222940 (SATT)BUILDING PERMIT DEPARTMENT OF BUILDING & SAFETY
VENT SYSTEM (RFAN OEVAP. COOL 5LHOOD
COUNTY OF RIVERSIDE
CONSTRUCTION ESTIMATE...,-
ELECTRICAL FEES--,..
I ST FL. SQ. FT. @ /J
�EV "' NO.
2ND FL. SO. FT. @_
APPLIANCE
POR. SQ.:FT. 0_2
MOTOR I OR LESS H.P.
GAR. SQ.FT. @ !VOA' 4!24._9AV
MOTOR 5 OR LESS H.P.
CAR P. SQ. FT. @
f�OTOR 20 OR LESS H.P.
WALL SO.FT. @
SQ. FT. @
/9
ESTIMATED CONSTRUCTION VALUATION
K.W. UNITS
NOTE: Not to be used as property toxv oluotion 4r'
AIR HANDLING UNIT CFM
AAFCHANICAI FFF.1;
FIXTURE OR SOCKET
FIELD OFFICE
PLUMBING FEES
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
FLOOR DRAIN
WATFR SOFTENER
2 22794
VENT SYSTEM (RFAN OEVAP. COOL 5LHOOD
HK. FEEII]jIC;R�0 H.
C FE,�j
SIGN
P�. CK. FEE CONST. FEE
1
WASHER (AUTO) (D")
ELECT. FEE
I DBL.
APPLIANCE
,;3.. cia
TRANS-,
FORMER K.W.
BL.
GARBAGE DISPOSAL
IMOB.
;�FEE,,-
'0
,4E
FURNACE OUNIT OWALL 0 FL60R A SUSPENDED
OUTLETS
/9
LAUNDRY TRAY
AIR HANDLING UNIT CFM
FIXTURE OR SOCKET
jOB ADDRESS
KITCHEN SINK
73
74
GAS PIPE ONATURAL CIL.P.G. 0011.
F.C.
CONST. SERV. ENTRANCE
_2
WATER CLOSET
M.H. HOOKUP FEE
COMPRESSOR HP
POLE
DST
LAVATORY
ROOMS
VALUATION
APPLIANCE VEN
OFFICE
AMPERES SERV. ENT.
SHOWER
ABSORPTION SYSTEM B.T.U.
I/NITS
z
SO. FT. @
I Zr
BATH TUB
.-3 -?j
MICROFILM FEE"
INCINERATOR 0 DOMESTIC 0 INDUS. OR COMM.,
$
SQ. FT. @
LEGAL DrTCRI'PTION
WATER HEATER
HEATING SYSTEM a.FORCED 0 GRAVITY
oad
SO. FT. RESID.@14
DBL
SEWAGE DISPOSAL
SET BACK
BOILER B.T.U.
SQ. FT. GARAGE @,1/24 _2
GRP
HOUSE SEWER
PERMIT FEE
BALANCE OF MIN. FEE
]ZONE
GAS PIPING
2 22794
TOTALFE
HK. FEEII]jIC;R�0 H.
C FE,�j
DBL I
P�. CK. FEE CONST. FEE
1
DBL.
ELECT. FEE
I DBL.
SMIFEE
FEE B.FEE
BL.
01,/
IMOB.
;�FEE,,-
'0
,4E
I
/9
.7- J I F I M - -A t M I J I J !-A I S. 1 0 1 N I D
jOB ADDRESS
- OWNER
elzi6
73
74
USE`6F BUILDING
F.C.
DATE
1p
ER
mZ2294C
75
M.H. HOOKUP FEE
COMMUNITY/
DST
ROOMS
VALUATION
SUPP. TO PE RMIT
OFFICE
I
I/NITS
z
I
I Zr
MICROFILM FEE"
COPIES
$
LEGAL DrTCRI'PTION
MECHANICAL.FEE
DBL
$
SET BACK
LOT SIZE
USE NO.
GRP
]ZONE
ITYPE J�K�BY
F S IR
40-
PLAN CHECK FEE'
$
�:f
BOND AMT. NO.
PLAN CHECKER
FINAL DAIV,�,� INSPECTOR
-Oz 7'6
/0 1
CONSTRUCTION EEE
DBL
$
NAME OF CONST. LENDER. B
RANCH OFF ICE -
NO LENDER INVOLVED
�LECTRICAL FEE�
DB L
$
ADDRESS CITY
STATE
w;
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 -
LORDANCE WITH THE LAWS OFRIVERSIDE COUNTY AND THE'STATE OF CALIFORNIA, I ALSO
PLUMBING FEE
DBL
$
AGREE TO CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLIANCE WITH
THE L"S OF THE. -STATE OF CALIFORNIA COVERING CONTRACTORS Is ALSO GUARANTEED.
I HEREBY`�EIiTfrY_T4;AT THE INDWIMA.L. WHO PREPARED THE PLANS AND SPECIFICATIONS
$
TOTAL FEES - -
HAS DONE -Sb IN ACCbRDANGE'WIT ECTION 5541 'OF THE BUSINESS AND PROFESSIONS
CODE OF fdE STATE OF CALIFORNIA. _�A
CASH 0 CHECK 16-1 M.O. 0" N.C. 0
OWNER._,,�
CONTRACTOR
RECEIVED BY
ADDRESS
ADDRESS
SEWAGE SYSTEM
_TT
LL
1p
CITY 7-,
CITY
REQUIRED
YES
I NO
INFORMATIO N D
-rEL. NO-
TEL. NO. LICENSE
FORM 284-208(Re�. 11/721 4--A.&E
PVZ-7747
: A5'-1JrAA