176661 (ELEC)DEPARTMENT OF BUILDING & SAFETY
0 COUNTY OF RIVERSIDE •
1st FI. Sq. Ft. @
2nd FI. Sq. Ft. @
Par. Sq. Ft. @
Gar. Sq. Ft. @
Car P. Sq. Ft. @
Wall Sq. Ft. @
Sq. Ft. @
I
ESTIMATED VALUATION $
MECHANICAL FEES
VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD
APPLIANCE
FURNACE UNIT❑ WALL❑ FLOOR SUSPENDED
AIR HANDLING UNIT
GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
COMPRESSOR D HP
APPLIANCE VENT
ABSORPTION SYSTEM D
INCINERATOR DOMESTIC ❑ INDUS. ❑ COMM.
HEATING SYSTEM ❑ FORCED ❑ GRAVITY
BOILER B.T.U.
PERMIT FEE
FIELD OFFICE
PLUMBING FEES
1
POLES
NUMBER
REN. DBL.
SIGNS
'TOTAL FE E�
HEAT IN VENT FEE
DRAINAGE PIPING
. ANO/
OR TRANSN ELK.
EIEC. FEE
PLUMB. FEE
DRINKING FOUNTAIN
MOTOR
H. P.
URINAL
MOTOR
H. P.
WATER PIPING
MOTOR
H. P.
J F - M A M Jr� J A, S�
F M -. AW" J J. .._ ,A ___
FLOOR DRAIN
MOTOR
H. P.
WATER'SOFTENER
MOTOR
H. P.
OWNER
WASHER (AUTO) (DISH)
FIXTURES
GARBAGE DISPOSAL
OUTLETS
LAUNDRY TRAY
SUB -PANEL
F
S
KITCHEN SINK
iwa
WATER CLOSET
RANGE AND/OR OVEN
ZONE
SE OF BUIL ING D%AT
LAVATORY
WATER HEATER
SHOWER
B.T.U. SPACE HEATER
MECHANICAL FEE $
.t'
BATH TUB
CONSTRUCTION POLE
GRO P
71Y PE
WATER HEATER
SERVICE ENTRANC*412
CONSTRUCTION FEE $
dO_
SEWAGE DISPOSAL
RESID. 12 SO. FT.
176661-
HOUSE SEWER
GARAGE i 9 SO. FT.
SUPP. TO PERMIT
GAS PIPING
1 PERMIT FEE
ELECTRICAL FEE $
PERMIT FEE
PERMIT
NUMBER
REN. DBL.
'TOTAL FE E�
HEAT IN VENT FEE
PLN. CK, FEE
CONST. FEE
EIEC. FEE
PLUMB. FEE
1
12 a.+•s�
J 1,11
J F - M A M Jr� J A, S�
F M -. AW" J J. .._ ,A ___
q.�� p,
O – "N D - -
SET BACK
LOT SIZE
USE #
JOB ADDRESS
OWNER
.O
F
S
RR
F
ZONE
SE OF BUIL ING D%AT
PLAN CHECK FEE $
CHECKED BY
OMMUNI r (YISTRICT F/.C. —JUIOItS F C if Z
MECHANICAL FEE $
.t'
JVAL+TION
.4 J .5" �0
GRO P
71Y PE
LEGAL DESCFfIPTION
PERMIT NUMBER
CONSTRUCTION FEE $
'/
y
176661-
SPEC. IN5P.
SUPP. TO PERMIT
ELECTRICAL FEE $
1
"
PLAN CHECKER
BOND $
BONO
CAA
PLAN FILE #
FINAL DATE
-
INSPECTOR
PLUMBING FEE $
/
r _ �O -7O
G'
TOTAL FEES
✓''
PERMITTHIS SHALL I RIS NOTCOMMENCED
WITHIN 60DAYS.CESSAT ON OF WORKFOR 120DAYS SHALALSO
CAUSE PERMIT TO BECOME VOID.
I HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS
CASH CHECK r M. 0. N. C.
RECEIVED 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
p
i i11
T
p
CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLI-
ANCE WITH LAWS OF THE STATE OFC-ALIFORNIA COVERING CON-
TRACTORS IS ALSO GUARANTEED
NAME OF CONSTRUCTION LENDER
OWNER
CONTRACTOR
BRANCH OFFICE
,
ADDRESS
ADDRESS
AD ESS
CITY STATE
NO LENDER INVOLVED 61-11
INFORMATION
Cot/—
TEL. NO.
TE/L/y)NO.
Y�� �v�� ! �0�� �����,1 •
LICENSE NO.
284-208 12/88
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