160486 (SFD)DEPARTMENT OF BUILDING & SAFETY
lftk COUNTY OF RIVERSIDE AdftL FIELD OFFICE
CONSTRUCTION ESTIMATE
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ELECTRICAL FEES
PLUMBING FEES
1st FI.
k 2nd FI.
Por.
6 Gar.
Car P.
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I WOII
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Sq. Ft. @
NO.
ITOTAL,F��
NO.
pLN��; FEE
Sq. Ft. @
ELEC. FEEIPLUMB.
Sq. Ft. @
IF M A M J J A s
J F M A M J J A S
POLES
Sq. Ft. @
/] SIGNS
Sq. Ft. @
DRAINAGE PIPING
TRANS. AND/
Sq. Ft. @ OR T. CLK.
DRINKING FOUNTAIN
Sq. Ft. @ MOTOR H. P.
URINAL
MOTOR H. P.
WATER PIPING
ESTIMATED VALUATION Is
USE OF BUILDING
DAD(.j/
MOTOR
H. P.
FLOOR DRAIN
MECHANICAL FEES
MOTOR
H. P.
WATER SOFTENER
VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD
MECHANICAL FEE
MOTOR
H.P.
WASHER (AUTO) (DISH)
APPLIANCE
FIXTURES
GARBAGE DISPOSAL
y FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
TYPE
OUTLETS
LAUNDRY TRAY
J
Z AIR HANDLING UNIT
0
SUB-PAMEL
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+ r iji/ j�F,/1f/Y
KITCHEN SINK
+ J GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL -
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ELECTRICAL FEE
SPEC. INSP.
WATER CLOSET
Q
U COMPRESSOR D HP
PLAN CHECKER
RANGE AND/OR OVEN
BOND
LAVATORY
u
W APPLIANCE VENT
FINAL DATE
WATER HEATER
PLUMBING FEE
SHOWER
f ABSORPTION SYSTEM D B.T.U.
1 I
SPACE HEATER
BATH TUB
O
U INCINERATOR DOMESTIC ❑ INDUS. ❑ COMM.
TOTAL FEES
CONSTRUCTION POLE
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED
WATER HEATER
HEATING SYSTEM ❑ FORCED ❑ GRAVITY
WITHIN 60 DAYS. CESSATION OF WORK FOR 120 DAYS SHALL ALSO
CAUSE PERMIT TO BECOME VOID.
IHEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS
PERMIT WILL BE DONE IN ACCORDANCE WITH THE LAWS OF RIVER-
SIDE COUNTY AND THE STATE OF CALIFORNIA. I ALSO AGREE TO
SERVICE ENTRANCE
RECEIVED BY
SEWAGE DISPOSAL
BOILER B.T.U.
RESID. IC SO. FT.
f
HOUSE SEWER
RESIDENTAL FEE SQ.FT.�@
f
,�r�
GARAGE iQ SO. FT.
7
GAS PIPING
PERMIT FEE
OWNER
PERMIT FEE
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PERMIT FEE
PERMIT ry/Mp(f�
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REN. DBL.
ITOTAL,F��
HEAT & VENT FEE
pLN��; FEE
CONS'.��
ELEC. FEEIPLUMB.
FEE
IF M A M J J A s
J F M A M J J A S
O N D
O N D
OWNER
J
SET BACKLOT
SIZE
USE :t
JOB ADDRESS
PLAN CHECK FEE
ZONE
USE OF BUILDING
DAD(.j/
DATE
CHECKED BY
COMMUNITY -DISTRICT
F.C.
UNITS
VALUATION
OFFICE
MECHANICAL FEE
-
_/
C2
GROUP
TYPE
LEGAL_ DESCRIPTION
PERMIT N MBER
CONSTRUCTION FEE f
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+ r iji/ j�F,/1f/Y
60 86
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ELECTRICAL FEE
SPEC. INSP.
SUPP. TO PERMIT
PLAN CHECKER
BOND $
BOND
CASH
PLAN FILE 11
FINAL DATE
INSPECTOR
PLUMBING FEE
1 I
CI..) (;;y
I .{
TOTAL FEES
�Jd�
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.
IHEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS
PERMIT WILL BE DONE IN ACCORDANCE WITH THE LAWS OF RIVER-
SIDE COUNTY AND THE STATE OF CALIFORNIA. I ALSO AGREE TO
CASH CHECK M.O. N.C.
RECEIVED BY
SEWAGE SYSTEM
f
T
LL
P
CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLI-
ANCE WITH LAWS OF THE STATE OF CALIFORNIA COVERING CON-
TRACTORS IS ALSO GUARANTEED.
INFORMATION
OWNER
CONTRACTOR
ADDRESS
ADDRESS
TEL. NO.
TEL. NO.
284-208 11/87,f y,•;a+ti
�.�^- .t.._ --
LICENSE NO.