165440 (AR)DEPARTMENT OF BUILDING & SAFETY
COUNTY OF RIVERSIDE
FIELD OFFICE
I'
CONSTRUCTION ESTIMATE
ELECTRICAL FEES
PLUMBING FEES
1st Fl.
E 2nd FI.
Par.
Gar. A&W3 -
Car P.
Wall
nn
l/ t
Sq. Ft. @
No.
No. 11
Sq. Ft. @
Sq. Ft. @
Sq. Ft. @ POLES
Sq, Ft, @ SIGNS DRAINAGE PIPING
S Ft. TRANS. AND/ I
q, @ OR T. CLK. DRINKING FOUNTAIN
Sq. Ft. @ MOTOR M.P. URINAL 4
J
MOTOR H. P. WATER PIPING
ESTIMATED VALUATION $
MOTOR H. P.
FLOOR DRAIN
i MECHANICAL FEES
MOTOR H. P.
WATER SOFTENER
VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD
MOTOR H. P.
WASHER (AUTO) `DISH)
�. APPLIANCE
FIXTURES
GARBAGE DISPOSAL j
C ) FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
OUTLETS
LAUNDRY TRAY
AIR HANDLING UNIT
SUB -PANEL
KITCHEN SINK
GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
WATER CLOSET
COMPRESSOR �HP
RANGE AND/OR OVEN
LAVATORY
APPLIANCE VENT
WATER HEATER
SHOWER
ABSORPTION SYSTEM D B.T.U.
SPACE HEATER
BATH TUB
INCINERATOR DOMESTIC ❑ INDUS. ❑ COMM.
CONSTRUCTION POLE
i
WATER HEATER
HEATING SYSTEM ❑ FORCED ❑ GRAVITY
SERVICE ENTRANCE
SEWAGE DISPOSAL
BOILER D B.T.U.
RESID. IC SO. FT.
HOUSE SEWER
RZA"ANW64jo 6IEE S^ �T =a
GARAGE iQ SO, FT.
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE -
ERMITt{/M0�
_J
I
0
165
REN,
DBL.
TOTAL FEES
HEAT & VENT FEE
PLN. CK. FEE
CONST. FEE ,a/i
ELEC.
FEE
PLUMB. FEE
F M J
F
O N D
SET BACK
LOT SIZE
USE 4
JOB ADDRESS 1 ..+ OWNERS
J
S
R
ZONE
US OF MTLDING
DATE
PLAN CHECK FEE
*•�
*
CM KED BY
COPfaNITYD
ISTRICT
F.C.
UNITS
wM
IVALUATIONO'OFFIC
MECHANICAL FEE
,
GROUP
TYPE
LEGAL DES RIPT ION
PERMIT NUM R
I
165
4 0
CONSTRUCTION FEE
"
�
SPEC. INSP.
-
SUPP. TO PERMIT
ELECTRICAL FEE
—
PLAN CHECKER
BOND $
dON11301 CASH
FINAq A E
SPECTOR
PLUMBING FEE
jPLAiTFIL%eN
113 _&1?
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.O. N.C.
ECEIVE` 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 CON-
° INFORMATION
TRACTORS IS ALSO GUARANTEED.
OWNER
CONTRACTOR
ADDRESS
ADDRESS
TEL. NO.
T 51. N0.
1.
LICENSE NO. '
284-208 11/87
/.� 11 J.