240933 (CRES)BUILDING PERMIT
CONSTRUCTION ESTIMATE
I ST FL.
SQ.FT. @
2ND FL.
SQ. FT. @
POR.
SQ. FT. @
GAR.
SQ. FT. @
41
CAR P.
SQ.FT. @
WALL
SQ. FT. @
SOFT @ ¢ BATH TUB
SQ. FT. @
ESTIMATED CONSTRUCTION
VALUATION $
NOTE: Not !o be used as property tax valuation
MECHANICAL FEES
EPARTMENT OF BUILDING & SAFE
COUNTY OF RIVERSIDE
NO. ELECTRICAL FEES
UNITS
MOBILEHOME SVC.
POWER OUTLET
SWIM POOL, PVT
SWIM POOL, COMM
FIELD OFFICE
NO.] PLUMBING FEES
BOILER I I B.T.U.
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
FLOOR DRAIN
WATER SOFTENER
VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD SIGN WASHER (AUTO) (DISH)
APPLIANCE GARBAGE DISPOSAL
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED LAUNDRY TRAY
AIR HANDLING UNIT CFM IDLE METER KITCHEN SINK
ABSORPTION SYSTEM 0 B.T.U. TEMP USE PERM SVC WATER CLOSET
COMPRESSOR 0 HP POLE, TEMP/PERM LAVATORY
HEATING SYSTEM ❑ FORCED ❑ GRAVITY AMPERES SERV ENT SHOWER
SOFT @ ¢ BATH TUB
SOFT @ ¢ WATER HEATER
SQ FT RESID @ 1 ¢ SEWAGE DISPOSAL
SQ FT GARAGE @ HOUSE SEWER
PERMIT FEE TEMP ELEC SVC GAS PIPING
MOBILE HOME PERMIT FEE $
PERMIT FEE PERMIT FEE
PERMIT NO.
TOTAL FEES
�~ ?
MOB. HM. FEF
MICRO FEE
MECH. FEE
DBL.
PL. CK. FEE
,�
CONST. FEE
1L0
DBL.
ELECT. FEE
DBL.
SMI��j
FEE PLUMB. FEE
DBL.
J I F I M A I M I J I J A I S 1 O 1 N D
JOB ADDRESS SP NO
OWNER`
r
73
74
USE OF PERMIT t
'? !"' Y t l a
F. C.
.�
DATE
y CF —
PERMIT O. rI{�,
1 ''
75
M H PERMIT FEE
$
COMMUNITY
DST
UNITS jybOMS
lE
I VALUATION
ft f ^ r`iL.-
SUPP. TO PERMIT O 1 '
7
MICROFILM FEE
COPIES'LEGAL
DESCRIPTION �^ / ,� �r
6? 16- 3-, a T �7 ire Jl 1- L `/
MECHANICAL FEE
DBL
$
SET BACK
LOT SIZE ZONEUSE
`
� -11
f
NO.
GRP
TYPE CK BY
b
PLAN CHECK FEE
$
BOND AMT.
PLAN NO.
PLAN CHECKER
FINAL DATE INSPECTOR
CONSTRUCTION FEE
DBL
$
NAME OF CONST. LENDER BRANCH
OFFICE
NO LENDER INVOLVED
ELECTRICAL FEE
DBL
$
ADDRESS CITY
STATE
SMI FEE
$
47
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CASSA•
TION OF WORK FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
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 ALSO
AGREE TO CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLIANCE WITH THE
LAWS OF THE STATE OF CALIFORNIA COVERING CONTRACTORS IS ALSO GUARANTEED.
I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS
HAS DONE S CCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE
F THE STAT OF LIFORNIA.
FEE
$
PLUMBING FEE
DBL
$
TOTAL FEES
$
%
�^
OWNE AGENT'S SIGN TURE
CONTRACTOR
CASH X CHECK ❑ M.O. ❑ N.C. ❑
ADDR
ADDRESS
RECEIVED BY
TREES REQUIRED
7"
SEWAGE SYSTEM
T
LL P
CITY ZIP CODE
/i
CITY ZIP CODE
INFORMATION
ORM 284 208 (Rev. 9.731 05
7LT L.'RO.
TEL. NO. LICENSE