176612 (SATT)FIELD OFFICE
PLUMBING FEES
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
FLOOR DRAIN
VENT SYSTEM IFAN ❑ EVAP. COOL ODD
SETBACK
DEPARTMENT OF BUILDING 81 SAFETY
. COUNTY OF RIVERSIDE •
LOT S1ZE
CONSTRUCTION ESTIMATE
ELECTRICAL FEES
1st FI.
2nd FI.
Por.
Czar.
Car P.
Wall
Sq. Ft. @
gyp `
1 No.
OF
Sq. Ft. @
f
Sq. Ft. @
OUTLETS
Sq. Ft. @ • �'� ♦
�i f POLES
Sq. Ft. @
SIGNS
Sq. Ft. @
TRANS. AND/
OR T. CLK.
Sq. Ft. @
MOTOR H.P.
MOTOR M.P.
ESTIMATED VALUATION $
a
w MOTOR H, p,
WATER CLOSET(%
MECHANICAL
FEES A f
DISTRICT
FIELD OFFICE
PLUMBING FEES
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
FLOOR DRAIN
VENT SYSTEM IFAN ❑ EVAP. COOL ODD
SETBACK
MOTOR H. P.
LOT S1ZE
WASHER (AU TOI DISH)
Vv
APPLIANCE
FIXTURES
GARBAGE DISPOSAL
S
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
OUTLETS
24
Zgy
LAUNDRY TRAY
AIR HANDLING UNIT
SUB -PANEL
PLAN CHECK FEE $
KITCHEN SINK
GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
& 3/
�-�� ;P,4
h
WATER CLOSET(%
COMPRESSORHP
DISTRICT
RIIINGE AND/OR OVEN
LAVATORY
MECHANICAL FEE $
APPLIANCE VENT
WATER HEATER
SHOWER
!�v
J_
ABSORPTION SYSTEM E=== B.T.U.
SPACE HEATER
GRO P
BATH TUB
"'!)
INCINERATOR DOMESTIC 13INDUS. ❑ COMM.
PERMIT
CONSTRUCTION POLE
0
WATER HEATER
HEATING SYSTEM FORCED ❑ GRAVITY
Q
SERVICE ENTRANCE
/ I'
SEWAGE DISPOSAL
BOILER B.T. U.
RESID. IQ SO. FT.
♦ , 0.,�"
HOUSE SEWER
� t
PERMIT FEE
ELECTRICAL FEE $
GARAGE zQ SO. FT.
GAS PIPING
(%
,r}
PERMIT FEE
//
"y�!
PERMIT FEE
y
P R T U BE REN. DBL. TOTAL FE ES_ HEAT & VENT FEE PLN. CK. FEE CONST. FEE ELEC. FEE PLUMB. FEE
J
...
J F M A• M J J A 5 O N D
IJ F M �A I M J J A l e 1
SETBACK
LOT S1ZE
USE #
JOB ADDRESS JOWNER
� 40
F!
S
R
!
f i. �l.'
24
Zgy
ZONE
U9,E O BUILDING DATE
PLAN CHECK FEE $
!j �r+r�.
& 3/
�-�� ;P,4
h
CHECK D BY
COMMUNITY
DISTRICT
F.C.
VALUATION OF ICE
MECHANICAL FEE $
JUNITS
V o
GRO P
I TYPE
LEGAL DES RIP ION
,O
PERMIT
NUMBER
CONSTRUCTION FEE $
7r..
176612
'?T
SPEC.
INSP.
� t
SUPP. TO PERMIT
ELECTRICAL FEE $
t
PLAN CHECKER
BOND a
BOND
CASH
PLAN FILE #
DATE
INSPECTOR '
PLUMBING FEE $
"�
I
TFINAL
'/C' j/
�•J
TOTAL FEES
�+'
1.......
4M.O.
�
BECOME VOID 1 COMMENCED
Rt
WI WIIS THIN 60ERMIT DAYS.SHALL
CESSAT ON OF WORK FOR 0SHALL
DAYS ALSO
CAUSE PERMIT TO BECOME VOID.
I HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS
CASH CHECK N.C.
RECEIVED BY
SEWAGE SYSTEM
r
PERMIT WILL BE DONE IN ACCORDANCE WITH THE LAWS OF RIVER-
SIDE COUNTY AND THE STATE OF CALIFORNIA. I ALSO AGREE TO
T
app
LL
P
✓fl
CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLI-
ANCE WITH LAWS OF THE STATE OF CALIFORNIA COVERING CON-
TRACTORS IS ALSO GUARANTEED.
NAME OF CONSTRUCTION
LENDER
tt
f
OWNER
CONTRACTOR
BRANCH OFFICE Al
b Z 0
ADDRESS
1
ADDRESS
ADDRESS 1
CITY
STATE
NO LENDER INVOLVED
INFORMATION
-7 v 4
/
TEL. NO.
TEL. NO.
!i 00Yk S&A .4k j)lF 1_ 6 !
r )
LICENSE NO.
284.208 12/88