160524 (AR)DEPARTMENT OF BUILDING & SAFETY
COUNTY OF RIVERSIDE
FIELD OFFICE
CONSTRUCTION ESTIMATE ELECTRICAL FEES PLUMBING FEES
1St FI. _ NO. NO.
I. Sq. t. @ ,
or. r Sq. Ft. @
Gar.
Sq. Ft. @ �'
POLES
LOT SIZE
Car P.
Sq. Ft. @
SIGNS
Wall
V
Sq. Ft. @
TRANS. AND/
OR T. CLK.
R
Sq. Ft. 0
l
MOTOR
H. P.
ZONE
/r
/ [�
USE OF BUILDING
_
+Itfyt r!r
00 MOTOR
H. P.
1 ESTIMATED VALUATION
Is
q4l
DISTRICT
F.C.
MOTOR
H. P.
MECHANICAL Fr=ES
MOTOR
H. P.
VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD
MOTOR
H. P.
APPLIANCE
FIXTURES
tt
�'�^ -4^-'V
y FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
OUTLETS
J
Z AIR HANDLING UNIT
0
SUB -PANEL
GROUP
I J GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
LESCRON
I
Q I��
U COMPRESSOR l� HP
RANGE AND/OR OVEN
E
W APPLIANCE VENT
WATER NEATER
SPEC. INSP.
ABSORPTION SYSTEM B.T.U.
SPACE HEATER
i'
. 0
U INCINERATOR DOMESTIC ❑ INDUS. ❑ COMM.
CONSTRUCTION POLE
BOND
. HEATING SYSTEM ❑ FORCED ❑ GRAVITY
SERVICE ENTRANCE
�L
BOILER C� B.T.U.
�RESID. 1Q SQ. FT.
RESIDENTAL FEE SQ.FT. 1 @
401�GARAGE ?Q SO. FT.
PERMIT FEE
PERMIT FEE
PERMIT y/M�il/�
_J
/�
•IF63
TOTAL FEES.ai.,
REN.
DBL.
TO^AEE
titEAT & VENT FEE
ALN. CK. F
'FEE
EiJL EC.
CHECK M.O. N.C.
U � �
RECEIVED BY
SEWAGE SYSTEM
PERMIT WILL BE DONE IN ACCORDANCE WITH THE LAWS OF RIVER-
SIDE COUNTY AND THE STATE OF CALIFORNIA.
ICONST,
q5 ,` •
F M A M J J A
J F
O
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
FLOOR DRAIN
WATER SOFTENER
WASHER (AUTO)r`4MGd
GARBAGE DISPOSAL
LAUNDRY TRAY
KITCHEN SINK
WATER CLOSET
LAVATORY
SHOWER
BATH TUB
WATER HEATER
SEWAGE DISPOSAL
HOUSE SEWER
GAS PIPING
PERMIT FEE
PLUMB. FE
i)
t°
N ID
SET BACK
LOT SIZE
USE #
JOB ADDRESS OWN R
— it
&3A el�sjw, K
�F t.
j
S
R
Tu f
PLAN CHECK FEE
ZONE
/r
/ [�
USE OF BUILDING
_
+Itfyt r!r
OAT
CHECK�EDI BY
COMMUNITY
DISTRICT
F.C.
UNITS
VA LUA O
I
.
MECHANICAL FEE
tt
�'�^ -4^-'V
/, .4 & \ I,
GROUP
TYPE
LESCRON
I
N
CONSTRUCTION FEE
5�
SPEC. INSP.
ELECTRICAL FEE
i'
SUPP. TO PERMIT
PLAN CHECKER
BOND $�
BOND
ASH ]PLAN
FILE # ljt. T
INSPECTOR
PLUMBING FEE
TOTAL FEES.ai.,
''''�'
THIS PERMIT '
���.....••??J
SHALL BECOME VOID IF WORK IS NOT COMMENCED'
WITHIN 60 DAYS. CESSATION OF WORK FOR 120 DAYS SHALL ALSO
CASH
CHECK M.O. N.C.
CAUSE PERMIT TO BECOME VOID.
I HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS
RECEIVED BY
SEWAGE SYSTEM
PERMIT WILL BE DONE IN ACCORDANCE WITH THE LAWS OF RIVER-
SIDE COUNTY AND THE STATE OF CALIFORNIA.
1 ALSO AGREE TO
CARRY COMPENSATION INSURANCE UPON.MY EMPLOYEES. COMPLI-
ANCE WITH LAWS OF THE STATE OF CALIFORNIA COVERING CON—
- INFORMATION
TRACTORS IS ALSO GUARANTEED.
r
OWNER
CONTRACTOR
,j} r
% f J
ADDRESS
ADDRESS
TEL. NO. `
TEL. NO.
LICENSE NO. -
284-208 11/67
�J,4p�py��'�
C 1Xlf 1 _
) F
B t "' .•+ .� 7, C 7 (J