414055 (BLCK)14055
DEPARTMENT OF BUILDING & SAFETY
COUNTY OF RIVERSIDE
FIELD
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL.
2ND. Fl.
FOR.
GAR.
CAR P.
WALL
ESTIMATED CONSTRUCTION
SO. FT. @ $
UNITS
p• 41405 5
F
SQ. FT. @
YARD SPKLR SYSTEM
SO. FT. @ MOBILEHOME SVC.
BAR SINK
SO. FT. @ POWER OUTLET
ROOF DRAINS
SQ. FT. @
DRAINAGE PIPING
SQ. FT. @
DRINKING FOUNTAIN
SO. FT. @
URINAL
VALUATION $
.WATER PIPING
NOTE: Not to be used as pppetty tax valuation
SWIM POOL, PVT
FLOOR DRAIN
MECHANICAL FEES
SWIM POOL, COMM
WATER SOFTENER
VENT SYSTEM FAN EVAP. COOL HOOD
SIGN
WASHER (AUTO)(DISH)
APPLIANCE DRYER
Type
s
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
Bond Amt.
S
LAUNDRY TRAY
AIR HANDLING UNIT CFM
IDLE METER
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET
COMPRESSOR HP
POLE, TEMP/PERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SQ. FT. @ a
BATH TUB '
SO. FT. @ a
WATER HEATER
4 Reinsp. Fee $
S0. FT. RESID @ 1 %c
SEWAGE DISPOSAL'
S0. FT. GAR @ t/a
HOUSE SEWER
City - Zip
/'{ ^�•.. �• �fy J L.�• i:..
•
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL.
TOTAL FEES,i
MOB. HM. FEE
MICRO'FEE
MECH. FEE PL. CK. FEE
1. CONST. FE 3- ELECT. FEE
SMI FEE
FEE PLUMB. FEE
PERMIT NO.
Job A dross -Spore
/orJ
-" ` o' ;te,t,v
Zip
,r
Owner .•+ / ,•
;,^; / iz
p• 41405 5
F
..
Community
f " .•v . t yi / 1' �f :1
Valuation
S -+ � ' ... .� '" -
r�
Dote'
v _ -
Dist
/
Off.
F.C.C.
MH Permit Fee $
Micro Film Fee Cop $
U mit ,.+ (r ♦k
_
�...-.•—....r�+��
F���j''�''"'�, +t/�/ff
Parcel No. Use%Gose No. Ck. By
r �!/ � ~ ��� �' O• J r.
�-' t
Mech. Fee Dbl $
CJ
d+ i
_
Lot Size
F S S
Set BacksP-rou,
PI. Ck. Fee S
----------------
Construction FeeID
Legal Description
`:/ - '"�^ \
% : /Tc �" �• ...... — �y/� � ' /
Electrical Fee 5
Zone Restrictions /
•( 'ri _ /•
Type
s
SMI FeeS
Plumbing Fee $
Bond Amt.
S
Plan No.
Plan Checker
Final Date
!�Demol.
Inspector
Unit
Sp. Insp. Fee$
Fee$
Const. Lender Branch
Supplimental Permit NvmbWs
t Registr. Fee $
° Mileage Fee $
Address �' ( // City Zip
! Witness Fee $
4 Reinsp. Fee $
Owner/Agent
fir
Tel. Zip
Total Fees Is �77 r +
Address
',Ji' •_ J�;i'
City - Zip
/'{ ^�•.. �• �fy J L.�• i:..
M.O. ❑ N.C. ❑ Cash ❑ Check
�. Y
.J ,tet ,J f
Received b
Contractor
Tel.
LicenteR
Trees re wired
Sewage System /� Address City Zip
�p�
T LL THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF WORK veriLied by:
Sewer District FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
I HEREBY AGREE THAT 'ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE WITH
• /jJ THE LAWS OF RIVERSIDE, COUNTY AND THE'STATE OF CALIFORNIA.
-
CERTIFY THAT THE ANDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE SO IN
Form 28e•208 (Rev. 1/80) ACCORDANCE WITH SECTION 5541, OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA.
NO.
OPERATION
DATE
INSPECTOR
NO.
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
I
Set Back
Z _ �' — $
33
Ventilation System
2
Ftgs & Frms
�(
Y
34
Plenums 8 Ducts
2A
Slab Grade
35
Furnace Comport.
3
Steel
Z -� 7
36
Inlets 8 Outlets '
4
Grout Blocks
37
Combustion Air
5
Bond Beams
Zz 5 - �(�
U
38
Compressor
6
Roof Deck
39
Appl. Clearance
7
Framing
40
Fire Damper
8
Vents
41
Smoke Detection Device
9
Garage Fire Wall
42
Commercial Hood
10
Fireplace P. L.
43
Final
10A
Fireplace T. 0.
❑
°o
ADDITIONAL INFORMATION
r
SEWAGE SYSTEM SIZE & LOCATION
11 Exterior lath
12 Internal Lath
12A Drywall
13 Finish Grade
INSULATION Thick
Value
7A Walls (Botts)
12B Ceiling (Botts)
12C Ceiling (Blown)
14 Final
PLUMBING_ APPROVALS, _
'15 Ground Plumb
16 Water Piping
17 Rough Plumb
18 Vents
19 Sewage Disposal
20 Sewer
21 Water Heater.
22 Water Softener '
23 Water Service
24 Gas Test
25
Final
Tank Pit L. Line
REAR OF PROPERTY LINE
'
PSL P/
ELECTRICAL APPROVALS
26 Power Pole
27 Conduit
• 28 Service Entrance
29 Wiring
29A Grounding Wire
29B Bonding
30 Fixtures
' 31 Service '
32 Final
1
STREET NAME
BUILDING PERMIT
PERMIT NO.
414055
DEPARTMENT OF BUILDING & SAFETY FIELD OFFICE M
I
COUNTY OF RIVERSIDE
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL.
2ND. FL.
POR.
GAR.
CAR P.
WALL
ESTIMATED CONSTRUCTION
SO. FT. @ $
UNITS
Communiyy
`'� �� �"1Jy �^f. ;�
SO. FT. @
YARD SPKLR SYSTEM
SO. FT. @ MOBILEHOME SVC.
BAR SINK
SO. FT. @ POWER OUTLET
ROOF DRAINS
SO. FT. @
DRAINAGE PIPING
SO. FT. @
DRINKING FOUNTAIN
SO. FT. @
URINAL
VALUATION $
WATER PIPING
NOTE: Not to be used as property tax v,oluation
SWIM POOL, PVT
FLOOR DRAIN
MECHANICAL FEES
SWIM POOL, COMM
WATER SOFTENER
VENT SYSTEM FAN EVAP. COOL HOOD
SIGN
WASHER (AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
Electrical Fee Dbl S
LAUNDRY TRAY
AIR HANDLING UNIT CFM
IDLE METER
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET
COMPRESSOR HP
POLE, TEMP/PERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SO. FT. @ c
BATH TUB
S
SO. FT. @ a
WATER HEATER
Supplimental Permit NumWs
/
S0. FT. RESID @ 1 t/aa
SEWAGE DISPOSAL
r. Fee S
e
S0. FT. GAR @ t/<a
HOUSE SEWER
Witness Fee S
Reinsp. Fee
g
GAS PIPING
PERMIT FEE
Tel.Zip
_
/,
-`
Total Fees
S f 0 (/
Address
City ,
Ll! I^ � C�.-
zip
7 .! .;2
M.O. ON C. E]Cash [3 Check
Received
Trees required
lo
Contractor
Tel.
Licensell
/
Sewage System
Address
City Zip
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF WORK
...it;.a k—
Sewer District FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
I HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE WITH
Av THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA.
CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE SO IN
Form 284.208 (Rev. 1/80) C RDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA.