167039 (BLCK)DEPARTMENT OF BUILDING & SAFETY
sk COUNTY OF RIVERSIDE Alffilk FIELD OFFICE
CONSTRUCTION ESTIMATE
ELECTRICAL
FEES
PLUMBING FEES
lst FI.
2nd Fl.
Par.
Gar.
Car P.
.
Sq. Ft. @
NO.
HEAT B VENT FEE
NO.
Sq. Ft. @
ELEC. FEE
Sq. Ft. @
Sq. Ft. @ - POLES
US]
SIGNS
Sq. Ft. @
DRAINAGE PIPING
j
OleWall Sq. Ft. @ j� ORAT SC LK.D/
DRINKING FOUNTAIN
Sq. Ft. @ MOTOR H. P.
URINAL
MOTOR H.P.
WATER PIPING
ESTIMATED VALUATION is
MOTOR
H. P. j
j 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
ZONE
AIR HANDLING UNIT
SUB -PANEL
PLAN CHECK FEEzv)
KITCHEN SINK
/
`IST
GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
'
CHCC KED B
WATER CLOSET
IC
COMPRESSOR �HP
RANGE AND/OR OVEN
VALUATION
LAVATORY
APPLIANCE VENT
WATER HEATER
SHOWER
ABSORPTION SYSTEM �J B.T.U.
SPACE HEATER -
MECHANICAL FEE
BATH TUB .
_e -
INCINERATOR DOMESTIC ❑ INDUS. ❑ COMM.
CONSTRUCTION POLE
WATER HEATER
HEATING SYSTEM ❑ FORCED ❑ GRAVITY
SERVICE ENTRANCE
GROUP
SEWAGE DISPOSAL
BOILER B.T. U.
RESID. 1Q SQ. FT.
NU
HOUSE SEWER
R�@
GARAGE iQ. SO. FT.
GAS PIPING
PERMIT FEE ..
PERMIT FEE
PERMIT FEE
PERMIT NU
E
A
REN. DBL.
TOTAL FEES
HEAT B VENT FEE
PLN. CK. FEE
CONST. 'FEE
ELEC. FEE
PLUMB. FEE
US]
J F M A M J J A 3
J F M A M J J A S
O N D
O N p
SET BACK
LOT SIZE
USE if
JAD�D/E$-
JOWNE
ZONE
USE OF BUIL
PLAN CHECK FEEzv)
/
`IST
" +'
'
CHCC KED B
CrO WM 0 NI TY
IC
F.C. -
UNITS
VALUATION
OF -
MECHANICAL FEE
_e -
1"
GROUP
TYPE
LEGAL E CRIPTION ,
NU
E
�CONSTRUCTION FEE �%
C `�
1P67,03
SPEC. INSP.
- -
SVPP. TO PERMIT
ELECTRICAL FEE
PLAN CHECKER
BOND $
-BOND
CASH
PLAN FILE It
FINAL DATE
'INSPECTOR
PLUMBING FEE
J
TOTAL FEES]♦��,.
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 C 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 -
,+r ," T
LL
P
CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLI-
ANCE WITH LAWS OF THE STATE OF CALIFORNIA COVERING CON-
TRACTORS IS ALSO GUARANTEED.
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3i[rEi (JF
OWNER
.ate
CONTRACTOR r
1 t C #? OF.
ADDRESS
GI .fir Y _ 1 (� .�L
N4
TEL NO. -1
tfL7NO.
LICENSE NO.
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