272296 (SFD)BUILDING PERMIT DEPARTMENT OF BUILDING & SAFETY
COUNTY OF RIVERSIDE
CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES
I ST FL. SQ.FT. @ re / 'et 7,9 UNITS
2ND FL. SQ. FT. @
POR. L/. SQ. FT. (@ -"/ �" " % MOBILEHOME SVC.
iGAR. r?%) SO. FT. @ POWER OUTLET
CAR P. SOFT. @
WALL SQ. FT. @
SQ. FT. @
ESTIMATED,CONSTRUCTION VALUATION $ ,! ? 1 ` �--
NOTE: Not to be used as property tax valuation
I
MECHANICAL FEES
VENT SYSTEM ❑ FAN ❑ EVAP. COOL n HOOD )0
SWIM POOL, PVT
SWIM POOL, COMM
SIGN
FIELD OFFICE
NO.
PLUMBING FEES
O`WNEERR
74
I
YARD SPKLR SYSTEM
75
BAR SINK
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR] SUSPENDED
ROOF DRAINS
I O.
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
AIR HANDLING UNIT CFM
WATER PIPING
IDLE METER
FLOOR DRAIN
!
WATER SOFTENER
_ jU
WASHER (AUTO) 106Mt1'
DST
mm
APPLIANCE 1 41 ; G; .1
� DLJ
O`WNEERR
74
I
GARBAGE DISPOSAL
75
USE OF PERMIT
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR] SUSPENDED
DATE
I O.
LAUNDRY TRAY
IPE
AIR HANDLING UNIT CFM
IDLE METER
!
KITCHEN SINK
_ jU
ABSORPTION SYSTEM 0 B.T.U.
VALUA/TION
TEMP USE PERM SVC
OFFICE
/
WATER CLOSET
COMPRESSOR HP
�f :,
POLE, TEMP/PERM
LAVATORY
Ov
HEATING SYSTEM I9 FORCED ❑ GRAVITY
�� , J /�jj)
AMPERES SERV ENT
7J
SHOWER
BOILER 0 B.T.U.
SQ FT @ c
MECHANICAL FEE
DBL
BATH TUB
!,'J
SET BACK J
LOT SIZE ZONE
SQ FT @ a
USE NO.
/
WATER HEATER
CK BY
SQ FT RESID @ 1¢
- ry
/
SEWAGE DISPOSAL
SQ FT GARAGE @ Vxt
L/
HOUSE SEWER
PERMIT FEE
GAS PIPING
MOBILE HOME PERMIT FEE $
/
PERMIT FEE
p!1
f
PERMIT FEE
-w- ,
27R2IT O.
9
TOTAL FEES ,.�
OB. HM.FEE
MICRO FEE
MECH. FEE
DBL.
PL. CK. FEE
CONST. FES
DBL.
ELECT. FEE
;BL.
-
SMI FE
,
FEE�.�
PLUMB. FEF
DBL.
J I E M A M J J A S Q N D
lOB ADDRESS SP NO
O`WNEERR
74
�)
.� /"i r;'U :r si F: i'+T�Yt
-' 0 � )),7 YI i C. C'
75
USE OF PERMIT
F.C.
DATE
I O.
J
IPE
M H PERMIT FEE
$
COMMUNITY
DST
UNITS
ROOMS
VALUA/TION
SUPP. TO PERMIT
OFFICE
1
I
MICROFILM FEE
COPIES
$
LEGAL DESCRIPTION
MECHANICAL FEE
DBL
$
SET BACK J
LOT SIZE ZONE
USE NO.
GRP
TYPE
CK BY
f 7
v off.ON.A.T.
PLAN CHECK FEE
$
11
PLAN NO.
PLAN CHECKER
FINAL DATE/
INS CTOR
CONSTRUCTION FEE
DBL
$
NAME OF CONST. LENDER BRANCH
OFFICE
NO LENDER INVOLVED
ELECTRICAL FEE
DBL
$
ADDRESS CITY
STATE
STRONG MOTION
$
OWNER/AGENT'S SIGNATURE
CONTRACTOR S•--=.;'%. '. - y' '�
INSTRUMENTATION FEEK
ff -r
7-
$
ADDRESS
ADDRESS
FEE
, ---�
PLUMBING FEE.
DBL
$
CITY ZIP CODE
ZIP CODE
,CIITYY-�
TOTAL FEES
$
// 7/1
f_?
TEL. NO. _
LICENSE
CASH ❑ CHECK ,Q9 M.O. ❑ N.C. p
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSA•
OF WORK FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
RECEIVED BY/% TREES REQUIREDj46N
_ �
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 ALSC
SEWAGE SYSTEM
T
LL
an'v
P
AGREE TO CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLIANCE WITH THE
C/ II I A Pl, J C n I A II llA IT AI llnf iC Al C/, iiA n nIT C CM
I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS
FORM 284-208 (Rev. 10-74) @L HAS DONE SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE
[L OF THE STATE OF CALIFORNIA.