176704 (ELEC)FIELD OFFICE
PLUMBING FEES
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
FLOOR DRAIN
WATER'SOFTENER
VENT SYSTEM ❑ FAN ❑
EVAP. COOL ❑ HOOD
DEPARTMENT OF BUILDING & SAFETY
• COUNTY OF RIVERSIDE 0
H. P.
CONSTRUCTION ESTIMATE
ELECTRICAL FEES
1st FI.
2nd FI.
Por.
Gar.
Car P.
Wall
FIXTURES
Sq. Ft. @
GARBAGE DISPOSAL
NO.
Sq. Ft. @
OUTLETS
Sq. Ft. @
LAUNDRY TRAY
Sq. Ft. @
POLES
Sq. Ft. @
SIGNS
Sq. Ft. @
TRANS. AND/
OR T. L.K.
C
Sq. Ft. @
MOTOR H.P.
MOTOR M.P.
ESTIMATED VALUATION Is
OHP
MOTOR H.P.
4
OVEN
MECHANICAL FEES
MOTOR H.P.
FIELD OFFICE
PLUMBING FEES
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
FLOOR DRAIN
WATER'SOFTENER
VENT SYSTEM ❑ FAN ❑
EVAP. COOL ❑ HOOD
MOTOR
H. P.
WASHER (AUTO) (DISH)
APPLIANCE
JOB ADDRESS OWNER
s
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
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 ENT
/
SEWAGE DISPOSAL
BOILER
D B.T.U.
RESID. IC SO.
FT.
HOUSE SEWER
PERMIT FEE
GARAGE iQ SO.
FT.
GAS PIPING
PERMIT FEE
«.es40
PERMIT FEE
P RT U IRE", 111L, TOTAL FEES HEAT & VENT FEE PLN. CK. FEE CONST, FEE ELEC, FEE PLUMB. FEE
J
4 1111;1
11
F M A M J J A S O.- N D _-`
I IJ IF IM IA IM J J IA S �O �N ID �"
SET BACK
ILOT
SIZE
USE #
JOB ADDRESS OWNER
s
F
S
R
ZONE
DATE
UISE OF B L N "" r'' "..,.✓y'
/d
`•
��
PLAN CHECK FEE $
r'`�
C. E KED BY
"MM 1
ICT]
_.C.
VALUATION OFFICE
JUNITS
u
�...
MECHANICAL FEE $
YPE
L ALbeAAIPTION W
PERMIT
NUMBER
CONSTRUCTION FEE $
/ _� - �( �:
17.
6704
SPEC. INSP,
SUPP. TO PERMIT
ELECTRICAL FEE $
�.-
PLAN CHECKER
BOND §
BOND
CASH
PLAN FILE #
FINA O
INSP CTOR
PLUMBING FEE $/
4 j
yy9
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 r M. 6. N.C.
RECEIVE 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
I 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
f �
OWNER
CONT TOW I i (I!,-i.'C.
BRANCH OFFICE
-
Add
ADDRESS
,
A DRESS
A RESS
CITY
STATE
NO LENDER INVOLVED
INFORMATION
TEL. -NO.
LICENSE NO.�,
84-208 12/88 4/