191644 (ELEC)DEPARTMENT OF BUILDING & SAFETY
• COUNTY OF RIVERSIDE •
FIELD OFFICE
CONSTRUCTION ESTIMATE I ELECTRICAL FEES I PLUMBING FEES 4
1 ST FL. SQ. FT. @
2ND FL. SQ. FT. @
POR. SQ. FT. @
GAR. SQ.FT. @
CAR P. SQ. FT. @
WALL SQ.FT. @
SQ. FT. @
ESTIMATED VALUATION $
MECHANICAL FEES
VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD
APPLIANCE
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
AIR HANDLING UNIT I CFM
GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
COMPRESSOR 0 HP
APPLIANCE VENT
ABSORPTION SYSTEM O B.T.U.
INCINERATOR ❑ DOMESTIC ❑ INDUS. OR COMM.
HEATING SYSTEM ❑ FORCED ❑ GRAVITY
BOILER I B.T.U.
PERMIT FEE
TRAILER ISSUANCE FEE -'PERMIT FFE
nia
NO.
MOTOR I OR LESS N.P.
B
MOTOR 5 OR LESS H.P.
REN. TRAILER FEE HEAT & VENT. FEE
MOTOR 20 OR LESS H.P.
DRAINAGE PIPING
DBL. ELEC. FEE
DRINKING FOUNTAIN
INSP. FEE
URINAL
OK w. UNITS
WATER PIPING
FLOOR DRAIN
WATER SOFTENER
SIGN
WASHER (AUTO) (DISH)
TRANS-
FORMER K.W.GARBAGE
D
DISPOSAL
OUTLETS
LAUNDRY TRAY
FIXTURE OR SOCKET
KITCHEN SINK
CONST. SERV. ENTRANCE
WATER CLOSET
POLE
LAVATORY
AMPERES SERV. ENT.
SHOWER
SQ. FT. @ ¢
BATH TUB
SQ. FT. @ ¢
WATER HEATER
SQ. FT. RESID. @ 1 ¢
SEWAGE DISPOSAL
SQ. FT. GARAGE @1�2¢
HOUSE SEWER
BALANCE OF MIN. FEE (J
GAS PIPING
/ PERMIT FEE lJ !'S
PERMIT FEE
PER
B
TOTAL FEES o
REN. TRAILER FEE HEAT & VENT. FEE
I PL. CK. FEE I CONST.
FEE
DBL. ELEC. FEE
IDBL.ISPEC.
INSP. FEE
PLUMBING FEE
JDBL
- JF M A
- M J J A S O
N D
SET BACK
LOT SIZE
USE #
JOB ADDRESS OWNER
7—
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USE OF BU DI G
DATE p.
PLAN CHECK FEE
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4 w
CHECKED B
COMMUNITY DISTRICT
F. C.
UNITS
VALUATION
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JOFFICE
MECHANICAL FEE
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'
DBL
GRO
TYPE
LEGAL DESCRI ION
qRjITGM4ER
CONSTRUCTION FEE
DBL
PLAN CHECKER
-
SUPP. TO PERMIT
f
ELECTRICAL FEE
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0 0
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DBL
BOND f
BOND
CASH
PLAN FILE# FINAL
DATE
INSPECTOR
f
I I
y A C 7�
PLUMBING FEE
NAME OF CONSTRUCTION LENDER
BRANCH OFFICE
NO LENDER
TRAILER PERMIT
f
INVOLVED
ISSUANCE FEE
ADDRESS
CITY
STATE
FEE
f
TOTAL FEES 1$OF
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 60 DAYS. CESSATIO
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 ACCOR-
DANCE WITH THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA. I ALSO AGREE TO
CARRY. COMPENSATiON INSURANCE UPON MY EMPLOYEES. COMPLIANCE WITH THE LAWS OF THE STATE
CASH CHECK M.O. N.C.
RECEIVED BY SEWAGE SYSTEM
OF CALIFORNIA COVERING CONTRACTORS IS ALSO GUARANTEED.
IHEREBY CERTIFY THATTHEINDIVIDUALWHOPREPAREDTHE.PLANS AND SPECIFICATIONS HAS DONE
r T LL p
SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE
OF CALIFORNIA,
- INFORMATION
OWNER �i,,/ fJ
CONTRACTOR
ADORES S
� �
ADDRESS
,Iva` !7 tl'5' c
TEL. NO.
TEL. NO.
LICENSE NO.