24374 (PLBG)I BUILDING PERMIT
DEPARTMENT OF BUILDING & SAFETY
COUNTY OF RIVERSIDE .
ELECTRICAL FEES
UNITS
MOBILEHOME SVC.
POWER OUTLET
SWIM POOL, PVT
SWIM POOL, COMM
FIELD OFFICE
PLUMBING -FEES
BOILER � E
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
FLOOR DRAIN
WATER SOFTENER
DST i
CONSTRUCTION ESTIMATE
1 ST FL.
— SQ.F-. @
2ND FL.
SQ. FT. @
POR.
SQ. FT. @
i GAR.
SQ. FT. @
CAR P.
SQ.FT. @
WALL
SQ. FT.- @
VALUATION
SQ. FT. @
ESTIMATED CONSTRUCTION VALUATION $
NOTE: Not to be used as property tax valuation
MECHANICAL FEES
DEPARTMENT OF BUILDING & SAFETY
COUNTY OF RIVERSIDE .
ELECTRICAL FEES
UNITS
MOBILEHOME SVC.
POWER OUTLET
SWIM POOL, PVT
SWIM POOL, COMM
FIELD OFFICE
PLUMBING -FEES
BOILER � E
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
FLOOR DRAIN
WATER SOFTENER
DST i
I J F M A 1 M J I i I A_-} —S � —O--� N �D JOB ADDRESS IPNOOw`n{E�s+
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74 -
VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD
SIGN
WASHER (AUTO) (DISH)
PERMIT243 7
APPLIANCE
M H PERMIT FEE$
GARBAGE DISPOSAL
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
D
LAUNDRY TRAY
ROOMS
VALUATION
AIR HANDLING UNIT 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 @ ¢
BATH TUB
MICROFILM FEE
COPIES
SQ FT @ ¢
WATER HEATER
LEGAL DES RIPTION
SQ FT RESID @ 1 ¢
SEWAGE DISPOSAL
a 0
MECHANICAL FEE -
DBL.
SQ FT GARAGE @ 'h¢
HOUSE SEWER
SETBACK
LOT SIZE ZONE
PERMIT FEE
TEMP ELEC SVC
GAS PIPING
TYPE
MOBILE HOME PERMIT FEE Is
I
PERMIT FEE
PERMIT FEE
GI 0
^,R 1 4
J
`�AL FE
42
MOB. HM. FEE
MICRO FEE7CH.,'FEE
DBL.
PL. CK. FEE
CONST. FEE
DBL.
ELECT. FEE
DBL:
SMI FEE
FEE
PLUMB. EO
DBL
I J F M A 1 M J I i I A_-} —S � —O--� N �D JOB ADDRESS IPNOOw`n{E�s+
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74 -
USE OF P}ERMIT
F.C.
DATE �—
PERMIT243 7
75
M H PERMIT FEE$
COMtT1UNITY
D
UNITS
ROOMS
VALUATION
SUPP. TO PERMIT
OFFICE
"
ly
MICROFILM FEE
COPIES
$
LEGAL DES RIPTION
4 4-1
"��`` / a►f f L./! 1i-^? t''� �1��"!� - " end 'p �.
MECHANICAL FEE -
DBL.
$
SETBACK
LOT SIZE ZONE
USE NO.
GRP
TYPE
Y
.
J
F S R
PLAN CHECK FEE
$
BOND AMT.P
LAN NO.
PLAN CHECKER
FI/NAL DATE IN
SP CTOR r!
CONSTRUCTION FEE
DBL
$
NAME OF CONST. LENDER BRANCH
OFFICE
NO LENDER INVOLVED
ELECTRICAL FEE
DBL
$
ADDRESS CITY
—
STATE
SMI FEE
$
THIS PERMIT SHAD BECOME VOID IF WORK IS NOT COMMENCED WITHIN O 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.
$
FEE
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.
PLUMBING FEE
DB'
$
I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS
1,2
HAS DONE SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE
OF THE STATE OF CAIIfORNIA.
$
OWNER/AGENT'S IGN URE
{ `
CONTRACTOR
TOTAL FEES �
,%�
��
a,
CASH CHECK ❑ M.O. ❑ N.C. ❑
ADDRESS
- ADDRESS +
RECEIVED BY
TREES REQUIRED
y%
SEWAGE SYSTEM
Y�.�
L4o�f>td
P
CITY x..., ZIP CODE.
j" +�•��r` { A 1 2•V "J'
CITYZIP CODE
INFORMATION
TEL. NO. -
TEL -NO. LICENSE
FORM 284.208 IRev. 9-73i 05
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