETY FIELD OFFICE
COUNTY OF RIVERSIDE
CONSTRUCTION ESTIMATE,,,,,._,,, , ELECTRICAL FEES_,,,,,,,,,,,,„.,, PLUMBING FEES DST
I ST FL. SQ. FT. @ I NO. NO. /J
2ND FL. SQ. FT. @
POR. SQ. FT. @
GA� j' SQ.FT. @
CA j7/ SQ. FT. @
WALL D SOFT. @
0a SQ. FT. @
ESTIMATED CONSTRUCTION VALUATION L-41
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 HP
APPLIANCE VENT
ABSORPTION SYSTEM B.T.U.
INCINERATOR ❑ DOMESTIC ❑ INDUS. OR COMM.
HEATING SYSTEM ❑ FORCED ❑GRAVITY
BOILER 0 B.T.U.
PERMIT FEE
MOBILE HOME HOOKUP FEE $
9 IFf �T, I � TOTAL FS _ MOB. HK. FEE MICRO
MOTOR I OR LESS H.P.
J08 ADDRESS �+
OWNER y� C
MOTOR 5 OR LESS H.P.
74
USE OF BUILDING
Y A7 i lr CY04
MOTOR 20 OR LESS H.P.
DATE
/J- y� 7J
DRAMII5AGE PIPING
4 31
75
DRINKING FOUNTAIN
$
URINAL
D K.W. UNITS
UNITS
WATER PIPING
VALUATION
':S_ 0
SUPP. TO PERMIT
FLOOR DRAIN
MICROFILM FEE
COPIES
WATER SOFTENER
SIGN
LEGAL DESCRIPTION
LOT -' � e 5/—J� �ts �' JS/ 0//
WASHER (AUTO) (DISH)
TRANS- K.W.
FORMER
$
GARBAGE DISPOSAL
OUTLETS
ZONE
s F
LAUNDRY TRAY
FIXTURE OR SOCKET
TYPE
KITCHEN SINK
CONST. SERV. ENTRANCE
WATER CLOSET
POLE
LAVATORY
AMPERES SERV. ENT.
TOR\
SHOWER
SQ. FT. @ ¢
$
BATH TUB
SQ. FT. @ ¢
OFFICE .NO
WATER HEATER
-a+�60. FT. RESID. @) ¢
DBL
SEWAGE DISPOSAL
SQ. FT. GARAGE @/2¢
ADDRESS
HOUSE SEWER
BALANCE OF MIN. FEE
PERMIT FEE
PL. CK*FEE CONST. FEE DBL.
ELECT. FEE DBL.
GAS PIPING
PERMIT FEE
SMI FEE FEE
ly1? .�5 SO
J I F I M A I M I J I J A I S 1 O 1 N D
J08 ADDRESS �+
OWNER y� C
73
74
USE OF BUILDING
Y A7 i lr CY04
F.C.
?o
DATE
/J- y� 7J
1E RNA VSJ 8
4 31
75
M.H. HOOKUP FEE
$
COMMUNITY DST
UNITS
I ROOMS I
VALUATION
':S_ 0
SUPP. TO PERMIT
OFFIC& ,
d
MICROFILM FEE
COPIES
$
LEGAL DESCRIPTION
LOT -' � e 5/—J� �ts �' JS/ 0//
MECHANICAL FEE
DBL
$
SET BACK LO SIZE
R
ZONE
s F
USE NO.
GRP
TYPE
CK 'BY�
}
PLAN CHECK FEE
$
S
PLAN NO. PLAN CHECKER
F:�ATE INSPE
TOR\
CONSTRUCTION FEE
DBL
$
®�
..rr
NAME OF CONST. LENDER BRANCH
OFFICE .NO
LENDER INVO VED
{
ELECTRICAL FEE
DBL
$
ADDRESS
CITY STATE
7
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.
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 PLAPS AND SPEC ICATIONS
HAS DONE SO IN ACCORDANCE WITH SECTION 5541 O E ES0
CODE OF THE A P NS
STATE OF CALIFORNIA. rl—
FEE
$
PLUMBING FEE
DBL
$
$
TOTAL FEES
1
<��
CASH ❑ CHECK M.O. ❑ N.C. ❑
OWNER.
CONTggA
RECEIVED BY
ADDRESS
ADDRESS !
SEWAGE SYSTEM
T
LL
P
TREES REQUIRED
YES
NO
CITY
+
CITY
/ 1
� .!/ i .• .� t�A ! 11 n i7 � i
INFORMATIONTEL. NO. TEL. NO. / LICENSE G -'�
,11172) y� V.+f"v