176838 (SFD)DEPARTMENT OF BUILDING & SAFETY
0 COUNTY OF RIVERSIDE 0 FIELD OFFICE.
CONSTRUCTION ESTIMATE I ELECTRICAL FEES PLUMBING FEES
1st FL 1,,oe
2nd FI.
Par.
Gar. E4,4.
Car P.
WQII
Sq. Ft. @ �'� ='Y
7 NO.
NO,
Sq. Ft. @
WASHER (AUT ' iDISH)
Sq. Ft. @
APPLIANCE
Sq. Ft. @ 5w POLES
FIXTURES
/SIGNS
Sq. Ft. @
DRAINAGE PIPING
'
Sq, Ft, @ ORAT SC LK.
DRINKING FOUNTAIN 1
Sq. Ft. @ MOTOR H.P.
URINAL
MOTOR H.P.
WATER PIPING
ESTIMATED VALUATION $ _
MOTOR K. P.
FLOOR DRAIN
MECHANICAL FEES
MoroR H.P.
WATER'SOFTENER
VENT SYSTEM FAN ❑ EVAP. COOL HOOD
REN. DBL.
MOTOR
H.P.
HEAT & FEE
WASHER (AUT ' iDISH)
1
APPLIANCE
PLUMB. FEE ,("?
FIXTURES
GARBAGE DISPOSAL
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FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
OUTLETS
J F M A M _ ... J _ _ Jw`' A S
J F M A M J J A S
LAUNDRY TRAY
AIR HANDLING UNIT
SUB -PANEL
USE A
JOB ADDRESS
-
KITCHEN 'SINK
S
GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
R
USE OF BUILDING - f DATE
WATER CLOSET
41 422
COMPRESSOR HP
PLAN CHECK FEE $
RANGE AND/OR
OVEN
LAVATORY
COMMUNITY
APPLIANCE VENT
F.C.
WATER HEATER
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r
SHOWER
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I
ABSORPTION SYSTEM B, T. U.
vee
SPACE HEATER
BATH TUB
L1
INCINERATOR DOMESTIC ❑ INDUS. ❑ COMM.
CONSTRUCTION
POLE
LEGAL D CRIPTION
WATER HEATER
J
HEATING SYSTEM VI FORCED ❑ GRAVITY
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M"
SERVICE ENTRANCE.
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SEWAGE DISPOSAL
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BOILER �B.T.A1.
RESID. 16 SO.
FT,
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HOUSE SEWER
-
PERMIT FEE
�" GARAGE 11SQ.
FT./
GAS PIPING
ELECTRICAL FEE $ I
PERMIT FEE
fPLAN
PERMIT FEE
i Y
P R 7Tgj gEj
REN. DBL.
ITOTALFEES ESh
HEAT & FEE
PLNs. CK. FEE
CONST. FE
ELEC. FEE
PLUMB. FEE ,("?
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..
J F M A M _ ... J _ _ Jw`' A S
J F M A M J J A S
O N _ U
O N D
SET BACK
LOT S1ZE
USE A
JOB ADDRESS
-
OWNER
F
S
R
USE OF BUILDING - f DATE
PLAN CHECK FEE $
CHECKED BY
COMMUNITY
DISTRICT
F.C.
VALUATION OFFICE
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JS
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I
JUNITS
vee
MECHANICAL FEE $
L1
G OUP
TYPE
LEGAL D CRIPTION
176838,
PERMIT NUMBER
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CONSTRUCTION FEE $
SPEC. INSP.
SUPP. TO PERMIT
ELECTRICAL FEE $ I
fPLAN
CHECKER
BOND $
BOND I
CASH
PLAN FILE 11
FINALDATE
INSPECTOR
PLUMBING FEE $ „j / •+""
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�- I - 7 U
IL, -
TOTAL FEES
$...
THIS BECOME VOID R NOT COMMENCED
RMIT SCESSATION
�'
01
OF WORKHALL
WI DAYS SHALLS ALSO
WITHIN 60EDAYS. FOR
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 CALIFOIA COVERING CON-
TRACTORS IS ALSO GUARANTEED. t
NAME OF CONSTRUCTION LENDER
.
OWNER
CONTRACTOR
BRANCH OFFICE
f
ADDRESS04?z4a1
CITY STATE
ADDRESS
/1DORE55
NO LENDER INVOLVED
•1 % _��_ '��
INFORMATION'
TEL. NO.
TEL. NO.
LICENSE NO.
284-208 12/888
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