200320 (SPIN)VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD
SIGN WASHER (AUTO) (DISH)
DEPARTMENT OF BUILDING & SAFETY
• COUNTY OF RIVERSIDE
FIELD OFFICE
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
CONSTRUCTION ESTIMATE
r ELECTRICAL FEES
PLUMBING FEES
1 ST FL.
2ND FL.
POR.
GAR.
CAR P.
WALL
CONST. SERV. ENTRANCE WATER CLOSET
SQ. FT. @
NO.
NO.
SQ. FT. @
ABSORPTION SYSTEM O B.T.U. SQ. FT. @ Q BATH TUB
SO. FT. @ MOTOR I OR LESS H.P.
SQ. FT. @ Q WATER HEATER
@ MOTOR 5 OR LESS H.P.
SOFT.
SQ. FT. RESID. @ j Q SEWAGE DISPOSAL
@ MOTOR 20 OR LESS H.P.
SQ. FT.
SQ.FT. @
DRAINAGE PIPING
DRINKING FOUNTAIN
SQ. FT. @
URINAL
IK W. UNITS
WATER PIPING
ESTIMATED VALUATION $
FLOOR DRAIN
FEES
MECHANICAL FEES
PL. CK. FEE CONST.
WATER SOFTENER
VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD
SIGN WASHER (AUTO) (DISH)
APPLIANCE
TRANS-
FORMER K y� GARBAGE DISPOSAL
O
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
OUTLETS LAUNDRY TRAY
AIR HANDLING UNIT CFM
FIXTURE OR SOCKET KITCHEN SINK
GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
CONST. SERV. ENTRANCE WATER CLOSET
COMPRESSOR 0 HP
POLE LAVATORY
APPLIANCE VENT
AMPERES SERV. ENT. SHOWER
ABSORPTION SYSTEM O B.T.U. SQ. FT. @ Q BATH TUB
INCINERATOR ❑ DOMESTIC Cl INDUS. OR COMM.
SQ. FT. @ Q WATER HEATER
HEATING SYSTEM ❑ FORCED ❑ GRAVITY
SQ. FT. RESID. @ j Q SEWAGE DISPOSAL
BOILER O B.T.U.
SQ. FT. GARAGE @1�2Q HOUSE SEWER
PERMIT FEE
BALANCE OF MIN. FEE GAS PIPING
TRAILER ISSUANCE FEE - PERMIT'FEE
PERMIT FEE PERMIT FEE
PER
FEES
REN. HEAT & VENT. FEE
PL. CK. FEE CONST.
FEE
'oBL.
ELEC. FEE
oBL. SPEC.
INSP. EE
PLUMBING FEE
DBL.
ITOTAL11��
ITRAILER'FEE
M A
J _F.. �. _ -..� A __.. _
IFI
MJ J _ J _ A 5 0
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BA
LOT SIZE
USE #
JOB ADDRESS OWNER
F
S R
,/y
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E iJ �l7G�0~
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'
lONE
USE OF BUILDING
DATE
PLAN CHECK -FEE
f
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J�_`�
CHEC ED BY
COMMUNITY -
F, C, UNITS
VALUATION pF/jF'IC+E'
MECHANICAL FEE
f
JDISTRICT
'7
/
DBL
GROOP
TYPE
LEGAL DESCRIPTION
ER IT ER
CONSTRUCTION FEE,
f
ep T J j
.2 , O
DBL
-PLAN
CHECKER
-
SUPP. TO PERMIT
ELECTRICAL FEE -
f
„ 76 !
'
DBL
R ND f
BOND
CASHPLAN
FILE p
FINAL DATE
INSPECTOR
f
PLUMBING FEE
P— –
Q•
NAME
OF CONSTRUCTION LENDER
BRANCH OFFICE
LENDER
TRAILER PERMIT
f
IND
INVOLVED
ISSUANCE FEE
a w /AZ,
ADDRESS _
CITY
STATE -
,5i*.,Cf
FEE
f
13'T�%
-
i�5l�
G
TOTAL FEES
$.. d
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 PERMIT WILL BE DONE IN ACCOR-
CASH ❑ CHECK M.O. N.C.
❑
DANCE WITH THE LAWS OF RIVERSIDE COUNTY AND T.H,E STATE OF CALIFORNIA. I ALSO AGREE TO
CARRY. COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLIANCE WITH THE LAWS•OF THE STATE
RECEIVED BY SEWAGE SYSTEM
OF CALIFORNIA COVERING CONTRACTORS IS ALSO GUARANTEED.
T LL p
I HEREBY CERTIFY THATTHE INDIVIDUALWHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE
SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE
OF CALIFORNIA.
INFORMATION
OWNE.8 _ '
CONTRACTOR
'
ADDRESS - �-
ADDRESS
'
TEL. NO. %
TEL. NO.
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LICENSE NO.
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