BLCK (204550)APPLIANCE
•
DEPARTMENT OF BUILDING & SAFETY
• COUNTY OF RIVERSIDE •
FIELD OFFICE'
AIR HANDLING UNIT CFM -FIXTURE OR SOCKET KITCHEN SINK f
CONSTRUCTION ESTIMATE
ELECTRICAL -'FEES
PLUMBING FEES'
1 ST FL.
2ND FL.
POR.'
GAR.
CAR P.
WALL
lkk IZ9
SQ. FT. @
NO..
NO.
SQ. FT. Cia
s
SQ. FT. @ MOTOR I OR LESS H.P.
BOILER [� B.T.U.
SQ.FT. @ MOTOR 5 OR LESS H.P.
PERMIT FEE
SQ. FT. CID k MOTOR 20 OR LESS H.P.
DRAINAGE PIPING
SQ.FT. @�
DRINKING FOUNTAIN
SQ. FT. Cai
URINAL
OK W..UNITS
WATER PIPING
•• ESTIMATED VALUATION` - $J13.--•
FEE
FLOOR DRAIN
INSP. FEE
MECHANICAL FEES .
WATER SOFTENER
MbU
VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD
SIGN
WASHER (AUTO) (DISH)
APPLIANCE
TRAFORMER E=K'W• GARBAGE DISPOSAL
FURNACE. ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
OUTLETS LAUNDRY TRAY
AIR HANDLING UNIT CFM -FIXTURE OR SOCKET KITCHEN SINK f
GAS PIPE . ❑ NATURAL ❑ L.P.G. ❑ OIL
CONST. SERV. ENTRANCE .WATER CLOSET
COMPRESSOR 0 HP
POLE LAVATORY,
APPLIANCE VENT
AMPERES SERV. ENT, SHOWER
ABSORPTION SYSTEM 0 B:T.U. SQ. FT. @ Q BATH TUB 4
INCINERATOR ❑ DOMESTIC ❑ INDUS. OR COMM.
SO. FT. @ Q WATER HEATER
HEATING SYSTEM ❑ FORCED Cl GRAVITY
SQ. FT. RESID. Ciu 1 d SEWAGE DISPOSAL
BOILER [� B.T.U.
SG. FT. GARAGE @1/2¢ HOUSE SEWER
PERMIT FEE
BALANCE OF MIN. FEE, GAS PIPING i
TRAILER ISSUANCE FEE : PERMIT FEE.." `
PERMITFEE PERMIT FEE
PIR11
TOTAL FEES
REN. TRAILER FEE HEAT 8 VENT.. FEE
PL. {K. FEE. CONST.
FEE
ELEC. FEE
INSP. FEE
PLUMBING FEE.
MbU
I
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JOB ADDRESS OWNER
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USE OF BUILDING
DAT.
PLAN CHECK FEE
$
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X . ' ..fix 40c1,11A L ..
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CHECKED BY
COMMUNITY - - DISTRICT
F.C.
UNITS
VALUATION OFFICE
MECHANICAL FEE
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Cid
DBL
$
GR
P.
TYPE
LEGAL DES IPTION -
flT51�Ro'CONSTRUCTION
FEE
-
DBL
`PLAN CHECKER
-
SUPP. TO PERMIT
f
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ELECTRICAL FEE
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•
DBL •
°
BOND $ •
BOND
CASH
FILE .q
FINAL DATE
ANSPECTOR
PLUMBING FEE
f
JPLAN
t -•1'�
i
S
NAME
OF. CONSTRUCTION LENDER
BRANCH OFFICE'
ftNDER '
TRAILER PERMIT
f
IND
INVOLVED
ISSUANCE FEE
•
ADDRESS - _ ..
CITY
STATE F
FEE
$
.
r
TOTAL FEES$
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN- 60 DAYS. CESSATION
..
OF WORK FOR 120 DAYS SHAH ALSO CAUSE PERMIT TO BECOME VOID. 1j
`CHECK
I HEREBY AGREE THAT -ALL WORK IN CONNECTION, WITH -THIS PERMIT WILL BE DONE IN ACCOR-
N.C.
CASH M.O. ❑ ❑
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
RECEIVED BY' SEWAGE SYSTEM
OF CALIFORNIA COVERING CONTRACTORS IS ALSO GUARANTEED.
1 HEREBY CERTIFY THAT THE INDIVIDUA L WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE v
j LL P
S O IN ACCORDAWITH SECTION 5541 OF THE BUSINESS AND PROFESSION.S CODE OF THE 'STATE
OFC F RNI NCAl k
-a INFORMATION
OWNER y r C NTRACTOR ° • _ i
•
ADDRESS "- -
ADDRESS
t
•
TEL NO. - -
TEL. NO.
•
LICENSE NO.