240858 (BLCK)BUILDING PERMIT DEPARTMENT OF BUILDING & SAFETI, FIELD OFFICE
COUNTY OF RIVERSIDE
CONSTRUCTION ESTIMATE
1 ST FL. SQ.FT. @
2ND FL. SQ. FT. @
POR. SQ. FT. @
GAR. SQ. FT. @
CAR P. SQ.FT. @
WALL SQ. FT. @
SQ. FT. @
ESTIMATED CONSTRUCTION VALUATION $
NOTE: Not to be used as property tax valuation
MECHANICAL FEES
VENT SYSTEM fl FAN ❑ EVAP. COOL ❑ HOOD
NO. I ELECTRICAL FEES
UNITS
MOBILEHOME SVC.
POWER OUTLET
SWIM POOL, PVT
SWIM POOL, COMM
SIGN
NO.I PLUMBING FEES
BOILER
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
FLOOR DRAIN
WATER SOFTENER
WASHER (AUTO) (DISH)
1f
A
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 O FORCED ❑GRAVITY AMPERES SERV ENT SHOWER
SQ FT @ a BATH TUB
SQ FT @ C WATER HEATER
SQ FT RESID @ la SEWAGE DISPOSAL
SQ FT GARAGE @ 'he HOUSE SEWER
PERMIT FEE TEMP ELEC SVC GAS PIPING
MOBILE HOME PERMIT FEE is
PERMIT FEE PERMIT FEE
P R
T
81
TOTAL FEES
MOB. -HM. FEE
MICRO FEE _1
MECH. FEE
DBL.
PL. CK. FEE
CONST. F/EE
s{ (dA
DBL.
ELECT. FEE
DBL.
SMI FEE
FEE PLUMB. FEE
OBL.
J I F I M A I M I J I J A I $ 1 O 1 ND
I SP NO
JOB ADDRESS JJ
U1, ! r t f A
OWNER
r r
73
74
USE OF PERMIT
1 X
F.C.
DATE
PEW T NO.
75
M H PERMIT FEE
$
COMMUNITY
ry
DST
UNITS
ROOMS
VALUATION �SUPP.TOPERMIT
7 _U
OFFICE
Ir
MICROFILM FEE
COPIES
$
-4-.--,
LEGAL DESCRIPTION J
,/- *13 9 t
MECHANICAL FEE
DBL
$
SETBACK
LOT SIZE ZONE
—/?—
USE NO.
)Y, -
GRP
TYPE
CK BY
F S R
PLAN
PLAN CHECK FEE
$
BOND AMT.
PLAN NO.
PLAN CHECKER
FINAL DATE f INSPECT
R
CONSTRUCTION FEE
DBL
$
O �
NAME OF CONST. LENDER BRANCH
OFFICE
NO LENDER INVOLVED
ELECTRICAL FEE
DBL
$
ADDRESS CITY
STATE
SMI FEE
$
THIS PERMIT SHALL BECOME VOID IF WORK 15 NOT COMMENCED WITHIN 120 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 SPECIFI ATIONS
HAS DONE SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESS C E
OF THE STATE OF CALIFORNIA.
FEE
$
PLUMBING FEE
DBL
$
TOTAL FEES
$
OWNER/AGENT'S SIGNATURE
CO O ✓
w �!
CASH ❑ CHECK CK M.O. ❑ N.C. Q
ADDRESS
ADDRESS
RECEIVED BY
TREES REQUIRED
'
SEWAGE SYSTEM T
LL P
CITY 21P CODE
CITY 21P CODE
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P f
�J( INFORMATION
FOPM 284.208 (Re, 9.731 Os
TEL. NO.
TEL. NO. LICENSE}
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