BLCK (160525)DEPARTMENT OF BUILDING & SAFETY
0
COUNTY OF RIVERSIDE
is
FIELD OFFICE
CONSTRUCTION ESTIMATE
ELECTRICAL FEES
PLUMBING FEES
1st FI.
2nd Fl.
Por.
Gar.
Car P.
Wall
a
Sq. Ft. @
NO.
NO.
Sq. Ft. @
Sq. Ft. @
Sq. Ft. @ POLES
Sq. Ft. @ SIGNS
ORAINAGE PIPING
(-11✓ •� TRANS. AND/
Sq, Ft, @ OR T. CLK.
DRINKING FOUNTAIN
Sq Ft @ MOTOR H. P.
J
URINAL
MOTOR H. P.
WATER PIPING
ESTIMATED VALUATION Is
MOTOR H. P.
FLOOR DRAIN
MECHANICAL FEES
i
MOTOR H.P.
WATER SOFTENER
. VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD
MOTOR H.P.
WASHER (AUTO) (DISH)
APPLIANCE
FIXTURES
GARBAGE DISPOSAL
} FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
J
OUTLETS
LAUNDRY TRAY
Z AIR HANDLING UNIT
O
SUB-PAMEL
KITCHEN SINK
J GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
( Q
LEGAL D @ IPTION -
WATER CLOSET
t COMPRESSOR E::�HP
RANGE AND/OR OVEN
LAVATORY
1 IL
W APPLIANCE VENT
r 2
WATER HEATER
SHOWER
I ABSORPTION SYSTEM B.T.U.
O
SPACE HEATER
BATH TUB
i U INCINERATOR DOMESTIC ❑ INDUS. ❑ COMM.
CONSTRUCTION POLE
WATER HEATER
ri{ HEATING SYSTEM ❑ FORCED ❑ GRAVITY
SERVICE ENTRANCE
SEWAGE DISPOSAL
' BOILER LTJ B.T.U.
RESID. 1C SO. FT.
HOUSE SEWER
RESIDENTAL FEE SQ.FT.E:::���
GARAGE zQ SO. FT.
GAS PIPING
-. PERMIT FEE
PERMIT FEE
PERMIT FEE
.'PERMIT
5
REN,
DBL.
TOTAL FEES,
•IEAT & VENT FEE
PLN. CK. FEE
CONST. 'FEEELEC.
FEE
J
PLUMB. FEE
J FM q M
F
J J A S
O N D '
SET BACK
_j
LO SIZE
USE 11
JOB ADDRESS OW NE
ZONE ..�
USE OF BUILDING j r
DAT
PLAN CH EC K.FEE..�1
yt
.� ._;'I�7T Cr
CHECKED BY
I-- IT
DISTRICT
F.C.
UNITS
VALUATION
FFI
MECHANICAL FEE ....�..•.M"'-
`�,(' {J5.-- -
I+. ` %4 1
GROUPTYPE
LEGAL D @ IPTION -
PERMIT M/B�JE
5
CONSTRUCTION FEE,_._
_ 'e,
6 0 2
SPEC. INSP.
"' + - r
SU P. TO PERMIT
ELECTRICAL FEE
o4 t I CA k.-` i�
PLAN CHECKER
BOND $
BOND
'CASH
PLAN FILE N`
Rk.LN` AL D,- ATOi
INSPECTOR
PLUMBING FEE
TOTAL FEES,
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED
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 II N.C.
RECEIVED BY
SEWAGE SYSTEM
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-
ANCE WITH LAWS OF THE STATE OF CALIFORNIA COVERING CON -
INFORMATION
TRACTORS IS ALSO GUARANTEED.
OWNER 'i
CONTRACTOR
•0• t:.:+ls,
ADDRESS
ADDRESS �•
1.2 � '
.f' a C
�r
TEL. NO.
TEL. NO.
LICENSE NO.
284-208 11/67