166696 (SATT)DEPARTMENT OF BUILDING& SAFETY
COUNTY OF RIVERSIDE
FIELD OFFICE
CONSTRUCTION.ESTIMATE I IELECTRICAL FEES PLUMBING "FEES
1st FI f S Ft a rY a_.: t, No: No.
x P` q• -
2nd FI. Sq. Ft. @�
1
Par. w Sq. Ft. @+j
Gar. Sq. Ft. @
Car P. Sq. Ft. @ j
Wall Sq. ft. @
Sq. Ft. @
'ESTIMATED VALUATION $ 4�'6n-
MECHANICAL FEES
VENT SYSTEM FAN ❑ EVAP. COOL ❑/HOOD
p�•.;"Q F3j
APPLIANCE f d
FURNACE UNIT 11 WALL FLOOR 11 SUSPENDED
AIR HANDLING UNIT
GAS PIPE -❑,NATURAL ❑ L.P.G. ❑ OIL
COMPRESSOR - �HP J
APPLIANCE VENT
ABSORPTION SYSTEM L ......... j B.T.U.
INCINERATOR DOMESTIC ❑ INDUS. ❑ COMM.
HEATING SYSTEM WFORCED ❑ GRAVITY
BOILER B.T.U.
RA-UM."64".SQ.FT.
PERMIT FEE
$ERMIT I�M6� 6 � � REN. DBL. TOTAL FEES HEA. & VENT
I
JF M A
J F
SET BACK
LOT SIZE
POLES
JOB . ADDRESS OWNER
SIGNS
Y
Rj
DRAINAGE PIPING
TRANS. AND/
OR T. CLK.
/y C/ , , M
•
DRINKING FOUNTAIN
Z.04R "`*"
` MOTOR
H. P.
PLAN CHECK FEE
URINAL'
MOTOR
H. P.
WATER PIPING
CME KED'BY
MOTOR
H. P.
FI.C. -]bNITS7VALUATION
FLOOR DRAIN - -
MOTOR
H. P.
WATER SOFTENER
\,
-MOTOR
H. P.
WASHER (AUTO)4jIDISH)
l
FIXTURES
'R Off
GARBAGE DISPO �L
LEG Lf D CR PA O
OUTLETS
PERMIT N
-
LAUNDRY TRAY
CONSTRUCTION FEEF3
SUB -PANEL
"�
KITCHEN SINK
#.A
66
9
6
WATER CLOSET
V
RANGE AND/OR OVEN
SUPP. TO PERMIT
LAVATORY
WATER HEATER
fP
SHOWER
V j
SPACE HEATER
BATH TUB
{lN
CONSTRUCTION POLE
BOND $
- �-
WATER HEATER
/
SERVICE ENTRANCE
INSPECTOR
T
SEWAGE DISPOSAL
RESID. 10 SQ. FT.
-
HOUSE SEWER
�.
GARAGE iQ SQ. FT.
"�
GAS PIPING
`•��
PERMIT FEE
I
PERMIT FEEA4
PLN. CK. F�EE�
-v
CONST. 'FEE
69-
JELEC. FEE -
PLUMB. FEE
-
J A
S
O
N D
SET BACK
LOT SIZE
USS,jEEy a
JOB . ADDRESS OWNER
Y
Rj
. � k� -
/y C/ , , M
•
-
Z.04R "`*"
USE OF BU LOING ' ' s J i '< <
DATE
PLAN CHECK FEE
77 er'ly -
A
s /
CME KED'BY
COM MNIT.. - f
DIS RYCT
d
FI.C. -]bNITS7VALUATION
OFFICE
MECHANICAL FEE'S
\,
�3 L
-
'R Off
+� f YPE
LEG Lf D CR PA O
PERMIT N
MBER
CONSTRUCTION FEEF3
y
"�
.� ` I -
66
9
6
SPEC-INSP.
SUPP. TO PERMIT
ELECTRICAL FEE
PLAN CHECKER.
BOND $
BOND
CASH
PLAN•FI LE is
FINAL DATE
INSPECTOR
PLUMBING FEE -
z
�.
TOTAL FEES
69-
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED',
WITHIN 60 DAYS. CESSATION OF WORK FOR 120 DAYS SHALL ALSO
CASH
CHECK M. O`.
N. C.
CAUSE PERMIT'TO BECOME VOID.
I HEREBY AGREE THAT -ALL WORK IN. CONNECTION WITH. THIS
IECEIVED BY
SEWAGE
SYSTEM
PERMIT WILL BE DONE IN ACCORDANCE WITH THE LAWS OF RIVER-
y�
SIDE COUNTY AND THE STATE OF CALIFORNIA. I ALSO AGREE TO
{
T Cli
LL'
i
a xE`yff/•P'
CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLI-
ANCE WITH LAWS OF THE STATE OF CALIFORNI COVERING CON -
4�
INFORMATION
�y •7
�t
TRACTORS IS ALSO GUARANTEED.
�+�,�y
�Af�
OWNER
I0 .RAC OR
UT
ADDRESS
ADDRESS
f�ADDIMSB
MIT E
V.O .LMER TNVOL
- -
TEL. NO.
TEL. NO.
-
LICENSE NO., -
184-208 11/87