217983 (PAT)BUILDING PERMIT DEPARTMENT OF BUILDING & SAFET
IO FIELD OFFICE
COUNTY OF RIVERSIDE
CONSTRUCTION ESTIMATE ELECTRICAL FEES PLUMBING FEES
1ST FL.
2ND FL.
POR.
GAR.
CAR P.
WALL
(!
SQ. FT. @
NO.
NO.
SQ. FT. @
FURNACE❑UNITE] WALL❑FLOOR ❑SUSPENDED
SQ. FT. @ MOTOR 1 OR LESS H.P.
LAUNDRY TRAY
SQ. FT. @ MOTOR 5 OR LESS H.P.
FIXTURE OR SOCKET
SQ. FT. @ MOTOR 20 OR LESS H.P.
DRAINAGE PIPING
SQ. FT. @
DRINKING FOUNTAIN
SQ. FT. @ $ 7
URINAL
OK.W.UNITS
WATER PIPING
ESTIMATED VALUATION $
SHOWER
FLOOR DRAIN
SQ. FT.@ Ir
MECHANICAL FEES
INCINERATOR ❑ DOMESTIC ❑ INDUS. OR COMM.
WATCM cn cTcnlco
VENT SYSTEM ❑ FAN ❑ EVAP.COOL❑ HOOD
SIGN
WASHER (AUTO) (DISH)
APPLIANCE
TRANSFORMER OK•W•
GARBAGE DISPOSAL
FURNACE❑UNITE] WALL❑FLOOR ❑SUSPENDED
OUTLETS
LAUNDRY TRAY
AIR HANDLING UNITI 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 O B.T.U.
SQ. FT.@ Ir
BATH TUB
INCINERATOR ❑ DOMESTIC ❑ INDUS. OR COMM.
SQ. FT.@ ¢.
WATER HEATER
HEATING SYSTEM ❑ FORCED ❑ GRAVITY
SQ. FT. RESID. @ 1 Q
SEWAGE DISPOSAL
BOILER E== B.T.U.
SQ. FT. GARAGE@ x' Q
HOUSE SEWER
PERMIT FEE
BALANCE OF MIN. FEE
GAS PIPING
MOBILE HOME HOOKUP FEE
I$ • • I -1
I I IPERMIT FEE I
I I PERMIT FEE I l
2PERMIT NUMBER T07gL F�E�S
MOB. HOOK FEE
HEAT & VENT FEE [131-1
PL. CK. FEE
C� TyF E
117* FEE
DBL
J
�,�� ^�
PLUMBING FEE
DBL
J F M A M J J I
A
S O
N D
JOB ADDRESS
OWNER
7251-986
73
USE OF BUILDIN
F.C.
DAT PE I17983 NQS
O�Acrean
74ft2o
rpm!
_ 7 9
8 3
75
COMMUNITY DST
UNITS
OOMJ
V ALU ATIIONnR-'y
SUPP. TO PERMIT
OFFICE
C
76
MOBILEHOME
$
LEGAL DESCRIPTION
HOOKUP FEE
Tnt 14 s Q *ntia 14 *A Vr_771_lrprt_nlj
DBL
SET BACK
LOT SIZE
ZONE
USE NO. GRP
TYPE
CK BY
MECHANICAL FEE
$
F s R
BO D AMT. PLAN
PLAN CHECKER
FINAL DATE
IN ECTOR
PLAN CHECK FEE
$/^/y
��_
CONSTRUCTION
DBL
NAME OF CONST. LENDER
BRANCH OFFICE/
NO LENDER INVOLVED
FEE
�
��
,
f
DBL
ADDRESS
CITY
STATE
ELECTRICAL FEE
$
�} j
$
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 60 DAYS.
�/ /
p�
CESSATION 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 ACCORDANCE WITH THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIF-
DBL
j `CE UPON MY EMPLOYEES.
ORNIA. I ALSO AGREE TO CARRY COM NoAOTF'QL'lNS0U8RN"
COMPLIANCE WITH THE LAWS OF THE S A COVERING CONTRACTORS
ISALSO GUARANTEED.
HEREBY CERTIFY THAT THE INDIVI ° UHO PREPA p THE PLANS AND SPECIF�-
CATIONS HAS DONE SO IN ACCORDANC SECTION 1 OF THE BUSIN66SAND
TOTAL FEES S
PROFESSIONS CODE OF THE STATE OF CALII . L sic
CASH F-1CHECKM
N.C. ❑
OWNER
C . ACTOR
Received By
ADDRESS
ADDRESS
�/
3 l3
Sewage System
T
LL
P
`
CITU
CITY
Trees Required Yes
NoAl
Ap/V f� 7�
INFORMATION
TEL. NO.
TEL. NO. LICEENSE73
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FORM 284-208 (REV. 4/71) V
.