24393 (SFD)1 BUILDING PERMIT
DEPARTMENT OF BUILDING & SAFETY
► COUNTY OF RIVERSIDE A
ELECTRICAL FEES
MOBILEHOME SVC.
POWER OUTLET
SWIM POOL, PVT
SWIM POOL, COMM
FIELD OFFICE
NO.I PLUMBING FEES
BOILER �� I
BARSINK.
ROOF DRAINS
DRAINAGE PIPING
DEINKING FOUNTAIN
UF' -NAL
WATER PIPING
FLOOR DRAIN
WATER SOFTENER
.a -
CONSTRUCTION ESTIMATE
1 ST FL.
j
SQ.FT. "
FURNACE ❑UNIT ❑WALL ❑FLOOR [SUSPENDED LAUNDRY TRAY
s
2ND FL.
ABSORPTION SYSTEM 0 B.T.U. 'TEMP USE PERM SVC ,2 WATER CLOSET 00
SQ. FT. @�
POR.
FT. �
SQ'FT '
AY4
s s
GAR. _
SO. FT. @
CAR P.
SQ FT GARAGE @ 'ha HOUSESEWER
I SQ FT @
WALL
MOBILE HOME PERMIT FEE $
SQ. FT. @
41TN
TOTALFE
SO. FT. @
ESTIMATED CONSTRUCTION
VALUATION $%
NOTE: Not to be used as property tax valuation
PL.CK.FEE
CONST. FEE DBL. ELECT.•FEE
MECHANICAL FEES
DEPARTMENT OF BUILDING & SAFETY
► COUNTY OF RIVERSIDE A
ELECTRICAL FEES
MOBILEHOME SVC.
POWER OUTLET
SWIM POOL, PVT
SWIM POOL, COMM
FIELD OFFICE
NO.I PLUMBING FEES
BOILER �� I
BARSINK.
ROOF DRAINS
DRAINAGE PIPING
DEINKING FOUNTAIN
UF' -NAL
WATER PIPING
FLOOR DRAIN
WATER SOFTENER
.a -
VENT SYSTEM L't}�FAN ❑ EVAP. COOL Lt�HOOD SIGN WASHER IAUTO ISH) -
APPLIANCE GARBAGE DISPOSAL U
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 ,2 WATER CLOSET 00
COMPRESSOR HP 00 POLE, TEMP/PERM LAVATORY'.300
HEATING SYSTEM 6,FORCED ❑GRAVITY `j AMPERES SERV ENT g9O SHOWER V
SQ FT @ ¢ BATH TUB
SQ FT @ ¢ j WATER HEATER "-0
SQ FT RESID @ )a j 16 l ' SEWAGE DISPOSAL
SQ FT GARAGE @ 'ha HOUSESEWER
PERMIT FEE 0TEMP ELEC SVC GAS PIPING
MOBILE HOME PERMIT FEE $
>/ PERMIT FEE 00 % PERMIT FEE L?
41TN
TOTALFE
JMOB.HM.FEE
MICRO FEE
MECH.FE
DBL.
PL.CK.FEE
CONST. FEE DBL. ELECT.•FEE
DBL.SMI
FEE
FEE PLUMB. FE
DBL
J F M A I M I J I J A I S 1 O 1 N D
JOB ADDRESS _ SP NO
.. "_ V t ! L I
OW
!"'�
73
74
USE OF PER/MIT�-1
1 7 T1 h! -r Odp
F.C.
DATE -ry
PERMIT
24 93
75
M H PERMIT FEE
$
COMMUNITY%DSI
? U 1 &11t
UNITS
ROOMS
VALUATION
SUPP. TO PERMIT
OFFICE
MICROFILM FEE
COPIES
$
LEGAL DESCRIPTION . —1
er
MECHANICAL FEE
DBL
$
SET BACK
LOT SIZE ZONE
USE NO.
GRP
TYPE
CK BY
PLAN CHECK FEE
$
BOND AMT.
PLAN NO.
PLAN CHECKER
I FINAL DATE INSPECTOR
J
CONSTRUCTION FEE
DBL
$
47
/}
NAME OF CO NDF�RT� � / }� BRANCH
OFFICE
NO LENDER INVOL466
ELECTRICAL FEE
DBL
$
j�!
♦° f/
�s '
7''
J
��r ADDRESS / CITY
F''.. ! � i
STATE
STATTE "
cz 1
SMI FEE
$
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHINaUO DAYS. CESSA.
TION OF WORK FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOIIS:
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
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 CALIF RNIA,,,
FEE
$
PLUMBING FEE
DBL
$
Q
TOTAL FEES �
$
� � �
� (j
OWNER/AGENT'SSIGNATURE j•�,.!lf",..
�..!��
J5 i; i �e 3 Lf!J vws�--Y P
CONTRACTOR
--
CASH ❑ �C HECK'A M.O. ❑ N.C. ❑
ADDRESS
ADDRESS "
RECEIVED BY rr
TREES REQUIRED
'
SEWAGE SYSTEM
CITY ZIP CODE
INFORMATION
ORM 284.208 (Rev 9.731 05 de&4* .11
TEL. NO.
TEL. NO. LICENSE