230003 (SOTB)BUILDING PERMIT
.., . CONSTRUCTION ESTIMATE
); l ST FL.
SQ. FT. @D
2ND FL.
SQ. FT. @
POR.
SQ. FT. @
GAR.
SQ.FT. @
CAR P.
SQ. FT. @
' WALL
SQ.FT. @
i / lu,p
SQ. FT. @
ESTIMAAFED CONSTRUCTION VALUATION
$
NOTE. Not to be used as orooerty tax valuation
DEPARTMENT OF BUILDING& SAFETY
I COUNTY OF RIVERSIDE
MECHANICAL FEES
VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD
APPLIANCE
FURNACE ❑ UNIT ❑ WALL ❑FLOOR ❑SUSP.ENDED
AIR HANDLING UNIT CFM
GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
COMPRESSOR 0 HP
APPLIANCE VENT
ABSORPTION SYSTEM 0 B.T.U.
INCINERATOR ❑ DOMESTIC O INDUS. OR COMM.
HEATING SYSTEM ❑ FORCED ❑ GRAVITY
BOILER 0 B.T.U.
PERMIT FEE
MOBILE HOME HOOKUP FEE is
�PEfjrMl O - TOTAL FEES MOB. HK. FEE MICRO FEE
2 "Pli ;
J I F M A M J J A' S O N D
73
74
75
M.H. HOOKUP FEE $
_ELECTRICAL FEES
NO.
MOTOR I OR LESS H.P.
MOTOR 5 OR LESS H.P.
MOTOR 20 OR LESS H.P.
9a% ^"- L I K.W. UNITS
SIGN
TRANS K W
FORMER
OUTLETS
FIXTURE OR SOCKET
CONST. SERV, ENTRANCE
POLE
AMPERES SERV. ENT.
SO. FT. @ d
SO. FT. @ d
SO. FT. RESID. @ I d
SQ. FT. GARAGE@1124
BALANCE OF MIN. FEE
PERMIT FEE
MECH. FEE I DBL. PL. CK. FEE CONST. FEE DBL. ELECT. FEE DE
JOB ADDRESSI OWNER
+6/ l A/ris Lel i..li %
.c
DST I UNITS I ROOMS I VALUATION
FIELD OFFICS
PLUMBING FEES I DST
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
FLOOR DRAIN
WATER SOFTENER
WASHER (AUTO) (DISH)
GARBAGE DISPOSAL
LAUNDRY TRAY
KITCHEN SINK
WATER CLOSET
LAVATORY
SHOWER
BATH TUB
WATER HEATER
SEWAGE DISPOSAL
HOUSE SEWER
GAS PIPING
PERMIT FEE I ,2I &Av'
SMI FEE FEE PLUMB. FEE DBL.
5N33003
MECHANICAL FEE
'
DBL
$
vi
SET BACK
LOT SIZE
ONE
�yf
'l OFINAL
USE NO.
GRP
TYPE
CK BY
F S. R
.PLAN CHECK FEE -
-
$
BOND AMT.
PLAN NO. - -.
PLAN CHECKER
DATE
INSjP TOR '
' CONSTRUCTION FEE
DBL
$
y
NAME OF CONST. LENDER
BRANCH OFFICE .NO
J
LENDER INVOLVED
ELECTRICA_L.FEE
DBI.
$
•
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 ND SPE IFICATIONS
HAS DONE SO IN ACCORDANCE WITH SECTION 5541�F T BySl�W OFESSIONS
H E O CALIFORNIA. �-'�s Afl-
FEE
$
PLUMBING FEE
DBL
$ •
.��
TOTAL FEES
$ �,
Com}
CASH ❑ CHECK 1 M.O. ❑, N.C. ❑%�at!'�Drrri%/rn
OWNER.
CONTRACTOR' /1'
QV
SEWAGE SYSTEM T LL P
'TREES REQUIRED YES NO
INFORMATION
FORM 284-208 We, 11/721
TEL
AUUNC»
Cm
EL. NO.
'tc-��:�i