176333 (CP)FIELD OFFICE
PLUMBING FEES
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
FLOOR DRAIN ...y,
WATER'SOFTENER
VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD
MOTOR H. P.
DEPARTMENT OF BUILDING & SAFETY
COUNTY OF RIVERSIDE
APPLIANCE
CONSTRUCTION ESTIMATE
ELECTRICAL FEES
1st F1.
2nd F1.
Por.
Gar.
UUUC���a��-r P.�r
11 t.'
'1
J
Sq. Ft. @
AIR HANDLING UNIT
NO.
Sq. Ft. @
GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
Sq. Ft. @
WATER CLOSET
Sq. Ft. @
POLES
Sq. Ft. @
SIGNS
Sq. Ft. @
OR S. 4-2
Sq. Ft. @
MOTOR H.
BATH TUB
MOTOR H.P.
E TT• AT
D VALUATION is
HEATING SYSTEM ❑ FORCED ❑ GRAVITY
MOTOR H. P.
SEWAGE DISPOSAL
MECHANICAL FE
/
MOTOR H. P.
FIELD OFFICE
PLUMBING FEES
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
FLOOR DRAIN ...y,
WATER'SOFTENER
VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD
MOTOR H. P.
WASHER (AUTO) (DISH)
APPLIANCE
FIXTURES
GARBAGE DISPOSAL
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
OUTLETS
4,1
LAUNDRY TRAY
Lo
AIR HANDLING UNIT
SUB -PANEL
KITCHEN SINK
GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
! 5-7.4
WATER CLOSET
COMPRESSOR OHP
RANGE AND/OR OVEN
LAVATORY
APPLIANCE VENT
WATER HEATER
SHOWER
ABSORPTION SYSTEM D B.T.U.
SPACE HEATER
BATH TUB
INCINERATOR DOMESTIC ❑ INDUS. ❑ COMM.
CONSTRUCTION POLE
WATER HEATER ..}
HEATING SYSTEM ❑ FORCED ❑ GRAVITY
SERVICE ENTRANCE
SEWAGE DISPOSAL
BOILER � B.T.U.
RESID. 1C SO. FT.
HO -R
PERMIT FEE
GARAGE iC SO. FT.
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT NUMBER REN. DBL. TOTAL FEES HEAT & VENT FEE PLN. CK. FEECONST. FEE ELEC. FEE PLUMB. FEE
%.c a-,,-
J F M A M J J A` S D
I IJ F N IN I1
SET BACK
ILOT SIZE
USE #
JOBADDRESSADDRESS OWNER
F__ S
f
_y �,^" 1 _
ONE
USE OF BU LD NG" - DATE
PLAN CHECK FEE $
! 5-7.4
-
�~•� ) -17
CHECKED B
O UN"I VALUATION OFFICE
jD'ISYlRYd'I`j0.d!"ITS
MECHANICAL FEE $
rTYPE
LEGAL IrP 10 ,I
E MIT NUMB R
CONSTRUCTION FEE
$
.I- {I�
1793
SPEC. INSP.
r
SUPP. TO PERMIT
ELECTRICAL FEE $/�"
'
PLAN CHECKER
BOND
BOND
CASH
PLAN FILE It
FINAL DATE
INS Cj�TO,R
PLUMBING FEE $
Sf�
I
/U / 70`CvC�Lt.(
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.T. N. C.
RECEIVED BY
SEWAGE SYSTEM
PERMIT WILL BE DONE IN ACCORDANCE WITH THE LAWS OF RIVER-
SIIIDE 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 CALIFORNIA COVERING CON-
TRACTORS IS ALSO GUARANTEED.
NAME OF CONSTRUCTION
LENDER
�" 1-
f".-
_
OWNER
CONTRACTOR
BRANCH OFFICE
ADDRESS
AODRE
ADDRESS
CITY
STATE
NO LENDER INVOLVED ie-
.
INFORMATION
fJ
I
`
t
` ,
-�
TEL. NO.
TEL. NO'.
LICENSE NO.