171386 (SFD)DEPARTMENT OF BUILDING & SAFETY
I&
COUNTY OF RIVERSIDE
FIELD OFFICE
USE if
CONSTRUCTION ESTIMATE
ELECTRICAL FEES
PLUMBING FEES
1st FI .•
2.,M
Por.
Gar. X 1
' Car P.
Wall
Sq. Ft
NO,
NO,
+►
:[WNER
— �.%
Sq. Ft. @ . 'f
Sq. Ft. @ ��
Sq. Ft. @ " % POLES
Sq. Ft. @ SIGNS ORAINAGE PIPING
Sq. Ft. @ ORAT SCLK.D/ DRINKING FOUNTAIN
Sq. F}. @ .MOTOR H. P. URINAL
' MOTOR H. P. WATER PIPING
ESTIMATED VALUATION Is
9,9 MOTOR H. P.
USE OF BUILDING DATE
FLOOR DRAIN
MECHANICAL FEES
MOTOR H. P.
CM C ED B?
WATER SOFTENER
UNITSLUAT 10 OFF E
HOOD
F VENT SYSTEM FAN ❑ EVAP. COOLJe
MOTOR H.P.
jDTS*RICT]F.4r.—
WASHER (AUTO:WDISH)
'
��
I APPLIANCE
FIXTURES
LEGAL DE RI T O - �-ax
GARBAGE DISPOSAL
V
• y FURNACE UNIT❑ WALL❑ FLOOR SUSPENDED
J
OUTLETS
LAUNDRY TRAY'
�
Z AIR HANDLING UNIT
O
SUB-PAMEL
SPEC. INSP.
KITCHEN SINK
SUPP. TO PERMIT
J GAS PIPE ❑ NATURAL O L.P.G. ❑ OIL
Q
w,'7f
WATER CLOSET
' £'
®
U COMPRESSOR HP
Rm9rE AND/OR OVEN
BOND CASH
LAVATORY
DATE
B
W APPLIANCE VENT
f
WATER HEATER
/C o I-
SHOWER
ABSORPTION SYSTEM O B.T.U.
0
SPACE HEATER
—
BATH TUB
Cie
U INCINERATOR DOMESTIC ❑-INDUS. ❑ COMM.
CONSTRUCTION POLE
WATER HEATER
' CHEATING SYSTEMFORCED ❑ GRAVITY
SERVICE ENTRANCE Q/(y�
SEWAGE DISPOSAL
THIS PERMIT SHALL
r
BOILER - B.T.U.
s
RESID. IC SO. FT.
HOUSE SEWER
CASH CHECK M. o. N.C.
RESIDEN TAL FEE SQ. FT. @
_30
y
GARAGEza SO. PT. f>'6/
v
GAS PIPING
PERMIT WILL BE DONE IN ACCORDANCE WITH THE LAWS OF RIVER-
PERMIT FEE
PERMIT FEE,
PERMIT FEE
pERM1T!1/M7l
3 86
SIDE COUNTY AND THE STATE OF CALIFORNIA. IfALSO AGREE TO
REN.
JDBL.
TOTAL FEES
HEAT & VENT FEE
PLN, CK, FEE
CONST. 'FEE
ELEC. FEE
y�
PLUMB,. `FEE
+s.
J+ /
J F M M J J A S
C
10-
IN ID
SET BACK
LOT SIZE
USE if
JOB ADDRESS
+►
:[WNER
— �.%
F
s
R
i
ZONE -
USE OF BUILDING DATE
PLAN CHECK FEE--
10
CM C ED B?
COMMUNITY--
UNITSLUAT 10 OFF E
MECHANICAL FEE +.+o
jDTS*RICT]F.4r.—
V'
'
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G P
TYPE
LEGAL DE RI T O - �-ax
1713M8
6
CONSTRUCTION FEE
4
'
SPEC. INSP.
SUPP. TO PERMIT
ELECTRICAL FEEw
w,'7f
' £'
®
PLAN CHECKER
BOND $
BOND CASH
PLAN FILE #
DATE
INSPECTOR
PLUMBING FEE
/C o I-
gqFINAL
/U- %U
—
I
' 40'O
TOTAL FEES
6rIF
7
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. IfALSO AGREE TO
T
�L
P
CARRY COMPENSATION INSURANCE UPON MY' EMPLOYEES. COMPLI-
ANCE WITH LAWS.OF THE STATE OFCALIF NIA C_OVF&R+NG CON-
INFORMATION
TRACTORS IS ALSO GUARANTEED.
sm or 0=2w=ov L0m
J+ /
OWNER
CO AeTOR -
✓
ADDRESS
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'TEL. NO.
TEL. NO.
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LICENSE NO.
VS
284-208 11/87