23227 (SFD)BUILDING PERMIT DEPARTMENT OF BUILDING & SAFETY
COUNTY OF RIVERSIDE
CONSTRUCTION ESTIMATE, , w ELECTRICAL FEES,.,".r.
.�/ NO.
FIELD OFFICE
PLUMBING FEES
1 ST FL.
2ND FL.
POR.SQ.
GAR.
CAR P.
WALL
ESTIMATED CONSTRUCTION VALUATION
SQ. FT.
SQ. FT. �i0
MOB. HK. FEE MICRO FEE MECH. FEE.
�T.
PL. CK.� E
CONST. FEE
DBL. ELECT. FE DBL. SMI FEE
FT. ""�'�'^ fMOTOR I OR LESS H.P.
DBL!
SQ.FT. `' ? ' MOTOR 5 OR LESS H.P.
MOTOR 20 OR LESS H.P.
SQ. FT. @
DRAINAGE PIPING
SQ.FT. @
DRINKING FOUNTAIN
SQ. FT. @
URINAL
p
7 (P K.W. UNITS
WATER PIPING
NOTE: Not to be used as property tax valuation
OWNER
O /1
73
74
USE OF BUILDING
is?
FLOOR DRAIN
MECHANICAL FEES
PGR 2N�2272
75 `G
M.H. HOOKUP FEE
WATER SOFTENER
VENT SYSTEM 19 FAN ❑ EVAP. COOL ;Q -HOOD
F�I
SIGN
UNITS
ROOMS VALUATION SUPP. TO PERMIT OFFICE '.
11 WASHER (AUT(e(DISH)
APPLIANCE
+r3
TRANS- K.W. FORMERGARBAGE
/OMMUNITY
/
DISPOSAL
FURNACE ❑ UNIT ❑ WALL ❑FLOOR ❑SUSPENDED
MICROFILM FEE
OUTLETS
$
"
LAUNDRY TRAY
I
AIR HANDLING UNIT I CFM
FIXTURE OR SOCKET
KITCHEN SINK
GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
CONST. SERV. ENTRANCE
.� ` 7— VY / ,
MECHANICAL FEE
WATER CLOSET
COMPRESSOR HP
POLE
LOTS IZE
ZONE
LAVATORY
APPLIANCE VENT
TYPE CK Y
AMPERES SERV. ENT.
Ej
SHOWER
ABSORPTION SYSTEM 0 B.T.U.
~FINAL
SO. FT. @ Q
J
/
BATH TUB
INCINERATOR ❑ DOMESTIC ❑ INDUS. OR COMM.
SQ. FT. @ 4
PLAN CHECK FEE
WATER HEATER
HEATING SYSTEM y)® FORCED ❑ GRAVITY
j 074
+- SO. FT. RESID. @ I a
PLAN NO.
1
SEWAGE DISPOSAL
_
BOILER 0 B.T.U.
SQ. FT. GARAGE @]�y¢
S"
HOUSE SEWER
PERMIT FEE
BALANCE OF MIN. FEE
/
GAS PIPING
MOBILE HOME HOOKUP FEE is , I
PERMIT FEE
OFFICE .N
LENDER INV LVED
PERMIT FEE
>.
P %
TOTAL FEF,i
MOB. HK. FEE MICRO FEE MECH. FEE.
DBL.
PL. CK.� E
CONST. FEE
DBL. ELECT. FE DBL. SMI FEE
FEE P"LUUMB�E�
DBL!
470f
J I F I M A M J J A I $ 1 O 1 N I D
JOB ADDRESS d
'Ei Q /
OWNER
O /1
73
74
USE OF BUILDING
is?
F. C.
15ATE 7_':t
-y
7
PGR 2N�2272
75 `G
M.H. HOOKUP FEE
$
DST
UNITS
ROOMS VALUATION SUPP. TO PERMIT OFFICE '.
/OMMUNITY
/
/
9 "
MICROFILM FEE
COPIES
$
"
LEGAL DESCRIPTION
.� ` 7— VY / ,
MECHANICAL FEE
DBL
$
SETBACK
LOTS IZE
ZONE
USE NO.
GRP
TYPE CK Y
.
~FINAL
J
1>0
$
PLAN CHECK FEE
BOND AMT.
PLAN NO.
PLAN CHECKER
DATE INSP
TOR
a
CONSTRUCTION FEE
DBL
$
NAME OF CONST. LENDER BRANCH
OFFICE .N
LENDER INV LVED
_
/
j0e4__'.d J ai
A j
ELECTRICAL FEE
DBL
$
ADDRESS CITY
STATE
�1
�
/
i•/
SMI FEE
$'
THIS PERMIT SHALL BECOME VOID IF WORK IS NQIT COMMENCED WITHIN 60 DAYS. CESSA• "
TION OF WORK FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
FEE
$
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
PLUMBING FEE
DBL
$
-g
AGREE TO CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLIANCE WITH
I'
D
THE LAWS OF THE STATE OF CALIFORNIA COVERING CONTRACTORS IS ALSO GUARTEED.
1 HEREBY CERTIFY THAT THE INDIVIDUAL WHO?PR THE A A SPE IF TIONS
$
TOTAL FEES
HAS DONE SO IN ACCORDANCE WITH SECTION1 E SSIONS
STATE OF CALIFORNIA.�i�
CASH ❑ CHECK e? M.O. ❑ ' N.C. ❑
OWNER.
CONTRACTOR
RECEIVED BY ArADDRESS
ADD Ess
— %
SEWAGE SYSTEM i T
LL P
clrr
c rry
TREES REQUIRED
YES NO
/�A
INFORMATION
TEL. NO.
TEL. NO. LICENSE
FORM 284.2081Rev. 11/721
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