162318 (CRES)pr N DEPARTMENT OF BUILDING & SAFETY
COUNTY OF RIVERSIDE AmIlk FIELD OFFICE
CONSTRUCTION ESTIMATE
ELECTRICAL
FEES
PLUMBING FEES
1st FI.
2nd FI.
1
Por.
I Gar.
Car P.
1 WCII
Ij
If
Sq. Ft. @
NO.
MEAT $ VENT FEE
NO.
Sq. Ft. @
ELEC. FEE
Sq. Ft. @
[PERMIT2
I&S
Sq. Ft. @ POLES
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Sq. Ft. @ «/� SIGNS
q.
IPING
DRAINAGE PIPINGS
TRANAND/
@OR T.C
S Ft. S- LK.
DRINKING FOUNTAIN
Sq. Ft. @ MOTOR H. P.
URINAL
MOTOR H. P.
WATER PIPING
ESTIMATED VALUATION$
6 MOTOR
H.P.
FLOOR DRAIN
MECHANICAL FEES
MOTOR
H. P.
WATER SOFTENER
I(.
VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD
MOTOR
H. P.,
WASHER (AUTO) DISH)
�t APPLIANCE
FIXTURES
R
GARBAGE DISPOSAL
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
�1
OUTLETS
,�10
LAUNDRY TRAY
.J
Z AIR HANDLING UNIT
O
SUB-PAMEL
D I' i
KITCHEN SINK
J GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
ttt
,D
WATER CLOSET
Q
I V COMPRESSOR D HP
RANGE AND/OR OVEN
T ICT
LAVATORY
E APPLIANCE VENT
WATER HEATER
OF
SHOWER
EABSORPTION SYSTEM B.T.U.
SPACE HEATER
BATH TUB
O
INCINERATOR DOMESTIC ❑ INDUS. ❑ COMM.
CONSTRUCTION POLE
WATER HEATER
HEATING SYSTEM ❑ FORCED ❑ GRAVITY
SERVICE ENTRANCE
LEGAJ/L DESCRIPTION
SEWAGE DISPOSAL
- BOILER D B.T.U.
RESiD. 10 SO. FT.
t
HOUSE SEWER
I RESIDENTAL FEE SO.FT.1
GARAGE z SO. FT.
162318
GAS PIPING
F PERMIT FEE
PERMIT FEE
PERMIT FEE
/�
FEES
MEAT $ VENT FEE
PLN. CK, FEE
ELEC. FEE
PLUMB. FEE
[PERMIT2
I&S
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LOT SIZE
USE #
JOB ADDRESS
OWNER
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R
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U E BI LD IN -
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f PLAN CHECK FEE
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CNECKED Y
OM U ITY "
T ICT
F -C.
UNITS
J
VALU ION U
OF
MECHANICAL FEE777
GROUP
TYPE
LEGAJ/L DESCRIPTION
PERMIT NUMBER
t
I
�V
162318
CONSTRUCTION FEE o
i.
'^ t `'
SPEC. INSP.
I'l y 141E
SUPP. TO PERMIT
ELECTRICAL FEE
. .,� /
PLAN CHECKER
BOND $
BOND
CASH
PLAN FILE #
FINAL DATE
INSPECTOR ,
PLUMBING FEE
I
`I '�1-�-�
ff11
P{Z L.VV1�.
TOTAL FEESi,,
$
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
ICASH CHECK M.O. N.C.
(RECEIVED BY
- SEWAGE SYSTEM
I'
PERMIT WILL BE DONE IN ACCORDANCE WITH THE LAWS OF RIVER-
SIDE COUNTY AND THE STATE OF CALIFORNIA. I ALSO AGREE TO
r
LL
P
CARRY COMFEN AT10N INSURANCE UPON MY EMPLOYEES. COMPLI-
ANCE WITF LAW OF THE STATE OF CALIFORNIA COVERING CON—
INFORMATION
INFORMATION
IS O G RA TEED.
OWNER
CONTRACTOR
V
ADDRESS
ADDRESS
f
•
�ryi'
d!04 1
TEL. NO.
TEL. NO.
- u
'284.208 11/87
.� -•
I�
LICENSE NO.