201589 (RPL)OF BUILDING'& SAFETY '
-'JEPARTMENT
FIELD OFFICE
GOUNTYS,OF RIVERSIDE T •
CONSTRUCTION ESTIMATE':--
ELECTRICAL FEES PLUMBING FEES '.
I ST FL.
SQ. FT.' @
NO: I NO.;
2ND FL.
SQ. FT. @
+''
r a ,ow op
i
POR.
SQ. FT.` @
MOTOR ]'OR LESS H.P. ,•� ea t
GAR. M
0 @
SQ.FT.
MOTOR 5 OR LESS H.P.
CAR P.
SO. FT. @
'MOTOR 20 OR,LESS H.P. DRAINAGE PIPING
WALL
SQ.FT. @
DRINKING FOUNTAIN
^
SQ. FT. - @
URINAL -
✓
�K W. UNITS WATER PIPING
ESTIMATED VALUATION $
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM .❑ FAN. p EVAP. COOL'❑ HOOD
SIGN'. WASHER, (AUTO) (DISH)
APPLIANCE
FRAMER •O-K.W. GARBAGE DISPOSAL '
- FURNACE ❑UNIT ❑ WALL FLOOR •❑SUSPENDED ''
OUTLETS LAUNDRY TRAY ;
" AIR HANDLING UNIT CFM
FIXTURE OR SOCKET f £> KITCHEN SINK '.
GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL'
CONST. SERV. ENTRANCE WATER CLOSET
COMPRESSOR- r HP
POLE . LAVATORY.
APPLIANCE VENT
AMPERES SERV. ENT. SHOWER 1
ABSORPTION SYSTEM 0 B.T.U.
4- SQ. FT: @ 4 BATHTUB
INCINERATOR ❑ DOMESTIC ' ❑ INDUS. OR COMM.
SQ. FT. @ Q WATER HEATER
HEATING SYSTEM ❑ FORCED ❑ GRAVITY
, SQ. FT. RESID. @ I ¢ SEWAGE DISPOSAL
BOILER 0 B.T.U.
SQ. FT. 'GARAGE @ 1�2QSF�ZS�E SEWER) --I -'
PERMIT FEE
BALANCE OF MIN. FEE GAS PIPING_ -
TRAILER ISSUANCE FEE - PERMIT FEE
PERMIT FEE PERMIT FEE
PER
�Gj
JTO,AL F
REN. TRAILER FEE'
HEAT & VENT. FEE
PL. CK. FEE CONST..FEE.-
DBL.
ELEC. F E
IDSL.ISPEC.INSP.
FEE
PLUMB G FEE
OBC.
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., J F M A M J J -
_
N -'.-
11 C IS
/-LOT
Fri. 5 ""lo R
SIZE,.. •.
�. • �.
USE p
_ ` .�
A S O
JOB ADDRESSIS
^- OWNER
�'" -ry Z,'
�0 / 6+C. `O'. 'Jr i� i� (.� i�, �%
D
�,�>�.
PLAN CHECK FEE
/
ZONE
USE OF BUILDING - - - ' [DATE
-
•
CHECKED/BY
COMMUNITYDISTRICT
F.C. .,p
NIBS - VALUATION �
1/,04 f 49
OFFICE -
MECHANICAL FEE
DBL
CONSTRUCTION FEE ..
•�''
CROUP._
TYPE
LEGAL DE CRIPTION - - ',
�I.� -ti.S%ybS-c+�
ERMIT NUMBER I
015 S LJ i
' DB
PLAN CHECKER
- SUPP.
TO PERMIT
ELECTRICAL FEE
. DBL
$
j
P,y
BOND $
BOND
�
CASH
PLANFILEp .. • FINAL
y
DATE^
INS ECTOR
��
PLUMBING FEE
�,'
TRAILER PERMIT
INANE OF.CONSTRUCTION' LENDER -
BRANCH OF FICE•
-
N VOENDER
INVOLVED j
ISSUANCE FEE
$
-
ADDRESS
CITY
STATE
r -
FEE
g
R
TOTAL FEES
y J
$ '.
THIS PERMIT SHALL BECOME VOID IF WORK 'IS NOT COMMENCED WITHIN 60 DAYS. CESSATION
-ALSO
OF WORK FOR 120 DAYS SHALL CAUSE PERMIT TO BECOME VOID..
CASH CHECK
M.O. N.C.-
❑
•I HEREBY AGREE THAT- ALL WORK-IN CONNECTION -WITH THIS PERMIT WILL BE DONE IN ACCOR
DANCE WITH -THE LAWS OF RIVERSIDE COUNTY AND T,H,E' STATE OF-CAUFORNIA. I ALSO AGREE TO
RECEIVED BY SEWAGE SYSTEM
CARRY. COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLIANCE WITH THE LAWS OF THE STATE 7
T
T
~I
OF CALIFORNIA COVERING CO3NfRACTORS IS ALSO GUARANTEED_
IHEREBY.CERTIFYTHATTHEINDIVIDUALWHOPREPAR�DTH S )CIFtCATlO DONE
T
LL
P`
.YHA
SO IN ACCORDANCE WITH SECTION 5541 OF THE BUS 5 A P ES "I C D i ATE
INFORMATION '
OF,CALIFORNIq a , r. �I 5
•
OWNER �•
CONTRACYiff '`
Ile
�4✓
-
ADDRESS •
ADDRESS ' " ` /. ','
•' - TEL. NO. _.t' TEL. NO ✓� F/�F _}' /•"; - - ti:
Al
LICENSE NO.
to
-FORM-284-208 (REV. I-70) OsV-
:a