159029 (PLBG)_ DEPARTMENT OF BUILDING & SAFETY
SET BACK
1
LOT SIZE
FIELD OFFICE
JOB ADDRESS ��, OWN R
COUNTY OF RIVERSIDE
CONSTRUCTION ESTIMATE
ELECTRICAL FEES
PLUMBING FEES
1st FI.
Sq. Ft. @
NO.
NO.
CHECKED BY
Sq. Ft. @
jDIlTlIC
.C.
UNITS
2nd FI.
Sq. Ft. @
GROUP
I TYPE
Por.
Sq. Ft. @
POLES
2
I. Gar.
Sq. Ft. @
SIGNS
DRAINAGE PIPING
.ELECTRICAL FEE
! Car P.
Sq. Ft. @
TRANS. AND/
OR T. CLK.
DRINKING FOUNTAIN
I. PLUMBING FEE
f' Wa 11
Sq. Ft. @
MOTOR H. P.
URINAL
I CASH
S
II
FINAL DATE
✓���%�+
MOTOR H. P.
WATER PIPING
k ESTIMATED VALUATION $
MOTOR H. P.
FLOOR DRAIN
`
IIF MECHANICAL FEES
MOTOR H. P.
WATER SOFTENER
SEWAGE SYSTEM
e VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD
MOTOR H. P.
WASHER (AUTO) (DISH)
' APPLIANCE
FIXTURES
GARBAGE DISPOSAL
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
OUTLETS
LAUNDRY TRAY
LL
J
r
P —MC)
CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLI-
ANCE WITH LAWS OF THE STATE OF CALIFORNIA COVERING CON-
TRACTORS IS ALSO GUARANTEED.
INFORMATION
I /
Z AIR HANDLING UNIT
O
SUB -PANEL
KITCHEN SINK
n
J GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
CONTRACTOR
WATER CLOSET
ADDRESS
v"
Q
U COMPRESSOR �HP
RANGE AND/OR OVEN
LAVATORY
t`
W APPLIANCE VENT
WATER NEATER
SHOWER
"
84-208 11/&7
F
f ABSORPTION SYSTEM D B.T.U.
SPACE HEATER
BATH TUB
LICENSENO.
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0
P U INCINERATOR DOMESTIC ❑ INDUS. ❑ COMM.
CONSTRUCTION POLE
WATER HEATER
HEATING SYSTEM ❑ FORCED ❑ GRAVITY
SERVICE ENTRANCE
SEWAGE DISPOSAL
I
1 BOILER B.T.U.
RESID. 16 SQ. FT.
HOUSE SEWER
RESIDE. TAIL FEE SQ.FT.�@
GARAGE)
yQ SO- FT.
GAS PIPING
C FEE
PERMIT FEE
PERMIT
77
Q
PERMIT
FEE
Q 9
ERMITNV
REN.
DBL.
TOTAL FEES
HEAT & VENT FEE
PLN. CK. FEE
CONST. PEE
ELEC. FEE
PLUMB. FEE
-1
TB
n
2 9,
J F M A M J J A S
O N D
SET BACK
R
LOT SIZE
USE I
JOB ADDRESS ��, OWN R
IS
ZONE
SE OF BUILDING DATE
PLAN CHECK FEES{
/l
> MECHANICAL FEE
CHECKED BY
COMMUNITY
jDIlTlIC
.C.
UNITS
VALUATION OFFICE
CONSTRUCTION FEE
GROUP
I TYPE
LEGAL DESCRIPTIONP
RMIT NUMBE
9 0
2
SPEC. INSP.
SUPP. TO PERMIT
.ELECTRICAL FEE
I. PLUMBING FEE
PLAN CHECKER
BOND $
BOND
I CASH
PLAN FILE 11
FINAL DATE
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INSPECTOR
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TOTAL FEES
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED
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WITHIN 60 DAYS. CESSATION OF WORK FOR 120 DAYS SHALL ALSO
CAUSE PERMIT TO BECOME VOID.
1 HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS
PERMIT WILL BE DONE IN ACCORDANCE WITH THE LAWS OF RIVER-
' CASH CHECK M.O. N.C.
ECEIVED BY
1
SEWAGE SYSTEM
SIDE COUNTY AND THE STATE OF CALIFORNIA. I ALSO AGREE TO
T
LL
P —MC)
CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLI-
ANCE WITH LAWS OF THE STATE OF CALIFORNIA COVERING CON-
TRACTORS IS ALSO GUARANTEED.
INFORMATION
I /
OWNER
CONTRACTOR
ADDRESS
ADDRESS
v"
/-" N -A,
TEL. NO.
TEL. 1N O.
"
84-208 11/&7
-}I►�F
LICENSENO.
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