188000 (CRES)FIELD OFFICE
PLUMBING FEES
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
FLOOR DRAIN
W ATER'Sl1F TFUFR
VENT SYSTEM ❑ FAN ❑
EVAP. COOL
DEPARTMENT OF BUILDING & SAFETY
0 COUNTY OF RIVERSIDE is
LOT SIZE
CONSTRUCTION ESTIMATE
ELECTRICAL FEES
1st FI.
2nd Fl.
Par.
Gar.
Car P.
Wall
WASHER (AUTO) (DISH)
Sq. Ft. @
F
NO.
Sq. Ft. @
FIXTURES
Sq. Ft. @
(/
Sq. Ft. @
POLES
Sq. Ft. y 4e
SIGNS
a
'r
Sq. Ft. @
TRANS. AND/
OR T. LK.
C
Sq. Ft. @
MOTOR H. P.
LAUNDRY TRAY 1
MOTOR H. P.
ESTIMATED VALUATION Is
MOTOR N.P.
SUB -PANEL
MECHANICAL FEES
MOTOR
FIELD OFFICE
PLUMBING FEES
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
FLOOR DRAIN
W ATER'Sl1F TFUFR
VENT SYSTEM ❑ FAN ❑
EVAP. COOL
❑ HOOD
LOT SIZE
MOTOR
H. P.
WASHER (AUTO) (DISH)
APPLIANCE
F
S
R
FIXTURES
(/
GARBAGE DISPOSAL 1
FURNACE UNIT❑ WALL❑
FLOOR❑
SUSPENDED
'DATE
OUTLETS
,, �4^'
LAUNDRY TRAY 1
AIR HANDLING UNIT
CHECKED BY
SUB -PANEL
DIST I T
F.C.
KITCHEN SINK
GAS PIPE ❑ NATURAL
❑ L.P.G. ❑
OIL
Q,
14 42
JUNIT1S
WATER CLOSET
COMPRESSOR
�HP
�-fftI5UP
RANGE AND/OR
OVEN
LAVATORY
APPLIANCE VENT
WATER NEATER
SHOWER _
ABSORPTION SYSTEM
E::�
B.T.U.
SPACE HEATER
} i
BATH TUB
INCINERATOR DOMESTIC
❑ INDUS.
❑ COMM.
SPEC. INSP.
CONSTRUCTION
POLE
WATER HEATER
HEATING SYSTEM ❑ FORCED ❑ GRAVITY
SERVICE ENTRANCE
ELECTRICAL FEE $
SEWAGE DISPOSAL
BOILER
O B.T.U.
RESID. 16 SQ.
FT.
BOND $
HOUSE SEWER
PERMIT FEE
PLA FIL
FINAL DATE
INSPECTOR
GARAGE yQ SQ.
FT.
GAS PIPING
/— 7-71
PERMIT FEES
TOTAL FEES
$
PERMIT FEE
P R T U REN. DBL. TOTAL FEES HEAT �&VENT �CK. E CONST. FEEJ F M A M A cJ FI n - - - - - -
ELEC. FEE PLUMB. FEE
r..
7,
SET BACK
LOT SIZE
USE 11
JOB ADDRESS OWNER
F
S
R
•••! t�lr 'tiJ
4 WE,
'
ZONE
USE OF BUILDING w
'DATE
PLAN CHECK FEE $
CHECKED BY
COMMUNITY
DIST I T
F.C.
OFFICE
MECHANICAL FEE $I
Q,
14 42
JUNIT1S
IVALUATION
�-fftI5UP
7PE
LEG L DE CRIPTION
PERMIT NUMBER
j
CONSTRUCTION FEE $
.-....,
} i
0 0
SPEC. INSP.
AIL0
A•" "'
SUPP. TO PERMIT
ELECTRICAL FEE $
A_ r _ 2 9^'
PLAN CHECKER
BOND $
BOND
CASH
PLA FIL
FINAL DATE
INSPECTOR
PLUMBING FEE $
/— 7-71
f&O�
TOTAL FEES
$
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED
WITHIN 60 DAYS. CESSATION OF WORK FOR 120 DAYS SHALL ALSO
CAUSE PERMIT TO BECOME VOID.
I HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS
CASH CHECK 1C.2 M.O. N.C.
RECEIVED BY
SEWAGE SYSTEM
PERMIT WILL BE DONE IN ACCORDANCE WITH THE LAWS OF RIVER-
SIDE COUNTY AND THE STATE OF CALIFORNIA. I ALSO AGREE TO
-2-4,,,-..0
T
LL
P
CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLI-
ANCE WITH LAWS OF THE STATE OF CALIFORNIA COVERING CON-
TRACTORS IS ALSO GUARANTEED.
NAME OF CONSTRUCTION
LENDER
OWNER
CONTRACTOR
BRANCH OFFICE
'
r'1
ADDRESS
ADDRESS ,. i�� -
ADDRESS
CITY
STATE
NO LENDER INVOLVED
INFORMATION
TEL. NO.
TEL. NO.
.,
LICENSE NO.
284-208 12/6B
s T�I�J \