403697 (RPL)PIRMIT� DEPARTMENT OF BUILDING & SAFETY DST
036 7 COUNTY OF RIVERSIDE FIELD I � f I /(I
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
I ST FL.
2ND. FL.
POR.
GAR.
CAR P.
WALL
ESTIMATED CONSTRUCTION
SO. FT. @- $
UNITS
"nor
SQ. FT. @
YARD SPKLR SYSTEM
SO. FT. @ MOBILEHOME SVC.
BAR SINK
SO. FT. POWER OUTLET
ROOF DRAINS
SO. FT.
DRAINAGE PIPING
SO. FT.
DRINKING FOUNTAIN
SO. FT. @
URINAL
VALUATION $
WATER PIPING
NOTE: Not to be used os property tox voluotion
SWIM POOL, PVT
FLOOR DRAIN
MECHANICAL FEES
SWIM POOL, COMM
WATER SOFTENER L
VE14T SYSTEM FAN EVAP. COOL HOOD
SIGN
WASHER (AUTO)(DISH)
APPLIANCE DRYER
F S S
r 5-- 1 .
-7,
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
Gro,p
LAUNDRY TRAY
AIR HANDLING UNIT CFAA
IDLE METER
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET
COMPRESSOR HP
POLE, TEMP/PERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SO. FT. @
BATH TUB
Branch
SO. FT. @
WATER HEATER
Registr. Fee $
.79
SO. FT. RESID @ 1 'Aa
SEWAGE DISPOSAL
Wines, Fee S
SO. FT. GAR @ 3/4 a
HOUSE SEWER 7,
O.ner/Agent
GA PIPING
PERMIT FEE
PERM11 FEE
01fie.Fa-
DBL.
TOTAL FEES
1 14�
OB. HM. FEE
IM
MICRO FEE
MECH. FEE PL. CK. FEE
I CONST. FEE ELECT. FEE
SmI FEE
FEE PLUMB. FEE
/� . ' ,
PERMIT NO.
1'4036971
Job Address
"nor
Community
Z
Valuation
S
Dote
Dist.
Off.
F.C.C.
MH Permit Fee S
Micro Film Fee
Cop S
Us I it
ly-
Parcel No.
U,@/Cow No.
Ck. By
Mech. Fee Dial S
Pl. Ck. Fee S
Set Sock,
Lot Si�e
Construction Fee DbI $
Legal Description
- 15— I,— 101�
Z4.
F S S
r 5-- 1 .
Electrical Fee DbI S
Zone Restrictions
Gro,p
Type
SMI Fee S
Plumbing Fee
Dbl S
Bond Amt.
$
Ion No.
I p
Plan Checke,
I
Final Dote It
-16- Do I
In pe
Unit
I I
Sp. Insp. Fee S
Demol. Fee
S
Const. Lander
Branch
Supplimental Permit Numbers
Registr. Fee $
.79
Mileage Fee S
Address City Zip
Wines, Fee S
Reinsp. Fee
$
O.ner/Agent
Tel.
Zip
Total Fees
S
Ajd,e,,
Pty
Zip
M.O. 0 N.C. E] Cash 12'Chock
Received by
Conlractor
—A�
Tel.
Ucense#
Trees
se��ag`. S�yv.m
011
Address
City Zip
T LL P THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF WORK
FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
Sov,er District
1EHEREBY AG:EE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE WITH
TH LAWS OF IV15RSIDE COUNTV AND THE STATE OF CALIFORNIA.
4�AMGERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE 50 IN
CE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA.
Farm 284-208 (Rev. 1/80)
verified by:
Ov