195816 (AR)VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD
SIGN WASHER (AUTO) (DISH)
APPLIANCE
DEPARTMENT OF BUILDING & SAFETY
• COUNTY OF RIVERSIDE •
FIELD OFFICE
OUTLETS LAUNDRY TRAY
CONSTRUCTION ESTIMATE— ELECTRICAL FEES
PLUMBING FEES a
1 ST FL.
2ND FL.
POR.
GAR.
CAR P..C
WAL)��. 6
CONST. SERV. ENTRANCE WATER CLOSET
50. FT.
@
NO.
NO.
SQ. FT. @
SQ. FT. @ ¢ BATH TUB
SQ. FT. @ MOTORZ OR LESS H.P.
SQ. FT. @ d WATER HEATER
SQ.FT. @ MOTOR 5 OR LESS H.P.
SQ. FT. RESID. @ 14 SEWAGE DISPOSAL
SQ. FT. @ MOTOR 20 OR LESS H.P.
DRAINAGE PIPING
SQ.FT. @
DRINKING FOUNTAIN
SQ. FT. @
URINAL
OK W. UNITS
WATER PIPING
ESTIMATED VALUATION$
TOTA L FEE$
�.,�y �+
FLOOR DRAIN
FEE
MECHANICAL FEES
ELEC. FEE
WATFR S()FTFNFR
VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD
SIGN WASHER (AUTO) (DISH)
APPLIANCE
TRANS. K.W.GARBAGE DISPOSAL
FORMER D
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR Cl SUSPENDED
OUTLETS LAUNDRY TRAY
AIR HANDLING UNIT I CFM
FIXTURE OR SOCKET KITCHEN SINK,
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 B.T.U.
SQ. FT. @ ¢ BATH TUB
INCINERATOR ❑ DOMESTIC ❑ INDUS. OR COMM.
SQ. FT. @ d WATER HEATER
HEATING SYSTEM ❑ FORCED ❑ GRAVITY
SQ. FT. RESID. @ 14 SEWAGE DISPOSAL
BOILER I B.T.U.
SQ. FT. GARAGE @112Q HOUSE SEWER
PERMIT FEE
BALANCE OF MIN. FEE GAS PIPING
TRAILER ISSUANCE FEE .PERMIT FEE
PERMIT FEE PERMIT FEE
PER
�'4 A
TOTA L FEE$
REN. TRAILER FEE HEAT & VENT. FEE
PL. CK. FEE CONST.
FEE
DBL.
ELEC. FEE
FEE
PLUMBING FEE
i8 I
1 '.v—
� s�
IDBL.ISPEC.INSP.
JDBL.
M A M
J F M A M
J J A S O
J l A - S - 0
N D
- - N _ 0 .- —..
LOT SIZE
USE #
JOB ADDRESS OWNNEER
ZONE
SE OF BUILDINGD
E
PLAN CHECK FEE
$
♦�
l JL fir-, >v -bLt 1-' -6-21-71
CHECKED BY
COM MUNIT - DISTRICT
F.C.
UNITSVALUATION
OFFICE
`
MECHANICAL FEE
l
jy++�y,
DBL
S
Gfl P'TYPE
LEGAL DESCRIPTION
1 E T UM@ER
CONSTRUCTION FEE
aC
I
6 6
DBL
PLAN CHECKER
SUPP. TO PERMIT
ELECTRICAL FEE
®
`s
DBL
f
BOND $
BOND
CASH
PLAN FILE# FINAL
DATE
INSPECTOR
PLUMBING FEE
I
I/
% �
NAME OF. CONSTRUCTION
LENDER
BRANCH OFFICE
NLENDER
TRAILER PERMIT
f
VOLVED
ISSUANCE FEE
ADDRESS
CITY
STATE
FEE
s
TOTAL FEES
$
THIS ERMT SHALL COMMNCED WITHIN 60 DAYS. CESSATION
ECOME VOID IF WORK IS NO
TBE
IV 13
OF WORKPFORI120 DAYSBSHAALL ALSO CAUSE PERMIT OMEE VOID,
HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCOR-
CASHI
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
IT
OF CALIFORNIA COVERING CONTRACTORS IS ALSO GUARANTEED.
ILL p
I HEREBY CERTIFY THAT THE INDIVIDUALWHOPREPARED THE PLANS AND SPECIFICATIONS HAS DONE
SO INACCORDANCEWITHSECTION 5541OFTHE BUSINESS AND PROFESSIONS CODE OF THE STATE
OF CALIFORNIA,
INFORMATION
OWNER
CONT CTOR
d
ADDRESS
`�•� `"
ADD ESS
TEL. NO.
TEL. NO.
�1 P
LICENSE NO.
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