176787 (BLCK)FIELD OFFICE
PLUMBING FEES
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
FLOOR DRAIN
WATER'SnCTFNER
VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD
MOTOR H. P.
DEPARTMENT OF BUILDING & SAFETY
COUNTY OF RIVERSIDE .
APPLIANCE
CONSTRUCTION ESTIMATE
ELECTRICAL FEES
1st FI.
2nd FI.
Par.
Gar.
Car P.
Wall
OUTLETS
Sq. Ft. @
AIR HANDLING UNIT
NO.
Sq. Ft. @
GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
Sq. Ft. @
WATER CLOSET
Sq. Ft. @
POLES
Sq. Ft. @
Sq. Ft. @ '�.w�
SIGNS
�.+�' TRANS. LKD/
Sq. Ft. @
MOTOR H. P.
ABSORPTION SYSTEM B.T.U.
MOTOR H. P.
ESTIMATED VALUATION Is
ry
tlU Moron H. 0.
WATER NEATER
MECHANICAL FEES
MOTnR N R
FIELD OFFICE
PLUMBING FEES
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
FLOOR DRAIN
WATER'SnCTFNER
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 �HP
RANGE AND/OR OVEN
LAVATORY
APPLIANCE VENT
WATER HEATER
SHOWER
ABSORPTION SYSTEM B.T.U.
SPACE NEATER
BATH TUB
INCINERATOR DOMESTIC ❑ INDUS. ❑ COMM.
CONSTRUCTION POLE
WATER NEATER
HEATING SYSTEM ❑ FORCED ❑ GRAVITY
SERVICE ENTRANCE
SEWAGE DISPOSAL
BOILER D B.T.U.
RESID. iQ SO. FT.
HOUSE SEWER
PERMIT FEE
GARAGE zQ SO. FT.
GAS PIPING
R
PERMIT FEE
PERMIT FEE
PERMIT
NUMBER
REN.
11S
HEAT & IT FEE
PLN. CK. FEE
CONST. FEE
ELEC. FEE
PLUMB. FEE
R787v
11BLAITOTAL
oa
FM A M J J A 5
O N D
J F M A M J J A S
O N D
SET BACKLOT
SIZE
USE 0
JOB ADDRESS ii
*-w
OWNER
F
S
R
ZONE
USE OF BUILDING �/ DAT
PLAN CHECK FEE $
—/
Rx &4 moi' .4A S
CHECKED BY
COMMUNITY
U41 TT
VALU rtymOF ICE
Jf��
IDISTRICTr.
MECHANICAL FEE $
IS
A
�+ r
P
LEGAL D`E9-cFfIF,1rTOT
IFPERMIT
1767
NUMBER
CONSTRUCTION FEE $
� 7_-4,zvv,j v 4 o ' aC
ELECTRICAL FEE $
SPEC.INSP.
SUPP. TO PERMIT
PLAN CHECKER
BOND $
BOND CASH
PLAN FILE it
FINAL DATE
IN(/SpJ�E CST OflR
PLUMBING FEE $
I
[l1
TOTAL FEES
49
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
&&Z,
OWNER
CONTRACTOR'
/l 4j+
-� rl
BRANCH OFFICE
ADDRESS
ADDRESS
ADDRESS
)^J Y (/.� �]
0,,a 49X
CITY STATE
NO LENDER INVOLVED
t/ ! V�V
INFORMATION
/
h S
TEL. NO.
TEL. NO.
LICENSE NO.
zea-zoe iz/eek �-�•
D �*�