174929 (CONR)PE
FIELD OFFICE
PLUMBING FEES
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
FLOOR DRAIN
WATER'SOFTFNFR
VENT SYSTEM FAN ❑ EVAP. COOL ❑ HOOD
DEPARTMENT OF BUILDING & SAFETY
• COUNTY OF RIVERSIDE 0
H. P.
CONSTRUCTION ESTIMATE
ELECTRICAL FEES
1st Fl.
2nd Fl.4
P,*IO
Gar.
Car P.
Wall
�.�
Sq. Ft. @ f ��
^-� NO.
Sq. Ft. @
GARBAGE DISPOSAL
Sq. Ft. @
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
Sq. Ft. @
POLES
Sq. Ft. @
SIGNS
Sq. Ft. @
ORAT SCLK D/
Sq. Ft. @
MOTOR H. P.
• O FI E
MOTOR H. P.
ESTIMATED VALUATION $
MOTOR H. P.
MECHANICAL FEE
MOTOR
PE
FIELD OFFICE
PLUMBING FEES
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
FLOOR DRAIN
WATER'SOFTFNFR
VENT SYSTEM FAN ❑ EVAP. COOL ❑ HOOD
MOTOR
H. P.
LOT SIZE
WASHER (AUTO) (DISH)
JOB ADDRESS OWNER `�
,G
t ,f ? F !
APPLIANCE
FIXTURES
R
'
GARBAGE DISPOSAL
VSC OF BUILDING DATE
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
OUTLETS
¢,'7' S"
LAUNDRY TRAY
COMM NITY '-
AIR HANDLING UNIT
SUB -PANEL
-
• O FI E
KITCHEN SINK
.�
GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
WATER CLOSET
MECHANICAL FEE $
COMPRESSOR �HP
RANGE AND/OR
OVEN
LAVATORY
APPLIANCE VENT
WATER HEATER
GAL D 5 R PTION
SHOWER
PERMIT NUMBER
ABSORPTION SYSTEM D B.T.U.
SPACE HEATER
BATH TUB
-
INCINERATOR DOMESTIC ❑ INDUS. ❑ COMM.
CONSTRUCTION
POLE
f- —r,J�
4e
WATER HEATER
HEATING SYSTEM ❑ FORCED ❑ GRAVITY
SERVICE ENTRANCE
-
SEWAGE DISPOSAL
%
BOILER B.T.U.
R6. 13 SO.
FT.
V
HOUSE SEWER
—ho
PERMIT FEE
G fr jQ SO.
FT.
%4,S
GAS PIPING
11P
PERMIT FEE
-
/
PERMIT FEE
0N
REN. IDSL.
J F ..r., M
J F M
EAT EVENT FEE PLN. CK,
M ' J J
CONST, FEE ELEC. FEE ,�. VLu w
A S O N , o
SET BACK
LOT SIZE
USE It
JOB ADDRESS OWNER `�
,G
t ,f ? F !
F ?i
5
R
'
ZONE
VSC OF BUILDING DATE
PLAN CHECK"FEE $
r�,
¢,'7' S"
CHECKED BY
COMM NITY '-
ISTRICT
ve.UNITS
-
• O FI E
^
[VALtJAY'fON
MECHANICAL FEE $
4Ai
GROUPTY
GAL D 5 R PTION
PERMIT NUMBER
49,n
CONSTRUCTION FEE $
f- —r,J�
4e
17
SPEC. INSP.
-
SUPP. TO PERMIT
ELECTRICAL FEE $
PLAN CHECKER
BOND $
BOND
CASH
PLAN FILE 0
FINAL DATE
INSPECTOR
!��e
I
PLUMBING FEE g
- l' -7Q
t_,�
TOTAL FEES
$
a1„Zr
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-
ILL
IP
SIDE COUNTY AND THE STATE OF CALIFORNIA. I ALSO AGREE TO
;d
T
CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLI-
ANCE WITH LAWS OF THE STATE OF CALIFORNIA COVERING CON-
IS ALSO GUARANTEED.
NAME OF CONSTRUCTION LENDER
LENDER
/
i
OWNER
CONTRACTOR
BRANCH OFFICE
ADDRESS
-
,n+'
ADDRESS
ADDRESS
CITY 4 STATE
v
n
NO LENDER INVOLVED
INFORMATION
TEL. NO.
TEL. NO.
%f ,y /y�r� )� p /j1` /��/ q
I L� �I o l s 1 7 V✓ A 1l/'/� /�/
1!t'^
LICENSE NO.
;84-208 12/88 �
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