176644 (ELEC)FIELD OFFICE
PLUMBING FEES
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
FLOOR DRAIN
VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD
MOTOR H. P.
DEPARTMENT OF BUILDING & SAFETY
COUNTY OF RIVERSIDE
APPLIANCE
CONSTRUCTION ESTIMATE
ELECTRICAL FEES
1st FI.
2nd FI.
Par.
Gar.
Car P.
Wall
l
OUTLETS
Sq. Ft. @
AIR HANDLING UNIT
NO.
Sq. Ft. @
GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
Sq. Ft. @
WATER CLOSET
Sq. Ft. @
POLES
Sq. Ft. @
R
SIGNS
Sq. Ft. @
TRANS. AND/
OR T. ELK.
Sq. Ft. @
MOTOR H.P.
BATH TUB '
MOTOR M.P.
ESTIMATED VALUATION $
WATER HEATER
MOTOR H.P.
SERVICE ENTRANCE
MECHANICAL FEES
_ .. _
FIELD OFFICE
PLUMBING FEES
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
FLOOR DRAIN
VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD
MOTOR H. P.
WASHER (AUTO) (DISH)
APPLIANCE
FIXTURES
GARBAGE DISPOSAL
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
OUTLETS
LAUNDRY TRAY
AIR HANDLING UNIT
SUB -PANEL v++
KITCHEN SINK -
GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
UO. AZ
WATER CLOSET
COMPRESSOR �HP
ANGE AND/OR OVEN
LAVATORY
APPLIANCE VENT
WATER HEATER
SHOWER
ABSORPTION SYSTEM O 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. 10 SO. FT.
HOUSE SEWER
PERMIT FEE
GARAGE iQ SO. FT.
GAS PIPING
-
i PERMIT FEE t�
PERMIT FEE '
—P�NIIyLT�L REg REN. DBL. IT�AL FEES HEAT 8 VENT FEE(PLN. CK. FEE (CONST. FEE
•�.-- J- l(h�_, 4.. .-c �•-�_- - -" M_ _..__.--..I A......+�+-.1.
ELEC. FEE PLUMB. FEE
SET BACK
LOT SIZE
USE # -
JOB OWNER
IS
F
IR
.rAArDDRESSO
ZONE
USE OFBUILDING DATE
PLAN CHECK FEE $
l_QS�
t;,
CHECKED BY
"COMMUNI'Y
DISTRICT
F.C.
UNITSj'V*Ar.LUATN
OFFICE
MECHANICAL FEE $
_-77104-L
-
P TYPE
EGAL DESCRIPTION,
PERMIT NUMBER
CONSTRUCTION FEE $
+
76644
SPEC. INSP.
t • w
rr
SUPP. TO PERMIT
ELECTRICAL FEE $
PLAN CHECKER
BOND $ BOND
CASH
FINAL DATE
INSPECTOR
PLUMBING FEE $
IPLA7N-F-(LY-#
7o
TOTAL FEES
s
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED j
WITHIN 60 DAYS. CESSATION OF WORK FOR 120 DAYS SHALL ALSO •i
CAUSE PERMIT TO BECOME VOID. i
I HEREBY 'AGREE THAT ALL WORK IN CONNECTION WITH THIS
CASH CHECK M.O. N.C.
RECEIVED BY
SEWAGE SYSTEM
~
PERMIT WILL BE DONE IN ACCORDANCE WITH THE LAWS OF RIVER-
SIDE SIDE COUNTY AND THE STATE OF CALIFORNIA. I ALSO AGREE�TO
T
LL
P
CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLI-
ANCE WITH LAWS OF THE STATE OF CALIFORNIA COVERING CON-
TRACTORS IS ALSO GUARANTEED.
N AME'OF CONSTRUCTION LENDER
OWNER
CONTRACTOR
BRANCH OFFICE
y
1
ADDRESS
T 1'�•s�lf
d .!% E
_
A'GDRESS_
A O S
CITY STATE
o
NO LENDER INVOLVED 4zG�
INFORMATION
I
1
L
TEL. NO.
TEL'. NO.-
?84-208
284-208 12/88
IENSE/
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