162255 (SATT)DEPARTMENT OF BUILDING & SAFETY
` • FIELD OFFICE
COUNTY OF�RIVERSIDE. -
CONSTRUCTION ESTIMATE
SET BACKLOT
ELECTRICAL FEES
PLUMBING FEES
let Fl. fo
2nd FI. wISq.
,Par.
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Car P. Y
Wall -
Sq. Ft. @ �" No. tl:
JOB ADDRESS OWNER
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No.
Ft. @
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Sq. Ft. @ �
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�A
Sq. Ft. @ -'7. '.-" POLES
SE OF B ILDING -
Sq, Ft, @ SIGNS
DRAINAGE PIPING
Sq. Ft. @, OR AT.''`CLK.D/.
DRINKING FOUNTAIN
.Sq. Ft. @ MOTOR H.P.
URINAL
J MOTOR H. P.
'
WATER PIPING•
ESTIMATED VALUATION $
-X--
~. MOTOR H. P.
FLOOR DRAIN
MECHANICALFEES
CO UNjopow
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MOTOR H. P.
WATER SOFTENER
VENT SYSTEM M+FAN ❑ EVAP, COOL :Q"HOOD-MOTOR
OFF'I'CE
-H. P.
WASHER (AUTO)DISH)
APPLIANCE
.FIXTURES
J
GARBAGE DISPOSAL .
} FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
J
OUTLETS
GRO P
LAUNDRY TRAY
Z AIR HANDLING UNIT
0
SUB-PAMEL" - i
CONSTRUCTION FEE+
K ITCHEN SINK
J GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL. -
Q
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-
WATER CLOSET
U COMPRESSOR MP -
RANGE AND/OR OVEN'
+'
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LAVATORY
W.APPLIANCE VENT
:'WATER HEATER
LC
1 .SHOWER `
�.. ABSORPTION SYSTEM D B.T.U..
O
TSPACE HEATER.
$
BATH TUB
U'" INCINERATOR DOMESTIC, ❑ INDUS. ❑ COMM.
PLAN FILE
CO NSTRUCTION' POLE'
INSPECTOR
C��..C...I�••l..Q y
WATER HEATER
HEATING SYSTEM QrFORCED ❑3IGRAVITY
'SERVICE ENTRANCE
:�/
SEWAGE DISPOSAL
BOILER B.T.U.
RESID 12 SQ. FT.. .•
'�`_..
HOUSE SEWER
RESIDENTAL FEE SQ.FT.�@
GARAGE iQ SQ. FT.
-GAS PIPING
PERMIT FEE
THIS PERMIT SHALL BECOME VOID IF -WORK IS NOT'COMMENCED-
' WITHIN 60 DAYS. CESSATION OF WORK FOR 120 DAYS SHALL ALSO
CAUSE PERMIT TOBECOME 'VOID. _
I HEREBY -AGREE THAT ALL WORK IN CONNECTION,WITH THIS
PERMIT FEE
'EC EIVEDB
PERMIT FEE'
HERMIT NU
ES 5 5
22
REN.
DBL'.
JT�TAL FEES'
„
�.
HEAT & VENT E
�'
pLN. CK. FEE i.
CONST.FEE
ELEC.,
19.
FEE
PLUMB.- FEE
sem'
J F M A - M' J
J A -.
.S
O N D
SET BACKLOT
SIZE
U�S�IFE #
f
Y
JOB ADDRESS OWNER
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S
R_
-
-
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ZONE
SE OF B ILDING -
ze
1 E
- .�
PLAN -CHECK FEE19
04A*,
.4110 Lv qe
CHEC ED BY
CO UNjopow
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UNITS -
VALUATION
OFF'I'CE
MECHANICAL FEE'
"' e
J
GRO P
YY PE
LEGAL DESCRIPTION -
PERMIT NUB'
CONSTRUCTION FEE+
(
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16225
• .+
SPEC- IN5P.
+'
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SUPP. TO PERMIT
ELECTRICAL FEE
LC
• -
•,
PLAN CHECKER ,BOND
$
BOND
ASN
PLAN FILE
(FINAL DATE
^.. a.��
INSPECTOR
C��..C...I�••l..Q y
PLUMBING- FEE"
�'-
( l
TOTAL FEES
$
['d•
I
tsP'�
THIS PERMIT SHALL BECOME VOID IF -WORK IS NOT'COMMENCED-
' WITHIN 60 DAYS. CESSATION OF WORK FOR 120 DAYS SHALL ALSO
CAUSE PERMIT TOBECOME 'VOID. _
I HEREBY -AGREE THAT ALL WORK IN CONNECTION,WITH THIS
CASH - CHECK `E!" ", M.o.' -- N.C.
'EC EIVEDB
SEWAGE
SYSTEM
--
PERMIT WILL BE DONE IN ACCORDANCE WITH THE LAWS OF RIVER-
AY
SIDE COUNTY AND THE STATE OF.CGALIFORNIA. I ALSO AGREE TO
/�
T %
LL*
CARRY COMPENSATION INSURANCE`UPON MY EMPLOYEES. COMPLI-
ANCE WITH LAWS OF THE ST TE OF •CALI'FORNIA COVERING CON-'
" ; {
LN FOR MATION
TRACTORS IS PrCtp G, RNT E f
OWNER
CONTRACT
•
6
i•
•• _
ADDRESS
ADDR -
IVA
j
-
TEL. ND.-
TEL. -NO.
.LICENSE NO.
84-208 11/87
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