245807 (BLCK)BUILDING PERMIT
CONSTRUCTION ESTIMATE
i 1 ST FL. SQ.FT. @
2ND FL. SQ. FT. @
POR. SQ. FT. @
GAR. SQ. FT. @
CAR P. SQ.FT. @
WALLSQ. FT. @
SQ. FT. @
ESTIMATED CONSTRUCTION VALUATION $
NOTE: Not to be used as property tax valuation
_ MECHANICAL FEES
VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD
APPLIANCE
` FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPEN
AIR HANDLING HNIT C
DEPARTMENT OF BUILDING & SAFETY
COUNTY OF RIVERSIDE
NO. ELECTRICAL FEES
UNITS
DED
FM
MOBILEHOME SVC.
POWER OUTLET
SWIM POOL, PVT
SWIM POOL, COMM
SIGN
aA117-
IDLE METER
FIELD OFFICE
NO.] PLUMBING FEES
BOILER I I B.
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
FLOOR DRAIN
WATER SOFTENER
WASHER (AUTO) IDISHI
GARBAGE DISPOSAL
LAUNDRY TRAY
KITCHEN SINK
ABSORPTION SYSTEM O 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 @ C BATH TUB
SQ FT @ a WATER HEATER
SQ FT RESID @ le SEWAGE DISPOSAL
SQ FT GARAGE @ '/a¢ HOUSESEWER
PERMIT FEE TEMP ELEC SVC GAS PIPING
MOBILE HOME PERMIT FEE is
PERMIT FEE // PERMIT FEE
PERMIT NO.
TOTAL FEES
f
MOB, HM. FEE
MICRO FEE
MECH. FEE
DBL.
PL. CK. FEE
I CONST. FEE
U
DBL,
ELECT. FEE_
DBL.
SMI FEE
FEE PLUMB. FEE
DBL
J I F I M A I M I J IJI A I S O 1N D
JOB ADDRESS ' SP NO
OWNER
74
USE OFPERMIT�/'rep cwe"v/.rF'g C���,� �J�.C.
A
DATE
G!
PMR
75
M H PERMIT FEE
$
COMMUNITY
DST
UNITS
ROOMS
VALUATION
�j �v
SUPP. TO PERMIT OFFICE
MICROFILM FEE
COPIES
$
LEGALDESCRIPTION
r4
MECHANICAL FEE
DBL
$
SET BACK
LOT SIZE ZON
//?
E
--/
USE NO.
GRP
TYPE
CK BY
F S R
PLAN CHECK FEE
$
BOND AMT.
PLAN NO.
PLAN CHECKER
1 FINAL DAT Er✓ ^/n r 1
ECTOR f
CONSTRUCTION FEE
DBL
$
NAME OF CONST. LENDER BRANCH
OFFICE
NO LENDER INVOL SED
ELECTRICAL FEE
DBL
$
�}
U U
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
AGREE TO CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLIANCE WITH THE
LAWS OF THE STATE OF CALIFORNIA COVERING CONTRACTORS IS ALSO GUARANTEED.
1 HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS
HAS DONE SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE
OF THE STATE OF CALIFORNIA.
FEE
$
PLUMBING FEE
DBL
$
TOTAL FEES �
��
O(i
OWNER/AGENT'S SIGNATURE
CONTRACTOR '
CASH ❑ CHECK M.Q. ❑ N.C. ❑
ADDRESS /
v�u�
ADDRESS 1
RECEIVED BY
TREES REQUIRED
SEWAGE SYSTEM
TILL
P
CITY ZIP CODE
&Vrf
CITY ZIP CODE
INFORMATION
ORM 284 208 1%, 9.731 IDS Oa/
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