166706 (SPIN)DEPARTMENT OF BUILDING & SAFETY
Ilk COUNTY OF RIVERSIDE An
FIELD OFFICE
• CONSTRUCTION ESTIMATE
ELECTRICAL FEES
PLUMBING FEES
t1st FI.
Sq. Ft. @
NO.
NO.
Sq. Ft. @
PLN. CK. FEE
CONST. FEE
ELEC. FEE
' 2nd FI.
Sq. Ft. @
0
` Par.
Sq. Ft. @
POLES
Gar.
Sq. Ft. @
SIGNS
DRAINAGE PIPING
' Car P.
Sq. Ft. @
ANO/
OR TRANS.N CLK.
SET BACK LOT SIZE
DRINKING FOUNTAIN
Wall
!
Sq. Ft. @
MOTOR
H. P.
URINAL
S E OF L G - "
MOTOR
H. P.
WATER PIPING
jj
TIMATED VALUATION Is
MOTOR
H. P.
FLOOR DRAIN
MECHANICAL FEES
MOTOR
H. P.
WATER SOFTENER
VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD
i
MOTOR
H. P.
WASHER (AUTO) (DISH) I
F
J
APPLIANCE
FIXTURES
MECHANICAL FEE
GARBAGE DISPOSAL
r Y FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
OUTLETS
LAUNDRY TRAY
J
F Z AIR HANDLING UNIT
O
SUB -PANEL
KITCHEN SINK
I
J GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
LEGAL D IPTION
WATER CLOSET
Q
U COMPRESSOR �HP
RANGE AND/OR OVEN
LAVATORY
E
W APPLIANCE VENT
WATER HEATER
CONSTRUCTION FEE
SHOWER
2 ABSORPTION SYSTEM D B.T.U.
SPACE HEATER
BATH TUB
O
U INCINERATOR DOMESTIC ❑ INDUS. ❑ COMM.
CONSTRUCTION POLE
WATER HEATER
HEATING SYSTEM ❑ FORCED ❑ GRAVITY
SERVICE ENTRANCE
SEWAGE DISPOSAL
_ BOILER E::� B.T.U.
RESID. IQ SO. FT.
HOUSE SEWER
RESIDENTAL FEE SQ. FT.�@
GARAGE iQ SQ. FT.
BOND $
GAS PIPING
PERMIT FEE
PERMIT FEE
FINAL DATE
PERMIT FEE
PERMIT
REN. DBL.
TOTAL FE
HEAT & VENT FEE
PLN. CK. FEE
CONST. FEE
ELEC. FEE
PLUMB. FEE
0
J F MA M J J A S
O N D j
J F M_ A M J J A S
O N D
SET BACK LOT SIZE
USE #
_
JOB ADDRESS OWNER 't
F S R
.w
ZONE
S E OF L G - "
�1
PLAN CHECK FEE
r
CHECKED
COIDMNITY
TRIC
_C.
UNITS
VALUATION
OFFIC
IB,JY,�
J
MECHANICAL FEE
.- ,;'4za.f,�j
-------
GROUP
TYPE
LEGAL D IPTION
PERMIT M E
f��
f
166b�
CONSTRUCTION FEE
S r1 %''
SPEC. INSP.
SUPP. TO PERMIT
H
J
I
ELECTRICAL FEE
PLAN CHECKER
BOND $
BOND
CASH
PLAN FILE #
FINAL DATE
INSPECTOR CTOR
�� /J �S
C�, L"C I
PLUMBING FEE
4�
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.
RECEIVED BY
SEWAGE SYSTEM
PERMIT WILL BE DONE IN ACCORDANCE WITH THE LAWS OF RIVER-
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- j
INFORMATION
TR ORS IS ALSQ GU A TEED.
MAHi .)F C,J)NWRUCTICN LENDERS
OWNER
`
- ONTRACTOR I
W'CH 1J a
t w� ryy� S
ADDRES
ADDRESS
CITY
/
b
NO LIMB I14VOLV$D
i
`Yifl. NO.
LICENSE NO. .I
28 4.2 08 11/87
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