272460 (SPIN)FIELD OFFICE
BUILDING PERMIT DEPARTMENT OF BUILDING & SAFETY
r COUNTY OF RIVERSIDE Adlmhk
CONSTRUCTION ESTIMATE
1 ST FL. SQ.FT. @
2ND FL. SQ. FT. @
POR. SO. FT. @
GAR. SO. FT. @
CAR P. SO.Fl. @
WALL' SQ. FT. @
SQ. FT. @
ESTIMATED CONSTRUCTION VALUATION $
NOTE: Not to be used as property tax valuation
MECHANICAL FEES
VENT SYSTEM ❑ FAN Cl EVAP. COOL ❑ HOOD
NO. I ELECTRICAL FEES
UNITS
MOBILEHOME SVC.
POWER OUTLET
SWIM POOL, PVT
SWIM POOL, COMM
SIGN
NO. PLUMBING FEES
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING i
FLOOR DRAIN
WATER SOFTENER
WASHFB IAI ITn) Ir)ISHI
DST
I/
.APPLIANCE
JOB ADDRESS 1/ SP NO
-V-;; C4%1!" r7�/FA/��t
OWNER
H'l "'c Tx r y kK
GARBAGE DISPOSAL
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
F. C.
LAUNDRY TRAY
AIR HANDLING UNIT
CFM
IDLE METER
KITCHEN SINK
ABSORPTION SYSTEM
B.T.U.
TEMP USE PERM SVC
WATER CLOSET
COMPRESSOR
HP
POLE, TEMP/PERM
LAVATORY
HEATING SYSTEM ❑ FORCED ❑ GRAVITY
AMPERES SERV ENT
SHOWER
BOILER 0 B.T.U.
/, .4 /,v7-4
SQ FT @ a
BATH TUB
I
SQ FT @ a
WATER HEATER
MICROFILM FEE
COPIES
SQ FT RESID @ I a
SEWAGE DISPOSAL
LEGAL DESCRIPTION
SQ FT GARAGE @ 'ha
HOUSE SEWER
PERMIT FEE
07
MECHANICAL FEE
GAS PIPING
MOBILE HOME PERMIT FEE
$
SETBACK
PERMIT FEE
PERMIT FEE
PERMIT NO.
272460a°a
TOTAL FEES
MOB. HM.FEE
MICRO FEE
MECH. FEE
DBL.
PL CK. FEE
CONST. FEE
DBL.
ELECT. FEE
sr
DBL.
SMI,FEE
��Onc
FEE
PLUMB. FEE
DBL.
F I M I A I M I 1 I J A I S 1 O 1 N I D
74
JOB ADDRESS 1/ SP NO
-V-;; C4%1!" r7�/FA/��t
OWNER
H'l "'c Tx r y kK
75
76
USE OF PERMIT
s� � f fH.�. /v-f,O,
F. C.
DATE
�3-%�,�
PERMIT NO.
272460
MH PERMIT FEE
$
COMMUNITY
DST
UNITS
ROOMS
VALUATION
SUPP. TO PERMIT
FFICE
/, .4 /,v7-4
l�
I
Tz
MICROFILM FEE
COPIES
$
LEGAL DESCRIPTION
07
MECHANICAL FEE
DBL
$
SETBACK
LOT SIZE ZONE
USE NO.
GRP
TYPE
CK BY
/
/
]7CN,:'
j/
F S R
PLAN CHECK FEE
$
1
BOND AMT.
PLAN NO.
PLAN CHECKER
FINAL DATESPECTOR
l
-!5- -Hi �('
CONSTRUCTION FEE
DBL
$
NAME OF CONST. LENDER BRANCH
OFFICE
NO LENDER INV LV D
ELECTRICAL FEE
DBL
$
ADDRESS CITY
STATE
STRONG MOTION
$
OWNER/AGENT'S SIGNATUREX V
CONTRACTOR
INSTRUMENTATION FEE
Plot e �A ILrx �
$
ADDRESS
ADDRESS
!!'Yz�FEE
a f�
00
C -`r-, / PC,
A1, W A
PLUMBING FEE
DBL
$
CITY eZIP CODE
124 tt''✓)'v7A
CITY ZIP CODE
TOTAL FEES �
$
TEL. NO.
TEL. NO. LICENSE
CASH CHECK ❑ M.O. ❑ N -C. ❑
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSA
E ON OF WORK FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
3 I HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN AC
CORDANCE WITH THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, I ALSC
RECEIVED BY ,�
TREES REQUIRED
SEWAGE SYSTEM
ILL
mm ,,G
T
P l,ir
AGREE TO CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLIANCE WITH THI
I I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPAREDTHEPLANS AND SPECIFICATIONS
FORM 284-206 (Rei. 10-74) pL HAS DONE SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE
OF THE STATE OF CALIFORNIA.