176877 (PLBG)FIELD OFFICE
PLUMBING FEES
DRAINAGE P.fPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
FLOOR DRAIN
VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD
MOTOR H. P.
DEPARTMENT OF BUILDING & SAFETY
• COUNTY OF RIVERSIDE 0
WASHER (AUTO) (DISH)
CONSTRUCTION ESTIMATE
ELECTRICAL FEES
1st FL
2nd FI.
Par.
Gar.
Car P.
Wal I '
GARBAGE DISPOSAL
Sq. Ft. @
OUTLETS
NO.
Sq. Ft. @
AIR HANDLING UNIT
Sq. Ft. @
r t .'-r
Sq. Ft. @
POLE
Sq. Ft. @
SIGHS
Sq. Ft. @
oRRTT.k
Sq. Ft. @
MOTOR H. P..
LAVATORY
MOTOR H. P.
ESTIMATED VALUATION is
MOTOR H. P.
ABSORPTION SYSTEM D B.T.U.
MECHANICAL FEES
T e
FIELD OFFICE
PLUMBING FEES
DRAINAGE P.fPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
FLOOR DRAIN
VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD
MOTOR H. P.
WASHER (AUTO) (DISH)
APPLIANCE
FIXTURES
JOB ADDRESS ` OWNER a
J
GARBAGE DISPOSAL
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
OUTLETS
F
LAUNDRY TRAY
AIR HANDLING UNIT
SUB -PANEL
KITCHEN SINK
GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
WATER CLOSET
COMPRESSOR E=�HP
RANGE.AND/OR OVEN
PLAN CHECK FEE $
LAVATORY
APPLIANCE VENT
WATER HEATER
SHOWER
ABSORPTION SYSTEM D B.T.U.
SPACE HEATER
COMMUNITY'DIS
BATH TUB
INCINERATOR DOMESTIC ❑ INDUS. ❑ COMM.
CONSTRUCTION POLE
VALUATION
WATER HEATER
HEATING SYSTEM ❑ FORCED ❑ GRAVITY
SERVICE ENTRANCE
SEWAGE DISPOSAL
BOILER B.T.U.
RESID. 10 SO. FT.
J
HOUSE SEWER
PERMIT FEE
GARAGE iG SO. FT.
GAS PIPING
PERMIT FEE
-
PERMIT FEE
PERMIT NUMBER REN. DBL. TOTAL FEES HEAT B VENT FE PLN. CK. FEE CONST. FEE ELEC. FEE PLUMB. FEE
17 77
J F M M J- J A S
U . __
SET BACK
LOT SIZE
USE #
JOB ADDRESS ` OWNER a
J
F
5
RV�
ZONE
U F BUI ING'
DATE
PLAN CHECK FEE $
_ "� '. �r 4
'
CHECK D BY
COMMUNITY'DIS
I T
`V -C-. 0
UNITS
VALUATION
F ICES
MECHANICAL FEE $
J
alp
I
G R O/V�-'
LEGAL DES IPTION
PERMIT NUMBER -
CONSTRUCTION FEE $
-
j
4 &V`.`
6
ELECTRICAL FEE $�
P
SPEC. INSP.
'
! 4 .''
SUPP. TO PERMIT
PLAN CHECKER
BON. $
BOND
CASH
PLAN FILE 71
"AL DATE
INSPECTOR
PLUMBING FEE $
^ :..�^'
1
•
I
•
z
-J �5 �V
1
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 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
rpm
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
OWNER
CONTRACTOR
BRANCH OFFICE
�� t
-,iJ
ADDRESS
-
f• i !s (.. ( t
ADDRESS
ADDRESS
CITY
STATE
1
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v �,T /
{
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NO LENDER INVOLVED
)"e!_Qw! .. /i/sy fi►
INFORM
TION
� s
TEL. NO.
TEL. NO. '
f�-
ss
LICENSE NO. i
I/
284-208 12/88�.....�