272642 (PAT)BUILDING PERMIT
DEPARTMENT OF BUILDING & SAFETY
COUNTY OF RIVERSIDE
CONSTRUCTION ESTIMATENO. ELECTRICAL FEES
UNITS
ST
JOBADORE
ORE55 _ -SP NO
n f-
LAUNDRY TRAY
2ND FL.SQ.
CFM
FT, @
POR. ✓LL'
ABSORPTION SYSTEM
SO. FT. @ ^�
GAR.
WATER CLOSET
SQ. FT. @
CAR P.
POLE, TEMP/PERM
SOFT. @
WALL
AMPERES SERV ENT
SO. FT. @
BOILER � B.T.U.
*
SO FT @ 4
SO. FT. @
ESTIMATED CONSTRUCTION VALUATION $ ;1
NOTE: Not to be used as property tax valuation
SO FT @ ¢
MECHANICAL FEES
VENT SYSTEM
❑ FAN ❑ EVAP. COOL ❑ HOOD
APPLIANCE
SEWAGE DISPOSAL
MOBILEHOME SVC.
POWER OUTLET
SWIM POOL. PVT
SWIM POOL. COMM
SIGN
FIELD OFFICE
NO. PLUMBING FEES
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
FLOOR DRAIN
WATER SOFTENER
WASHER (AUTO) (DISH)
rARRArF nlcur-xnl
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
JOBADORE
ORE55 _ -SP NO
n f-
LAUNDRY TRAY
AIR HANDLING UNIT
CFM
IDLE METER
KITCHEN SINK
ABSORPTION SYSTEM
0 B.T.U.
TEMP USE PERM SVC
WATER CLOSET
COMPRESSOR
HP
POLE, TEMP/PERM
LAVATORY
HEATING SYSTEM ❑ FORCED ❑ GRAVITY
AMPERES SERV ENT
SHOWER
BOILER � B.T.U.
*
SO FT @ 4
BATH TUB
ITS
I ROOMS
SO FT @ ¢
WATER HEATER
OFFICE
SO FT RESID @ 1 ¢
SEWAGE DISPOSAL
SO FT GARAGE @ 'h¢
HOUSESEWER
PERMIT FEE
GAS PIPING
MOBILE HOME PERMIT FEE
Is
$
PERMIT FEE
PERMIT FEE
2I2' E IT O.
42
TOTAL F S
/��
MOB. HA•1.FEE
MICRO FEE
MECH. FEE
DBL.
PL. CK. FEE
��-d
CONST. FEE
?`�`'
DBL.
ELECT. FEE
DBL.
SMI FEE
`'
FEE
PLUMB. FEE
JDBL.
J F M A M J ) A $ O N D
JOBADORE
ORE55 _ -SP NO
n f-
OWNER
74
,j " p'1 G. 5 .) r,�U4 l � l±. t?
L.�G 4�/� %� ' j?C'AZ T
75
USE OF PERMIT n
API? )T 1 �r %' C/
F.C..�IDATE
�
IP272642°
76
o
M H PERMIT FEE
$
*
COMMUNIT'
DST
ITS
I ROOMS
VALUATION n` F
SUPP. TO PERMIT
OFFICE
MICROFILM FEE
COPIES
$
LEGAL DESCRIPTION
MECHANICAL FEE
DBL
$
SETBACK
LOT SIZE Z/OONN;E
USE NO.
GRP
TYPE
CK BY
/'
//
5-/
Jv
! r�
F S✓r<i jL R 3&
PLAN CHECK FEE
$
BOND AMT.
PLAN NO.
PLAN CHECKER
FINAL DATE
INS P CTO^`C/W`n
'5-o
9-I�i
CONSTRUCTION FEE
DBL
$
NAME OF CONST. LENDER BRANCH
OFFICE
NO LENDER INVOLVED
00
ELECTRICAL FEE
DBL
$
ADDRESS CITY
STATE
STRONG MOTION
$
OWNER/AGENT'S SIGNATURE
CONTRACTOF'_y-
INSTRUMENTATION FEE
/}
j Ii Li
7
•
$
ADDRESS
ADDRESS
FEE
� , o
PLUMBING FEE
DBL
$
CITY ZIP CODE
CITY ZIP CODE
TOTAL FEES Is
S
TEL. NO.
TEL. NO. '� LICENSE
NZ - // w v P, • j _ / f �� j P'
CASH1 CHECK Cl M.O. ❑ N.C. ❑
�'� THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSA
ON 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
RECEIVED BY f
TREES REQUIRED
SEWAGE SYSTEM
[LL
CCRDANCE WITH THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, I ALSC
T
F
AGREE TO CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLIANCE WITH THI
r�
I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS
FORM 284-208 (Rev. 10-74) @L HAS DONE SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE
OF THE STATE OF CALIFORNIA.