189991 (MECH)NO.
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
. . 0
0
APPLIANCE
CONSTRUCTION ESTIMATE
ELECTRICAL FEES
1st FI.
2nd FI.
Par.
Gar.
Car P.
Wall
OUTLETS
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. @
TRANS. AND/
OR T. CLK.
Sq. Ft. @
l:
MOTOR H. P.
BATH TUB ,
MOTOR H. P.
ESTIMATED VALUATION is
WATER HEATER
MOTOR H. P.
SERVICE ENTRANCE
MECHANICAL FEES
e
NO.
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 I
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
OUTLETS
LAUNDRY TRAY
AIR HANDLING UNIT
SUB -PANEL
KITCHEN SINK I
GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
WATER CLOSET
COMPRESSOR w HP V
RANGE AND/OR OVEN
LAVATORY
APPLIANCE VENT
WATER HEATER
SHOWER
ABSORPTION SYSTEM 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.
RE5ID. 1Q SQ. FT.
HOUSE SEWER
PERMIT FEE ?
GARAGE pQ SQ. FT.
GAS PIPING
Y
PERMIT FEE
PERMIT FEE
AIT NUMBER REN. DBL. TOTAL
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JOB ADDRESS
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USE OF BUILDING DATE
PIAN CHECK FEE $
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/UNITS
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CHECKED BY
OMMUNITY
ISTRICT
F.C.
VALUAYION• OFFICE I
MECHANICAL FEE $
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PERMIT NUMBER
CONSTRUCTION FEE $
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SPEC. INSP.
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SVPP. TO PERMIT
ELECTRICAL FEE $
PLAN CHECKER
BOND $
BOND
CASH
PLAN FILE #
I D T
INSPECTOR
PLUMBING FEE $
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FEES
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LEOTOTAL
ERMIT
WITHIN 60IS CL
DAYS. SCESSAT CEHALL SSATION WORK ME VOID I FOR WORKIS
DAYS SHALL ALSO 9
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
T
LL
P
CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLI-
ANCE WITH LAWS OF THE STATE OF CALIFORNIA COVERING CON -
NAME OF COk�NSTRUCTION
LENDER
TRACTORS IS ALSO GUARANTEED. i
OWNER _
CONTRACTOR
BRANCH OFFICE
P``"//�%,o�
ADDRESS
//://.-'(.,!•I _.�,'•
ADDRESS
ADDRESS/ ^' I
CITY
STATE
NO LENDER INVOLVED
INFORMATION
r
TEL. NO.
TEL.
-/ 3
/NO.
LICENSE NO. ¢
284-208 12/8 .
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