184359 (ELEC)DEPARTMENT OF BUILDING & SAFETY
COUNTY OF RIµERSIDE
FIELD OFFICE i
CONSTRUCTION ESTIMATE
ELECTRICAL FEES
PLUMBING FEES
1st FI.
2nd F I.
Par.
Gar.
Car P.
Wall _ - _
Sq. Ft. @
Sq. Ft. @
Sq. Ft. @
Sq. Ft. @
Sq. Ft. @
Sq. Ft. @
Sq. Ft. @
NO.
NO.
I.
POLES
SIGNS
DRAINAGE PIPING
TRANS. AND/
OR T. CLK.
DRINKING FOUNTAIN
MOTOR H.P.
URINAL
MOTOR H.P.
WATER PIPING
4
ESTIMATED VALUATION Is
MOTOR H.P.
FLOOR DRAIN
MECHANICAL FEES
MOTOR H.P.
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
KIT4HEN 519K
GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
-
�� ''..
J�
WATER CLOSET
COMPRESSOR �HP
ANGE.AND/OR OVEN•
LAVATORY
721
APPLIANCE VENT
WATER HEATER
SHOWER
,
ABSORPTION SYSTEM B.T.U.
SPACE HEATER
BATH TUB
INCINERATOR DOMESTIC ❑ INDUS. ❑ COMM.
I
CONSTRUCTION POLE
��
Ci �
WATER HEATER
HEATING SYSTEM ❑ FORCED ❑ GRAVITY
SERVICE ENTRANCE
SEWAGE DISPOSAL
BOILER
PERMIT FEE
J F
J F
SET BACK.
F S R
PLAN CHECK FEE $
MECHANICAL FEE $
CONSTRUCTION FEE $
ELECTRICAL FEE $
PLUMBING FEE $
TOTAL FEES
CASH CHECK
RECEIVED BY
B.T.U.
IR EN.
DBL.
TOTAL FEES
J
HE
M
M A
'-1
LOT SIZE
USE 4
ZONE
CHECK BY
A)P I ' TYP
SPEC. INSP.
M.O. N.C.
SEWAGE SYSTEM
LL P
NAME OF CONSTRUCTION LENDER
BRANCH OFFICE
ADDRESS
CITY STATE
NO LENDER INVOLVED
INFORMATION
RESID. 19t SO. FT, HOUSE SEWER
GARAGE iR 50. FT. GAS PIPING
PERMIT FEE t.9 fi PERMIT FEE
VENT FEE PLN. CK. FEE CON5T. FEE ELEC. FEE ' PLUMB. FEE
r
1 J. A — O_ _
A 5 O N D
JOB ADDRESS OWNER
5 OF UI LO ING y 7 DATE
COMMUNITY (STRICT F.C. UNITS ALUATION OFF(
FE
pa
1 p'o
E EG L DE CR PTI PERMIT NUMBER
8
SUPP. TO PERMIT
p
'BOND ,$ BOND CASH PLAN F LE It_Ny,Q.LV ATE INSPECTOR
� is � I ���L���
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
PERMIT WILL BE DONE IN ACCORDANCE WITH THE LAWS OF RIVER-
SIDE COUNTY AND THE STATE OF CALIFORNIA. I ALSO AGREE TO
CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLI-
ANCE WITH LAWS OF THE STATE OF CALIFORNIA COVERING CON-
TRACTORS IS ALSO GUARANTEED.
OWNER CONTRACTOR
Zr
ADDRESS
DA S 1
1
�r C- �I� r ►� -%
l
TEL. NO.
TEL. NO.
284-208 12/68
(LICENSE NO.
1