240883 (ELEC)BUILDING PERMIT
CONSTRUCTION ESTIMATE
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 $
NOTE: Not to be used as property tax valuation
MECHANICAL FEES
VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD
PARTMENT OF BUILDING & SAFET6
COUNTY OF RIVERSIDE
NO. ELECTRICAL FEES
UNITS
MOBILEHOME SVC.
POWER OUTLET
SWIM POOL, PVT
SWIM POOL, COMM
SIGN
FIELD OFFICE
NO.I PLUMBING FEES
BOILER L B.
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
FLOOR DRAIN
WATER SOFTENER
WASHER (AUTO) (DISH)
DST t,
APPLIANCE GARBAGE DISPOSAL
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED LAUNDRY TRAY
AIR HANDLING UNIT CFM IDLE METER KITCHEN SINK
ABSORPTION SYSTEM 0 B.T.U. TEMP USE PERM SVC WATER CLOSET
COMPRESSOR 0 HP POLE, TEMP/PERM LAVATORY
HEATING SYSTEM ❑ FORCED ❑GRAVITY AMPERES SERV ENT {jr _SHOWER
SQ FT @ ¢ BATH TUB
SQ FT @ ¢ WATER HEATER
SQ FT RESID @ le SEWAGE DISPOSAL
SQ FT GARAGE @ ''/v¢ HOUSE SEWER
PERMIT FEE TEMP ELEC SVC GAS PIPING
MOBILE HOME PERMIT FEE Is
PERMIT FEE Oz'3 PERMIT FEE
PERMIT NO.
31
,TOTAL FEES HM. FEE
c41,
MICRO FEE
MECH. FEE
DBL
PL. CK. FEE
CONST. FEE
�DBLI�
ELECT. FEE
��,
DBL.
SMI FEE
FEE PLUMB. FEE
JDBL.
J I F I M A-1 M I J I A I S 1 O 1 N D
�oeA D�fREssnn r- - SPNO
d! "7A' ,3 %, 7c� C3 I
OWNER-'-+-� y/ _. +
�' {�+OIY Y14AM-1
73
74
75
L EjOF PERMIT .t y� /�•�j/ �!
�d 4/t/f i f�M (C t lFi� /l {+
F.C.
DATE J�
+� ` /
PERMIT NO.
6
M H PERMIT FEE$
i
COMMUNITY
1AIPli>
DST
UNITS
ROOMS
VALUATION
SUPP. TO PERMIT dnldw-
MICROFILM FEE
COPIES
$
LEEGA�LDESC/RIPTION
^
re: 51
MECHANICAL FEE
DBL
$
SETBACK
LOT SIZE ZONEUSE
�
NO.
GRP
TYPE
CK BY
F 5 R
PLAN CHECK FEE
$
BOND AMT.
PLAN NO.
PLAN CHECKER
FINAL DATE INSPECTOR
J
CONSTRUCTION FEE
DBL
(
$
r
NAME OF CONST. LENDER BRANCH
OFFICE
NO LENDER INVOLVED
ELECTRICAL FEE
DBL
���
LIV
ADDRESS CITY
STATE
SMI FEE
$
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.
1 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 PREPARED THE PLANS AND SPECIFICATIONS
HAS DONE SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE
OF THE STATE OF CALIFORNIA, y
FEE
$
PLUMBING FEE
DBL
$
't
TOTAL FEES
�.....+��
OWNER/AGENT'S SIGNATURE
CONTRAC OR
-
J/4—yyl
CASH ❑ C ECK M.O. ❑ N.C. ❑
ADDRESS
ADDR 5
r
RECEIVED BY
TREES REQUIRED��{
SEWAGE SYSTEM'
T
LL Psi`'`
CITY ZIP CODE
CITY 11 ZIP/CODE
INFORMATION
7}
FORM 284.208 (Rev. 9-73) Os 1
TEL. Nn
O.
TEL. NO. LICENSE
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