166613 (SATT)DEPARTMENT OF BUILDING'& SAFETY
COUNTY OF,,RIVERSIDE'
ELECTRICAL FEES
1st FI.
2nd FI.
Por.
Gar. '
Car P.
Wall
'
Sq. Ft. @
nlo.
REN. JDBL.
Sq. F.t..@
TOTAL -FEES„
Sq. -.Ft. @
pLN, CK. FEE
Sq. Ft. @ ..' POLES
ELEC': FEE
Sq Ft @ SIGNS
J F M A, M J J A " S -
J F M A, M J J A S
SET BACK
Sq. Ft. @ OR ATSCLK'.D/
_'
- - MOTOR
'Sq., Ft. @
H. P.
MOTOR -
H. P.
ESTIMATED VALUATION is'Moron
OWNER
r
H. P.
MECHANICAL FEES
Moron '
H. P.
VENT SYSTEM ❑ FAN ❑ EVAP. COOL;.❑ HOOD
MOTOR
H. P.
APPLIANCE
FIXTURES
USE OF
y� t'
} FURNACE ❑'UNIT ❑.WALL ❑ FLOOR ❑ SUSPENDED
J
- OUTLETS
UA4$. SE W ER
Z AIR HANDLING UNIT
0
- 'SUB-PAMEL
F,C,
J GAS PIPE ❑ NATURAL .❑ L.P.G. ❑ OIL
Q
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OF F I.C�
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RANGE AND/OR OVEN
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Ir
W APPLIANCE VENT -
WATER HEATER
-
ABSORPTION SYSTEM O B.T.U.
O
--SPACE HEATER -
U INCINERATOR DOMESTIC '❑ INDUS. ❑ COMM.
CONSTRUCTION POLE
LE GA I. DE SCR IJPT I ON
Y
HEATING SYSTEM ❑ FORCED ❑ GRAVITY
SERVICE ENTRANCE
E
BOILER B.T.U.
RESID. IC SO. FT.
RESIDENTAL FEE SO-. FT.� @
GARAGE 1C SQ. FT.
666
PERMIT FEE _
PERMIT FEE
SPEC. INSP..
FIELD OFFICE
PLUMBING FEES
DRAINAGE PIPING
DRINKING FOUNTAIN
REN. JDBL.
URINAL
TOTAL -FEES„
WATER PIPING
pLN, CK. FEE
FLOOR DRAIN
ELEC': FEE
WATER SOFTENER
J F M A, M J J A " S -
J F M A, M J J A S
SET BACK
' WASHER (AUTO) (DISH)
GARBAGE DISPOSAL
LAUNDRY TRAY
USitE.1}9 y-
KITCHEN SINK,
OWNER
r
WATER CLOSET
S
LAVATORY
SHOWER -
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BATH TUB -
PLAN CHECK FEE
WATER HEATER
USE OF
y� t'
SEWAGE DISPOSAL
-'
UA4$. SE W ER
COMMIT
Its
GAS PIPING
F,C,
PERMIT FEE
✓LCD
>ERMIT NU w
(o` `o`�
TES
REN. JDBL.
TOTAL -FEES„
HEAT & VENT FEE
pLN, CK. FEE
ICONST, FEE
ELEC': FEE
JPLUMB:.,,�
J F M A, M J J A " S -
J F M A, M J J A S
SET BACK
'p N p
O N D
LOT SIZE
USitE.1}9 y-
JOB ADDRESS �
T
OWNER
r
S
R
Ci L�'�I L7' ;V °3
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t
PLAN CHECK FEE
ZONE
USE OF
y� t'
DATE _
-'
CHECKED BY
COMMIT
Its
DISIF I CT
F,C,
UNITS
VALUATION
OF F I.C�
MECHANICAL FEE
- t�
i"
-
'
.GROUP
TYPE -
LE GA I. DE SCR IJPT I ON
Y
PERMIT NUM
E
CONSTRUCTION FEE -
p ""
1
666
-
' ELECTRICAL FEE
SPEC. INSP..
SUPP. TO PERMIT
• �.�•+� �jp+'�;
PLAN CHECKER
BOND $
BOND I
CASH
PLAN FILE 11
FINAL DATE
INSPECTOR
PLUMBING FEE
TOTAL FEES.
THIS PERMIT SHALL BECOME VOID IF'WORK ISNOT 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
CASH CHECK M.O. N.C.
'ECE.IVED BY-
SEWAGE SYSTEM
PERMIT WILL BE DONE IN ACCORDANCE WITH THE LAWS OF-RIVER-
F RIVER-
�
SIDE COUNTY AND THE STATE OF CALIFORNIA. I ALSO AGREE TO
LL'.
LL`:. P t
CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLI-
ANCE WITH LAWS OF THE STATE OF CALIFORNIA COVERING CON-'
INFORMAnoN.
TRACTORS IS ALSO GUARANTEED. "
•
OWNER, -
CONTRACTOR
ADDRESS
AD DR E5j9 '
TEL. NO. i
VE L. NOY; y
"
�i
1
LIC'EN'SE NO.
-
84-208 11/87