230115 (SATT)BUILDING PERMIT DEPARTMENT OF BUILDING & SAFETY
COUNTY OF RIVERSIDE
IT O. TOTAL FEE$
d,
FIELD OFFICE
r CONSTRUCTION ESTIMATE,,.,,,,..,_
�1
PL. CK: FEE CONST. FEE
r ; ELECTRICAL FEES , ..
,
PLUMBING FEEH
DST
ST FLsQ.
2ND FL.
POR.
GAR.
CAR P.
WALL
•
ESTIMATED CONSTRUCTION VALUATION
FT. ( 1.2
NO,:,
NO.
r
SQ. FT. @
SQ. FT. ,"' MOTOR I OR LESS H.P.
SQ.FT. @ r MOTOR S OR LESS H.P.
SQ. F7. @° MOTOR 20 OR LESS H.P. DRAINAGE PIPING
JOB ADDRESS — - ----- —
9 <v`ELM
SQ.FT. l; @ DRINKING FOUNTAIN
73
73
SQ. FT. @ URINAL
USE OF BUILDING
C � .& Atth era1001h—?3
a
$ . "; K.W. UNITS j WATER PIPING
DATE
6w
NOTE: Not to be used as property tax valuation
75
M.H. HOOKUP FEE
FLOOR DRAIN
MECHANICAL FEES
UNITS
ROOM$
VALUATION
WATER SOFTENER
OFFICE
VENT SYSTENL7�$ FAN ❑EVAP. COOL ® HOOD
SIGN
WASHER (AUT ISH) .
APPLIANCE
0
FORM ER 0 K W
GARBAGE DISPOSAL
COPIES
FURNACE ❑ UNIT ❑ WALLOFLOOR_tl SUSPENDED
OUTLETS
LAUNDRY TRAY
AIR HANDLING UNIT I = CFM
Lot -26 --.Tr— 18
FIXTURE OR SOCKET
DBL`
KITCHEN SINK
GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
ZONE
CONST. SERV. ENTRANCE
GRP
WATER CLOSET
CK BY
COMPRESSOR HP
60
POLE
��'
LAVATORY
APPLIANCE VENT
AMPERES SERV. ENT.2S
SHOWER
ABSORPTION SYSTEM 0 B.T.U.
SO. FT. @ 4
/
BATH TUB
-
INCINERATOR ❑ DOMESTIC ❑ INDUS. OR COMM.
SQ. FT. @ d
%
WATER HEATER
HEATING SYSTEM �g FORCED ❑ GRAVITY
ago
y SQ. FT. RESID. @ 1
!
SEWAGE DISPOSAL
zs) 0
_ BOILER 0 B.T.U.
DBL
SO. FT. GARAGE @/2!
HOUSE SEWER
OFFICE .NO
PERMIT FEES
BALANCE OF MIN. FEE
%
GAS PIPING
MOBILE HOME HOOKUP FEE Is I
PERMIT FEE
Fs.,
PERMIT FEF
t
IT O. TOTAL FEE$
d,
MOB. HK. FEE MICRO FEE MECH. FEE
DBL.
PL. CK: FEE CONST. FEE
DBL. ELECT. FEE
DBL.
SMI FEE
FEE PLUMB. FEE
DBL.2JU,
77
J I F I M A I M I J I J A I S 1 O 1 ND
JOB ADDRESS — - ----- —
9 <v`ELM
WNER
OWNER-
CORP.!_
73
73
74
USE OF BUILDING
C � .& Atth era1001h—?3
a
F. C.
DATE
6w
PERMZ3
3 0 15
75
M.H. HOOKUP FEE
$
COMMUNITY DST
UNITS
ROOM$
VALUATION
SUPP. TO PERMIT
OFFICE
Ouinta ��
35.14 9.0-0
i
MICROFILM FEE
COPIES
$
LEGALLDDEESCRIPTIONN
Lot -26 --.Tr— 18
MECHANICAL FEE
-
DBL`
$
SET BACK LOT SIZE
ZONE
USE NO.
GRP
TYPE
CK BY
��'
F S R
A • 0 '
PLAN CHECK FEE
$
BOND AMT.PAN
NO. PLAN CHECKER
INSPECTOR
-
[INALDATE
CONSTRUCTION FEE
DBL
$
NAME OF CONST. LENDER BRANCH
OFFICE .NO
LENDER INVOLVED
Fs.,
t
ELECTRICAL FEE
DBL
$
CITY
STATE
.
SMI FEE
$
PERMIT SHALL BECOME VOID IF -WORK O ED WITHIN 60 CESSA-
TION OF WORK FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
FEE
$THIS
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
PLUMBING FEE
DBL
$
AGREEJO 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 PLAN ,4ND SPECIFICATIONS
$
TOTAL FEES
7
HAS DONE SO IN ACCORDANCE WITH SECTION 5541�F E USI D OFESSIONS
E OF CALIFORNIA. Go
CASH ❑ CHECK M.O. ❑ N.C. ❑
OWNER.
CONTRACTOR(—
�^
H
RECEIVED BY
ADDRESS
ADDRESS
7��
SEWAGE SYSTEM s IT
LL LL
P
-
TREES REQUIRED YES
NOS,
CITY _.
CITY
`y{f?�•
INFORMATION
TEL. NO.
TEL. NO. LICENSE
7erC! z 53 c'
FORM 284.2081Rev. 11 /721