222770 (GRES).BUILDING PERMIT .
y
VENT SYSTEM ❑ FAN ❑EVAP. COOL ❑ HOOD„
DEPARTMENT OF BUILDING & SAFETY
• •
MECH. FEE 7
•.
COUNTY OF RIVERSIDE •
CONSTRUCTION ESTIMATE--, -j.:
- ELECTRICAL FEES: w .;--
' "I ST FL.
SQ. FT. @
LAUNDRY TRAY
NO. '
2ND F.L.
SQ. FT. @
KITCHEN SINK I
POR..
SQ. FT. @
WATER CLOSET ti
MOTOR f`OR LESS H.P.
GAR.
SQ.F,T. @
LAVATORY
MOTOR 5 OR LESS H.P.
SQ. FT. .@
AMPERES SERV.' ENT.
MOTOR 20 OR LESS H.P. '-
CAR P. '
SQ FT @
SQ. FT. @ Q
BATH TUB
XA/ A 1
Y .
�D 6-,j SQ. FT. @
ESTIMATED CONSTRUCTION VALUATION $ZZ+
NOTE: Not to be used as property tax valuation
MFCHANICAI FFFS .
K W. UNITS
FIEMOFFICE
PLUMBING-F.EES._:�..�esri,��
NO.
DRAINAGE PIPING
DRINKING FOUNTAIN '
URINAL
WATER PIPING g
FLOOR DRAIN
WATER SOFTENER
MOBILE HOME HOOKUP FEE Is PtHMII Ftt ov I I PERMIT FEE
VENT SYSTEM ❑ FAN ❑EVAP. COOL ❑ HOOD„
SIGN
'WASHER (AUTO) (DISH)'
MECH. FEE 7
APPLIANCE
TRANS, K.W.GARBAGE
FORMER - .
DISPOSAL
DBL. ELECT. FEE
FURNACE ❑ UNIT ❑ WALL' ❑FLOOR ❑SUSPENDED
OUTLETS
LAUNDRY TRAY
PLUMB. FEE -
-
AIR HANDLING UNIT CFM
FIXTURE OR SOCKET.
KITCHEN SINK I
GAS PIPE Cl NATURAL ❑ L.P.G. ❑ OIL
CONST. SERV. ENTRANCE
WATER CLOSET ti
COMPRESSOR 0 HP
POLE
LAVATORY
APPLIANCE VENT
AMPERES SERV.' ENT.
SHOWER
-ADDRESS �•.',^^+.-..+r•...:-• - --
Ai
ABSORPTION SYSTEM 0 B.T.U.
SQ. FT. @ Q
BATH TUB
USE OF BUILDIN -
_ �vN r��2T � rr _
INCINERATOR ❑ DOMESTIC ❑ INDUS. OR COMM.
:SQ. FT..(al.
WATER HEATER
_
75
HEATING SYSTEM Cl FORCED ❑GRAVITY'
t SOFT-RESID.@ld
SEWAGE DISPOSAL
f��
BOILER 0 B.T.U.
SQ. FT. GARAGE @1/2Q f
HOUSE SEWER
$
PERMIT FEEBALANCE
OF MIN: FEE
GAS PIPING '
MOBILE HOME HOOKUP FEE Is PtHMII Ftt ov I I PERMIT FEE
2
TOTAL FEES
MOB. HK. FEE MILRO FEE
MECH. FEE 7
DBL.
CK: FEE
CONST. FEE
DBL. ELECT. FEE
DBL.
SMI FEE:
FEE
PLUMB. FEE -
-
JDBL�
�.
/c .I. F-.I•pq. ,q•. _.M, .��..-.,.�w ..A..-S�I•O. -N• -D -JOB
-ADDRESS �•.',^^+.-..+r•...:-• - --
Ai
IOWNER.•.�...:..-
74 S
USE OF BUILDIN -
_ �vN r��2T � rr _
F.C.
DA E
y
�
PE N
-P2770 7 a
_
75
r� .�
1
f��
(.
M.H. HOOKUP FEE'
$
coMM NITY:- DST
UNITS
ROOMS
VALUAT ON
SUPP. TO PERMIT"
OFFICE .
MICROFILM FEE
COPIES'
$
LEGAL DESCRIPTION
AL
-MECHANICAL FEE ".
DBL$'
-
•
,SET BACK
.R
LOT SIZE ZONE -
SE NO.
GRP
TYPE
BY
.. .,
�1 "
JK
I
t ' -
F S- r
_
$
PLAN CHECK FEE . ,.
-
_....
ONAMT:
• •'..
PLAN NO.'
l„ r
PLAN CHECKER
FINAL DATE - I INSPECTOR
� � 1' � � L(�.
7-
e��
CONSTRUCTION FEE.-
DBL.`
$ r. "
� y'
NAME OF CONST. LENDER • ,. • , BRANCH
OFFICE.
NO LENDER INVOLVED
ELECTRICAL FEE
DBL'
$
�'V °�
ADDRESS - CITY
- STATE
-
. SMI FEE
$
THIS -PERMIT SHALL BECOME VOID IF WORK IS NOT -COMMENCED WITHIN 60 DAYS.-CESSA• g
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.
CORDANCE WITH 'THE'LAWS F RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, I ALSO;--
y
PLUMBING FEE a :.
'DBL,.
$-
.,•
AGREE TO CARRY CO EN TION INSURANCE.UPON MY EMPLOYEES. COMPLIANCE WITH
THE LAS OF THE ST E CA'£tFORNIA COVERING CONTRACTORS IS ALSO GUARANTEED.
I H BY CERTIF THE INDIVIDUAL WHO PREPF,RED THE PLANS AND SPECIFICATIONS
_+ $
�`
TOTAL FEES< . ' �,
,,HAS O IN, AC H- SECTION 5541 OF THE BUSINESS AND PROFESSIONS
r
F A It
.CASH CHECK M.O,❑ N.C.❑
I-
Ow R L Z CONT croR jQ �n
AMA�c"qI P' .'' O1\ Fi
RECEIVED BY
ADDREP -
ADDRESS
SEWAGE SYSTEM T
-
LL
P, -
_
TREES REQUIRED
YES
NO
CITY ...
CITY
INFORMATION"-
TEL. NO.
TEL. N0.2• LICENSE
,FORM
284-2081Rev. 11/721