162251 (SATT)DEPARTMENT OF BUILDING & SAFETY
COUNTY OF RIVERSIDE
ELECTRICAL FEES
1st FI, t2 Sq. Ft. @ If , �'• No.
2nd FI. Sq. Ft'. @
N b rs
Por. Sq. Ft. @ 2
FIELD OFFICE
PLUMBING FEES
Gar. ,a Sq. Ft. @i POLES "
� -SIGNS -... DRAINAGE PIPING
Car P. Sq. Ft. @
TRANS. AND/ DRINKING FOUNTAIN
Wall Sq. Ft.'@ OR T. CLK.
Sq. Ft. @ MOTOR H. P. URINAL
MOTOR -H. P. WATER PIPING-
• ESTIMATED VALUATION $'� � ?' MOTOR H. P. FLOG R`ORAIN
MECHANICAL-�!FEES MOTOR H. P. WATER SOFTENER
VENT SYS 'EM FAN ,❑ EVAP. COOL aYHOOD MOTOR H. P. WASHER (AUTO)DISH)
APPLIANCE FIXTURES GARBAGE DISPOSAL
y FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED OUTLETS LAUNDRY TRAY
J
Z AIR HANDLING UNIT SUB -PANEL KITCHEN SINK
O
J GAS PIPE ❑ NATURAL ❑ L.P.G. 11 OIL WATER CLOSET
Q
U COMPRESSOR HP _ - RANGE AND/OR OVEN LAVATORY
E
W APPLIANCE VENT - - WATER HEATER SHOWER
f `
f ABSORPTION SYSTEM '� B.T.U. SPACE HEATER E BATH TUB
O
U INCINERATOR DOMESTIC ❑ INDUS. ❑ COMM. CONSTRUCTION POLE WATER HEATER
HEATING SYSTEM 5 (FORCED ❑ GRAVITY4 �' SERVICE ENTRANCE' SEWAGE DISPOSAL
BOILER B.T.U. k� RESID. 1C SQ. FT. /i f3 HOUSE SEWER -y!
R ESIDEN TAL FEE SQ.F•T.�F yp1;� 'GARAGE •zQ•SQ.-FT. - •�-. 'Q E;I GAS PIPING
,/[,�, w
PERMIT FEE iaV PERMIT FEE PERMIT FEE
PERMIT NUTES REN. JOBL."TOTAL FEES j,HEAl`_& VENT FEE PLN. CK. FEE CONST. FEE ELEC. FEE PLUMB. FEE
22
J
J
J F M A M J J A S O N - D
SET"BACKq'
LOT SIZE
US # -
JOB ADDRESS�tq OW ER{
r ,r i - ,r r lAll
F
S Q
R �}
'
'
ZONE
USE OF BUILDING - '- -
1
DATE
G.
PLAN CHECK FEE
��
/j� fj,,,,✓�
Y
C H E C KED Y
•OM MU No Y
DISTRICT
F.C.
UNITS
EVALUATION
OFFIC
MECHANICAL FEE
-
,• t {'!`.'
6' ,1
�
¢�� /� Gla
"J
GROUPTYP -
LEGAL DE CRIPTI ON
-
PERMIT NU
CONSTRUCTION FEE
'
r �
�° " . -•
16
2
".., �/�•
-
'SPEC. INSP.
- J
SUPP. TO PERMIT
ELECTRICAL FEE
-
PLAN CHECKER
BOND $ -
BOND
I CASH IPLAN,FILE
#
FINAL DATE
INSPECTOR
PLUMBING FEES+""
/��'
Wye"
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.
I HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS '
CASH CHECK M.O. N.C.
RECEIVED BY
SEWAGE SYSTEM
PERMIT -WILL BE DONE IN ACCORDANCE WITH THE LAWS OF RIVER-
SIDE COUNTY AND THE STATE OF CALIFORNIA. I ALSO AGREE TO
T /
•3
CARRY COMPENSATION INSURANCE UPON MX EMPLOYEES. COMPLI-
ANCE WITH LAWS OF THE STATE OF."C LIFQ NIA COVERING CON-
INFORMATION
TRACTORS IS ALSO GUARANTEED
OWNER
CONTRACTOR 11�
ADDRESS
ADDRESS
TEL. NO. .-
TE/LL. NO.
"
-
LICENSE NO.
284-208 1 1/6
r)
,�