214865 (SOTB)BUILDING PERMIT
CONSTRUCTION ESTIMATE
1ST FL.
SQ. FT. @
2ND FL.
SQ. FT. @
POR.
SQ. FT. @
GAR.
SQ. FT. @
CAR P.
SQ. FT. @
WALL
SQ. FT. @
CONST. SERV. ENTRANCE
SQ. FT. @ .
ESTIMATED VALUATION $
MECHANICAL FEES
DEPARTMENT OF BUILDING & SAFETY
COUNTY OF RIVERSIDE
7 ELECTRICAL- FEES
NO.
MOTOR 1 OR LESS H.P
MOTOR 5 OR LESS H.P
MOTOR 20 OR LESS H.P.
K.W. UN
FIELD OFFICE
PLUMBING FEES
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
FLOOR DRAIN
wnTro en rrr�iro
VENT SYSTEM ❑ FAN Cl EVAP.COOL ❑ HOOD
SIGN
WASHER (AUTO) (DISH)
APPLIANCE
TRANSFORMER OK•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 HP
POLE
LAVATORY
APPLIANCE VENT
AMPERES SERV. ENT.
SHOWER
ABSORPTION SYSTEM E:= 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
SEWAGE DISPOSAL
BOILER � B.T.U.
SQ. FT. GARAGE @ 'z Q
HOUSE SEWER
PERMIT FEE
BALANCE OF MIN. FEE
GAS PIPING
MOBILEHOME HOOKUP FEE I$ , I I I ' IPERMIT FEE I I I I PERMIT FEE I 1
PERMIT NUMBER T ,T L FEES MOB. HOOK FEE HEAT & VENT FEE DBL Pl CK. FEE COAST. FEE DBL ELEC. FEE DBL FEE PLUMBING FEE DBL
nA A nnr 9.� r BVI FiI
J F M A M J J A. S O
N D
JOB ADDRESS 19
OWNER
73
74
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6f
D/ w f— 7
!F
P ERS IT14865N
2
i
P
75
76
COMMUNITY
ss/
DSIT
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OOM
VALUATION�Q
/0
SUPP. TO PERMIT
I OFF�JCE
/ �'f
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MOBILEHOME
- HOOKUP FEE
$
LEGTION
PAL DESCRI
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MECHANICAL FEE
DBL
$F
SET BACK
LOT SIZE
ZONE
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USE NO.
GRP
TYPE
CK BY
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s 1t�3 R
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1_7i�
PLAN CHECK FEE
$
BOND AMT.
PLAN NO.
PLAN CHECKER
FINAL DATE INSPECTOR
-
CONSTRUCTION FEEJ�
DBL
�^'"`
NAME OF CONST. LENDER
BRANCH OFFICE-
NO LENDER INVOLVED
ELECTRICAL FEE
DBL
$
ADDRESS \..
CITY STATE
�
$
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 60 DAYS.
CESSATION OF WORK FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
FEE
I HEREB`! 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
FEE
ORNIAI ALSO AGREE TO CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES.
'PLUMBING
COMPLIANCE WITH THE LAWS OF THE STATE OF CALIFORNIA COVERT CONTRACTORS
IS ALSO GUARANTEED.
I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARE THE ANS AND SPECIFI-
CATIONS HAS DONE SO IN ACCORDANCE WITH SE
TOTAL FEES $
r^�
C'
O THE BUSINESS AND
PROFESSIONS CODE OF THE STATE OF CALIF OFINI
CASH ❑ CHECK ❑ M.O. ❑ N.C. ❑
ow ER
/r.
CON -.
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RQCQIVed By -
ADDRESS
ADDRESS
%tee.
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'T Arl1f0
Sewage System
T
LL
P
/�
Trees Required
Yes
CITY
CITY
INFORMATION
t
TEL. NO.
TEL. NO..
`✓/ LICENSE
( 1 1
I ��—9`
FORM 284-208 (REV. 4/71) V
C