226353 (BLCK)BUILDING PERMIT
CONSTRUCTION ESTIMATE
1 ST FL.
SO. FT. @
2ND FL.
SQ. FT. @
POR.
SQ. FT. @
GAR.
SQ.FT. @
CAR P.
SQ. FT. @
WALL
SOFT. @
1}00, FC- N4 S
SQ. FT. @
ESTIMATED CONSTRUCTION VALUATION
$
NOTE: Not to be used as property tax valuation
MFCHANICAI FEES
DEPARTMENT OF BUILDING & SAFETY
COUNTY OF RIVERSIDE '
ELECTRICAL FEES •-
NO.
MOTOR I OR LESS H.P.
MOTOR 5 OR LESS H.P.
MOTOR 20 OR LESS H.P.
K.W. UN
FIELD OFFICE
• r
PLUMBING FEES
NO. I/ :
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
FLOOR DRAIN
WATER SOFTENER
MOBILE HOME HOOKUP FEE Is, NtHMII t-tt VtHMII Ftt
VENT SYSTEM ❑ FAN ❑EVAP. COOL ❑ HOOD
SIGN
WASHER (AUTO) (DISH)
MECH. FEE
APPLIANCE
TRANS-. K.W.
FORMER
GARBAGE DISPOSAL
DBL.
FURNACE ❑ UNIT ❑ WALL ❑FLOOR ❑SUSPENDED
OUTLETS
LAUNDRY TRAY
FEE
AIR HANDLING UNIT CFM
FIXTURE OR SOCKET
KITCHEN SINK
JOBADDRESS�/ --
GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
CONST. SERV. ENTRANCE
WATER CLOSET
i
COMPRESSOR 0 HP
POLE
LAVATORY
75
APPLIANCE VENT
AMPERES SERV. ENT,
SHOWER
ABSORPTION SYSTEM 0 B.T.U.
SQ, FT. @ Q
BATH TUB
ROOMS
INCINERATOR ❑ DOMESTIC ❑ INDUS. OR COMM.
SQ. FT. @
WATER HEATERa
MICROFILM FEE
HEATING SYSTEM ❑ FORCED ❑ GRAVITY
SQ. FT. RESID. @ 4
SEWAGE DISPOSAL
_
BOILER 0 B.T.U.
SO. FT. GARAGE @124
HOUSE SEWER
PERMIT FEE
BALANCE OF MIN. FEE
GAS PIPING
MOBILE HOME HOOKUP FEE Is, NtHMII t-tt VtHMII Ftt
PE IT NO
TOTAL FEES
MOB. HK. FEE MICRO FEE
MECH. FEE
DBL.
PL. CK. FEE
74_
CONST. FEE
DBL.
ELECT. FEE
DBL.
SMI FEE
FEE
PLUMB. FEE
DBI
J
J F I M A I M-1 J I J A I S 1 0 -N- -D
JOBADDRESS�/ --
OWN R f
74
U�SE O�FBUILDING-�,l)t�A (�oov "c�w�eiil
!J
F.C.
DATE - r
P ERM
,
6 3 5 j
75
M.H. HOOKUP FEE
" $
COMMUNITY�j
`7 LiJ{MTi�
DST
UNITS
ROOMS
VALUATION
J/ ®�
SUPP. 70 PERMIT
OFFICE
T
MICROFILM FEE
COPIES
$
LEGAL
LDDESCRIPTION
v/ /
MECHANICAL FEE
DBL
$
SETBACK
LOT SIZE ZONE
USE NO.
GRP
TYPE
CK BYJ
11 4 �.
R
PLAN CHECK -FEE
-
$
+
.
PLAN NO. .PIAN
CHECKER..
FINAL DATE, INSPECTOR1CONSTRUCTION
� 073
FEE
DBL
$
T4)BOND
ONST. (ENDER BRANCH
OFFICENO
LENDER INVOLVEDELECTRICAL
e✓
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.
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.
I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS
HAS DONE SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSPNS
COD54FITIPAVATE OF IF IA.
FEE
$
PLUMBING FEE
DBL
$
$
TOTAL FEES.
5-4j
CASH CHECK ❑ M.O. ❑ N.C.❑
OWNER .�
;e fl� 0 �lT
CONTRACTOR
RECEIVED BY.�
ADDRESS
�j
ADDRESS
SEWAGE SYSTEM T
LL
PJ
TREES REQUIRED
YES
NO
CITY
CITY
INFORMATION p
FORM 284.2081Rev. 11/721 a
TEL. NO.
TEL. NO. LICENSE