171412 (AR)DEPARTMENT OF BUILDING & SAFETY
_
FIELD OFFICE
COUNTY OF RIVERSIDE
CONSTRUCTION ESTIMATE
1st FL Sq._Ft. @
2nd FI. Sq. Ft. @
Por. Sq. Ft..@
Gar. Sq. Ft. @
Car P. Sq. Ft: @
Wall Sq. Ft. @'
Sq. Ft. @ .
ESTIMATED VALUATION' $
MECHANICAL FEES
VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ WOOD
APPLIANCE
') FURNACE UNIT WALL FLOOR SUSPENDED
IJ
Z AIR HANDLING UNIT '
O
J GAS PIPE O NATURAL. ❑ L.P.G. ❑ OIL
Q
U COMPRESSOR. D HP
E
W APPLIANCE VENT
- ABSORPTION SYSTEM "� B. T. Y.
O
U INCINERATOR DOMESTIC ❑ INDUS. ❑ COMM. -
HEATING SYSTEM ❑ FORCED ❑ GRAVITY-
' BOILER D B.T.U. '
RESIDENTAL FEE SO. FT. @
PERMIT -FEE
ELECTRICAL
FEES
-PLUMBING FEES
TOTAL, FEES
NO. -
PLN. CK. FEE
NO.
ELEC. FEE
PLUMB. FfE
`•di+y
.POLES
J F M A M J '.J A - S�.
- __ J _ F M' A- M_ J J A _ S
p N... D
O - N D _
SIGNS
•.
ORAINAGE PIPING
'
TRANS. 'ANO/.
' OR T. CLK.
JOB ADDRESS Vi
DRINKING FOUNTAIN
'
'
MOTOR
H. P.
URINAL _
• MOTOR ..
N.P.
WATER PIPING -
V
MOTOR'-
H.V.
FLOOR,ORAIN _
MOTOR• -
H. P.
WATER' SOFTENER
MOTOR
H.P. -
:WASHER (AUTO): DISH)
DATE.
•FIXTURES'
GARBAGEDISPOSAL
OUTLETS
CHECKED
.�1+•,. -COMMUNITY
LAUNDRY TRAY
DISTRICT
SUB-PAREL
VALUATION
.KITCHEN SINK -
'
WATER CLOSET
9
RANGE,AND/OR OVEN
LAVATORY
/.ABY
7 '1• v/
.WATER. HEATER
:SHOWER.
-
SPACE HEATER
BATH TUB
-
CONSTRUCTION POLE
1PERMIT
-WATER HEATER
CONSTRUCTION FEE
' SERVICE ENTRANCE
-
SEWAGE DISPOSAL
RESID.- 1Q SO.,FT.
` ELECTRICAL FEE..'
HOUSE SEWER
y)
. GARAGE i'R 50. FT.
_
GAS PIPING
BOND $
- PERMIT FEE
CASH
PERMIT FEE
//ryry
PERMIT IN71 � � -/.��
•G�
IREN.. DBL.
TOTAL, FEES
HEAT & VENT.FEE
PLN. CK. FEE
CONST. FEE -,
ELEC. FEE
PLUMB. FfE
`•di+y
J F M A M J '.J A - S�.
- __ J _ F M' A- M_ J J A _ S
p N... D
O - N D _
SET BACKLOT
517E -
USE 4 -
JOB ADDRESS Vi
OWNER
ZONE
USE OF BUILDING -
DATE.
' PLAN CHECK FEE
'
CHECKED
.�1+•,. -COMMUNITY
-
DISTRICT
F. C., UNITS
VALUATION
MECHANICAL FEE
/.ABY
7 '1• v/
-.}J"
G UPTY.
PE
LEGAL DE• CR'IPTI ON -
1PERMIT
NUMBER
CONSTRUCTION FEE
-
Iii o/ 194
1.71412
` ELECTRICAL FEE..'
SPEC.'INSP.
- - -' -
J 27 _ ,.. 04>1
SUPP. TO PERMIT
r
PLAN CHECKER
BOND $
BOND
CASH
11
. FINAL DATE
INSPECTOR
PLUMBING FEE
I
JPLANFILF
TOTAL
:rGGJ
f
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 I N," CONNECTION . WITH THIS
CASH CHECK 70. N. C.
RECEIVED BY
SEWAGE SYSTEM -
PERMIT WILL BE DONE 1N ACCORDANCEWITHTHE LAWS OF,RIV,ER-
_
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 STATE OF CALIFORNIA COVERING CON -
6++
IN FOR MA no"N;
TRACTORS IS ALSO GUARANTEED.
��'f1Lli{77�1iiiJJ VV.FP
XAM OF �Y7fttl#�J rv.s �iij>➢-{t."kii��ii -
OWNER`,,.-
CONTRACTOR - -
.
.. .. w4:
0`114",
ADDRESS
ADDRESS -
DR3 q
.a.rr.r
TEL. NO.
TEL. NO.
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LICENSE NO.