176643 (PLBG)DEPARTMENT OF BUILDING & SAFETY
• COUNTY OF RIVERSIDE
FIELD OFFICE
CONSTRUCTION ESTIMATE
ELECTRICAL FEES
PLUMBING FEES
1st FI.
2nd FL
Par.
Gar.
.Car. P.
Wall
Sq. Ft. @
NO.
NO.
Sq. Ft. @
S
Sq. Ft. @
Sq. Ft. @' POLES
ZONE
/
Sq. Ft. @ SIGNS i
DRAINAGE PIPING
Sq. Ft. @ ORAT SCLND/
DRINKING FOUNTAIN
Sq. Ft. @ MOTOR H. P.
URINAL
MOTOR H. P.
WATER PIPING
ESTIMATED VALUATION is
MOTOR H. P.
FLOOR DRAIN
MECHANICAL FEES
MOTOR H. P.
WATER'SOFTENER
VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD
MOTOR H. P.
WASHER (AUTO) (DISMI
APPLIANCE
FIXTURES _
GARBAGE DISPOSAL
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
OUTLETS
LAUNDRY TRAY
AIR HANDLING UNIT
- SUB -PANEL �.•
KITCHEN SINK
GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
-�
WATER CLOSET
COMPRESSOR DMP
R' N-GE.AND/OR OVEN
LAVATORY
APPLIANCE VENT.
WATER HEATER
SHOWER
_ ABSORPTION SYSTEM D B.T.U.
SPACE HEATER .,
BATH TUB
INCINERATOR DOMESTIC ❑ INDUS. ❑ COMM.
'CONSTRUCTION POLE
WATER HEATER
HEATING SYSTEM ❑ FORCED ❑ GRAVITY
SERVICE ENTRANCE
SEWAGE DISPOSAL
BOILER B.T.U.
RESID. 1Q SO. FT.
HOUSE SEWER
PERMIT FEEGARAGE
zQ SO. FT.
GAS PIPING
PLAN CHECKER
PERMIT FEE -.7
PERMIT FEE
PERMIT NUMBER
1766
IN' - T
REN,
DBL.
TOTAL FEES
HEAT& VENT FEE
PLN, CK, FEE
CONST. FEE
ELEC. FELE ,..��
PLUMB. FEE "
F M .. ' A.�.� M..-..--. J �. _ J A
J F _ ...
.- _
SET BACK
ILOT SIZE
USE #
JOB
�ADDRESS OWNER -
.,e ®'.,. S
F
S
R
ZONE
'SE OF BUILDING "' �' DATE
PLAN CHECK FEE $
"" 1 �• - /'
C: CKED BY
COMM'N Y
DISTRICT
F.C.UNITS]WALUATION��
OFFICE ,
MECHANICAL FEE $
J
I
ii7�
Yew'
1
al}'
of
TV PE
LEG'A'L D C IPTION v
PERMIT NUMBER
CONSTRUCTION FEE $
,' -/ .-.J
6 643
SPEC. INSP.
v
�..y�
SUPP. TO PERMIT
ELECTRICAL FEE $
tn.
PLAN CHECKER
IrOND $ BONE'
CASAP
CAW LE A
IN' - T
INSPECTOR
PLUMBING.FEE $
JF
)
/ �U`70�,(
TOTAL FEES
$ R4:11 '
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-
IT
SIDE COUNTY AND THE STATE OF CALIFORNIA. I ALSO AGREE TO
LL
P
CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLI-
ANCE WITH LAWS OF THE STATE OF CALIFORNIA COVERING CON-
NAME OF CONSTRUCTION LENDER
c
__p_..+��
TRACTORS IS ALSO GU ARAN TEED.1�j
OWNER -
CONTRACTOR r
BRANCH OFFICE
ADDRESS
44,w
-
ADDRESS` -- •'•
DS v 'y
CITY STATE
'
v.
NO LENDER INVOLVED
'ION
IN FO RMA
'
TEL. NO.
L. N
r
LICENSE NO.
284-208 12/08.
y -V. j•
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