160330 (AR)DEPARTMENT OF BUILDING & SAFETY
COUNTY OF RIVERSIDE FIELD OFFICE
CONSTRUCTION ESTIMATE ELECTRICAL FEES PLUMBING FEES 71
1st FI. e Sq. Ft. @ -
2nd FI. Sq. Ft. @
Por. Sq. Ft. @14-V
Gar. Sq. Ft. @
Car P. Sq. Ft. @
Wall Sq. Ft. @
Sq. Ft. @
ESTIMATED VALUATION is
MECHANICAL FEES
VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD
APPLIANCE
> FURNACE 11 UNIT❑ WALL❑ FLOOR SUSPENDED
J
Z AIR HANDLING UNIT
O
J GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
Q
U COMPRESSOR OHP
WAPPLIANCE VENT
O
ABSORPTION SYSTEM D B.T.U.
U INCINERATOR DOMESTIC ❑ INDUS. ❑ COMM.
HEATING SYSTEM ❑ FORCED ❑ GRAVITY
BOILER B.T.U.
RESIDENTAL FEE SQ.FT.� @
PERMIT FEE
ERMIT IR 3 3 0 REN. DBL. TO TA`E��
J F M A M
NO.
POLES
SIGNS
TRANS. AND/
OR T. CLK.
MOTOR H. P.
MOTOR H. P.
MOTOR H. P.
MOTOR H. P.
MOTOR H. P.
FIXTURES
OUTLETS
SUB-PAR,EL
RANGE AND/OR OVEN
WATER HEATER
SPACE HEATER
CONSTRUCTION POLE
SERVICE ENTRANCE
RESID. IC SQ. FT.
GARAGE i Q SO. FT.
PERMIT FEE p
;ENT]FEEPLN. CK. FEE CONST FEE 'FE;E//�y�� JELEC,
I _,o ! 9!r �•" ! ( I
J A S O
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
FLOOR DRAIN
WATER SOFTENER
WASHER (AUTO) (DISH)
GARBAGE DISPOSAL
LAUNDRY TRAY
KITCHEN SINK
WATER CLOSET
LAVATORY
SHOWER
BATH TUB
WATER HEATER
SEWAGE DISPOSAL
HOUSE SEWER
GAS PIPING
PERMIT FEE
PLUMB. FEE
r1 z
N D
SET BACK
LOT SIZE
USE #
JOB ADDRESS OWNER - -'
'lf �!
F
5
R
PLAN CHECK FEE
ZONE
USE OF BUILDING -
/l'?
DATE
CHECKED BY
CIOMMUNITY
DISTRICT F.C.
ITS
VA/lLUATION
OFFICE
MECHANICAL FEE
QC
CONSTRUCTION FEE
GROUP
.i+'
TYPE
LEGAL 314CRIPTION
y� �r-
PERMIT NUM 14 y
NT
60 0 .
ELECTRICAL FEE
SPEC. INSP.
_
SUPP. TO PERMIT
PLAN CHECKER
BOND $
BOND
CASH
PLAN FILE #
FINAL DATE(
INSPECTOR
- PLUMBING FEE
(''J�
ljf�j FJ
�•�I a'-� t
1�.
TOTAL FEES
$ �yv, a
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED 9
WITHIN 60 DAYS. CESSATION OF WORK FOR 120 DAYS SHALL ALSO r
CAUSE PERMIT TO BECOME VOID. -
I HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS
CASH CHECK M. o. N.C.
BY
SEWAGE SYSTEM
PERMIT WILL BE DONE IN ACCORDANCE WITH THE LAWS OF RIVER -
[RECEIVED
/J
T -
'
LL %tJ jJ
�+'y
P'!C.�'
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.
INFORMATION
OW JiLERf,
CONTRACTOR
y\
ADDRESS
kADDItESS,
d
v
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TEL. HI
TEL. NO.
LICENSE NO. _
284-208 11/87