AR (162564)DEPARTMENT OF BUILDING & SAFETY
' COUNTY OF RIVERSIDE A&
FIELD OFFICE
CU145TRUCTION ESTIMATE
ELECTRICAL FEES
PLUMBING FEES
1st Fl.
2nd FI.
Por.
[ Gar.
Car P.
Wall
Sq. Ft. @
No.
No.
Sq. Ft. @
Sq. Ft. @
R'
Sq. Ft. @ POLES
Sq. Ft. @ SIGNS
ORAINAGE PIPING
TRANS. AND/
Sq. Ft. @ OR T. CLK.
DRINKING FOUNTAIN
Sq. Ft. -.TOR H. P.
URINAL
MOTOR H. P.
WATER PIPING
ESTIMATED VALUATION $
MOTOR K. P.
FLOOR DRAIN
MECHANICAL FEES
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
.0
SUB-PAREL
KITCHEN SINK
J GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
Q
1
WATER CLOSET
U COMPRESSOR �HP
RANGE AND/OR OVEN
LAVATORY
G
W APPLIANCE VENT
WATER HEATER
SHOWER
f ABSORPTION SYSTEM O B.T.U.
O
SPACE HEATER BATH TUB
V
U INCINERATOR DOMESTIC ❑ INDUS. ❑ COMM.
CONSTRUCTION POLE
WATER HEATER '
HEATING SYSTEM ❑ FORCED ❑ GRAVITY
SERVICE ENTRANCE
SEWAGE DISPOSAL
BOILER B.T.U.
RESID. 12 SO. FT.
HOUSE SEWER
RESIDENTAL FEE SO.FT.I
GARAGE iQ SO. FT.
GAS PIPING
PERMIT FEE
PERMIT FEE A PERMIT FEE O
VELEC`FEE
IERMIT IM62
5 6 4IRE-N.
1
JOBL__JTOTALE
HEAT & VENT FEE
JPLN. CK. FEE
�NST.. FEE
t
J
PLUM�EE,
M q M J J A S lI
07
N 10
SE ACKI.O'r
S17E
U E 9
JOB ADDRESS OWNER
S
R'
Ag ge
w
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ZONE
u7§E OF BUILDING
p
PLAN CHECK FEE
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ED BY
CHECKED
XOMMUNITY
F.C.
ION
OFFIC
1
0
j.,vT1,CT
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�IbNirtjVFLUAT
MECHANICAL FEE
O TYPE'LEGAL
DESC IPTION
PERMIT N M ER
CONSTRUCTION FEE ""
"_ '�
1
62 4
SPEC. )NSP.
� �
SUPP. TO PERMIT
ELECTRICAL FEE
..r .Sr"r
�.
PLAN CHECKER
BOND §
BOND
CASH
PLAN FILE #"FINAL
DATE
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 M.0. N.C.
ECEI�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 (;ON -
INFORMATION
TRACTORS IS ALSO GUARANTEED.
OWNER
CONTRACTOR
/
f i
j
'4
ADDR•
_ACRESS
ai
TEL. NO. 1
TEL. -NO.
84-208 1 1/67
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f �1 V .
LICENSE NO.
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K- % .✓ 1 _V9'-7