179163 (RPL)DEPARTMENT OF BUILDING & SAFETY
VENT SYSTEM ❑ FAN ❑ EVAP, COOL ❑ HOOD
is
COUNTY OF RIVERSIDE
•
FIELD OFFICE'
CONSTRUCTION ESTIMATE
ELECTRICAL FEES
PLUMBING FEES
1st FI.
2nd FI.
Por.
Gar.
Car P.
Wall
GARBAGE DISPOSAL
Sq. Ft. @
NO.
OUTLETS
NO.
Sq. Ft. @
LAUNDRY TRAY
Sq. Ft. @
AIR HANDLING UNIT
Sq. Ft. @ POLES
PLAN CHECK FEE
Sq. Ft. @ SIGNS
t
DRAINAGE PIPING S O
�Q
Sq. Ft. @ gfvf�S 'R-/
l CL
DRINKING FOUNTAIN
Sq. Ft. @ MOTOR H. P.
URINAL
MOTOR H.P.
WATER PIPING
Q
ESTIMATED VACUA IO $ r'
MOTOR
H. P.
FLOOR DRAIN
VALUATION OFFICE
MECHANICAL FEES
MOTOR
H. P.
WATER'SOFTENER
VENT SYSTEM ❑ FAN ❑ EVAP, COOL ❑ HOOD
MOTOR
M.P.
WASHER (AUTO) (DISH)
APPLIANCE
FI%TURESV
F
S
GARBAGE DISPOSAL
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
OUTLETS
//t/
LAUNDRY TRAY
ZONE
AIR HANDLING UNIT
SUB -PANEL
PLAN CHECK FEE
KITCHEN SINK
GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
CHECKED
WATER CLOSET
COMMUNITY
COMPRESSOR �HP
RANGE AND/OR
OVEN
VALUATION OFFICE
LAVATORY
APPLIANCE VENT
WATER HEATER
JOISTRICTJVC.u
SHOWER
ABSORPTION SYSTEM D B.T.U.
SPACE HEATER
R
BATH TUB
T PE
INCINERATOR DOMESTIC ❑ INDUS. ❑ COMM.
CONSTRUCTION
POLE
WATER HEATER
HEATING SYSTEM ❑I�FORCED ❑ GRAVITY
SERVICE ENTRANCE
.'.,E DISPOSAL
BOILER LJ B.T.U.
RESID. 10 SO.
FT.
r"'
HOUSE SEWER
-
PERMIT FEE
GARAGE iQ SO.
FT.
GAS PIPING
PERMIT FEE
SUPP. TO PERMIT
PERMIT FEE
NUMBER REN. DBL. TOTAL FEE MEAT & VENT FEE PLN. CK. ;EE CONST. FEE JELEC.' EE 4.71
J
.7%
JF M A M J J A 1.S O N
Ir Inn I n Inn l i
MB. F9�
SET BACK
ILOT SIZE
USE #
JOB ADDRESS OWNER
F
S
R
ZONE
USE OF BUILDING D TE
PLAN CHECK FEE
CHECKED
BY
COMMUNITY
NI s
VALUATION OFFICE
MECHANICAL FEE $
JOISTRICTJVC.u
Y ,
�,/
rJ
0
R
T PE
LEGAL DESC I T O
PERMIT NUMBER
CONSTRUCTION FEE $
r"'
SPEC. INSP.
SUPP. TO PERMIT
ELECTRICAL FEE $
"'ter
j{y rte• y� �' 49
�r
' � v
PLAN CHECKER
BOND E
BOND
CASH
PLAN FILE # FINAL DATE
INSP CTOR
PLUMBING FEE $
n+
/ ) 0
TOTAL FEES
$
-'=
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED
r3"
al
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 I 4j, M.O. I N.C.
RECEIVED BY SEWAGE SYSTEM
Air }
PERMIT WILL BE DONE IN ACCORDANCE WITH THE LAWS OF RIVER-
SIDE COUNTY AND THE STATE OF CALIFORNIA. I ALSO AGREE TO
4 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
/
a.
OWNER
CONTRACTOR
BRANCH OFFICE
j
C
ADDRESS
ADDRESS
ADDRESS
CITY
STATE
ry p
NO LENDER INVOLVED
INFORMATI N
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TEL. NO.
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LICENSE NO.
^ -208 12/88
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