176684 (SATT)DEPARTMENT OF BUILDING & SAFETY
COUNTY OF RIVERSIDE .
FIELD OFFICE I
CONSTRUCTION ESTIMATE ELECTRICAL FEES PLUMBING FEES
1st FI. 3 4)
Sq. Ft. (�/
NO.
NO.
WASHER (AUTO (DISH)
f
APPLIANCE
FIXTURES
2nd Fl.
Sq. Ft. @
GARBAGE DISPOSAL
ZONE,USE
Sq. Ft. @ off'
Por. 17,0
Sq. Ft. @ 7
/ POLES
;1
r
Gar.
Car P.
Sq. Ft. @
SIGNS
DRAINAGE PIPING
�.D
Sq. Ft. @
TRANS. AND/
.a✓ OR T. CLK.
DRINKING FOUNTAIN
Wall
Sq. Ft. @
MOTOR H. P.
URINAL
RANGE AND/OR OVEN
MOTOR H. P.
WATER PIPING
ApfIF
ESTIMATED VALUATION Is /
MOTOR H. P.
FLOOR DRAIN
MECHANICAL FEES-/
MOTOR H.P.
WATER SOFTENER
VENT SYSTEM FAN ❑ EVAP. COOLgHOOD
MOTOR H. P.
LOT SIZE
WASHER (AUTO (DISH)
JOB ADDRESS OW OWNER
J
APPLIANCE
FIXTURES
R
GARBAGE DISPOSAL
ZONE,USE
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
OUTLETS
j r
LAUNDRY TRAY
AIR HANDLING UNIT
SUB -PANEL
COMMUNITY
DISTRICT
KITCHEN SINK
UNITS
GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
WATER CLOSET
COMPRESSOR MP {i
RANGE AND/OR OVEN
MECHANICAL FEE $
LAVATORY
ApfIF
APPLIANCE VENT
WATER HEATER
SHOWER
1J
ABSORPTION SYSTEM B.T.U.
SPACE HEATER
"TYPE
/
BATH TUB
INCINERATOR DOMESTIC ❑ INDUS. ❑ COMM.
CONSTRUCTION POLE
.�
WATER HEATER
CONSTRUCTION FEE $
HEATING SYSTEM FORCED ❑ GRAVITY
SERVICE ENTRANCE
�€
SEWAGE DISPOSAL
BOILER `-� B.T.U.
RESID. 1Q SO. FT.
SUPP. TO PERMIT
HOUSE SEWER
A
v�
PERMIT FEE
GARAGE iQ SO. FT.
I
GAS PIPING
U
BOND $
PERMIT FEE
VCY
PLAN FILE 9I
PERMIT FEE
INSPECTOR
P RT U E REN. DBL. IT.TAL;;KI..E; & FEE PLN. CK. FEE CONST. FEE ELEC. FEE PLUMB. FEE
J
J F M A M J J A '^� S O N D
I J F M A I M J J A S O N D
SET BACK
LOT SIZE
USE if
JOB ADDRESS OW OWNER
J
F5
R
ZONE,USE
OF BUILDI G
PLAN CHECK FEE $
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*46% V .,rWT
CHECKED BY
COMMUNITY
DISTRICT
F.C.
UNITS
VALUATION
MECHANICAL FEE $
I
4A.�-
G P
"TYPE
LEGAL DE CRIPTION`j
PERMIT NUMBER
.�
176684
CONSTRUCTION FEE $
�€
SPEC. INSP.
SUPP. TO PERMIT
ELECTRICAL FEE $
A
v�
I
PLAN CHECKER
BOND $
BOND
I CASH
PLAN FILE 9I
FINAL DATE
INSPECTOR
PLUMBING FEE $
- .r•
TOTAL FEES
$
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED
177��
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.I 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
1,
T
IOJWLL
P
CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLI-
ANCE WITH LAWS OF THE STATE OF CALIFORNIA COVERING CON-
TRACTORS IS ALSO GUARANTEED. ,
NAME OF CONSTRUCTION
LENDER
OWNER
C C R
BRANCH OFFICE
6211 AIAN of -
ADDRESS j
b
ADDRESS
ADDRES SF
CITVY•
STATE
NO LENDER INVOLVED
INFORMATION
liao
,r
TEL. NO.
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F�
�I �"{'f'�
LICENSE NO.
284.208 12/88
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