222859 (RER)BUILDING PERMIT
DEPARTMENT OF BUILDING & SAFETY
SIGN
WASHER (AUTO) (DISH)
.• COUNTY OF RIVERSIDE
APPLIANCE
CONSTRUCTION ESTIMATE_ ._ ELECTRICAL FEES,.,;
1 ST FL.
SQ. FT. @
NO...
2ND FL.
SQ. FT. @
3'
POR.
SQ. FT. @
1' MOTOR 1 OR LESS H.P.
GAR.
SQ.FT. @
MOTOR 5 OR LESS H.P.
CAR P.
SQ. FT. @
MOTOR 20 OR LESS H.P.
WALL
SQ.FT. @
J
RTIC
SQ. FT. @
SHOWER
�v
A N
RUC N VALUATION
$ OK W• UNITS
NOTE: Not to be used as property tax valuation
E b7F BUInING F.C.
INCINERATOR ❑ DOMESTIC ❑ INDUS. OR COMM.
MFCHANIC'AI FFFS
WATER HEATER
FIELD OFFICE
PLUMBING FEES DST 11
ll
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
FLOOR DRAIN
WATFR it7FTFNFR
MOBILE HOME HOOKUP FEE Is I I je I I rCHM11 rcc I I I I NtHMII t-tt I )
VENT SYSTEM ❑ FAN ❑EVAP. COOL ❑ HOOD
SIGN
WASHER (AUTO) (DISH)
DBL.
APPLIANCE
TRANS- FORMER K W
GARBAGE DISPOSAL
ELECT. FEE
FURNACE ❑•UNIT ❑ WALL ❑FLOOR ❑SUSPENDED
OUTLETS
LAUNDRY TRAY
PLUMB. FEE
AIR HANDLING UNIT I CFM
FIXTURE OR SOCKET
KITCHEN SINK
.� e=
GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
CONST. SERV. ENTRANCE
WATER CLOSET
~
COMPRESSOR HP
POLE
LAVATORY
J
APPLIANCE VENT
AMPERES SERV. ENT.
SHOWER
F
ABSORPTION SYSTEM O B.T.U.
SO. FT. @ Q
BATH TUB
E b7F BUInING F.C.
INCINERATOR ❑ DOMESTIC ❑ INDUS. OR COMM.
SQ. FT. @ d
WATER HEATER
HEATING SYSTEM ❑ FORCED ❑ GRAVITY
SO. FT. RESID. @ 14
SEWAGE DISPOSAL 2
_
BOILER 0 B.T.U.
SO. FT. GARAGE @I1,0
HOUSE SEWER
®
PERMIT FEE
BALANCE OF MIN. FEE
GAS PIPING
MOBILE HOME HOOKUP FEE Is I I je I I rCHM11 rcc I I I I NtHMII t-tt I )
I�Ty/QqN TOTAL FEE++ESS7y//
MOB. HK. FEE MICRO FEE
M ^H. FEE
DBL.
PL. CK. FEE
CONST. FEE
DBL.
ELECT. FEE
DBL.
SMI FEE
FEE
PLUMB. FEE
DBL.
f®JAPE//g�yM,
9-7-
.� e=
�9
w,/�Gj
J
J I F I M .A I M -1•-J-. .J_ -,A I_S 1 .O •1 N _1
.oe ADARESS
y115-11
OWNER'
11
73
74
E b7F BUInING F.C.
DWTE - P"222859
ERtv1•GG]]xN� 2 8 5 9
75
M.H. HOOKUP FEE
$
N T ` D.1 UNITS ROOMS V ATION ' SUPP. TO PERMIT OFFICE }
:LEGAL
®
IPTION
tMICROFILM
FEE'
COPIES
$
1
d ,
MECHANICAL FEE
DBL
$
SET BACK
ONE
rJ
USE NO.
GRP TYPE
CK 8Y
PLAN CHECK FEE
$
BOND AMT.PLAN
NO.
PLAN CHECKER
FINAL DATE
INSPECTOR
I- a 0
CONSTRUCTION FEE
DBL
- $
NAME OF CONST. LENDER
BRANCH OFFICE .NO
LENDER INVOLVED
�� L
ELECTRICAL FEE
DBL
$
ADDRESS .
CITY -
STATE
SMI FEE
$
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 60 DAYS. CESSA-
TION OF WORK FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
$
FEE
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
PLUMBING FEE
DBL
$
AGREE TO CARRY %COMP€NSATION INSURANCE UPON MY EMPLOYEES. COMPLIANCE WITH
THE LAWS OF THE STATE OF CALIFORNIA COVERING CONTRACTORS IS ALSO GUARANTEED.
IL HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS
$
HAS DONE SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS
TOTAL FEES
"r OF THF E OF CALIFORNIA.
CASH � CHECK ClM.O. ❑ N.C. ❑
OWNER,
t
CONTRACTOR
RECEIVED BY��
S• � �
ADDRESS
SEWAGE SYSTEM T
LL
P
/ "z tall be,
CTy
CITY
TREES REQUIRED
YES
NO
TEL. NO.
INFORMATION
TEL. NO.
FORM 284.208 (Re, 1 1 /72)