166689 (SATT)DEPARTMENT OF BUILDING & SAFETY FIELD OFFICE
COUNTY OF RIVERSIDE
CONSTRUCTION ESTIMATE ELECTRICAL FEES PLUMBING FEES
'1st FL Sq. Fr. @ - No. NO.
2nd FI.
Por.
Gar.
Car R.
Wa:II
• -
Sq., Ft. @
JOB ADDRESS - OWNER
S R1.
Sq. Ft. @
JJyy'�
Sq'. Ft. @; r .' D POLES'"
NE _ -
:.-
Sq. Ft. /� SIGNS JRA INAGE PIPING
1:
PLAN CHECK FEE
., TRANS. AND/
Sq. Ft. @ OR T.-CLK. DRINKING FOUNTAIN
MOTOR --H. P. - URINAL
Sq: ft. @
CHECKED BY
°
-MOTOR`N.P. WATER PIPING
DI 9-PITI &r
ESTIMATED VALUATION.$'
"
borOR
H:P:
FLOOR DRAIN
}1y
' ,MECHANICAL FEES
MOTOR
H.P.
WATER SOFTENER -
kir& P TYPE.
VENT SYSTEbPJZFAN ❑'EVAP.-COOL HOOD
1PERMIT
'MOTOR- _
H.P.
WASHER (AUTO' `DISH1
�S
APPLIANCE
.'FIXTURES
SPEC., INS P.
GARBAGE DISP05AL
y
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR SUSPENDED
OUTLETS
r
LAUNDRY.TRAY
AIR HANDLING UNIT -' •
•':
SUB-PAMEL �'�
.PLAN CHECKER_
KITCHEN SINK
BOND
GAS PIPE .0 NATURAL ❑ L.P.G. ❑ OIL
PLAN FILE # -
•.
INSPECTOR
WATER CLOSET
Alf_
COMPRESSOR.. HP
RANGE AND/OR OVEN
4> LAVATORY
APPLIANCE VENT -
d'
WATER HEATER .
SHOWER -
ABSORPTION SYSTEM. �-B.T.U.-,
SPACE HEATER
BATH TUB -
THIS '
INCINERATOR DOMESTIC ", ❑ INDUS. ❑ COMM. -.
CONSTRUCTION POLE
PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED'
WITHIN 60 DAYS. CESSATION, OF WORK -FOR 120 DAYS SHALL ALSO
WATER HEATER
M?O.
HEATING SYSTEM ❑ FOR CL ED ❑•GRAVITY '' -
CAUSE'PERMIT TO BECOME VOID..
I-HE'R.EBY AGREE THAT ALL WORK IN CONNECTION WITH THIS
SERVICE HN TRANCE
. SEWAGE SYSTEM'
SEWAGE DISPOSAL
...
BOILER. • B.T.U.
_ ;-
RESID. IC SO. FT.
'HOUSE SEWER
'Ta
REFI NTA' Fc - SO:FT.�@
,"G'ARAGE. iC. SO.FT:.-
•.'GAS
PIPING
PERMIT 'FEE V, `
`PERMIT•',FEE'
CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLI-
ANCE WITH LAWS OF THE STATE OF CALIFOR COVERING'.-CON-
OVERING' CON-
PERMIT FEE -
p�r
IERMIT NUREN.
E
S6
89
�.BL.'
jT0.fAL FEES.
HEAT
& VENT FEE
N
PL: CK. FEE.
CONST. EE
'F
EIEC, FEE
PLUMB, FEE
• J F - M M
F
•• _ J
- J - A. �'.
S -
O N.
SET BACK. - LOT SIZE -
USE #
JOB ADDRESS - OWNER
S R1.
JJyy'�
NE _ -
U E F B
PLAN CHECK FEE
Y
CHECKED BY
C ' T
DI 9-PITI &r
F.C.' o UNITS
VALUATION
OF 69C a
MECHANICAL FEE-. "'"
`r�,,,,
}1y
kir& P TYPE.
LE GA LlDES Llfi I ;t ION
1PERMIT
NUMBER
6 6 689
CONSTRUCTION FEE
-
/'� "^'S '�'"^1
- -
SPEC., INS P.
SUPP. 'TO PERMIT
ELECTRICAL FEE
.PLAN CHECKER_
BOND $
BOND
CASH
PLAN FILE # -
FIN ALDATE -
INSPECTOR
PLUMBING FEE - •
9
d'
It
TOTAL
TOTAL FEES.�,%""
THIS '
PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED'
WITHIN 60 DAYS. CESSATION, OF WORK -FOR 120 DAYS SHALL ALSO
CASH CHECK
M?O.
N.C.
CAUSE'PERMIT TO BECOME VOID..
I-HE'R.EBY AGREE THAT ALL WORK IN CONNECTION WITH THIS
ECEIVED BY
. SEWAGE SYSTEM'
PERMIT WILL. -BE DONE IN ACCORDANCE WITH THE LAWS OF RIVER-
'Ta
SIDE COUNTY AND THE STATE OF.CALIFORNIA. I ALSO AGREE TO
fy
LL
P�"�:
CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLI-
ANCE WITH LAWS OF THE STATE OF CALIFOR COVERING'.-CON-
OVERING' CON-
f INF�pOyRMyATION
p�r
TRACTORS
TRACTORS IS ALSO GUARANTEED.
gg
Wu ON lvg,
2
OWNER
A OR
t>t( i �+�, yye
Ik,
wd-OR_ SS , -
ADD ES
go 1101 PEP. 'INVOLVR
84-208 11/67
LICENSE NO
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