176912 (FSS)NO.
FIELD OFFICE
PLUMBING FEES
DRINKING FOUNTAIN
URINAL
WATER PIPING
FLOOR DRAIN
WATER'SDFTFUFR
VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD
DEPARTMENT OF BUILDING & SAFETY
COUNTY OF RIVERSIDE
WASHER (AUTO) (DISH)
CONSTRUCTION ESTIMATE
ELECTRICAL FEES
1st FI.
2nd Fl.
Par.
Gar.
Car P.
Wall
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
Sq. Ft. @
NO.
Sq. Ft. @
SUB -PANEL
Sq. Ft. @
GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
Sq. Ft. @
POLES
Sq. Ft. @
SIGNS
Sq. Ft. @
ryRAut pull
OR T. CLK.
Sq. Ft. @
MOTOR H. P..
ABSORPTION SYSTEM D B.T.U.
MOTOR H.P.
ESTIMATED VALUATION Is
MOTOR H. P.
CONSTRUCTION POLE
MECHANICAL FEES
MOTOR
NO.
FIELD OFFICE
PLUMBING FEES
DRINKING FOUNTAIN
URINAL
WATER PIPING
FLOOR DRAIN
WATER'SDFTFUFR
VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD
MOTOR H. P.
WASHER (AUTO) (DISH)
APPLIANCE
FIXTURES
GARBAGE DISPOSAL
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
OUTLETS
LAUNDRY TRAY
AIR HANDLING UNIT
SUB -PANEL
KITCHEN SINK
GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
WATER CLOSET
COMPRESSOR D HP
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.V.
RESID. IC SO. FT.
HOUSE SEWER
PERMIT FEE
GARAGE 12 SO. FT.qq
GAS PIPING
PERMIT FEE 'tJ-
PERMIT FEE
P R T
U
BEREN.
DBL.
TOTA FEES
HEAT & VENT FEE
PLN. CK. FEE
CONST. FE
ELEC. Fj/E(�E
PLUMB.
J
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LOT SIZE
USE V
JOB ADDRESS
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DATE
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y.r
PLAN CHECK FEE $
i -`
-r. I! _
CHECKED BY
7UNITY14"•'
O15•lTg~RICT
ITS
VALUA
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OFYC f
MECHANICAL FEE $
Y
7
}TION
('�.��
GROUP
TYPE
LEGAL DES PTIONJ
PERMIT
I
.�r
Sp�
17
�IABER
612
CONSTRUCTION FEE $
�"'"+ L
SPEC. INSP.
iF -
SUPP. TO PERMIT
ELECTRICAL FEE $
66PLUMBING
PLAN CHECKER
BOND $
BOND
CASH
PLAN FILE 0
FINAL DATE
I
[INZSPTOR
FEE $
CI'�-i,?0
TOTAL FEES
$ `-'7 IfG
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 4C�.. 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
ADDRESS
ADDRESS
ADDRESS* �,'�•�..�'
CITY STATE
-
�`�- �•�
NO LENDER INVOLVED
"� •--r, _ _
O RM ATION
`
TEL. NO.
TEL. NO.
"
�'
LICENSE NO.
84-208 12/88 .r �