201774 (ELEC)41 EPARTMENT OF BUILDING & SAFETY
COUNTY OF RIVERSIDE •
FIELD OFFICE
CONSTRUCTION ESTIMATE ELECTRICAL FEES PLUMBING FEES
I ST FL SQ FT NO. NO.
2ND FL.
POR.
GAR.
CAR P.
WALL
SQ. FT. @
TO AL�,F,E/ESS
,REN. TRAILER FEE HEAT & VENT. FEE
SQ. FT. @ MOTOR I OR LESS H.P.
FEE
@ MOTOR 5 OR LESS H.P.
SQ.FT.
oBL.
@ MOTOR 20 OR LESS H.P.
SQ. FT.
SQ.FT. @
DRAINAGE PIPING
DRINKING FOUNTAIN
SQ. FT. @
URINAL
K.W. UNITS
WATER PIPING
ESTIMATED VALUATION $
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM O FAN ❑ EVAP. COOL O HOOD
.SIGN
WASHER (AUTO) (DISH)
APPLIANCE
TRANS-
FORMER K.W.
O
GARBAGE DISPOSAL
_ 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
Am. POLE
LAVATORY
APPLIANCE VENT
AMPERES SERV. ENT. '
SHOWER
ABSORPTION SYSTEM O B.T.U.
SQ. FT. @ ¢
BATH TUB
INCINERATOR O DOMESTIC O INDUS. OR COMM.
SO. FT. @ Q
WATER HEATER
HEATING SYSTEM ❑ FORCED ❑ GRAVITY
SQ. FT. RESID. @ 14
SEWAGE DISPOSAL
BOILER 0 B.T.U.
SQ. FT. GARAGE @11/2¢
HOUSE SEWER
PERMIT FEE
BALANCE OF MIN. FEE
GAS PIPING
TRAILER ISSUANCE FEE PERMIT FEE
PERMIT FEE
PERMIT FEE
PER
TO AL�,F,E/ESS
,REN. TRAILER FEE HEAT & VENT. FEE
PL. CK. FEE CONST.
FEE
DBL. ELECFEE
oBL.
SPEC. INSP: FEE
PLUMBING FEE
DBL.
01
7
f
M -' A - AI. J-m..-^�� J A.�� S 0
N D
SET
LOT SIZE
USE #
JOB ADDRESS j/p `
Q
S
R,
+✓ i!r1 YJ(}'w7 j
T �/ -"�j
ZONE
USE OF BUILDING
DATE
PLAN CHECK FEE
$
W -.;)-
CHECVP BY
COMMUNITY
S
F.C.
UNITS
VALUATION OFFICE
MECHANICAL FEE
IDISTRT
DBL
-OUP
7
LEGAL- DESCRIPTION
CONSTRUCTION FEE'.
f+� O S� f " �'j (► .e �•
GRJIT77R
4
DBL
PLAN CHECKER
SUPP. TO PERMIT
ELECTRICAL FEE
!; OBLBOND
t
i
§
BOND
CASH
PLAN FILE # FINAL
DATE
INSPECT R
/ 4
PLUMBING FEE
TRAILER PERMIT -
$
NAME OF, CONSTRUCTION LENDER
BRANCH OFFICE
NOL R
ENDENDS
NYL iVEO
ISSUANCE FEE
CITY
STATE -
FEE
$
JADDRESS
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 PERMIT WILL BE DONE IN ACCOR-
CASH ❑ CHECK M.O. N.C.
❑
DANCE WITH THE LAWS OF RIVERSIDE COUNTY AND THE 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.
.Azo," T LL P
IHEREBY CERTIFY THATTHEINDIVIDUAL\NHOPREPAREDTIVy PLANS -AND S ECIFICATIONS,H DONE
Cn IAI Al•r• A wlrC % i� CC T-11 c uC of �c�w�Ce�h A win CC .�r .lvm-f nK_ F GTATF
INYUNMAIIUN
FORM 284-208 (REV.1-70) @s
_ _
OF CALIFORNIA.^i 1 - t -
OWNER .. CO A TO
ADDRESS ADDRESS
all 2
TEL -.80 a ��'' ;• si