354150 (ELEC)OF BUILDING t& SAFETY FIELD DST
1 /� I %;OUNTY OF RIVERSIDE
CONSTRUCTION
ESTIMATE
NO.
ELECTRICAL FEES
NO.
PLUMBING FEES
I ST FJ.. SQ. Fj. , @
2ND. FL. SQ. FT. @
POR. SQ, FT. @
GAR. SQ. FT, @
CAR P. SQ. FT. @._
WALL SQ. FT. @
SQ. FT. @.
ESTIMATED CONSTRUCTION VALUATION
UNITS
=%
G
YARD SPKLR SYSTEM
MOBILEHOME SVC.
BAR SINK
POWER OUTLET
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
$
WATER PIPING
NOTF. Not to be used as property tax valuation
SWIM POOL, PVT
FLOOR DRAIN
MECHANICAL FEES
SWIM POOL, COMM
WATER SOFTENER
VENT SYSTEM FAN EVAP. COOL HOOD
SIGN
WASHER (AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
,AIR HANDLING UNIT CFM
IDLE METER
KITCHEN SINK
ABSORPTION SYSTEM B.T-U.
TEMP USE PERMIT SVC
WATER CLOSET
'COMPRESSOR HP
POLE,TEMP/PERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
`-' '
AMPERES SERV ENT
•r r:
SHOWER
IBOILER' B.T.U.
SQ. FT, @' c
BATHTUB
SQ. FT. @ c
WATER HEATER
SQ, FT. RESID @1'hc
SEWAGE DISPOSAL
SQ. FT. GAR @ IN c
HOUSE SEWER
GAS PIPING -
(PERMIT FEE
PERMIT FEE
_:
PERMIT FEE
(DEL.,
TOTAL FEES
MOB: HM FEE
MICRO FEE
MECH FEE
PL CK. FEE
CONST. FEE
ELECT. FEE
SMI FEE
FEE
PLUMB. FEE
Job Address -., Space Zip
r
Owner
OL/i r.
PERMIT NO.
T
Community /
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Valuation
E
Date // /
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Disl. Off.
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F.0 C
MH Permit Fee
f�
Micro Film Fee
Cop $
Use of Permit
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Parcel No
/ % .- i !� 7 %J
Use/Case No
Cl,. By
q
.!
Mech. Fee
Dbl 5
PI. CL Fee
S
Set Backs
Lot Size
Cantitrul:Han Fee
Dbl E
Legal Description
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f..� �//�•,. �I��pl/L
F
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Elearlrlcal Fee
Dbl $
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Zone Restrictions
Grou
5AM1I Fee
'6Plumbing
Fee
Dbl :6
Bond Aml.
S
Plan No.
Plan Checker
Final Date
7
Inspector
yType
nit
SR. Insp, Fee
S
Demol. Fee
'6
Const Lender Branch
Supplimenlal Permit Number
Registr. Fee
4
Mileage Fee
•5
Address Chy Zip
Witness Fee
:6
Reinsp. Fee
!6
Owner/Agent
Tel. ZIP
Total Fees $
+"�
T
Address
City Zip
M.O.. N.0 Cash Ch
Received by•-{y:
Contractor=� i�t,:/�n/v"�
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Address
Tel.
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City Zip
LicenseN
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Trees required
Sewage System
T LL P THIS PERMIT SHALL BECO.A V01D fF WORK tS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF WORK
Sewei District FOR 120 DAYS SHALL, AI I ET$� C 1NE
1 HEREBY AGREE THAT ALL WORK I OiJN`E':T' ElON.WWIITH THIS PERMIT WILL BE DONE !N ACCORDANCE WITH
THE LAWS OF RIVERSIDE COUSVTY A THE STATE OF CALIFORNIA.
h J � I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE SO IN
I f ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE OF CALIFORNIA.
Form 284-208 (Rev.8/78) -
verified by:
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