176786 (SFD)pp -
SET BACK
DEPARTMENT OF BUILDING & SAFETY
COUNTY OF RIVERSIDE •
WASHER (AUTO DI SM)
CONSTRUCTION ESTIMATE
ELECTRICAL FEES
1st FI.
2nd FI.
Par.
Gar.
Car P.
Wall
'T �T
a,7
Sq. Ft. @
y
_- NO.
Sq. Ft. @
OUTLETS
Sq. Ft. @ I
-�
77—
Sq. Ft. @
POLES
Sq. Ft. @
SIGNS
Sq, Ft. @
TRANS. AND/
OR T. CLK.
Sq Ft .@
r�
fir MOTOR H.P.
WATER CLOSETU
MOTOR M.P.
ESTIMATED VALUATION Is
s
Moron H.P.
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 kHOOD
SET BACK
MOTOR H. P.
WASHER (AUTO DI SM)
USE 4
APPLIANCE
F ,
FIXTURES
GARBAGE DISPOSAL
f/
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
OSC OF UILDING �' DA E
OUTLETS
LAUNDRY TRAY
-�
77—
AIR HANDLING UNIT
CPECIkED BY
SUB -PANEL
KITCHEN SINK
UNITS
GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
/s
'
WATER CLOSETU
COMPRESSOR HP
s
RANGE AND/OR OVENLAVATORY
APPLIANCE VENT
(
WATER HEATER
SHOWER
{�
ABSORPTION SYSTEM B.T.U.
L GAL D C IP ION
SPACE HEATER
BATH TUB
NUMBER
INCINERATOR DOMESTIC ❑ INDUS. ❑ COMM.
CONSTRUCTION FEE $.�,,��
CONSTRUCTION POLE
WATER HEATER
r ��
HEATING SYSTEM FORCED ❑ GRAVITY
SERVICE ENTRANCE
SEWAGE DISPOSAL
BOILER B.T.U.
-
RESID. 1Q SO. FT. 1.5HOUSE
SEWER
PERMIT FEE
'�
GARAGE iQ SO. FT.
GAS PIPING
OND $
BOND
CASH
PERMIT FEE
PERMIT FEE
INSPECTOR
P R T U REN. DBL. TOTAL FVHEAT & VENT FEE PLN. CKK..�F E� CONST. FEE ELEC. FEE PLUMB. FEE
J
J
J F - M P. .- - -- lA _- 1 - ! P 5 N D --
II F I� It lu
SET BACK
LOT SIZE
I
USE 4
JOB ADDRESSOWNER
1A44m OA e• %
F ,
S
R
J
ZONE
OSC OF UILDING �' DA E
PLAN CHECK FEE $
r
-�
77—
CPECIkED BY
COMMUNITY41
DISTRICT F.C.
UNITS
VALUATION OF 'ICE
/s
'
R �"aQ
MECHANICAL FEE $ ..
(
��
G UP
I TYPE
L GAL D C IP ION
176786
PERMIT
NUMBER
CONSTRUCTION FEE $.�,,��
g�
SPEC. INSP.
-
SUPP. TO PERMIT
ELECTRICAL FEE $
=46 05'/ rO
PLAN CHECKER
OND $
BOND
CASH
PLAN FILE 0
FINAL DATE
INSPECTOR
PLUMBING FEE $
l.,-70
� � �
cut'c �"'�.
TOTAL FEES
a
THIS S NOT COMMENCED
RMIT SCES HALL I R
f
WITHIN 60EDAYS. AT ON OF WORK FOR OI 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
r
OWNER
`fir;`( ,r./� ! Vii. /,74\
r
CONTRACTOR
�— • �/jT/'f-C �-✓r r' CM
BRANCH OFFICE
ADDRESS
'
CITY STATE
ADDRESS
..
ADDRESS - [
� '
�'� x' ell
NO LENDER INVOLVED
INFORMATION
/
TEL. NO.�y
TEL. NO.
fi li}IL'Irr r• 1176 P�I(a„
!l it ll
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LICENSE NO.
[/E
- - - "- f �"„=l"----�--
84-208 12/68Ry