183960 (BLCK)FIELD OFFICE i
PLUMBING FEES
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
FLOOR DRAIN
WATER'SOFTENER
VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD
MOTOR H. P.
DEPARTMENT OF BUILDING & SAFETY
0 COUNTY OF RIVERSIDE 0
APPLIANCE
CONSTRUCTION ESTIMATE
ELECTRICAL FEES
1st FI.
2nd FI.
Par.
Gar.
Car P.
Wall
+y
~Me>
Sq. Ft. @
AIR HANDLING UNIT
NO.
Sq. Ft. @
GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
Sq. Ft. @
WATER CLOSET
Sq. Ft. @
POLES
Sq. Ft. @
SIGHS
Sq. Ft. @ �U
�u ORAT. SCLKAND/
SCLKO/
Sq. Ft. @
MOTOR H. P.
BATH TUB
MOTOR M.P.
ESTIMATED VALUATION IsMOTOR
WATER HEATER
H.P.
SERVICE ENTRANCE
MECHANICAL FEES
MOTOR H. P.
FIELD OFFICE i
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
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 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 D B.T.U.
RESID. IC SO. FT.
HOUSE SEWER
PERMIT FEE
GARAGE iQ SO. FT.
GAS PIPING
�7
PERMIT FEE
PERMIT FEE
PER MJT
EN. IDBL. ITOT�..A IHEAT & VENT FEE IPLN. CK. FEE
J I FF I M I A 1M I J I J
CONST. FEE JELEC. FEE
4 f�!
A S O
N ID
FEE
SET BACK
LOT SIZE
USE #
JOB ADDRESS OWNER
J
F
S
R
'g -'r
'
ZONE
USE OF BUILDING
DATE
PLAN FEE $
#1
CHECK
i W Apf LV A I I
CHECKED BY
COMMUN T
S
VALUATION
OFFICE
FISfRICT7jFp'.C_'
�7
MECHANICAL FEE $
/1
f
-
.ate
G UP
PE
LEGAL DE SCR IPTION
183960
PERMIT NUMBER
CONSTRUCTION FEE $ r�
SPEC. INSP.
SUPP. TO PERMIT
ELECTRICAL FEE $
PLAN CHECKER
BOND $
BOND
CASH
PLAN FILE N
FINAL DATE
INSP CTOR
1
I
Q
-V-�O(.Z
PLUMBING FEE $
I
TOTAL FEES
$
vU
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. 0. 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
f
l.�r
zy
O NERy ,,p
CONTRACTOR
BRANCH OFFICE
ADDRESS
ADDRESS
ADDRESS
CITY STATE
�/ �.J` /
///,4
NO LENDER INVOLVED
Z/" ./3 �L .✓
INFORMATION
r.
L84-208
TEL. NO.
TEL. NO.
LICENSE NO.
12/&Bw