176914 (FSS)FIELD OFFICE
PLUMBING FEES
PP. j ts. �r
RA PIPING ,
0
DRINKING FOUNTAIN
URINAL
WATER PIPING
FLOOR DRAIN
WATER'SnFTFNFR
VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD
MOTOR
DEPARTMENT OF BUILDING & SAFETY
COUNTY OF RIVERSIDE
0 . 0
WASHER (AUTO) (DISH)
CONSTRUCTION ESTIMATE
ELECTRICAL FEES
1st Fl.
2nd F I.
Par.
Gar.
Car P.
Wall
GARBAGE DISPOSAL
Sq. Ft. @
OUTLETS
No.
Sq. Ft. @
if
Sq. Ft. @
f F
Sq. Ft. @
POLES
Sq. Ft. @
SIGNS
Sq. Ft. @
1.L84ND/ } 4L
OR T. ELK. 1
Sq. Ft. @
MOTOR H. P.
LAVATORY
MOTOR H. P.
ESTIMATED VALUATION is
MOTOR H. P.
ABSORPTION SYSTEM D B.T.U.
MECHANICAL FEES
MOTOR
FIELD OFFICE
PLUMBING FEES
PP. j ts. �r
RA PIPING ,
0
DRINKING FOUNTAIN
URINAL
WATER PIPING
FLOOR DRAIN
WATER'SnFTFNFR
VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD
MOTOR
H. P.
WASHER (AUTO) (DISH)
APPLIANCE
FIXTURES
GARBAGE DISPOSAL
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
OUTLETS
is
LAUNDRY TRAY
AIR HANDLING UNIT
SUB -PANEL
f F
KITCHEN SINK
GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
ZONE
E;bF BUILDING 4 1,KWITE
WATER CLOSET
COMPRESSOR E::�HP
RANGE AND/OR
OVEN
LAVATORY
APPLIANCE VENT
WATER HEATER
SHOWER
ABSORPTION SYSTEM D B.T.U.
SPACE HEATER
UNITS "
BATH TUB
INCINERATOR DOMESTIC ❑ INDUS. ❑ COMM.
CONSTRUCTION
POLE
WATER HEATER
HEATING SYSTEM ❑ FORCED ❑ GRAVITY
SERVICE ENTRANCE
SEWAGE DISPOSAL
BOILER �J B.T.U.
RESID. 1Q SO.
FT.
HOUSE SEWER
PERMIT FEE
GARAGE iQ SO.
FT.
GAS PIPING
PERMIT FEE
' a
PERMIT FEE
IR T U BE REN. DBL. TOTAL FEES HEAT & VENT FEE PLN. CK. FEE CONST. FEE JELEC, FEEPLUMB. FEE
8
IF -
SET
BACK
LOT SIZE
USE 4
JOB ADDRESS JOWNER <"t>
j�
�>
F
is
IR
f F
ZONE
E;bF BUILDING 4 1,KWITE
PLAN CHECK FEE $.-.
✓r
CHECKED B
CkOM� NI Y -
•DISTR C F.C.
UNITS "
VALUATION
OFF CE
MECHANICAL FEE $
['
1
_
-
GROUP
TYPE `
LE'G f DE P°tl N
PERMIT NUMB R
CONSTRUCTION FEE $
-��
176914
SPEC. INSP.
SUPP. TO PERMIT
ELECTRICAL FEE $
PLAN CHECKER
BOND $
BOND
CASH
PLAN FILE #
FINAL DATE
INSPECTOR
PLUMBING FEE $
1
w r- .
TOTAL FEES
Q
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-
SIDE 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
OWNER
CONTRACTOR
BRANCH OFFICE
a -
ADDRESS
ADDRESS
ADDRESS
CITY
STATE
_
-.t-."--
NO LENDER INVOLVED
IN FO RMATI ON
TEL. NO.
TEL. NO.
}
LICENSE NO.
�
284-208 12/88