230189 (RPL)BUILDING PERMIT DEPARTMENT. OF BUILDING & SAFETY
• COUNTY OF RIVERSIDE
O.
FIELD OFF[
CONSTRUCTION ESTIMATE-„,,,,.:
,ELECTRICAL FEES..,,
DBL
PLUMBING FEES
osT.�l
' 1 ST FL. SQ. FT. @a
2ND FL. SQ. FT. @
POR. SQ. FT.
GAR. SQ.FT.
CAR P. SQ. FT. @
WALL SCJ.FT.
PVI O%71 SQ. FT. N
ESTIMATED ONSTRUCTION VALUATION $
NO.
a re..
'MOTOR IOR LESS H.P. }/
MOTOR 5 OR LESS H.P.
MOTOR 20 OR LESS H.P.
0 K W. UNITS
NO.
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
NOTE: Not to be used as property tax valuation
DBL.
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM ❑ FAN ❑EVAP. COOL ❑ HOOD
SIGN
WASHER (AUTO) (DISH)
APPLIANCE
TRANS- K.W.
FORMER O
J F M A M J J A S -O N D-
GARBAGE DISPOSAL
OWNER 3 j
gm
FURNACE ❑ UNIT ❑ WALL ❑FLOOR ❑SUSPENDED
OUTLETS J"
USE OF BUILDING
Lrl r fi+� I 42
LAUNDRY TRAY
DATE/ ”'
- 6
AIR HANDLING UNIT CFM
FIXTURE OR SOCKET e 7-D
75
KITCHEN SINK
GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
CONST. SERV. ENTRANCE
COMMUNITY `
WATER CLOSET
ONITS
COMPRESSOR 0 HP
POLE
SU PP. TO PERMIT
LAVATORY
APPLIANCE VENT
AMPERES SERV. ENT.
SHOWER
ABSORPTION SYSTEM B.T.U.
SQ. FT. @ Q
BATH TUB
INCINERATOR ❑ DOMESTIC ❑ INDUS. OR COMM.
SQ. FT. @ Q
$
WATER HEATER
LEGAL DESCRIPTION d
/
_ HEATING SYSTEM ❑ FORCED ❑ GRAVITY
SQ. FT. RESID. @ 14
SEWAGE DISPOSAL
4- /ic '� `%3
�� �A A�,-�6ff
_ BOILER 0 B.T.U.
SQ. FT. GARAGE @a 1/24
$
HOUS&SEWER
SET BACK
PERMIT FEE
BALANCE OF MIN. FEE
GAS PIPING
GRP
_
MOBILE HOME HOOKUP FEE Is I I
PERMIT FEE
!
PERMIT FEE �.
tea)
O.
.TOTAL FEES , .MOB.
HK. FEE MICRO FEE
MECH.
DBL
PL. CK. FEE
CONST. FEE
DBL.
ELECT. FEE
DBL.
SMI FEE.
FEE PLUMB. FEE
DBL.
Ytid
4— .
/
J F M A M J J A S -O N D-
JOB ADDRESS
/ �g
06
OWNER 3 j
gm
73
74
USE OF BUILDING
Lrl r fi+� I 42
F.C.
0A,4
DATE/ ”'
- 6
PERM�N3 01�
0 9
75
M.H. HOOKUP FEE -
$
COMMUNITY `
DST
ONITS
ROOMS
VALUATION,
SU PP. TO PERMIT
OFFICE '
MICROFILM FEE
COPIES
$
LEGAL DESCRIPTION d
/
4- /ic '� `%3
�� �A A�,-�6ff
MECHANICAL FEE'
DBL
$
SET BACK
LOT SIZE ZONE
USE NO.
GRP
TYPE
CK BY
F /v s,�. fY. ' R
PLAN CHECK FEE
$
BOND AMT.
PLAN NO.
PLAN CHECKER
FINAL DATEINSPECTOR
CONSTRUCTION FEE
DBL
$
%
C�
NAME OF CONST. LENDER BRANCH
OFFICE - .NO
LENDER INVOLVED
ELECTRICAL FEE
DBL
$
t�
L!
ADDRESSCITY
_ STATE
SMI FEE
$
3300
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 60 DAYS. CESSA-
$
FEE
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 -
WRDANCE WITH THE LAWS OF RIVERSIDE COUNTY AND THE.STATE OF CALIFORNIA, I ALSO
PLUMBING FEE • _
DBL
$
So
AGREE TO CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLIANCE WITH
THE LAWS OF THE STATE OF CALIFORNIA: COVERING CONTR S IS ALSO GUARANTEED.
I HEREBY CERTIFY'THAT" THE INDIVIDUAL WHO PREPARIEPlofHE PLANS AND SPECIFICATIO
HAS DONE SO IN ACCORDANCE WITH SECTION 5541 PFTHE BUSINES AN PROFESS
$ = r
Q
TOTAL FEES
„�
'
CODE OF THE STATE OF CALIFORNIA. rte"" _ ✓s
CASH ❑ CHECK�k. ' M.O. ❑ N.C. ❑
OWNER,
CONTRACTOR �/ ""'"" T • ,Ir _
r
RECEIVED BY%�
ADDRESS
ADDRESS
SEWAGE SYSTE/Ml
LL
P
TREES
clTv
CITY¢/111
REQUIRED
YES
NO
INFORMATION
TEL. NO.
TEL. NO. LICENSE
WClr
&l.,I-208IRev-11/721
� it
.� .� i ((� •.