200245 (SFD)EPARTMENT OF BUILDING & SAFETY
COUNTY OF RIVERSIDE •
EN. TRAILER FEE HEAT 8 VE..t FEECDO
FIELD OFFICE
DBL.
CONSTRUCTION ESTIMATE
ELECTRICAL FEES
INSP. FEE
PLUMBING FEES
DBL.
1 ST FL.
2ND FL.
POR.
GAR. y1
� CAR P.
i WALL
SQ. FT.D�
SQ. FT. @
NO.
NO.
MOTOR I OR LESS H.P. -
SQ. Fr. @
_
MOTOR 5 OR LESS H.P.
SQ.FT.
J F
SQ. FT. @ MOTOR 20 OR LESS H.P. DRAINAGE PIPING
SQ.FT. @ DRINKING FOUNTAIN
O y N may. .� D
N D
SQ. FT. @ URINAL
ET RAtj
K.W. UNITS WATER PIPING
LOT SIZE- '-
I ESTIMATED VALUATION $`L%s
JOB ADDRESSa )j OWNER
+�7C1� .ST"g r` I!""
r}
FLOOR DRAIN
S o
R
i MECHANICAL FEES
WATER SOFTENER
USE OF BUILDING
DATE
VENT SYSTEM FAN ❑ EVAP. COOL05 HOOD
SIGN
WASHER (AUTO (DISH)
d'
to
APPLIANCE'C3
j <r
FORMER E=K•W•
1
GARBAGE DISPOSAL
COMMUNITY
CW
FURNACE ❑ UNIT ❑ WALL Cl iLOOR ❑ SUSPENDED
OUTLETS
OFF CE
LAUNDRY TRAY
$
AIR HANDLING UNIT I CFM
FIXTURE OR SOCKET
�
KITCHEN SINK
r
GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
CONST. SERV. ENTRANCE
WATER CLOSET
�P
TYPE
COMPRESSOR HP
POLE
NUMBE
LAVATORY
$
9 l
APPLIANCE VENT
AMPERES SERV. ENT. % 4
SHOWER
2fl
00
ABSORPTION SYSTEM O B.T.U.
SQ. FT. @ ¢
/
BATH TUB
i
INCINERATOR ❑ DOMESTIC ❑ INDUS. OR COMM.
SQ. FT. @ ¢
f
WATER HEATER
"0
55
HEATING SYSTEM 'J FORCED ❑ GRAVITY (
SQ. FT. RESID. @ jS " {/
%
SEWAGE DISPOSAL
(�
BOILER B.T.U.
SQ. FT. GARAGE @I'mHOUSE
BOND
SEWER
PLAN FILL#
FINAL DATE
PERMIT FEE too
BALANCE OF MIN. FEE
f
GAS PIPING -
TRAILER ISSUANCE FEE -PERMIT' FEE
PERMIT FEE 13 . t3
J
PERMIT FEE
If,,(.)
PERt+I{ 24 5 TOTAL FEEf,�s"41'
EN. TRAILER FEE HEAT 8 VE..t FEECDO
PL. CK. F.Eg CONST." FEiE,�„
DBL.
ELEC. F
DBL. SPEC.
INSP. FEE
PLUMBING�FF
DBL.
71
1
J F
M _y. A ..-- A
M A M ! .J A 5 O
O y N may. .� D
N D
ET RAtj
LOT SIZE- '-
USE #
JOB ADDRESSa )j OWNER
+�7C1� .ST"g r` I!""
r}
0
S o
R
ZONE
USE OF BUILDING
DATE
PLAN CHECK FEE
$
c
/ — J
d'
to
CHECKED BY
COMMUNITY
CW
Fles,�
4j
T-zc/
OFF CE
MECHANICAL FEE
$
,
a
�
f!
•
DBL
�P
TYPE
LEGAL DESCRIPTION
IT
NUMBE
CONSTRUCTION FEE
$
9 l
v
XDIS�
42
2fl
24
DBL
PLAN CHECKER
SUPP. TO PERMIT
ELECTRICAL FEE
S
"0
55
DBL
BOND $
BOND
CASH
PLAN FILL#
FINAL DATE
INSPE TOR 3
PLUMBING FEE
I
I
7i -
TRAILER PERMIT ' '
NAME OF, CONSTRUCTION LENDER
BRANCH OFFICEINO"
�
NVOLVED
ISSUANCE FEE
$
.
�
ADDRESS I
CITY
STATE
FEE
$
I
-
,
l✓
? s
TOTAL FEES 1$,Z
4%
""'"
THIS PERMIT SHALL ECOME VOID IF WORK IS NOT COMMENCED WITHIN 60 DAYS. CESSATION
7/
OF WORK FOR 120 DA SHALL ALSO CAUSE PERMIT TO BECOME VOID. {
I HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCOR-
CASH Q CHECK
M.O. N.C.
E]
DANCE WITH THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA. I ALSO AGREE TO
CARRY.COMPENSATION 'INSURANCE UPON MY EMPLOYEES. COMPLIANCE WITH THE LAWS OF THE STATE
RECEIVED BY
SEWAGE SYSTEM
OF CALIFORNIA COVERING CONTRACTORS IS ALSO GUARANTEED.
T tb@•O LL P.'Zxv
1 HEREBY CERTIFY THATTHEINDIVIDUALWHOPRP E E PLANA AND SPECIFICATIONS HAS DONE
SO -IN ACCORDANCEWITHSECTION5541OFTHE1U �1 S FESSI� ODE OF THE STATE
OF FORNI �r'*• -
-INFORMATION
OWNER
CONTRACTOR
y
/ [ f
ADDRESS
ADDRESS U
J
I
TEL. NO. "
TEL. NO.
LIC ENSNO.,j
1
�PS