159025 (AR)CONSTRUCTION 'ESTI MAT
1st Fl. Sq. Ft. @
), w
2nd FI. Sq. Ft. @
Por. Sq. Ft. @
Gar. Sq. Ft. @
Car P. Sq. Ft. @
Wall Sq, Ft. @
i Sq. Ft. @
ESTIMATED VALUATION $
s MECHANICAL' FEES 1
VENT SYSTEM 11 FAN 13EVAP. COOL 13 HOOD
APPLIANCE
1 FURNACE UNIT❑ WALL❑ FLOOR SUSPENDED
J
Z AIR HANDLING UNIT
r O
c J GAS PIPE 13 NATURAL ❑ L.P.G. ❑ OIL
' Q _
` U COMPRESSOR �HP
W APPLIANCE VENT
f ABSORPTION SYSTEM
i O
INCINERATOR DOMESTIC 11 INDUS. ❑ COMM.
i
HEATING SYSTEM ❑ FORCED 11 GRAVITY
BOILER B.T.U.
DEPARTMENT OF BUILDING & SAFETY
COUNTY OF RIVERSIDE
E ELECTRICAL FEES
I6 k3�i` NO.
B.T.U.
RESIDENTAL FEE SQ. FT.L
PERMIT FEE
-PERMIT NU F REN. DBL. TOTAL FEE
'r. � , y .sy�eYf
J F M A M
' J F
POLES'
SIGNS'
TRANS. AND/
OR T. CLK.
MOTOR H. P.
MOTOR H. P.
MOTOR H. P.
MOTOR H. P.
MOTOR H. P.
FIXTURES
OUTLETS
SUB - PARE L
RANGE ,AND/OR OVEN
WATER HEATER
SPACE HEATER
CONSTRUCTION POLE
SERVICE ENTRANCE
RESID. 10 SQ. FT.
GARAGE y Q SO. FT.
PERMIT FEE
PLN. CK. FEE ,.Iw JCONST. 'FEE
—2
FIELD OFFICE.
PLUMBING FEES
ORAINAGE 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
FEE PLUMB. FEE
t
O N D
SETBACK LOT SIZE
-
USE #
JOB ADDRESS OWNER
C S /1' R
f [
I�
ZONEUSE
OF BUILDING DATE
I.PLAN CHECK FEE
C�
'
CHECKED
tUK4MLMITYC,s
TRICT
F.CT
UNITS
VALUATION OFFICE
/BY
I
J
MECHANICAL FEE
{.L��1op
LEGAL DESCRIPTION
PERMIT NUMBE
..CONSTRUCTION FEE
77TYPE
f
159025
SPEC. INSP.
SUPP. TO PERMIT
SELECTRICAL FEE
,
F.
PLAN CHECKER
BOND
ON
AS
PLAN FITEN FTNAL DATE
INSPECTOR
p5
F PLUMBING FEE
11 %,� r, (I �,_
VAL
TOTAL FEES
$
'
THIS PERMIT SHALL BECOME VOID IF WORK IS NO�T/C10_MMMEENCED
WITHIN 60 DAYS. CESSATION OF WORK FOR 120 DAYS SHALL ALSO
CAUSE PERMIT TO BECOME VOID.
I HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS
CASH CHECK M. o. N. c.
ECEIVED BY
SEWAGE SYSTEM
I
PERMIT WILL BE DONE IN ACCORDANCE WITH THE LAWS OF RIVER-
SIDE COUNTY AND THE STATE OF CALIFORNIA. I ALSO AGREE TO
T
LL
P
CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLI-
ANC, WITH LAWS OF THE STATE OF CALIFORNIA COVERING*CON-
_
i _y INFORMATION
TRACTORS IS ALSO GUARANTEED.
f
OWNER
CONTRACTOR
eA?o .II
ADDRESS -
ADDRESS
to
TEL. NO.
TEL. NO.
I.
-
LICENSE NO. '
:84-208 11/67