259967 (AR)BUILDING PERMIT
CONSTRUCTION ESTIMATE
1 ST FL SQ.FT.
2ND FL. SQ. FT. @
POR. SQ. FT. @
GAR. SQ. FT. @
CAR P. SQ.FT. @
WALL SQ. FT. @
SQ. FT. @
ESTIMATED CONSTRUCTION VALUATION 7
NOTE: Not !o be used as property tax valuation
MECHANICAL FEES
VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD
APPI IANC'F
DEPARTMENT OF BUILDING & SAFETY
COUNTY OF RIVERSIDE
NO. ELECTRICAL FEE'S
% � -+"� UNITS
MOBILEHOME SVC.
POWER OUTLET
SWIM POOL, PVT
SWIM POOL. COMM
SIGN
FIELD OFFICE
NO.I PLUMBING FEES
BOILER L I B,
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
FLOOR DRAIN
WATER SOFTENER
WASHER (AUTO) (DISH)
GARBAGE DISPOSAL
/ P
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED LAUNDRY TRAY
AIR HANDLING UNIT CFM IDLE METER KITCHEN SINK
ABSORPTION SYSTEM 0 B.T.U. ' r v TEMP USE PERM SVC WATER CLOSET '
COMPRESSOR 0 HP POLE, TEMP/PERM LAVATORY
HEATING SYSTEM ❑ FORCED ❑ GRAVITY AMPERES SERV ENT SHOWER
SQ FT @ a BATH TUB
SQ FT @ a WATER HEATER
F(� SQ FT RESID @ la } SEWAGE DISPOSAL
SQ FT GARAGE @ 'ha HOUSE SEWER
PERMIT FEE O TEMP ELEC SVC GAS PIPING
MOBILE HOME PERMIT FEE $
l PERMIT FEE f3 PERMIT FEE
PERMIT NO.
TOTAL E
MOB. HM. FEE
MICRO FEE
MECH Ff
DBL.
PSL}. Cl. FEE
CONST. FEE&
DBL.
ELEC
DBL.
SMI FfE
FEE
PLUMB. FEE
DBI.
A I M I J I J A I S 1 O ND
^JOB ADDRE rf/l.,-'- SP NO
7
73
74
USE OF PERMIT- Z� j
F.C./
DATE P j
M H PERMIT FEE
$
COMMUNITY
±� lDST
UNITS
ROOMS[VALUATION
JIUPI.T.PEIMIT
OLFyF�ICE
MICROFILM FEE
COPIES
$ .
LEGAL DESCRIPTIO .2
MECHANICAL FEE
DBL
$
/
SETBACK
LOT SIZE ZONE
USE NO.
GRP
TYPE CK BY
�` )
s - RJB
PLAN CHECK FEE
$
0U
BOND AMT.
PLAN NO.
PLAN CHECKERFINAL
DATE
"3.7�
INSPECTOR
CONSTRUCTION FEE
DBL
$
NAME OF CONST. LENDER BRANCH
OFFICE
NO LENDER INVOLVED
ELECTRICAL FEE
DBL
$
ADDRESS CITY
STATE
SMI FEE
$
f
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSA•
TION 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.
CORDANCE WITH THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, I ALSO
AGREE TO CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLIANCE WITH THE
LAWS OF THE STATE OF CALIFORNIA COVERING CONTRACTORS IS ALSO GUARANTEED.
I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREP RED T E PLAN"ASPI ATIONS
HAS DONE SO IN ACCORDANCE WITH SECTION 5 HE INS CODE
OF THE STATE OF CALIFORNIA.
FEE
$
PLUMBING FEE
DBL
$
TOTAL FEES
$
OWNER/AGENT'S SIGNATURE
CgjJTRACTOR
C r{ 4J� E r� / //(G•I7� t�lL JM
CASH ❑ CHECK + M.O. ❑ N.C.❑
ADDRESS
ADDRESS
?
RECEIVED B
TREES REQUIRED
SEWAGE SYSTEM
CITY ZIP CODE
CITY ZIP CODE -
/ /'
INFORMATION
FORIA 284.2081Rev. 9731 @5
TEL. NO.
TEL NO. +-LtICENSE
?%y - G� {•}
Im