188616 (CPWU)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 9
is
APPLIANCE
CONSTRUCTION ESTIMATE
ELECTRICAL FEES
1st FI.
2nd FI.
Par.
Gar.
Car P..
Wall
.r
Sq. Ft. @i
"`
NO.
Sq. Ft.
GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
Sq. Ft. @
WATER CLOSET
Sq. Ft. @
POLES
Sq. Ft. @
SIGNS
Sq. Ft. @
0RAT SCLK.D/
Sq. Ft. @
MOTOR H. P.
BATH TUB
MOTOR H.P.
ESTIMATED VALUATION Is
WATER HEATER
MOTOR H. P.
SERVICE ENTRANCE
MECHANICAL FEES`
r e
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) i
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 �.J B.T.U.
RESID. iC SQ. FT.
HOUSE SEWER
PERMIT FEE -
GARAGE zQ SQ. FT.
GAS PIPING
PERMIT FEE
PERMIT FEE
P R 8TAU8 ^ REN. DBL. J]I� FEES MEAT & VENT FEE PLN. CK. FEE CONST. FEE EL
L6 '� -E,
..y„
J>.F_ M��-�.. A��...5.
I F
PLUMB. FEE
--I.N D _.-
SEAT
LOT SIZE
USE 0
JOB ADDRESS OWNER. '
J
.B.AACC+K�
ZONE
USE OF BUILDI G v DAT
PLAN CHECK FEE $
4L!
!'UNITS
CHECKED BY
COMMU TYr drDISTRI
VALUATION O C
MECHANICAL FEE $
�•
y
'�
GROUP 11
TYPE
LE AL r`E5CR1TION Y
- PERMIT NUMBER
CONSTRUCTION FEE $
.� 1 '
18 8 616
SPEC. INSP.
'" '`
SUPP. TO PERMIT
ELECTRICAL FEE $
PLAN CHECKER
BOND $
EVOND
-CASH' PLAN FILE tt
F D
INSPECTOR
PLUMBING FEE $
/ '�4
I
%-/�•7r
'
TOTAL FEESr
$
5
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMME ED
(/
WITHIN 60 DAYS. CESSATION OF WORK FOR 120 DAYS SHALL LSO
CAUSE PERMIT TO BECOME VOID.
I HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS '
C ASH. CHECK M.O. N. c.
RECEIVED A
SEWAGE SYSTEM
PERMIT WILL BE DONE IN ACCORDANCE WITH THE LAWS OF RIVER-
IT
SIDE COUNTY AND THE STATE OF CALIFORNIA. I ALSO AGREE TO
�..'
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 CO STRU CTION
LENDER
BRANCH OFFICE
OWNER f� 1 /
\
CONTRACTOR
ADDRESS
.tet
CITU
STATE
ADDRESS j
F �'���i�`%
ADDRESS
NO LENDER INVOLVED
INFORMATION
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fy•" "
(1......%�-./....mss .J•'C...�'��
TEL. NO.
TEL. NO,
284-208 12/88
LICENSE NO.