171089 (MECH)DEPARTMENT OF BUILDING & SAFETY
ok COUNTY OF RIVERSIDE Amk FIELD OFFICE
cUNSTRUCTION ESTIMATE
1st FI. Sq. Ft. @
2nd FI. Sq. Ft. @
Por. Sq. Ft. @
Gar. Sq. Ft. @
Car P. Sq. Ft. @
Wall Sq. Ft. @
Sq. Ft. 0 -
ESTIMATED VALUATION $
MECHANICAL FEES
VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD
APPLIANCE
} FURNACE UNIT❑ WALL FLOOR SUSPENDED
J
Z AIR HANDLING UNIT
0
J GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
Q
UCOMPRESSOR HP
8
W APPLIANCE VENT
2 I�
2 ABSORPTION SYSTEM B.T.U.
0
U INCINERATOR DOMESTIC ❑ INDUS. ❑ COMM.
HEATING SYSTEM ❑ FORCED ❑ GRAVITY
BOILER :j 9.T. U.
RESIDENTAL FEE SO.FT.� 0
PERMIT FEE
HERMIT NUtABFNM w REN. IDBL. TOTAL FEES
IF IM IA I"
NO.
ELECTRICAL FEES
POLES
SET BACK
SIGNS
LOT SIZE --
TRANS. AND/
OR T. CLK.
JOB ADDRESS
lel
MOTOR
H.P-
MOTOR
H.P.
MOTOR
H. P.
MOTOR
H. P.
MOTOR
H. P.
FIXTURES
USE OF BUILDING DATE
OUTLETS
SUB - PARE L
RANGE AND/OR OVEN
WATER HEATER
SPACE HEATER
CONSTRUCTION POLE
SERVICE ENTRANCE
RESID. IC SO. FT.
GARAGE f2 SO. FT.
PERMIT FEE
f FEE PLN. CK. FEE CONST. 'FEE
J J A S
PLUMBING FEES
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
ELEC. FEE IPLUMB. F
SET BACK
LOT SIZE --
USE 11
JOB ADDRESS
lel
5
R
S S 3 // f
! Ip• FG ` I'1 / f /T c_
ZONE
USE OF BUILDING DATE
PLAN CHECK FEE '�'�""'""^`^
/4 q -4 co
,�
y
.tit < 7-
CHECKED BY
COMMUNITYIIIITRICTI,C*
UNITS
VALUATION OFyFII�C-E
MECHANICAL FEE
/ / T
-. CONSTRUCTION FEE-
GROUP TYPE
LEGAL DESCRIPTION
1P
1 IT NUMBEE�
8
SPEC. -INSP.
-
'
-
SUPP. TO PERMIT
ELECTRICAL FEE 4—oD
PLAN CHECKER
BOND $ BOND
CASH
PLAN 71CE #
FINAL DATE
INSPECTOR
PLUMBING FEE
>0-/0 +5
TOTAL FEES/
{�
/ I +�J
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED
WITHIN 60 DAYS. CESSATION OF WORK FOR 120 DAYS SHALL ALSO
CASH CHECK
M.O. I N.C.
CAUSE PERMIT TO BECOME VOID.
i HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS
:ECEIVED Y
SEWAGE SYSTEM
PERMIT WILL BE DONE IN ACCORDANCE WITH THE LAWS OF RIVER-
SIDE COUNTY AND THE STATE OF CALIFORNIA. 1 ALSO AGREE TO
T
LL
P
CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLI-
ANCE WITH LAWS OF THE STATE OF CALIFORNIA COVERING CON-
N�■A��y����
TRACTORS
TRACTORS IS ALSO GUARANTEED.
/{�ows�I�Np�F}J�O{/��R��MATIO
1m -"- lom TAX=:
OWNER ;fix
CONTRACTOR
ADDRIw I
ADDRESS
?,•vis
CITY.......»....__.,....�
1MQ i.Sim hlitmm
TEL. NO.
TEL. NO.
r- /4-1-1 4: r 4_0
,j
;84-208 11/87
LICENSE NO.