189745 (ELEC)FIELD OFFICE
PLUMBING FEES
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
FLOOR DRAIN
VENT SYSTEM ❑ FAN ❑ EVAP, COOL
❑ HOOD
DEPARTMENT OF BUILDING & SAFETY
0 COUNTY OF, RIVERSIDE 0
WASHER (AUTO) (DISH)
CONSTRUCTION ESTIMATE
ELECTRICAL FEES
1st FI.
2nd FI.
Por.
Gar.
Car P.
Wall
GARBAGE DISPOSAL
Sq. Ft. @
SUSPENDED
NO.
Sq. Ft. @
AIR HANDLING UNIT
Sq. Ft. @
SUB -PANEL
Sq. Ft. @
POLES
Sq. Ft. @
SIGNS
Sq. Ft. @
TRANS. AND/
OR T. CLK.
Sq. Ft. @
MOTOR `/ M.P. C
I
LAVATORY
MOTOR M.P. t
ESTIMATED VALUATION Is
WATER HEATER
MOTOR H.P.
ABSORPTION SYSTEM
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
USE #
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
S
WATER CLOSET
COMPRESSOR E::�HP
RANGE AND/OR OVEN
LAVATORY
APPLIANCE VENT
WATER HEATER
SHOWER
ABSORPTION SYSTEM
D B.T.U.
SPACE HEATER
BATH TUB
INCINERATOR DOMESTIC ❑ INOU5.
❑ COMM.
CONSTRUCTION POLE
WATER HEATER
HEATING SYSTEM ❑ FORCED ❑ GRAVITY
SERVICE ENTRANCE
SEWAGE DISPOSAL
BOILER
T. U.
RESID. IC SQ. FT.
HOUSE SEWER
PERMIT FEE
OFFICE
GARAGE iQ SQ. FT.
GAS PIPING
PERMIT FEE Q
PERMIT FEE
PERMIT NUMBER REN. DBL. TO TA LEES HEAT & VENT FEE(PLN. CK. FEE (CONST. FEE JELEC,EPLUMB. FEE
18,87 4�
J F M A M J J A 5 O _ ._ N D
SET BACK
LOT SIZE
USE #
JOB ADDRESS OWNER
G
F
S
R•
ZONE
USE OF BUILDING -
DATE
PLAN CHECK FEE $
�•'
�.lC _
�l
CHECKED BY
COMMUNITY -
F.C.
UNITS
VALUATION
OFFICE
MECHANICAL FEE $
]DISTRICT
I
GIj
TYPE
LEGALC IPTION
PERMIT NUMBER
CONSTRUCTION FEE $
�( w
189745
SPEC. INSP.
SUPP. TO PERMIT
ELECTRICAL FEE $
�; — ,!v �•,� / r
PLAN CHECKER
BOND $
BOND
CASK
PLAN FILE #
A
�
INS
PLUMBING FEE $
�
IP,E^C'`TrO'R
l II//�0,�`
TOTAL FEES
$
7 e
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
C� .I-'-
T
LL
P
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
OWNER
CONTRACTOR
BRANCH OFFICE
ADDRESS
ADDRESS
ADDRESS `
CITY
STATE
QHS M �J �A J�
NO LENDER INVOLVED
INFORMATION
15 A51
TEL. NO.
TEL. NO.
/-,2
LICENSE NO.
ten•Zoe 12/ems
r
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