184167 (BLCK)DEPARTMENT OF BUILDING & SAFETY
0 COUNTY OF RIVERSIDE 0
CONSTRUCTION ESTIMATE ELECTRICAL FEES
Ist FI. Sq. Ft. @ NO.
2nd FI. Sq. Ft. @
Por. Sq. Ft. @
Gar. Sq. Ft. @ POLES
Car P. Sq. Ft. @ SIGNS
Wall h jg4ef Sq. Ft. @ / . Ie j 14t. DRAT SCLK O/
Sq. Ft. @ MOTOR H. P.
MOTOR H. P.
ESTIMATED VALUATION Is MOTOR H. P.
MECHANICAL FEES e
FIELD OFFICE
PLUMBING FEES
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
FLOOR DRAIN
VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD
MOTOR H. P.
WASHER (AUTO) (DISH)
APPLIANCE
FIXTURES
GARBAGE DISPOSAL
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 E::� B.T.U.
SPACE HEATER
BATH TUB
INCINERATOR DOMESTIC ❑ INDUS. ❑ COMM.
CONSTRUCTION POLE
WATER HEATER
HEATING SYSTEM ❑ FORCED ❑ GRAVITY
SERVICE ENTRANCE
SEWAGE DISPOSAL
BOILER B.T.U.
RESID. la 50. FT.
HOUSE SEWER
PERMIT FEE
GARAGEzC SO. FT.
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT NUMBER
REN. DBL.
TOTAL FEES
HEAT & VENT FEE
PLNRA1. CK. FEE
CONST. FEE
ELEC. FEE
PLUMB. FEE
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J F M A M J J A I S
O N D
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SET BACK
LOT SIZE
USE 4
JOB ADDRESS
OWNER
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SSE OF BUILDING -
DATE
PLAN CHECK FEE $
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CME D B
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COMMUNITY - DISTRIC064
F.C.
UNITS VALUATION
OFFICE
MECHANICAL FEE $'7.
GR Or
TY
LEGAL DES R PTI
PERMIT NUMBER
j
184167
CONSTRUCTION FEE $
SPEC. INSP.
SUPP. TO PERMIT
ELECTRICAL FEE $
F:m •+
PLAN CHECKER
BOND $
BON
CASH
PLAN FILE 0
FINAL DATE
INSP CTOR
PLUMBING FEE $
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.
RECEIVED 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 -
X ..
�'
TRACTORS IS ALSO GUARANTEED.
NAME -OF CONSTRUCTION LENDER
OWNER ¢
CONTRACTOR
BRANCH OFFICE
,, e'' •�I
ADDRESS
ADDRESS -
ADDRESS -
CITY STATE
NO LENDER INVOLVED
INFORMATIO
TEL. NO.
TEL. NO.
f1
LICENSE NO.
84-208 12/88 -
1