221519 (PC)BUILDING PERMIT
DEPARTMENT OF BUILDING & SAFETY
COUNTY OF RIVERSIDE
FIELD OFFICE
CONSTRUCTION ESTIMATE-,-_
ELECTRICAL FEES
PLUMBING FEES DST-,
1 ST FL. SQ. FT. @
2ND FL. SQ. FT. @
POR. SQ. FT. @
GAR. SQ.FT. @
CAR P. SQ. FT. @
ALL SQ.FT. @
� -
C(� SQ. FT.
EST1�fv17�TEEk NSTRUCTION VALUATION $
NO. NO.
' MOTOR I OR LESS H.P.
MOTOR 5 OR LESS H.P.
MOTOR 20 OR LESS H.P.
,,, �`
�K W. uNlrs
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
NOTE: Not to be used as property tax valuation
75
FLOOR DRAIN
MECHANICAL FEES
_ A- -51
WATER SOFTENER
VENT SYSTEM ❑ FAN ❑EVAP. COOL ❑ HOOD
SIGN
WASHER (AUTO) (DISH)
DST UNITS
APPLIANCE
TRANS- K.W.
FORMER
GARBAGE DISPOSAL
OFFICE
FURNACE ❑ UNIT ❑ WALL ❑FLOOR ❑SUSPENDED
OUTLETS
LAUNDRY TRAY
AIR HANDLING UNIT I = CFM
FIXTURE OR SOCKET
KITCHEN SINK
GAS PIPE ❑ NATURAL ❑ L.P.G. '❑ OIL
CONST. SERV. ENTRANCE
WATER CLOSET
COPIES
COMPRESSOR r 0 HP
POLE
LAVATORY
i
APPLIANCE VENT
AMPERES SERV, ENT.
SHOWER
T
ABSORPTION SYSTEM 0 B.T.U.
.- SO. FT. @ ¢
BATH TUB
INCINERATOR ❑ DOMESTIC ❑ INDUS. OR COMM.
SO. FT. @ Q
WATER HEATER
HEATING SYSTEM ❑ FORCED ❑ GRAVITY
SQ. FT. RESID. @ (4
SEWAGE DISPOSAL
GRP
BOILER 0 B.T.U.
SQ. FT. GARAGE @1�2¢
HOUSE SEWER
PERMIT FEE
BALANCE OF MIN. FEE
GAS PIPING
Y~MOBILE HOME HOOKUP FEE $ 0
PERMIT FEE
PERMIT FEE
PERMIT'140.
2:21
TOTAL FEES.
MOB. HK. FEE MICRO FEE
MEC.. FEE
DBL
PL. CK. FEE
CONST. FEE
DBL.
ELECT. FEE
DBL.
SMI FEE
FEE-
PLUMB. FEE
DBL.
J 1 F I M A I M I -J I J I d I S 1 O 1 N D
JOB ADDRESS
73
74
E BUIL INI.C.DATE
+� Pn NN S
75
_ A- -51
M.H. HOOKUP FEE
$
CO'M UNITY1
DST UNITS
ROOMS
VALUATION
SUPP.TOPERMIT
OFFICE
I
MICROFILM FEE
COPIES
$
CEGAUOESCR P IONS
FEE
DBL
MECHANICAL
'
$
SET BACK
OT SUE - ZONE
USE NO. -
GRP
TYPE BY
_�/PLAN
114,
ICK
df
F S R
CHECK FEE
$ -
-BOND
AMT.
PLAN NO.
PLAN CHECKER
IN A� •,
INSPECTOR
,I t^
CONSTRUCTION FEE
DBL
$
NAME OF CONST. LENDER BRANCH
OFFICEJ.NO
LENDE INVOLVED
ELECTRICAL FEE
DBL
$'
ADDRESS CITY STATE
SMI FEE
$
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 60 DAYS. CESSA-
$
FEE
TION OF WORK FOR 120 DAYS SHALL ALSO CAUSE PERMITTO 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
PLUMBING FEE
DBL
$
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
$
TOTAL FEES)
G1
HAS DONE SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS
E OF CALIFORNIA.
�y�
CASH ❑ CHECK ' M.O. ❑ 'WNER,
' N.C.NFC. ❑
CONTRACTOR
i�'
RECEIVED BY
ADDRESS
_. '.
ADDRESS
SEWAGE SYSTEM T
LL -
P
CITY
CITY -
TREES REQUIRED
YES
NO
TEL. NO.
TEL. NO. LICENSE T
INFORMATION X
FORM 284-208 (Rev. 11/721
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