167089 (SPIN)DEPARTMENT OF BUILDING & SAFETY
COUNTY OF RIVERSIDE
FIELD OFFICE
I' CONSTRUCTION ESTIMATE
ELECTRICAL FEES
PLUMBING FEES
lst F1.
` 2nd FI.
Par.
Gar.
UUC//a�-rLL P.
1� S
i+.
Sq. Ft. @
NO.
NO.
Sq. Ft. @
S
Sq. Ft. @
Sq. Ft. @ POLES
Sq. Ft. @ SIGNS
DRAINAGE PIPING
AND/
Sq. Ft. @ OR TRANS.N CLK.
DRINKING FOUNTAIN
Sq. Ft. @ MOTOR N.P.
URINAL
MOTOR H. P.
WATER PIPING
�E'STI ATED VALUATION is
MOTOR H. P.
FLOOR DRAIN
MECHANICAL FEES
MOTOR H. P.
WATER SOFTENER
VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD
MOTOR K. P.
WASHER (AUTO) (DISH)
APPLIANCE
FIXTURES
GARBAGE DISP05AL
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
OUTLETS
LAUNDRY TRAY
J
'- Z AIR HANDLING UNIT
O
SUB-PAMEL
KITCHEN SINK
1
J GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
WATER CLOSET
1 a
U COMPRESSOR OMP
RANGE AND/OR OVEN
LAVATORY
W APPLIANCE VENT
WATER HEATER
SHOWER
I[I
ABSORPTION SYSTEM D B.T.U.
f
SPACE HEATER
BATH TUB
`! U INCINERATOR DOMESTIC ❑ INDUS. ❑ COMM.
CONSTRUCTION POLE
WATER HEATER _I
I
HEATING SYSTEM ❑ FORCED ❑ GRAVITY
SERVICE ENTRANCE
SEWAGE DISPOSAL
BOILER D B.T.U.
RESID. 11 SO. FT.
HOUSE SEWER
RESIDENTAL FEE 50.FT.�
GARAGE iQ 50. FT,
GAS PIPING
PERMIT FEE
PERMIT FEE
1
PERMIT FEE
ERMIT NUMB E)L r REN. DBL. TOTAL FEES
HEAT & VENT FEE PLN. CK. FEE CONST. 'FEE
ELEC. FEE PLUMB. FEE
SET BACK
LOT SIZE
USE ;
JOB ADDRESS �/ OWNER
S
R
US OF
ZONE
PLAN CHECK FEE
CHECKED BY
COM NItY
UNIT
ION
I
EISTRTCT
jV7LUA
J
MECHANICAL FEE
17
S
GRO
YPE
L AL CRIP I
167089
PERMIT HUMMER
CONSTRUCTION FEE
--�
ELECTRICAL FEE
SPEC.INSP.
SU PP. TO PERMIT
N CFMCKER
BOND $
BOND
CASH
PLAN FILE A
FINALDATE
INSPECTOR
I
S"-,�
C(,'t..It
PLUMBING FEE
-(O
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.
ECEIVED 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
e'--
T
LL
P
CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLI-
ANCE WITH LAWS OF . HE STATE OF CALIFORNIA COVERING CON-
INFORMATION
S ALSO G RANTEED.
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ADDRESS
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TEL. NO.
84-20R 11/87
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LICENSE NO.