162345 (SFD)DEPARTMENT OF BUILDING & SAFETY
COUNTY OF RIVERSIDE FIELD OFFICE
CONSTRUCTION ESTIMATE
ELECTRICAL FEES
PLUMBING FEES
1st F1. �'
Sq. Ft. @
NO.
NO.
7
1
F
•
1 2nd FI.
Sq. Ft. @
I
Par.
Sq. Ft. @
POLES
Gar.
Sq. Ft. @
51 GNS
DRAINAGE PIPING
1
(•� Car P.
Sq. Ft. @
TRANS. AND/
OR T. CLK.
DRINKING FOUNTAIN
i-
Wall
Sq. Ft. @
MOTOR M.P.
URINAL
1
j7
Sq. Ft. @
MOTOR H.P.
WATER PIPING
ESTIMATED VALUATION Is "
MOTOR H.P.
FLOOR DRAIN
:7
MECHANICAL FEES
MOTOR H.P.
WATER SOFTENER
'
VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD
MOTOR H.P.
WASHER (AUTO) (DISH)
1
APPLIANCE
FIXTURES
GARBAGE DISPOSAL ,
}
J
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
X+^'
OUTLETS
LAUNDRY TRAY
Z
AIR HANDLING UNIT
_
SUB -PANEL
KITCHEN SINK
OGAS
PIPE ❑NATURAL ❑ L.P.G. ❑OIL
/RANGE
--+�
�."
WATER CLOSET
U
COMPRESSOR E::�HP
AND/OR OVEN
LAVATORY
W
APPLIANCE VENT
WATER HEATER
SHOWER
o
ABSORPTION SYSTEM B.T.U.
SPACE HEATER
BATH TUB
i
U
INCINERATOR DOMESTIC ❑ INDUS. ❑ COMM.
CONSTRUCTION POLE
^.'y
t
WATER HEATER
r
HEATING SYSTEM ❑ FORCED ❑ GRAVITY
SERVICE ENTRANCE;^'
SEWAGE DISPOSAL
9
1
BOILER B.T.U.
RESID. iQ 5Q. FT.
✓;. J`j
HOUSE SEWER
-;
RESIDENTAL FEE SQ. FT. �@
GARAGE pC SQ. FT.
K".
GAS PIPING
PERMIT FEE
PERMIT FEE
/ �
PERMIT FEET�a
F'1711�5'9
PERMIT NU
E
FEES
-ATHEAT & VENT FEE
CK. FETE
CONST. FEE
ELEC. FEE
PLUMB. FEE
IREN. ]DEL.
ITOTAL
A'I r ...Z {
JPLN,
-�,
..y ✓
h f rr� +
J
ff
J
J
F M A M
F M A M
J J A S
J J A S
O N D
O N D
SET BACK
I
LOT SIZE
USE 7t
JOB ADDRESS { C��[f
ti +
/�j�,f')"_;I5
„7
R .7. zr'
]}�"�f\5 1iViJ� i'JOWNER
1" 1R. ce'Y� r...f t tiw. f / I
ZONE
U E O UILDING DATE
PLAN CHECK FEE�'�
_
t
�' l �*` 1..,� 9 C !z' } r �, .�.+.: •`
h. d i 1•-
! v�f,; i
CHECKED BY
COMMUNITY
DISTRICT
F.C.
VALUATION OFFICE
cI
�- MECHANICAL FEE
��1
—7—
JUNITS
Ar /
�.. 11
f "'•
I
-;
G OUP«
TYPE
LEGAL DESCRIPTION
-
JJJ
PERMIT NUMBE
1 CONSTRUCTION FEE{, p
.>
,�.- ill
`
1'.
1.
SPEC. INSP.
p
SUPP. TO PERMIT
ELECTRICAL FEE �"� .�,5
iv{
^``'Z7PLAN
CHECKER
BOND $
CASH
PLAN FILE #
FINAL DATE
INSPECTOR
G
PLUMBING FEE
�BO..
I
t
�
i.-
F TOTAL FEES
�y �+
C f�
r+ 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.
1 HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS
I CASH CHECK M.o. N.C.
RECEIVED BY
SEWAGE SYSTEM
f 1
PERMIT WILL BE DONE IN ACCORDANCE WITH THE LAWS OF RIVER-
�}
c�
SIDE COUNTY AND THE STATE OF CALIFORNIA. I ALSO AGREE TO
1V� i
T 7: %
LL
P Y'
CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLI-
ANCE WITH LAWS OF THE STATE OF CALIFORNIA COVERING CON -
INFORMATION
f � �
TRACTORS IS ALSO GUARANTEED.
F
OWNER
CONTRACTOR
1.
ADDRESS
ADDRESS
I
/
f
TEL. NO.
TEL. NO.
LICENSE NO.
284-208 11/67