204542 (SFD)VENT SYSTEM p FAN ❑ EVAP. COOL ® HOOD SIGN WASHER (AUTOP(DISH) f j
APPLIANCE
1 FORMER D K.W. f GARBAGE DISPOSAL
DEPARTMENT OF BUILDING & SAFETY
FIELD OFFICE
CFM FD(TURE OR SOCKET KITCHEN SINK
GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
CONST. SERV. ENTRANCE WATER CLOSET v 0
•
COUNTY OF RIVERSIDE •
APPLIANCE VENT
AMPERES SERV. ENT. / SHOWER
CONSTRUCTION ESTIMATE
ELECTRICAL FEES `
PLUMBING FEES
1 ST FL.
7
SQ, FL,
PERMIT FEE
':l BALANCE OF MIN. FEE f GAS PIPING
NO.
NO.
2ND FL.
SQ. FT.
@
P,L. CK. FEE CONST.
FEE
oBL.
SQ. FT.
@
SPEC. INSP. FEE
MOTOR 1 OR LESS H.P.
DBL.
POR.
SQ,FT.
@
MOTOR 5 OR LESS H.P.
GAR.
CAR P.
SQ, FT.
@
MOTOR 20 OR LESS H.P.
DRAINAGE PIPING
WALL
SQ.FT.
@
LOT SIZE
USE #
DRINKING FOUNTAIN
SQ. FT.
@
URINAL
5
R
— 1' Arm
DK W. UNITS
, WATER PIPING 'ter
ESTIMATED VALUATION
$
j �'
PLAN CHECK FEEle2y
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM p FAN ❑ EVAP. COOL ® HOOD SIGN WASHER (AUTOP(DISH) f j
APPLIANCE
1 FORMER D K.W. f GARBAGE DISPOSAL
FURNACE ❑ UNIT ❑ WALL CIftLO6R ❑ SUSPENDED OUTLETS LAUNDRY TRAY
AIR HANDLING UNIT I
CFM FD(TURE OR SOCKET KITCHEN SINK
GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
CONST. SERV. ENTRANCE WATER CLOSET v 0
COMPRESSOR HP
POLE LAVATORY 33 1,10
APPLIANCE VENT
AMPERES SERV. ENT. / SHOWER
ABSORPTION SYSTEM O B.T.U. SQ. FT. @ Q BATH TUB -y
INCINERATOR ❑ DOMESTIC ❑ INDUS. OR COMM. SQ. FT. @ It f WATER HEATER
HEATING SYSTEM ®. FORCED ❑ GRAVITY
oil SQ. FT. RESID. @ 14 1 SEWAGE DISPOSAL o
BOILER B.T.U.
SQ. FT. GARAGE @1�2¢ HOUSE SEWER
PERMIT FEE
':l BALANCE OF MIN. FEE f GAS PIPING
TRAILER ISSUANCE FEE PERMIT FEE
PERMIT FEE OU PERMIT FEE
PER
FEES`S
EN. TRAILER FEE HEAT 8 VENT. FEE
P,L. CK. FEE CONST.
FEE
oBL.
E//LEC. FEE ,e
BL.
SPEC. INSP. FEE
PLUMBING FEE
DBL.
ITOTAL%
M A
J F M W A
M J J JAIS _ O
M J J A S 0
N D
N D
SET BALK
LOT SIZE
USE #
JOB ADDRESS .�*"� OWNER
. p
5
R
— 1' Arm
ZONE
USE OF BUILDTNG ATE
PLAN CHECK FEEle2y
CHECKED BY
COMMUNITY DISTRICT
F.C.
UNITS
VALUATION ,..... y_
OFFICE
MECHANICAL FEE
-�
f� 1
A
DBL
GR__ P TYPE
�
LEGAL DE I - N
pERIgJTMER�
CONSTRUCTION FEE
f
Q fj
�`
�i(Vjf{ 4!
DBL-
PLAN CHECKER
SUPP. TO PERMIT
ELECTRICAL FEE
S
,,�
L - � % » U /5—
5DBL
DBL
BOND $
,=AN
PLAN FILE p FINAL
DATE
INSPECTOR
$
`73
S �� �>�
PLUMBING FEE
dCL•U
NAME OF CONSTRUCTION LENDER}
�•'
BRANCH OFFICE
NO LENDER.
TRAILER PERMIT
ISSUANCE FEE
$
T�
INVOLVED
In •
ADDRESS
CLi
STATE
FEE
f
1 1>°,Kot�
,.
IF WRK IS NOCOMMNCED WITHIN 60 DAYS. CESSATION
TBE
TOTAL FEES
$ 7
OF WORKPFOR1120HDAYSBSHAALECOL ALSODCAU EOPERM T OMEE 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.
I HEREBY CERTIFY THATTHE INDIVIDUALWHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE
T
LL
P
SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE
OF CA F R IA
jFORMATION
A J
OWNER �
CONTRACTOR -
�a+•4
,
ADDRESS-
ADDRESS
'
TEL.
TEL. NO.
'
LICENSE -NO.,