RPL (173070)DEPARTMENT OF BUILDING & SAFETY
COUNTY OF RIVERSIDE
FIELD OFFICE
USE #
CONSTRUCTION ESTIMATE
ELECTRICAL FEES
PLUMBING FEES
3
1st Fl.
2nd Fl.
Por.
Gar.
Car P.
' W I
p i
Sq. Ft. @
NO.
NO.
w ..
Sq. Ft. @
Sq. Ft. @
USE F BU LO NG DATE
Sq. Ft. @ POLES
J .
+. ws
Sq. Ft. @ SIGNS ORAINAGE PIPING
yrsy
'"" I `0
COMM ITY vI RI F.C, VALUATION OFFICE
DRINKING FOUNTAIN
Sq. Ft. @ oR T..c`'L .
CHECKED BY
URINAL
Sq. Ft. /1 Qj94 X.P.A el
J C
MOTOR H. P. WATER PIPING
TNFTS
ESTIMATED VALUAT ON$ ►
MOTOR H.
r
FLOOR DRAIN
41
MECHANICAL FEES
MOTOR H. P.
L AL E RI 10 ` fE9MIT NOIR
730
WATER SOFTENER
VENT SYSTEM ❑ FAN ❑ EVAP, COOL ❑ HOOD
MOTOR H. P.
WASHER (AUTO) (DISH)
SPEC. INSP.
' APPLIANCE
FIXTURES
r ELECTRICAL FEE
GARBAGE DISPOSAL
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
OUTLETS
LAUNDRY TRAY
PLAN CHECKER
' AIR HANDLING UNIT
SUB -PANEL
PLAN ILE #`
KITCHEN SINK
INSPECTOR
I GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
f '
WATER CLOSET
COMPRESSOR HP
k
RANGE AND/OR OVEN
LAVATORY
r.+M
APPLIANCE VENT
WATER HEATER
SHOWER
ABSORPTION SYSTEM E:: B.T.V.
SPACE HEATER
$=''
BATH TUB
I INCINERATOR DOMESTIC ❑ INDUS. ❑ COMM.
CONSTRUCTION POLE
WATER HEATER
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
HEATING SYSTEM ❑ FORCED ❑ GRAVITY
SERVICE ENTRANCE
SEWAGE DISPOSAL
BOILER E:: B.T.U.
RESID. iC SO. FT.
E SEWER ' •
RFeIDcu TA+ e0 p , e
GARAGE zR SO. FT.
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
1,2
d0
ERMIT y/MJJ
3
0 O
CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLI-
ANCE WITH LAWS OF THE STATE OF CALIFORNIA COVERING CON -
REN,
DBL,
TOTAL FEE
H:7
PLN. CK. FEE
~
CONST.
'FEE /t
ELEC. FEE /
S '
PLUMB. FEE
{ •Mi
OWNER
J F M q M - J A
1 F
S
ON ` D
r, I
SET BACK
LOT SIZE
USE #
JOB ADDRESS OWNER
op
F
S ' '
R ,.I
w ..
'
ZONE
USE F BU LO NG DATE
PLAN CHECK FEE
J .
+. ws
.
yrsy
'"" I `0
COMM ITY vI RI F.C, VALUATION OFFICE
CHECKED BY
TNFTS
MECHANICAL FEE
r
f
P TYPE
L AL E RI 10 ` fE9MIT NOIR
730
CONSTRUCTION FEE
SPEC. INSP.
SUPP. TO PERMIT
r ELECTRICAL FEE
`
.• . -.•-
PLAN CHECKER
BOND $
OND CASH
PLAN ILE #`
F NAL,. DAYF
5•/
INSPECTOR
PLUMBING FEE
r.+M
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 M,o. N.C.
IECEIVED 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
ON' R`A C •TOR e y. •-
.If Ri1{S jiN
UME OF CONSTRUCTION IZ11
-
'
A R'ES
A KESS
e
+w
0iTf13
y V4 =10 pq '
No .,...`...._..'
EL. NO.
TeL. Wo.
.-
+i
'I NS 9 N0. '
t84-208 11/67