174617 (BLCK)DEPARTMENT OF BUILDING & SAFETY
COUNTY OF RIVERSIDE •
CONSTRUCTION ESTIMATE
1st FI.
Sq. Ft. @
2nd FI.
Sq. Ft. @
Por.
Sq. Ft. @
Gar.
Sq. Ft. @
Car P.
Sq. Ft. @
Wall
Sq. Ft. @
PLAN CHECK FEE $
Sq. Ft. @
ESTIMATED VALUATION $
MECHANICAL FEES
ELECTRICAL FEES
a`Q
POLES
MOTOR H. P.
SIGNS
APPLIANCE
TRANS. AND/
OR T. CLK.
GARBAGE DISPOSAL
MOTOR
H. P.
MOTOR
H. P.
MOTOR
H. P.
GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
PLAN CHECK FEE $
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
PLAN CHECK FEE $
WATER CLOSET
COMPRESSOR �HP
RANGE AND/OR OVEN
LAVATORY
APPLIANCE VENT
WATER HEATER
SHOWER
ABSORPTION SYSTEM D B.T.U.
SPACE HEATER
BATH TUB
INCINERATOR DOMESTIC ❑ INDUS. ❑ COMM.
CONSTRUCTION POLE
WATER HEATER
HEATING SYSTEM ❑ FORCED ❑ GRAVITY
SERVICE ENTRANCE
SEWAGE DISPOSAL
BOILER O B.T.U.
RESID. 10 SO. FT.
HOUSE SEWER
PERMIT FEE
GARAGE iQ SO. FT.
GAS PIPING
•
PERMIT FEE
PERMIT FEE
SET BACK
LOT SIZE
USE #
JOB ADDRESS OWNER
7� - f
F
S
R
ZONE
USE OF BUILDING DATE
PLAN CHECK FEE $
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CHECKED BY
C MMUNITY
DISTRICT
F.C.
UNITS
VALUATION `g OFFICE
MECHANICAL FEE $
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GROUP
TYPE
LEGAL DESCRIPTION
PERMIT NUMBER
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G
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CONSTRUCTION FEE $
SPEC. INSP.
SVPP. TO PERMIT
ELECTRICAL FEE $
PLAN CHECKER
BOND $
BOND
CASH
PLAN FILE #
NALATE
INSPECTOR
PLUMBING FEE $
I
- (0
[]�F
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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-
ILL
IPCARRY
SIDE COUNTY AND THE STATE OF CALIFORNIA. I ALSO AGREE TO
s�►,
r
COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLI-
ANCE WITH LAWS OF THE STATE OF CALIFORNIA COVERING CON-
TRACTORS ISA GUARANTEED.
NAME OF CONSTRUCTION
LENDER
� J
OWNER
CONTRACTOR
BRANCH OFFICE
-
ADDRESS
ADDRESS
ADDRESS
CITY
STATE
...—
NO LENDER INVOLVED /
INFORMATION
1
TEL. NO.
TEL. NO.
LICENSE NO.
84-208 12/__