193346 (RER): DEPARTMENT OF BLIIIDING & SAFETY•
- . COUNTY OF RIVERSIDE
FIELD OFFICE
CONSTRUCTION ESTIMATE
ELECTRICAL FEES
PLUMBING FEES '
1 ST FL.
2ND FL.
POR.
GAR.:�
CAR P. ... -� r. -
WALL, '
?, -. o 6' A
SQ. FT @ g
NO. NO.
SQ. F1. @ :
F
MOTOR COR LESS-H.P.
SQ. FT. :
MOTOR 5 OR LESS H.P.
SQ.FT.
MOTOR 20 OR_LESS H.P. z 'DRAINAGE PIPING
SQ. FT. ,@ ,. . ' _ - .,.
SQ.FT:@ •. r DRINKING FOUNTAIN
SQ. FT. @ «" ¢ URINAL '
" ; OK W. UNITS WATER PIPING
ESTIMATED VALUATION $,
pADDRESSER
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FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER -
VENT SYSTEM ❑ FAN ❑ EVAP.'000L ❑ HOOD
-SIGN �, •
WASHER (AUTO) (DISH)
APPLIANCE
TRANS -FORMER -K.W. +
GARBAGE DISPOSAL
FURNACE ❑ UNIT ❑ WALL Cl FLOOR ❑ SUSPENDED
OUTLETS
LAUNDRY•TRAY
AIR HANDLING UNIT CFM
FIXTURE OR SOCKET,
KITCHEN SINK
GAS PIPE ❑ NATURAL ❑ L.P.O. ❑ OIL
CONST. SERV. ENTRANCE'
WATER CLOSET -
COMPRESSOR' 0 HP
POLE
LAVATORY" '
APPLIANCE VENT
: AMPERES SERV. ENT.
SHOWER
ABSORPTION SYSTEM. 0 B.T.U.
SQ. FT. @ ¢
BATH TUB
INCINERATOR ❑ DOMESTIC' . ❑ INDUS. OR COMM_
SQ. FT. @ '. ¢
WATER HEATER
HEATING SYSTEM ❑ FORCED ❑ GRAVITY-
SQ:' FT. RESID. @ I ¢
SEWAGE DISPOSAL
BOILER 3 -B.T.U.
SQ. FT. GARAGE@12¢
HOUSE SEWER
PERMIT FEE'
BALANCE OF MIN. FEE
GAS PIPING
TRAILER ISSUANCE FEE : PERMIT. FEE
PERMIT FEE ,
PERMIT FEE
.:PER.
3,3
TOTAL FEES
M
REN..' TR ILER FEE HEAT '&
PL. CK. FEE`.
CONST. FEE
'DBL.
ELEC. FEE
DBL.
SPEC. INSP: FEE
PLUMBING FEE
DBL.'
;
M- A- M
-IJ A� S O
N 0
RAS�•'�'�
'
LOT.SIZE ..
USE # -
JOB ,.s /�
i sH:v P7�l�JL. Vtf/.
F
,SIT
pADDRESSER
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_
ZONE
SE OF BUILDING "ATE '
PLAN CHECK FEE .
$.
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CHECKED BY
COMMUNITY
DISTRICT -
F.C.
UNITS
'VALUATION -
OFFICE „
MECHANICAL FEE
$
4 I" '
'
DBL$
GR P.
TYPE'
LEGAL DES ION' -
E IT
UM Ej
CONSTRUCTION' FEE
DBL
a
PLAN CHECKER.
- -
SUPP. TO PERMIT '
ELECTRICAL.FEE
DBL
-
BOND $- .
BOND
-CASH
PLANFILE•# -
FINAL DATE -
INSPECTOR -
PLUMBING FEE.
-
NAME OFCON STRUCTION LENDER - - -
BRANCH OFFICE - - -ND
LENDER
TRAILER PERMIT
$
_
INVOLVED
ISSUANCE FEE
'
ADDRESS y - -
CITY_ ,• - 'STATE
FEE
$
I
TOTAL FEES
$
THIS PERMIT -SHALL BECOME VOID IF WORK 1S NOT COMMENCED WITHIN 60 DAYS. CESSATION
OF WORK FOR 120'DAYS SHALL ALSO. CAUSE PERMIT TO BECOME VOID.
I' HEREBY'AGr:EE-THAT- ALL WORK IN `CONNECTION WITH THIS PERMIT WILL BE .DONE IN ACCOR-
DANCE WITH THE:LA'WS OF RIVERSIDE- COUN AND. T.H;E STATE OF CALIFORNIA. I ALSO AGREE.TO .J`
CARRY. COMPENSATION INSURANCE UPON MY EMPLOYEES: COMPLIANCE WITH THE LAWS OF,THE STATE
CASH Q . CHECK [ M.O. N.C. 0
RECEIVED BY SEWAGE SYSTEM .
OF CALIFORNIA COVERING CONTRACTORS IS ALSO GUARANTEED.
✓ ,�I T LL P
''`"��.'7
I HEREBY CERTIFY THATTHETNDIVIDUALWHOPREPAREDTHE PLANS AND. SPECIFICATIONS HAS DONE
50 IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS' AND PROFESSIONS • CODE OF THE STATE "
INFORMATION
OF CALIFORNIA'
OWNER - _
CONTRACTOR-
.. .. `•'
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ADDRESS -
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ADDRESS
J?fJ� �/i/LI '�'�I! �! ✓�' Vii e� :-
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TEL. NO.
TEL.
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LICENSE NO
FORM 284-208 (REV• 1-70) OS y