186304 (BLCK)FIELD OFFICE
PLUMBING FEES
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
FLOOR DRAIN
VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD
MOTOR H. P.
DEPARTMENT OF BUILDING & SAFETY
COUNTY OF RIVERSIDE •
APPLIANCE
CONSTRUCTION ESTIMATE
ELECTRICAL FEES
1st FI.
2nd FI.
Por.
Gar.
Car P.
Wall
• A
Sq. Ft. @
AIR HANDLING UNIT
NO.
Sq. Ft. @
GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
Sq. Ft. @
WATER CLOSET
Sq. Ft. @
POLES
Sq. Ft. @
SIGNS
Sq. Ft. @
DRAT SC K.D/
Sq. Ft. @
t.
MOTOR H. P.
BATH TUB
MOTOR H. P.
ESTIMATED VALUATION $
WATER HEATER
•�� MOTOR H. P.
SERVICE ENTRANCE
MECHANICAL FEES
-T
FIELD OFFICE
PLUMBING FEES
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
FLOOR DRAIN
VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD
MOTOR H. P.
WASHER (AUTO) (DISH)
APPLIANCE
FIXTURES
GARBAGE DISPOSAL
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
OUTLETS
LAUNDRY TRAY
AIR HANDLING UNIT
SUB -PANEL
KITCHEN SINK
GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
WATER CLOSET
COMPRESSOR �HP
RANGE AND/OR OVEN -
LAVATORY
APPLIANCE VENT
WATER HEATER
SHOWER
ABSORPTION SYSTEM D B.T.U.
SPACE HEATER
BATH TUB
INCINERATOR DOMESTIC ❑ INDUS. ❑ COMM.
CONSTRUCTION POLE
WATER HEATER
HEATING SYSTEM ❑ FORCED ❑ GRAVITY
SERVICE ENTRANCE
SEWAGE DISPOSAL
BOILER B.T.U.
RESID. IT SQ. FT.
HOUSE SEWER
PERMIT FEE
GARAGE zQ SQ. FT.
GAS PIPING -
'
PERMIT FEE
PERMIT FEE
P1 R T U B y REN. DBL. TOTAL FEES HEAT & ;VENTFEEIPLN. CK. FEE CONST. FEE
IF I.n I n Ic
ELEC. FEE �PLUMB,
I r. I
SET BACK
LOT SIZE
USE 9
JOB ADDRESS OWNER i
F
S
R
} ..yL
ZONE
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USE -CF B LII IN ('� ti .
A T E
PLAN CHECK FEE $
i'fS
114 6 .,b 4 w Al
C ECKEO'BY
M M MIU Nq TY
ISIT R 1 T'
T.C.
VALUATION
OFFICE
MECHANICAL FEE $
JUNITS
^'g A..!2
1'PE
LEGAL E It 10 '
PERMIT NUMBER
CONSTRUCTION FEE $
:.^"
/�, 1 ., "" - _ -
86304 .
SPEC. INSP.
SUPP. TO PERMIT
ELECTRICAL FEE $zw
'
�.
PLAN CHECKER
OND $
BON
CASH
PLAN FI L`E #""
"INA DA T7E
INSPECTOR
PLUMBING FEE $
I
l.' 3�-/D
g- -
CL4 tet,,
TOTAL FEES
Ao
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 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
�6
r
LLP
CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLI—
ANCE WITH LAWS OF THE STATE OF CALIFORNIA COVERING CON—
r ,�-- -
TRACTORS IS ALSO GUARANTEED.
NAME OF CONSTRUCTION
LENDER
CONTRACTOR
BRANCH OFFICE
j
.....••^, �" t O T .a
,t r, s,.. ✓!
ADDRESS
ADDRESS
-
CITY
STATE
-
�-
w
NO LENDER INVOLVEDuf
- INFORMATION
TEL. NO.
`TELL. NO.
_
C E N S'Ll 7k '
284-208 12/68t 1(y;
101