142904 (PAT) Space 1DEPARTMENT OF BUILDING & SAFETY FIELD OFFICE
is COUNTY OF RIVERSIDE Allk
CONSTRUCTION ESTIMATE ELECTRICAL FEES PLUMBING FEES
1st FI. Sq. Ft. p NO. NO.
2nd FI. Sq. Ft.
Por. Sq. Ft. @
Gar.
Car P.
Wall pp
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JOB ADDRESS W //
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POLES
WOOD
Sq. Ft. SIGNS
DRAINAGE PIPING
TRANS. AND/
Sq. Ft. OR T. ELK.
DRINKING FOUNTAIN
Sq. Ft. MOTOR H.P.
URINAL
MOTOR H.P.
WATER PIPING
ESTIMATED VALUATION
OTHER
MOTOR
H.P.
FLOOR DRAIN
NO. MECHANICAL FEES
COM s `TYDISTRICT
MOTOR
H.P.
WATER SOFTENER
HEAT APPLIANCE
0 CE
MOTOR
H.P.
WASHER (AUTO) (DISH)
INLETS – OUTLETS
BO. RMS.
FIXTURES
GARBAGE DISPOSAL
M. SO. FT. – UNIT HEATER
ZONE ZONING CHECKED BY PERMIT
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OUTLETS
., •
LAUNDRY TRAY
M. SQ. FT. – PERF. CEILING MAT.
FRONT SIDE REAR LO
SUB -PANEL
KITCHEN SINK
APPLIANCE VENT
GROUP
TYPE
BOND
WATER CLOSET
GAS PIPE
$
PLAN CHECK FEE
RANGE AND/OR OVEN
LAVATORY
REPAIR OR ALTER
$
MECHANICAL FEE
WATER HEATER
SHOWER
VENT SYSTEM ❑HOOD ❑ EVAP. COOL ❑
SPACE HEATER
$
ELECTRICAL FEE
BATH TUB
COMPRESSOR
$
PLUMBING FEE
CONSTRUCTION POLE
WATER HEATER
COMPRESSOR
®
SERVICE ENTRANCE
RECEIVED BY
SEWAGE DISPOSAL
COMPRESSOR
LEACH LINE
SO. FT.
RESID. 10 SQ. FT.
TETTER 0 FILE F_�
HOUSE SEWER
GARAGE ;Q SQ. FT.
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
I EJ M 4 N M
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E`04REN
I F
I An
DBL.
PLN CHK FEE
J
I A
CONSTR. FEE
I M I J
HEATS VENT
11
ELECT. FEE
I A
PLUMB. FEE
I S n
TOTAL FEES
PLAN CHECKER
1—
J F i M I A I M J I J I A I S 10 N 0
BUILDING INFORMATION
JOB ADDRESS W //
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p ERRE
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WOOD
CONCRETE FIREPLACE
CONCRETE
PIERS MEMBRANE
USE 0 BUILDING
U:;&AIIAI
DATE
�r
BLOCK
FRAME STUCCO BRICK CONC. METAL
OTHER
COM s `TYDISTRICT
J
/
F.C.. '�
L$ 1
4�/J
UNITS
VALUATION
D� '—
0 CE
PLASTER
DRY WALL
ROOF COVERING
BO. RMS.
LEGAL DESCRIP_110
!2`�
PER IT N 2904
ZONE ZONING CHECKED BY PERMIT
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USE NO
Oj
�,
., •
SUPPLEMENT TO PERMIT
SET
BACK
FRONT SIDE REAR LO
-1/1 ZE
FIINAtLEEDD DATE
;^ _
INSPECTOR
GROUP
TYPE
BOND
BOND
CASH
$
PLAN CHECK FEE
CONTRACTOR
LICENSE -TYPE
RELEASE BOND
DATE
$
MECHANICAL FEE
In accordance with Sec. 302-D of the Uniform Building Code, this permit shall
expire if work is not commenced within 60 days. If work is suspended or aban-
for a period of 120 days, this permit shall automatically become null
and void.
This permit is issued, and shall continue in effect, pursuant to the terms and
conditions of Sec. 3800 of the Business and Professions Code and as a condi-
tion of the issuance hereof the following certificate is executed.
OWNER -BUILDER CONTRACTOR
I hereby certify that in performance I hereby certify that in performance
of the work for which this permit is of the work for which this permit is
issued I shall not employ any person issued I have complied with Title 8,
in any manner whatsoever as to be- Article 3, Sec. 3800 of the Labor
Come subject to the Workmen's Com- Code, and a certificate or certified
pensation Laws of the State of copy is on f' w/ith t r e
California. County Buil ar
Owner Contracto �J/�� (�
�J r'° /��'•�.r �i J%�
Address Add res 1
Telephone Tel.T. L1c. #
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$
CONSTRUCTION FEE
Qdoned
$
ELECTRICAL FEE
$
PLUMBING FEE
TOTAL FEE
t
$ /
®
:ASH CHECK M. 0. N.C.
RECEIVED BY
PLAN FILE
#
WATER VOLUME SEPTIC TANK
GAL,
LEACH LINE
SO. FT.
SEEPAGE PIT
GAL.
TETTER 0 FILE F_�
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