245604 (RPL)BUILDING PERMIT
I
CONSTRUCTION ESTIMATE
1 ST FL.
SQ.FT. @
2ND FL.
SQ. FT. @
POR.
SQ. FT. @
GAR.
SQ. FT. @
CAR P.
SQ.FT. @
'WALL
SO. FT. @
5 A-, / d!i
A di SQ. FT. @
ESTIMATED CONSTRUCTION VALUATION $
NOTE: Not to be used as property tax valuation
MECHANICAL FEES
F/GAIT CVCTGAA n CA AI n r\/ AD rnnl n Hnnr
DEPARTMENT OF BUILDING & SAFETY
COUNTY OF RIVERSIDE
NO. ELECTRICAL FEES
UNITS
MOBILEHOME SVC.
POWER OUTLET
SWIM POOL, PVT
SWIM POOL, COMM
SIGN
FIFLD OFFICE
NO.I PLUMBING FEES
BOILER L ...... JB.
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
FLOOR DRAIN
WATER SOFTENER
WASHER (AUTO) IDISHI
m
/I
APPLIANCE GARBAGE DISPOSAL
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED LAUNDRY TRAY
AIR HANDLING UNIT I —I CFM IDLE METER KITCHEN SINK
ABSORPTION SYSTEM B.T.U. TEMP USE PERM SVC WATER CLOSET
COMPRESSOR 0 HP POLE, TEMP/PERM LAVATORY
HEATING SYSTEM ❑ FORCED ❑GRAVITY AMPERES SERV ENT SHOWER
SQ FT @ a BATHTUB
SQ FT @ ¢ WATER HEATER SLS
SQ FT RESID @ 1 a SEWAGE DISPOSAL
SQ FT GARAGE @ 'ha ` HOUSE SENDER f %/ 5-.,0 >J
PERMIT FEE TEMP ELEC SVC j GAS PIPING 5
MOBILE HOME PERMIT FEE Is
f PERMIT FEE �� ` PERMIT FEE D t
P R T NO.
TOTALFEES
MOB. HM. FEE
MICRO FEE
MECH. FEE
DBL.
PL. CK. FEE
CONST. FEE
DBL. ELECT. FEESM;!'
DBL.
SME
I FE
FEE PLUMB. FEE
DBL
J f MA I M I J IJ A I S 1 Q 1 N D
JOB ADDRESS SP NO
OWNER
74
USE OF PERMIT
F.C.
'
J
DATE
*231
P26604
75
M H PERMIT FEE
$
COMMUNITY
DST
UNITS
ROOMS
VALUATIONSUPP.
TO PERMIT
OFFICE
MICROFILM FEE
COPIES
$
LEG/AL DESCRIPTION
MECHANICAL FEE
DBL
$
SET BACK
LOT SIZE ZONE
USE NO.
GRP
TYPE
CK BY
j�PLAN
R
CHECK FEE
$
PLAN NO.
PLAN CHECKER
FINAL DATE i IN
ECTOR
rNAMEOF
CONSTRUCTION FEE
DBL
$
ST. LENDER BRANCH
OFFICE
0 LENDER'INVOLVED
ELECTRICAL FEE
DBL
$
ADDRESS CITY
STATE
SMI FEE
$
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSA-
TION OF WORK 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 AC.
CORDANCE WITH THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, I ALSO
$
FEE
AGREE TO CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLIANCE W E
LAWS OF THE STATE OF CALIFORNIA COVERING CONTR TORS IS ALSO GUARANTE
1 HEREBY CERTIFY THAT THE INDIVIDUAL WHO PR ARED'TH PLANS AND ATI ONS
PLUMBING FEE
DBL
$
Gym
.
HAS DONE SO IN ACCORDANCE WITH SECTION 5 O USI NID $SIONSCO
OF THE STATE OF CALIFORNIA.
-
$
OWNER/AGENT'S SIGNATURE
Cq�6T
TOTAL FEES
.,. �
9�
�1�
CASH ❑ CHECK cyM.O. ❑ N.C. ❑
gooREss
AD
RECEIVED BY
TREES REQUIRED
sL
CITY ZIP CODE
CITY ZIP CODE
SEWAGE SYSTEM
Alp INFORMATION
TEL. NO.
TEL. NO. LI V,SE
FOPM 284.208 (Rev. 9.731 65 Qy.l[,.y�
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