176878 (PLBG)DEPARTMENT OF BUILDING & SAFETY
COUNTY OF RIVERSIDE
CONSTRUCTION ESTIMATE
ELECTRICAL FEES
(
PLUMBING FEES
1st FI.
2nd FI.
Par.
Gar.
Car P.
Wall
Sq. Ft. @
Sq. Ft. @
Sq. Ft. @
Sq. Ft. @
Sq. Ft. @
Sq. Ft. @
Sq. Ft. @
NO.
NO.
al'Jt:
POLES
SIGNS
DRAINAGE IPING
O ATC
DRINKING FOUNTAIN
_
MOTOR H.P.
URINAL
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
I
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
OUTLETS
LAUNDRY TRAY
AIR HANDLING UNIT
SUB -PANEL
KITCHEN SINK
{
GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
WATER CLOSET
I
COMPRESSOR �HP
RANGE AND/OR OVEN
LAVATORY
d
APPLIANCE VENT
WATER HEATER
SHOWER
ABSORPTION SYSTEM B.T.U.
SPACE HEATER
BATH TUB
INCINERATOR DOMESTIC ❑ INDUS. ❑ COMM.
CONSTRUCTION POLE
WATER HEATER
"
HEATING SYSTEM ❑ FORCED ❑ GRAVITY
SERVICE ENTRANCE
SEWAGE DISPOSAL
BOILER B.T.U.
RESID. iS SQ. FT.
HOUSE SEWER
PERMIT FEE
GARAGE zQ SQ. FT.
GAS PIPING
PERMIT FEE
tt
ft
_
PERMIT FEE
��hh
P
R T
U
REN. DBL.
TOTAL FEES
HEAT & VENT FE
PLN. CK. FEE
CONST. FEE
ELEC. FEE
PLUMB. FEE
J- F M A M J J A S
J F M A M J J A I.
O N D I
O N D
SET BACK
LOT SIZE
USE #
JOB ADDRESS
r r..
'.. S.4
OWNER
j
i y f
F
S
R
PLAN CHECK FEE $
ZONE
5E OF BUILDING
DATE
MECHANICAL FEE $
CHECKED BY
1 .; �.: :�+' `M
COMMUNITY
�rTA
F.VICT
.C. I
UhrITSf
VALUATION
�
rFICE
CONSTRUCTION FEE $
GROY10
11
Y E
LEGAL DE CRIPTION
4 j7 146 di - o*' L
176878
PERMIT
NUMBER
ELECTRICAL FEE $
SPEC. INSP.
'k -J�.
SUPP. TO PERMIT
{
PLUMBING FEE $
PLAN CHECKER
BOND $
BOND I
CASH
PLAN FILE # [;F
I NAL DATE
-15" �Q
INSPECTOR
�.
TOTAL FEES
G
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
PERMIT WILL BE DONE IN ACCORDANCE WITH THE LAWS OF RIVER-
SIDE COUNTY AND THE STATE OF CALIFORNIA. I ALSO AGREE TO
CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLI-
ANCE WITH LAWS OF THE STATE OF CALIFORNIA COVERING CON-
TRACTORS IS ALSO GUARANTEED.
CASH CHECK M.O. N.C.
RECEIVED BY
t -
SEWAGE SYSTEM
T
ILL
P
4.1
NAME OF CONSTRUCTION LENDER
BRANCH OFFICE
OWNER
CONTRACTOR
ADDRESS
CITY STATE
NO LENDER INVOLVED
ADDRESS
ADDRESS
INFORMATION
TEL. NO.
TEL. NO.
LICENSE NO.