169424 (PLBG)DEPARTMENT OF BUILDING & SAFETY FIELD OFFICE
COUNTY OF RIVERSIDE
CONSTRUCTION ESTIMATE
ELECTRICAL FEES
PLUMBING FEES
1st FI.
Sq. Ft. @
NO.
NO.
2nd FI.
Sq. Ft. @
Par.
Sq. Ft. @
POLES
f(
Gar.
Sq. Ft. @
SIGNS
AINAGE PIPING -
Car P.
Sq. Ff. @
1
OR T, CL /
- y
DRINKING FOUNTAIN
Wall
Sq. Ft. @
MOTOR H.P.
URINAL
�•
Sq. Ft. @
I
l:
MOTOR H.P.
WATER PIPING
ESTIMATED VALUATION Is
MOTOR H.P.
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
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FURNACE❑ UNIT❑ WALL❑ FLOOR❑ SUSPENDED
OUTLETS
LAUNDRY TRAY
Z
0
AIR HANDLING UNIT
SUB -PANEL
KITCHEN SINK
J
Q
GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
WATER CLOSET
U
COMPRESSOR �HP
RANGE AND/OR OVEN
LAVATORY
W
�
APPLIANCE VENT
WATER HEATER
SHOWER
f
I o
ABSORPTION SYSTEM B.T.U.
SPACE HEATER
BATH TUB
`1 U
2A'
INCINERATOR DOMESTIC ❑ INDUS. ❑ COMM.
CONSTRUCTION POLE
WATER HEATER
t
HEATING SYSTEM ❑ FORCED ❑ GRAVITY
SERVICE ENTRANCE
SEWAGE DISPOSAL
BOILER B.T.U.(U.
RESID. 1Q SQ. FT.
HOUSE SEWER
L__j
RESIDENTAL FEE SQ.FT.L ,_@
GARAGE zQ Sp. FT.
GAS PIPING
PERMIT FEE
t
iPLN.
PERMIT FEE
j
C� A')
PERMIT FEE
,
PERMIT
a
^
REN. DBL.
TOTAL
HEAT & VENT FEE
CK. FEE
FEE
ELEC. FEf.
PLUMB. FEE
JMG
aG,
1CONST.
4
y
J F M A M J J A
J F M A M J J A S
O N D
SET BACK LOT SIZE USE # JOB ADDRESS
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OWNER
+_ w
t,F 9
J
I•
ZONE
USE OF BUILDING -
DATE
PLAN CHECK FEE
I
i
CHECKED BY
NT
UNfTS
q'FFI E
l
I
IDISFT �F.C.
iN
I.VALUATION
MECHANICAL FEE
/,=
;1 '',,.
FLEGNIL
'-.
I
G O
TYPE
DE P ON -
ERMIT NUMBER
t, CONSTRUCTION FEE
P
^'�Z rt j i +�` ; 5 .I -769424
SPEC. INSP.
SUPP. TO PERMIT
a h
/
ELECTRICAL FEE
•CAS
i'
PLAN CHECKER
BOND $
BOND
-
#
FINAL DATE
INSPECTOR
kk
'
jPLXN
C
PLUMBING FEE .
�'•'^�rp-
TOTAL FEES
<,
$
I
1
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.
IRECEIVED BY
SEWAGE SYSTEM
PERMIT WILL BE DONE IN ACCORDANCE WITH THE LAWS OF RIVER-
ILL
SIDE COUNTY AND THE STATE OF CALIFORNIA. I ALSO AGREE TO
T
P
CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLI-
ANCE WITH LAWS OF THE STATE OF CALIFORNIA COVERING CON- -
INFORMATION
TRACTORS IS ALSO GUARANTEED.
»e of Constriction i*n3ev:
OWNER t� f).
CONTRACTOR
� s�y�r .
*t- nch '- lisp_
Cf
4 .drew
ADDRESS
ADDRESS
t41*y.='t::.to
yyy(
F
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k
TEL. NO.
TEL. NO.
12847208
LICEN SENO.
1 1 /87 7f��j