239768 (SOTB)BUILDING PERMIT
DEPARTMENT OF BUILDING & SAFETY
COUNTY OF RIVERSIDE
ESTIMATED CONSTRUCTION VALUATION Is
NOTE: Not to be used as property tax valuation
MECHANICAL FEES
VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD
APPLIANCE
FURNACE ❑ UNIT ❑ WALL. ❑FLOOR ❑SUSPENDED
AIR HANDLING UNIT CFM
GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
COMPRESSOR HP
APPLIANCE VENT
ABSORPTION SYSTEM B.T.U.
INCINERATOR ❑ DOMESTIC ❑ INDUS. OR COMM.
HEATING SYSTEM ❑ FORCED ❑GRAVITY
BOILER 0 B.T.U.
PERMIT FEE
MOBILE HOME HOOKUP FEE Is
,}�P$R�(4P9�Q. � 'T�IFEES M6t. HK. FEE MICRO FEE
3Vytl 6
J F M A M I J' -J A'I S 1 O 1 N I D
73
74
.75
M.H. HOOKUP FEE $
MICROFILM FEE -COPIES $
MECHANICAL FEE DBL $
ELECTRICAL .FEES__
NO.
MOTOR I OR LESS H.P.
MOTOR 5 OR LESS H.P.
MOTOR 20 OR LESS H.P.
JOB ADDRESS -
USE OF BUUILDD,IIN.G,�....
i6dC1t ,i'.fY
COMMUNITY
71 '_'m '? �
SET BACK
S
K.W. UNITS
SIGN
TRANS-, K.W.
FORMER
OUTLETS
FIXTURE OR SOCKET
CONST. SERV. ENTRANCE
POLE
AMPERES SERV. ENT.
SO. FT. @ ¢
SQ. FT. @ 4
-m-SQ. FT. RESID. @14
SQ. FT. GARAGE@1�2¢
BALANCE OF MIN. FEE
PERMIT FEE
PL. CKXFEE I CONST. FEE
9 '—"
m
VALUATION
FIELD OFFICE
PLUMBING FEES I DST _
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
FLOOR DRAIN
WATER SOFTENER
WASHER (AUTO) (DISH)
GARBAGE DISPOSAL
LAUNDRY TRAY
KITCHEN SINK
WATER CLOSET
LAVATORY
SHOWER
BATH TUB
WATER HEATER
SEWAGE DISPOSAL
HOUSE SEWER
GAS PIPING
PERMIT FEE
K BY
IDSL.
PLAN CHECK FEE
CONSTRUCTION ESTIh,
1ST FL.
SQ. FT.
@_
2ND FL.
SQ. FT.
�a _
POR.
PLAN NO.
SQ. FT.
FINAL DATE
GAR.
SQ.FT.
@_
CAR P.
SQ. FT.
@_
WALL
SQ.FT.
j/
Y �O 1lo t e
SQ. FT.
@—
DEPARTMENT OF BUILDING & SAFETY
COUNTY OF RIVERSIDE
ESTIMATED CONSTRUCTION VALUATION Is
NOTE: Not to be used as property tax valuation
MECHANICAL FEES
VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD
APPLIANCE
FURNACE ❑ UNIT ❑ WALL. ❑FLOOR ❑SUSPENDED
AIR HANDLING UNIT CFM
GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
COMPRESSOR HP
APPLIANCE VENT
ABSORPTION SYSTEM B.T.U.
INCINERATOR ❑ DOMESTIC ❑ INDUS. OR COMM.
HEATING SYSTEM ❑ FORCED ❑GRAVITY
BOILER 0 B.T.U.
PERMIT FEE
MOBILE HOME HOOKUP FEE Is
,}�P$R�(4P9�Q. � 'T�IFEES M6t. HK. FEE MICRO FEE
3Vytl 6
J F M A M I J' -J A'I S 1 O 1 N I D
73
74
.75
M.H. HOOKUP FEE $
MICROFILM FEE -COPIES $
MECHANICAL FEE DBL $
ELECTRICAL .FEES__
NO.
MOTOR I OR LESS H.P.
MOTOR 5 OR LESS H.P.
MOTOR 20 OR LESS H.P.
JOB ADDRESS -
USE OF BUUILDD,IIN.G,�....
i6dC1t ,i'.fY
COMMUNITY
71 '_'m '? �
SET BACK
S
K.W. UNITS
SIGN
TRANS-, K.W.
FORMER
OUTLETS
FIXTURE OR SOCKET
CONST. SERV. ENTRANCE
POLE
AMPERES SERV. ENT.
SO. FT. @ ¢
SQ. FT. @ 4
-m-SQ. FT. RESID. @14
SQ. FT. GARAGE@1�2¢
BALANCE OF MIN. FEE
PERMIT FEE
PL. CKXFEE I CONST. FEE
9 '—"
m
VALUATION
FIELD OFFICE
PLUMBING FEES I DST _
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
FLOOR DRAIN
WATER SOFTENER
WASHER (AUTO) (DISH)
GARBAGE DISPOSAL
LAUNDRY TRAY
KITCHEN SINK
WATER CLOSET
LAVATORY
SHOWER
BATH TUB
WATER HEATER
SEWAGE DISPOSAL
HOUSE SEWER
GAS PIPING
PERMIT FEE
K BY
IDSL.
PLAN CHECK FEE
$`
BOND AMT.
PLAN NO.
PLAN CHECKER
FINAL DATE
INSPECTOR
CONSTRUCTION FEE
DBL
$
NAME OF CONST. LENDER
BRANCH OFFICE'
NO LENDER -INVOLVED
1
ELECTRICAL FEE
DBL
$
ADDRESS
CITY
STATE
7
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.
CORDANCE WITH THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, I ALSO
PLUMBING FEE
DBL
$
AGREE TO CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLIANCE WITH
THE LAWS OF THE STATE OF CALIFORNIA COVERING CONTRACTORS IS ALSO GUARANTEED.
1 HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS
$
TOTAL FEES
HAS DONE SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS
CODE OF THE STATE OF CALIFORNIA.
CASH ❑ CHECK QY M.O. ❑ N.C. ❑
OWNER,
�
CO"CTOR /
RECEIVED BY
ADDRESS -
ADDRESS
1
SEWAGE SYSTEM
T
LL
P
CIN
CIT'
TREES REQUIRED
YES '�
NO
INFORMATION
TEL. NO.TEL.
-'�
NO. LICENSE
FORM
7
284.208 (Rev. 1 ] /721