166609 (PLBG)DEPARTMENT OF BUILDING & SAFETY
ER MIT -NU
COUNTY OF RIVERSIDE ,
`
FIELD OFFICE
CONSTRUCTION ESTIMATE
ELECTRICAL FEES
PLUMBING FEES
1st FI:
2nd F1.
Par.
. Gor:
_ C0r P.
WOII'
•
'
Sq. Ft. @
NO.
ELEC.FEE
No.
Sq. Ft.:@
Sq. 'Ft.. @.
Sq. Ft. @ POLES
Sq.- Ft:'@ _ -SIGNS
DRAINAGE PIPING
Sq'. Ft. @ ORAT SCLK.O/
DRINKING FOUNTAIN
_Sq Ft.: @ - MOTOR- H1 P.
J
URINAL -`
MOTOR H.P.
WATER PIPING. -
ESTIMATED VALUATION $
MOTOR
H. P.
FLOOR DRAIN
-MECHANICAL: FEES
MOTOR
H. P.
WATER SOFTENER.
" VENT SYSTEM ❑ FAN ❑ EVAPI COOL ❑HOOD
MOTOR
M.P.
WASHER (AUTO)- DISH)
` APPLIANCE
'.FIXTURES'.
! 1'e ii ,�1
GARBAGE DISPOSAL
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
J.
•• .' OUTLETS
ZOY4E
-LAUNDRY TRAY
Z AIR HANDLING UNIT
SUB -PANEL••
COMMUNE Y
- KITCHEN 'SINK
' -I GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
Q
VALUATION OF•F ICE
MECHANICAL FEE -
WATER CLOSET
i U COMPRESSOR �.HP
�
RANGE.AND/OR OVEN
LAVATORY
E ,
• W APPLIANCE VENT
WATER HEATER
TYPE.
SHOWER
I
E -ABSORPTION SYSTEM D B.T:U.
0
SPACE HEATER
CONSTRUCTION -FEE}
BATH TUB
U INCINERATOR DOMESTIC ❑ INDUS. ❑.COMM.
CONSTRUCTION POLE
WATER HEATER
HEATING SYSTEM ❑ FORCED ❑"GRAVITY
SERVICE ENTRANCE
!
SEWAGE DISPOSAL
BOILER B.T.U.
RESID. 1C SQ.' FT.
J
•OU Ey,SE.W ER .�`•, - �
F RESIDEN TAL FEE Sp.FT..�@
GARAGE iQ 50. FT.
BOND $
_ 'PING r
'PERMIT FEE
PERMIT FEF
-ror..,T
FINAL DATE
�« ,
_41 ..l
ER MIT -NU
66609
ICS
REN. DBL'.
TOTAL.FEES
HEAT 8: VENT FEE
pLN. CK. FEE.
CONST: FEE
ELEC.FEE
w
PLUMB. FEE
-,
J F M q M J J A 5
J F M A M J - J A S
O N. D
O N 7 D
-
SET BACK
LOT -SIZE
USE n
JOB ADDRESS •
_
OWNER f
F S
R�
! 1'e ii ,�1
C: .. ,✓
- i. rli "",o "
- -
' PLAN CHECK 'FEE
ZOY4E
U E IrF BIJ L G {/�•w'' .y C 'I'1/r�,•✓ DATE
CHECKED BY -
COMMUNE Y
DISTRICT F.C.
UNITS
VALUATION OF•F ICE
MECHANICAL FEE -
r J1 i
•
GROUP
TYPE.
LEGAL ESCRIPTI ON jj
1
PERMIT NUMBER
6 6 6 0 9
CONSTRUCTION -FEE}
'" C. �'
1
' - -
`SPEC. INSP.
!
SUPP. TO PERMIT
ELECTRICAL FEE
P
- PLAN CHECKER
BOND $
BOND
CASH
PLAN FILE it _
FINAL DATE
INSPECTOR
..
PLUM BIN G.FEE
..
Z•I3-(7 d�
�'I
TOTAL ^L FEES
THIS
-
PERMIT SHALL•BECOME VOID IF WORK IS NOT COMMENCED'
WITHIN 60 DAY'S. 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. -
IECEIVED BY
SEWAGE SYSTEM- - -
'
PERMIT'WILL BE DONE IN ACCORDANCE WITH THE LAWS OF RIVER-
''iJ.•
T
!L}
SIDE COUNTY AND -THE STATE OF,CALIFO.RN'IA. I ALSO AGREE TO
CARRY COMPENSATION' INSURANCE UPON MY EMPLOYEES. COMPLI-
WITH LAWS OF THE STATE OF CALIFORNIA COVERING -CON-
A!ANCE
INFORMAT1oN
TRACTORS IS ALSO GUARANTEED.
' • -
OWNER
CONTRACTOR
-ADDRESS
ADDRESS
'
t•
TEL. NO.
TEL..' NNOO..t.. -7-, t- j�
'•
-
.% •^-- '� ` i -,.rte-L�uv� f��r...
`
184-208 11/67;.
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