159079 (BLCK)=n -DEPARTMENT OF BUILDING & SAFETY
y , ;COUNTY. OF RIVERSIDE
� FIELD OFFICE
CONSTRUCTION ESTIMATE
ELECTRICAL FEES
PLUMBINGFE
E: 1st FI.
2nd. FI.
Por.
Gar. -
I, COf P. .
I WOII
!. (
Sq. Ft..@
Y NO.
NO.
Sq. Ft. @ a
PLUMB. FEE•
Sq,. Ft. @
000
POLES ..
Sq. Ft. @.
-
M _
Sq, Ft, CQ SIGNS
r ORAINAGE PIPING
• TRANS. AND/
Sq. Ft. ,@ OR T. CLK.
' DRINKING FOUNTAIN
MOTOR H.P.
Sq. Ft. @
F URINAL ..
MOTOR .. H. P.
'WATER PIPING
ESTIMATED VALUATION $ 91
- !A oTOR H. P:
FLOOR DRAIN
MECHANICAL FEES
MOTOR• H.P.
WATER SOFTENER
VENT SYSTEM ❑FAN ❑ EVAP. COOL ❑ H000
is
- - MOTOR '• H -P.
WASHER (AUTO) DISH)
APPLIANCE - - .
.FIXTURES
GARBAGE DISPOSAL
} FURNACE ❑ UNIT ❑WALL ❑ FLOOR ❑ SUSPENDED
dJ
OUTLETS '- ' �"
LAUNDRY TRAY
P Z AIR HANDLING UNIT '" -
0
SUB -PANEL
.KITCHEN SINKy
.J -GAS PIPE ❑NATURAL ❑L.P.G. ❑OIL`WATER
x
CLOSET
V COMPRESSOR �HP _
RANGE .AND/OR 'OVEN ?
LAVATORY'
WAPPLIANCE VENT
f
WATER HEATER
SHOWER
f ABSORPTION SYSTEM O B.T.U.
SPACE HEATER
BATH TUB
OINCINERATOR'DOMESTIC ❑ INDUS. -❑ COMM.
- CONSTRUCTION POLE
s• WATER HEATER
HEATING SYSTEM ❑ FORCED ❑ GRAVITY-.
SERVICE ENTRANCE
SEWAGE DISPOSAL
BOILER B.T.U.
f
RESID. IQ SO: FT.
HOUSE SEWER
�
RESIDENTAL FEE 50. FT.�@
GARAGE iQ SO. FT.
GAS PIPING
PERMIT FEE
- PERM.IT'FEE
PERMIT FEE .,
ERMIT. NV
BI
DBL'.
T EES
HEAT & VENT FEE
PLN. CK.•FEE
CO
ELEC. FEE
PLUMB. FEE•
I
000
79REN.:
J F - M A M_J' J A S
J F M A M J. J _ A S
O N _ D
O- N D
F-
SET BACK
LOT SIZE`
USE #
� - � �` ^ E ®
JOB ADDRESS •
`. f(r
]OWNER
S
A
ZONE
USE OF BUILDING -
DATE
1'PLAN CHECK FEE
BY
CO MUNITY
.C':,
UNITS
VALUATION
OFFICE -
-
jDISTRIt!T
MECHANICAL FEE
,���„�,,,,�•a
jP
{ 1IJ
I -
-GROUP
Tyet
LEGAL DESCRIPTION _ Ts -
:CONSTRUCTION FEE .�
tl
i
1PERMIT
159 6TR
9
'
I�ELECTRICAL FEE
- SPEC. 'INSP.
,1:
.'
SV PP. TO PERMIT
...
..
PLAN CHECKER•„.
BOND $
BOND
CASH
PLAN FILE #
FINAL DATE
INSPECTOR
I�PLUMBING FEE
CC •/��,Q
i
TOTAL FEES
y
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED-
e
DAYS. CESSATION OF WORK FOR 120 DAYS SHALL ALSO
CAUSE PERMIT TO BECOME VOID.
I HEREBY AGREE --THAT ALL WORK IN .CO.NNECTION WITH THIS
CASHWITHIN.60
1 CHECK M.O. N.C.
I.ECEIVED BY
SEWAGE SYSTEM _
PERMIT WILL BE -DONE IN ACCORDANCE WITH THE LAWS OF RIVER-
t'�
SIDE;'COUNTY AND THE STATE- OF CALIFORNIA. I ALSO AGREE TO
{�
T
LL
P,.
CARRY COMPENSATION INSURANCE{.UPON MY EMPLOYEES. COMPLI-
ANCE'WITH LAWS OF THE 'STATEO'F CALIFORNIA COVERING CON-
INFORMATION
TRACTORS IS ALSO GUARANTEED.
• - - -
OW NERC
CONTRACTOR
,
ADDRESS
YaDUf�ES )
• - a
Ir
-
TEL. NO. _ '
TEL. NO,
-
•
- - -
LICENSE N0
r ,.
I84-208 11/87