166611 (SATT)DEPARTMENT OF BUILDING & SAFETY
COUNTY OF RIVERSIDE
FIELD OFFICE
PLUMBING FEES
NO.
DRAINAGE PIPING
DRINKING, FOUNTAIN
URINAL
WATER PIPING.
FLOOR DRAIN '
WATER SOFTENER
WAS.HER,(AUTO) DISH)
GARBAGE DISPOSAL
LAUNDRY TRAY
KITCHEN SINK
WATER CLOSET
LAVATORY
SHOW -ER
BATH TUB
WATER HEATER
SEWAGE DISPOSAL
HOUSE SEWER
tM
' GAS PIPING
PERMIT FEE '•S
E LEC. FEE • PLUMB. FEE'
O N 10
CONSTRUCTION ESTIMATE ELECTRICAL FEES
1st FI.
`2nd FI.
• Por:
Gar.
Car P.
., Wall
-
Sq. Ft. @ No.
Sq. Ft. @
Sq. Ft. @
Sq. Ft. @ POLES
Sq. Ft. @ slcNs
TR AN S:. AND/
Sq. Ft.@ OR T. CLK.
_Sq. Ft. @' MOTOR " H. P.
MOTOR H. P. '.
ESTIMATED VALUATION Is MOTOR H. P.
' MECHANICAL FEES MOTOR H. P.
I VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD MOTOR H. P.
APPLIANCE - .' _ FIXTURES-
;> FURNACE ❑ UNIT ❑ WALL ❑. FLOOR ❑ SUSPENDED OUTLETS
J
z AIR HANDLING UNITSUB•'PARE L
-0
J GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL -
'
iQ
U COMPRESSOR E=�HP RANGE AND/OR OVEN -,
EAPPLIANCE VENT
� W WATER HEATER
If
F2 ABSORPTION .SYSTEM B.T.U. SPACE HEATER
:O
U INCINERATOR DOMESTIC ❑ INDUS. ❑ COMM. - - CONSTRUCTION POLE
k HEATING SYSTEM ❑ FORCED ❑ GRAVITY SERVICE ENTRANCE
BOILER �.B T. U. RESID. IQ S0. FT.
RESIDENTAL FEE .. SQ.FT.E@ GARAGE zQ SO. FT.
PERMIT FEE PERMIT FEE
IERMIT NU
EA
(o`
w
(o`
CHECKED BY
1
F.C.UNITSVALUATION
REN.
DBL'.
TOTAL FEES
-1 6�i0
�(,Y
HEAT & VENT FEE
PLN. CK. FEE
CONST. FEE
M J I J A S
FIELD OFFICE
PLUMBING FEES
NO.
DRAINAGE PIPING
DRINKING, FOUNTAIN
URINAL
WATER PIPING.
FLOOR DRAIN '
WATER SOFTENER
WAS.HER,(AUTO) DISH)
GARBAGE DISPOSAL
LAUNDRY TRAY
KITCHEN SINK
WATER CLOSET
LAVATORY
SHOW -ER
BATH TUB
WATER HEATER
SEWAGE DISPOSAL
HOUSE SEWER
tM
' GAS PIPING
PERMIT FEE '•S
E LEC. FEE • PLUMB. FEE'
O N 10
SET BACK
.LOT SIZE
USE 4
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JOB ADDRESS �� 1
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1 OWN �� ,I. />
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Rj.t�..f
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'PLAN
ZONE -
-
USE -OF B I 'DIN' - 4'
DATE
CHECK FEE
,'�
V i' ate. A- - '. dwCJ M.+"
/Sf
•ME
CHECKED BY
COMMUY JOISTRICIf
J'
F.C.UNITSVALUATION
OFFICE
CH ANICAL;FEE
Of �aI �
77
GROUP
TYPE
LE'GA['DESC RYPTI ONPER
I
PERMIT NUME
R
R
CONSTRUCTION FEE
A' �.,•�
I1
6 NU
`
SPEC. INSP.
V -
SUPP. TO PERMIT
-ELECTRICAL FEE
-
PLAN CHECKER
BONG $S
OND
CASH
PLAN FILE 4
FINAL DATE
INSPECTOR
'PLUMBING FEE
I
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. '
IIIHEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS
CASH _CHECK M. o. N.c.
ECEIVED BY
b.•', SEWAGE SYSTEM
PERMIT WILL BE DONE IN ACCORDANCE WITH THE LAWS OF RIVER-
SIDE COUNTY AND THE STATE OF CALIFORNIA. I ALSO AGREE
TO
LL
G"
CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLI-
ANCE WITH LAWS OF THE STATE OF CALIFORNIA COVERING CON -
INFORMATION
TRACTORS IS ALSO GUARANTEED. '
-
,
OWNER -
CONTRACTOR-
e
(.; �
ADDRESS .,
ADORE
1}ISS
TEL. NO.
TEL. NOS ,.
'
LICENSE NO.
84-208 11/87 - -