BLCK (196080)53424 Avenida Martinez
196080
VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD
SIGN WASHER (AUTO) (DISH) '
APPLIANCE
DEPARTMENT OF BUILDING & SAFETY
• COUNTY OF RIVERSIDE •
FIELD OFFICE
OUTLETS LAUNDRY TRAY
CONSTRUCTION ESTIMATE ELECTRICAL FEES'
PLUMBING FEES
1 ST FL.
2ND FL.
POR.
GAR.
CAR P.
WALL
`
SQ. FT.
@
NO.
NO.
SQ. FT. @
SQ. FT. @ d BATH TUB
SQ. FT. @ MOTOR I OR LESS H.P.
SQ. FT. @ Q WATER HEATER
@ MOTOR 5 OR LESS H.P.
SQ.FT.
SQ. FT. RESID. @ 14 SEWAGE DISPOSAL j
SQ. FT. @ / MOTOR 20 OR LESS H.P.
SQ.FT. / L
DRAINAGE PIPING
DRINKING FOUNTAIN
SQ. FT. @
URINAL
= JK w. UNITS
WATER PIPING
ESTIMATED VALUATION
$
10
FLOOR DRAIN
REN, r TRAILER FEE
MECHANICAL FEES
PL. CK. FEE 'CONST.
WATER SOFTENER
VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD
SIGN WASHER (AUTO) (DISH) '
APPLIANCE
TRANS-
FORMER O K.W. GARBAGE DISPOSAL
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑•SUSPENDED
OUTLETS LAUNDRY TRAY
AIR HANDLING UNIT CFM
FIXTURE OR SOCKET KITCHEN SINK
GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
CONST. SERV. ENTRANCE WATER CLOSET
COMPRESSOR 0 HP
POLE LAVATORY
APPLIANCE VENT
AMPERES SERV. ENT, SHOWER 'i
ABSORPTION SYSTEM O B.T.U.
SQ. FT. @ d BATH TUB
INCINERATOR ❑ DOMESTIC ❑ INDUS. OR COMM.
SQ. FT. @ Q WATER HEATER
HEATING SYSTEM ❑ FORCED ❑ GRAVITY
SQ. FT. RESID. @ 14 SEWAGE DISPOSAL j
BOILER I B.T.U.
SQ. FT. GARAGE @1 2¢ HOUSE SEWER
PERMIT FEE
BALANCE OF MIN. FEE GAS PIPING j
TRAILER ISSUANCE FEE - PERMIT FEE
PERMIT FEE PERMIT FEE
PER
6 Q 8
0
TOTAL FEES
REN, r TRAILER FEE
HEAT B VENT. FEE
PL. CK. FEE 'CONST.
FELE
DBL. ELEC. FEE
INSP. FEE
PLUMBING FEE
IDBL.ISPEC.
JDBL.
~ J F M _v A M
A » - S - 0
J J• A S O
N _ 0 --
N- D,SET
BA
LOT SIZE
USE #
JOB ADDRESS ,pOWNER
7 /f' C-`
t ` `'•-_ j. ,
di f t .•/ -e'er - 7
F
S R
ZONE
USE OF BUILDING - DATE
PLAN CHECK FEE
$
1 ' s^ --
CHECKED BY
CO MU ITY DISTRICT
F.C.
UNITS
VALUATION OFFI E
8
MECHANICAL FEE
;i
DBL
G P
TYPE
LEGAL DE CR PTION
ER IT NUM
Ell
CONSTRUCTION FEE
1
GY
I
p f f'
9
g 0
DBL
PLAN
CHECKER.
SUPP. TO PERMIT
s
ELECTRICAL FEE"zoGr
e
DBL
BOND $
BOND
-CASH PLAN
FICE # FINAL
DATE
INSP/FGTOR
PLUMBING FEE
TRAILER PERMIT
NAME OF, CONSTRUCTIONLENDER
BRANCH OFFICE
INVOLVED
LENDER
ISSUANCE FEE
$
IND
ADDRESS
CITY
STATE
FEE
9
=-'
THIS PERMIT SHALL BECOME VOID IF WORK, IS NOT COMMENCED WITHIN 60 DAYS. CESSATION
TOTAL FEES
$
OF WORK FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
I HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE'IN ACCOR-,
DANCE WITH THE LAWS OF RIVERSIDE COUNTY AND T.H.E STATE OF CALIFORNIA. I ALSO AGREE TO
CARRY. COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLIANCE WITH THE LAWS OF THE STATE
CASH Q CHECK M.O. N.C.
RECEIVED BY SEWAGE SYSTEM
OF CALIFORNIA COVERING CONTRACTORS IS ALSO GUARANTEED.
f T LL P
1 HEREBY CERTIFY THATTHE INDIVIDUALWHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE
SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE
OF CALIFORNIA. r , /' ,
INFORMATION
ER
)CONTRACTORESS 'L✓ w
F
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up Vj /-4H
LICENSE NO,
FORM -4-208 1— 1,01 ®T