159030 (PLBG)DEPARTMENT OF BUILDING & SAFETY
ft COUNTY OF RIVERSIDE Alak FIELD OFFICE
CONSTRUCTION ESTIMATE
ELECTRICAL FEES
PLUMBING FEES
lst FI.
Sq. Ft. @
NO.
NO.
R
2nd FI.
Sq. Ft. @
USE OF BUIL ING f
[PLAN CHECK FEECHECKED
Por.
Sq. Ft. @
BY
COMMUNITY }
ISTRIcY
' Gar.
Sq. Ft. @
POLES
FEE
,. L.
<
Cor P.
Sq. Ft. @
SIGNS
DRAINAGE PIPING
WOII
Sq. Ft. @
TRANS. AND/
OR T. CLK.
LEGAL ES TION
DRINKING FOUNTAIN
PERMIT �M�'Ro
Sq. Ft. @
MOTOR H. P.
w
URINAL
. ELECTRICAL FEE
MOTOR H. P.
WATER PIPING -
ESTIMATED VALUATION is
MOTOR H. P.
FLOOR DRAIN
MECHANICAL FEES
MOTOR H. P.
C
INSP-E.CyTOR
WATER SOFTENER
VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD
MOTOR H. P.
WASHER (AUTO) (DISH)
APPLIANCE
FIXTURES
-.ECEIVED BY
GARBAGE DISPOSAL
FURNACE ❑ UNIT ❑ WALL ❑ FLOORO SUSPENDED
OUTLETS
LAUNDRY TRAY
-J
FP
SIDE COUNTY AND THE STATE OF CALIFORNIA. I ALSO AGREE TO
Z AIR HANDLING UNIT
SUB-PAMEL
LL
KITCHEN SINK
O
. J GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
CONTRACTOR
ADDRESS
WATER CLOSET
Q
U COMPRESSOR CHP
RANGE AND/OR OVEN
LAVATORY
TEL. NO.
TEL. NO.
`
W APPLIANCE VENT
WATER NEATER
SHOWER
ABSORPTION SYSTEM D B.T.U.
SPACE HEATER
BATH TUB ,
0
U INCINERATOR DOMESTIC ❑ INDUS. ❑ COMM.
CONSTRUCTION POLE
WATER HEATER
HEATING SYSTEM ❑ FORCED ❑ GRAVITY
SERVICE ENTRANCE
J
SEWAGE DISPOSAL l•
BOILER B.T.U.
RE5ID. IC SO. FT.
HOUSE SEWER
RESIDENTAL FEE SQ.FT.1
GARAGE 'C SO. FT.
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
.ERMIT
/�
REN.
DBL.
TOTAL FEES
HEAT & VENT FEE
PLN. CK. FEE
CONST. 'FEE
ELEC. FEE
PLUMB. FEE
I �
0
3
0
J
F
M
A
M J
J A
S
O
N
D
J F M A
M J J A 5
O
N D
SET BACK
LOT SIZE
USE V
JOBB ADDRESS OW ER
LJf T l _
•DATE,
S
R
ZONE .'
USE OF BUIL ING f
[PLAN CHECK FEECHECKED
_
BY
COMMUNITY }
ISTRIcY
F.C.
UNITS
VALUATTIION CoFF ErECHANICAL
FEE
,. L.
<
tirJ
CONSTRUCTION FEE159
GROUP
TYPE
LEGAL ES TION
PERMIT �M�'Ro
SPEC. INSP.
w
SUPP. TO PERMIT
. ELECTRICAL FEE
("
PLUMBING FEE
PLAN CHECKER
BOND $ TBOND
A H
PLAN FILE it
FINAL DATE
C
INSP-E.CyTOR
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
PERMIT WILL BE DONE IN ACCORDANCE WITH THE LAWS OF RIVER-
CASH CHECK M. 0. N.c.
-.ECEIVED BY
SEWAGE SYSTEM
FP
SIDE COUNTY AND THE STATE OF CALIFORNIA. I ALSO AGREE TO
T
LL
CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLI-
ANCE WITH LAWS OF THE STATE OF CALIFORNIA COVERING CON-
TRACTORS IS ALSO GUARANTEED.
OWNER
CONTRACTOR
ADDRESS
ADDR SS
TEL. NO.
TEL. NO.
`
IL'CrN,5E 110,
84-208 11/87