268002 (RER)BUILDING PERMIT DEPARTMENT OF BUILDING & SAFETY
+ ` COUNTY OF RIVERSIDE Id
CONSTRUCTION ESTIMATE
I ST FL. '5' r6' SOFT. @
2ND FL. SQ. FT. @
POR. SO. FT. @
GAR. SO. FT. @
CAR P. SQ.FI. @
WALL SO. FT. @
SQ. FT. @
ESTIMATED CONSTRUCTION VALUATION $
NOTE: Not to be used as property tax voluotion
MECHANICAL FEES
VENT SYSTEM ❑ FAN ❑ EVAP. COOL Cl HOOD
APPLIANCE
NO. ELECTRICAL FEES
UNITS T
MOBILEHOME SVC.
POWER OUTLET
SWIM POOL, PVT
SWIM POOL. COMM
SIGN
FIELD OFFICE
NO. PLUMBING FEES
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
FLOOR DRAIN
WATER SOFTENER
WASHER (AUTO) (DISH)
r:ADRA([F nICDnCAI
DST
Ir
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR' ❑ SUSPENDED
JfubbAAuOk EbS �j % SP NO
F�t/�.�
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 � B.T.U.
SQ FT @ ¢
BATH TUB
UNITS
ROOMS
SQ FT @ ¢
WATER HEATER
OFFICE
SQ FT RESID @ I¢
SEWAGE DISPOSAL
A1T,4
SQ FT GARAGE @ '/a¢
HOUSE SEWER
PERMIT FEE
y�
GAS PIPING
MOBILE HOME PERMIT FEE
$
$
PERMIT FEE
PERMIT FEE
PERMIT NO.
26002°
TOTAL F ES
MOB. HM.FEE
MICRO FEE
MECH. FEE
DBL
PL. CK. FEE
CONST. EE
sQ�
DBL.
ELECT. FEE
JDBL.
SMI FEE
FEE
PLUMB. FEE
DBI.
J I F I M A I M I J I J I A I S 1 O N D
JfubbAAuOk EbS �j % SP NO
F�t/�.�
OWNER
SC!o%% DAU//D
74
!O' '��/`i IE JL .A
75
USE OF PERMIT ��[ I1ef � 13 y
F.C.
DATE
PE MIT N0
76
�0� GtrCJ R/t'S�/€f�S GT��/�j. �4
S�
�y
/� ^ ,'.L G2 /
68002
M H PERMIT FEE
$
COMMUNITY
XLII
DST
UNITS
ROOMS
VALUATION
d"
SUPP. TO PERMIT
OFFICE
A1T,4
/I
/
y�
�-
MICROFILM FEE
COPIES
$
LEGAL DESCRIPTION
769-/4/3-vo&-10T-/19 cs/ar V13 /iiAe-
MECHANICAL FEE
DBL
$
SET BACK
LOT SIZE ZONE
USE NO.
GRP
TYPE BY
I k'K
a
PLAN CHECK FEE
$
BOND AMT.P
LAN NO.
PLAN CHECKER
FINAL DATE
IN CTOR
CONSTRUCTION FEE
DBL
$
NAME OF CONST. LENDER BRANCH
OFFICE
NO LENDER INVOLVED
ELECTRICAL FEE
DBL
$
ADDRESS CITY
STATE
STRONG MOTION
$
OWNER/AGENT'S SIGNATURE "r :F -
CONTRACTOR
INSTRUMENTATION FEE
®
V'I.V/ p c *"e►EgT�-
FEE
$
ADDRESS
�-4
ADDRESS
PLUMBING FEE
DBL
$
CITY ZIP CODE
CITY ZIP CODE
TOTAL FEES
$
Q�
TEL. NO.
.3.y/6 - //(�Q
TEL. NO. LICENSE
CASH ❑ CHECK M.O. ❑ N.C. Ot,?
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSA
ION OF WORK FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
RECEIVED BY
TREES REQUIRED
I HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN AC
vCORDANCE WITH THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, I ALSC
SEWAGE SYSTEM
T
LL
P
AGREE TO CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLIANCE WITH 'THE
I I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPAREDTHEPLANS AND SPECIFICATIONS
FORM 284-208 (Rev. 10-74) QQ L HAS DONE SO IN ACCORDANCE WITH SECTION 554.1 OF THE BUSINESS AND PROFESSIONS CODE
OF THE STATE OF CALIFORNIA.