302023 (SFD)BUILDING PERMIT
DEPARTMENT OF BUILDING 8r SAFETY FIELD OFFICE
COUNTY OF RIVERSIDE
PERMIT Np.
23
DlFSrT
CONSTRUCTION ESTIMATE
NO.
ELECTRICAL FEES
NO.
PLUMBING FEES
1ST FL. ~�
2ND FL.
FOR.
GAR.
CAR P.
WALL
ESTIMATED CONSTRUCTION
SQ. FT_ @ u�
SQ. FT.
SQ. FT. @
SQ. FT. @ . 'r
SQ. FT. @
SO. FT, @ �}
SQ. FT. .@
VALUATION
$If 1
JUNITS
I
YARD SPKLR SYSTEM
'
MOBILEHOME SVC.
BAR SINK
/
IO
POWER OUTLET
ROOF DRAINS
DRAINAGE PIPING
!ScDRINKING
FOUNTAIN
URINAL
$
WATER PIPING
26
NOTE: Not to be used as property tax valuation
SWIM POOL, PVT
FLOOR DRAIN
MECHANICAL FEES
SWIM POOL, COMM
WATER SOFTENER
VENT SYSTEM AN ❑ EVAP. COOL [10100D
SIGN
WASHER( T S
APPLIANCE RYER
GARBAGE POS L
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT
CFM
IDLE METER
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERM SVC
WATER CLOSET
COMPRESSOR _ P
POLE, TEMP/PERM
LAVATORY
Q
��
HEATING SYSTEM E ORCED ❑ GRAVITY
AMPERES SERV ENT
CD4
SHOWER'
lj
BOILER B.T.U.
SQ.FT. @ ¢
BATH TUB
GU
&I SQ. FT. @ ¢
2,0t
WATER HEATER
60
Q.FT.RESID @ 11/4a
DISPOSAL
SQ.FT.GAR @ 3/4a
_66SEWAGE
HOUSE SEWER
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL,
TOTAL FEES
33oyo
MO B.H M,FEE
MICRO FEE
MECH, FEE
L CK. FEE
flta�
CONST. FEE
�g°1 °'-
ELECT. FEE
't/a3`�
SMI FEE
3 �-
FEE
PLUMB FEE
S 7
J
F
M
Aim
J
J
A
S
O
N
D
JOB ADDRESS SP NO
�/ . �� l�s�
OWNER
ei
76
77
COMMUNITY
_,4 4Q v�
VALUATION p
$ 5d gs�
' � I �"`��
DST
r
OF E
78
M H PERMIT FEE
$
U$E OF PERM/IT ■
P.G.
SUPP. TO PERMIT
PE
Y NO-
MI02022
MICROFILM FEE
COPIES
$
BOOK PAGE
LEGAL DESCRIPTION
JRCEL
7
' MECHANICAL FEE
DBL
$
USE NO. / 20WE//��) r �S`E�T BACK `//►� LOT SIZ GRP TV PE CK 11
BOND AMT PLAN NO PLAN CHECKER FINAL DATE IN5 7 LJ
I: PLAN CHECK FEE
$
CONSTRUCTION FEE
DBL
$
NAME OF CONST LENDER
OMRANCH OFFICE NO
LENDER INVOLVED
ELECTRICAL FEE
DBL
$
ADDRESS
CITY STATE
d b
STRONG MOTION
$
OWNER/AGENTS SIGNATURE
CONTRACTOR
I INSTRUMENTATION FEE
V na Mfg f'< c F' u. y�
SPECIAL INSP
ADDRESS
ADDRESS
Etv[N
T!FEE
ly
RRATI. RATION
wREGISS
V V JE
PLUMBING FEE
DBL
$
CITY ZIP CODE
CITY C ZIP CODE
LA00ff%AG` 1.'5�k n-ZS
TOTAL FEES $
�
TEL NO.
AREA CODE
TEL NO. AREA CODE
e �
LICEN5E %
n
CASH ❑CHECK O.❑N.C.❑
l41
RECEIVED BY . TREES REQUIRED
iT SHALL BECOME VOID IF WORK iS NOT COMMENCED WFLHIN 12ll DAYS. CE55ATIoN OF
O 2G DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID,
SEWAGE SYSTEM
1
Y GREE THAT ALL WORK IN CONNECTION WITH THIS PERMfTWILL BE DONE IN ACCORDANCE
T
LL
p /
THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CAUFORNIA, I ALSO AGREE TO CARRY
`CL7M17NtNSAIIUN INSURANCE UPON MY EMPLOYEES. COMPLIANCE WITH THE LAWS OF THE STATE OF
CA11F0RNIA COVERING CONTRACTORS IS ALSO GUARANTEED.
I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE
FORM 284-208 (REV 6-76) SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE
OF CALIFORNIA.
3