SFD (167069)DEPARTMENT OF BUILDING & SAFETY
COUNTY OF RIVERSIDE FIELD OFFICE
CONSTRUCTION ESTIMATE ELECTRICAL FEES PLUMBING FEES
1st FI. Sq. Ft. @ 19-50 �k ' i NO. NO.
2nd Fl. Sq. Ft. @
Por. Sq. Ft. @
Goir.
Car P.
Wall
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Sq. Ft. @
POLES
USE V
-
Sq. Ft. @ A Oil SIGNS
DRAINAGE PIPING
Sq.,Ft. @ ORAT SC LK.D/
DRINKING FOUNTAIN
Sq. Ft. @ MOTOR K. P.
URINAL
MOTOR H. P.
WATER PIPING
ESTIMATED VALUATION Is " Q=
MOTOR
H. P.
FLOOR DRAIN
' MECHANICAL FEES
i
MOTOR
M.P.
WATER SOFTENER
VENT SYSTEM 9FAN ❑ EVAP. COOL R HOOD
OFFICFE
MOTOR
H. P.
WASHER (AUTO) DISH)
APPLIANCE
in
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FIXTURES
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GARBAGE DISPOSAL
> FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ ,SUSPENDED
J
TYPE
OUTLETS
LAUNDRY TRAY
Z AIR HANDLING UNIT
O
.,
SUB-PARFL
KITCHEN SINK
JF_ GAS PIPE ❑ NATURAL ❑
L.P.G. ❑ OIL
g.-
.,
WATER CLOSET
Q
U COMPRESSOR
MP
_
RFANGE AND/OR OVEN
LAVATORY
Ir
W APPLIANCE VENT
WATER HEATER
SHOWER
2
2 ABSORPTION 'SYSTEM
D B.T.U.
PLAN
SPACE HEATER
BOND
BATH TUB
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U INCINERATOR DOMESTIC
❑ INDUS. ❑ COMM.
INSPECTOR
CONSTRUCTION POLE
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WATER HEATER
HEATING SYSTEM FORCED ❑GRAVITY
i SERVICE ENTRANCE
SEWAGE DISPOSAL
BOILER
B.T.U.
$
RESID. 1C SO. FT.
.• HOUSE SEWER
RESIDENTAL FEE
SO.FT.@
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GARAGE i6 SO. FT. �.
GAS PIPING '
PERMIT FEE
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PERMIT FEE
fTl PERMIT FEE
HERMIT NU I JES
7069
REN.
DBL.
TOTAL FE
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FE lso�
HEAT FE�
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PLN. F
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EL +E� '57
FEE
PLUM li-
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M A M J
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5
O N
c .I n I c yr
SET BACKLOT
SIZE
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JOB ADDRESS •;3� t� j OWNER
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USE OF BUILDING
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DATTEEE
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PLAN CHECK FEE so. ���
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CHECKED BY
CUMMUNITY
DISTRICT
F.C.
UNITS
VALUATION
OFFICFE
MECHANICAL FEE 0.
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GROUP-
TYPE
LEGAL DESCRIPTION
PERMIT NUMBER
67069.
7
L3 T -�ri`,. �-:5 - 4-
CONSTRUCTION FEE ..
g.-
.,
SPEC. INSP.
_
SUPP. TO PERMIT
ELECTRICAL FEES
PLAN
BOND $
BOND
CASH
PLAN FILE 11
FINAL TE
INSPECTOR
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PLUMBING FEE L..i ..
yCHECKER
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TOTAL FEES
$
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THIS PERMIT SHALL BECOME VOID I -F WORK IS NOT COMMENCED
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WITHIN 60 DAYS. CESSATION OF WORK FOR 120 DAYS SHALL ALSO
PERMIT .TO BECOME VOID.
I HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS
CASH CHECK M.O. N.C.CAUSE
-ECEIVE BY
SEWAGE SYSTEM
-�
PERMIT WILL BE DONE IN ACCORDANCE WITH THE LAWS OF RIVER-
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rte.ILL
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SIDE COUNTY AND THE STATE OF CALIFORNIA. I ALSO AGREE TO
P�
CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLI-
�.'+�Irvrtrvlr� �.vvcrc uvV C.vrv-
INFORMATION' TRACTORS IS ALSO GUARANTEED.
OWNER CONTRACTOR
ADDRESS
W
TEL. NO. TEL. NO. /•f/f �y8
LICENSE NO.
t8OB 11/87 - -
AT
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