210134 (RC)BUILDING PERMIT DEPARTMENT OF BUILDING & SAFET
COUNTY OF RIVERSIDE
CONSTRUCTION ESTIMATE ELECTRICAL FEES
FIELD OFFICE
PLUMBING FEES
1ST FL.
2ND FL.
POR.
GAR.
CAR P.
WALL
AIN
tl"�K.W,UNITS
SIGN
SQ. FT. @
NO.
NO.
SQ. FT. @
FURNACE❑UNIT ❑WALL❑FLOOR ❑SUSPENDED
SQ. FT. @ MOTOR 1 OR LESS H.P.
LAUNDRY TRAY
SQ. FT. @ MOTOR 5 OR LESS H.P.
FIXTURE OR SOCKET
SQ. FT, @ MOTOR 20 OR LESS H.P.
DRAINAGE PIPING
SQ. FT. @
DRINKING FOUNTAIN
SQ. FT. @0
URINAL
LAVATORY
WATER PIPING
ESTIMATED VALUATION I $
�'-'"
FLOOR DRAIN
SQ. FT.@ q
MECHANICAL FEES
INCINERATOR ❑ DOMESTIC ❑ INDUS. OR COMM.
I IwA-r=D cncTcKicD
VENT SYSTEM ❑ FAN ❑ EVAP.COOL ❑ HOOD
SIGN
WASHER (AUTO) (DISH)
APPLIANCE
TRANSFORMER =K.W.
GARBAGE DISPOSAL
FURNACE❑UNIT ❑WALL❑FLOOR ❑SUSPENDED
OUTLETS
LAUNDRY TRAY
AIR HANDLING UNITI CFM
FIXTURE OR SOCKET
KITCHEN SINK
GAS PIPE ❑ NATURAL ❑ L.P.G.. ❑ OIL
CONST.SERV.ENTRANCE -
WATER CLOSET
COMPRESSOR E:::= HP
POLE
LAVATORY
APPLIANCE VENT
AMPERES SERV. ENT.
SHOWER
ABSORPTION SYSTEM B.T.U.
SQ. FT.@ q
BATH TUB
INCINERATOR ❑ DOMESTIC ❑ INDUS. OR COMM.
SQ. FT.@ Q.
WATER HEATER
HEATING SYSTEM ❑ FORCED ❑ GRAVITY
SQ. FT. RESID. @ 1 Q
SEWAGE DISPOSAL
BOILER E:::= B.T.U.
SQ. FT. GARAGE @ 'z 2
HOUSE SEWER
PERMIT FEE
BALANCE OF MIN. FEE
GAS PIPING
MOBILEHOME HOOKUP FEE
I$ I I
I I IPERMIT FEE I
I I
I PERMIT FEE
PERMIT NUMBER
TOTAL
MOB. HOOK FEE
MEAT & VENT FEE
DBL
Pl. CK. FEE
COfffjjj�N(((S T. FEE
DBL EL EnC. FEE
DBL
FEE
PLUMBING FEE
DBL
134
75
f/F.IE�}SMS,
coots UNITY.
DST
UNITS
OOM
VALUATION
s�
J
J
76
.w
j/
C {1 4
/
�L7
J F M A M -J J A S O
N D
JOB
S�A�CfD�DRESSr
- '
O ER472 `,r� 9--fil
/GfVZ
Y'07�,tfI //f'IWS
73
US OF BUILDING4
F.C.
DATE
E N
74
134
75
coots UNITY.
DST
UNITS
OOM
VALUATION
s�
SUPP. TO PERMIT
OFFI E
76
j/
C {1 4
/
�L7
MOBILEHOME
$
LEGAL DESCRIPTION "
A —�;rcv '9
HOOKUP FEE
f �' /f'
MECHANICAL FEE
DBL
$
SET BACK
LOT SIZE
ZONE USE NO.
t(I—
GRP
I TYPE
CK BY
F s R
PLAN CHECK FEE
$
-
BOND AMT.
PLAN NO.
PLAN CHECKER
FINAL DATE INSPECTOR
CONSTRUCTION FEE
DBL
NAME OF CONST. LENDER
BRANCH OFFICE
NO LENDER. INVOLVED
ELECTRICAL FEE
DBL
s
ADDRESS
,
CITY STATE
$
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 60 DAYS.
FEE
CESSATION 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 ACCORDANCE WITH THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIF-
DBL
ORNIA. I ALSO AGREE TO CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES.
COMPLIANCE WITH THE LAWS OF THE STATE OF CALIFORNIA COVERING CONTRACTORS
r
IS ALSO GUARANTEED.
I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPA E JLANS AND SPECIFI-
HAS DONE IN ACCORDANCE ITH ECTIO 55 O HE BUSINESS ND
TOTAL FEES $
"CATIONS
�
PROFESSIONS CODE OFO
THE STATE O CALIFORNIA.
CASH 0 CHECK F� M.O. Q N.C. [
OWNER
r / a
CDN p;
1. /I
Received By
ADDRESS
ADDRESS
3_l?7
Sewage System
T
LL
P
->
Trees Required
Yes
No
CITY
CITY
rr r
4 A) 6A'I' 4
INFORMATION
NO.
T
gk)TEI.
r.
FORM 284-208 (REV. 4/711 TT