179319 (ELEC)DEPARTMENT OF BUILDING & SAFETY
COUNTY OF RIVERSIDE FIELD OFFICE'
CONSTRUCTION, ,ESTIMATE
ELECTRICAL .FEES
PLUMBING FEES
1Bt FI.
2nd FI.
Por.
Gar.
Car P.
Wa.II
-
Sq. Ft. @
NO.
NO,.
Sq. Ft. @:
y
Sq." Ft. @
Sq. Ft. @ POLES
SIGNS
5q. Ft;. @
DRAINAGE PIPING
TRANS..AND'/
Sq. Ft. @ OR T. CLK:
DRINKING FOUNTAIN' ,•
Sq. Ft. @ MOTOR H. P.
a
URINAL
MOTOR H.P-.
I
WATER PIPING
ESTIMATED VA,LUATLON is
MOTOR H.P.
FLOOR DRAIN
Y
MECHANICAL FEES
MOTOR H. P.
WATER'SOFTENER
VENT SYSTEM ❑ FAN ❑'EMAP. COOL ❑MOOD
MOTOR N. P.
WASHER' (AUTO) (DISH)
APPLIANCE
FIXTURES
,GARBAGE DISPOSAL
FURNACE 13 UN''.IT'❑ WALL O FLOOR ❑ SU,SPENDED
OUTLETS
LAUNDRY TRAY
1
AIR HANDLING UNIT
SUB -PANEL
MI'TCHEN'SINK
GAS PIPE ❑NATURAL ❑•L.P.G'.❑.OIL
WATER CLOSET
COMPRESSOR �HP
RANGE AND,/OR OVEN
LAVATORY
A'PPL'IANCE VENT
WATER HEATER.
SHOWERi
ABSORPTION SYSTEM O B. T. U.
SPACE HEATER
BATH TUB.. I
INCINERATOR DOMESTIC la INDUS. ❑ CDMM.
CONSTRUCTION POLE
WATER HEATER
HEATING_ SYSTEM [3 FORCED ❑ GRAVITY,
SER.V.ICE ENTRANCE
SEWAGE DISPOSAL
BOILER C::::] B.T.U..
RES',ID. 10- SO. FT:
HOUSE SEWER
PERMIT FEE
GARAGE :10 SO. 'FT.
F4
GAS PI PING
PERMIT FEE
PERMIT FEE
PEJMIT NUMBER
JREN.
JOBL.
ITOTAL FEES
I NEAT 8 VENT FEEP'LN.
CK. FEE
CONST. "FEE
ELEC. FEE
0'
PLUMB. 'FEE
e
SET BACK LOT SIZE
USE
JOB ADDRESSOW"ER .1
ZONE
USE OF B L'D,ING' TETE
ri
PLAN $
tGiJ
CHECK FEE
-�
CHECKED By
F.C.
VALUATION OFFICE
fZ
IDI!TTRICT
I
JUNITS
MECHANICAL FEE $
ch TYPE
'LI76XL IPTION
PERMIT' NUMB
R
J,
rr
CONSTRUCTION FEE' $
179319
SPEC. INSP.
SUPP. TO PERMIT ?
ELECTRICAL FEE $�
,PLAN CHECKER
BOND $
BOND'
CASH
PLAN'S FILE V
'FIN'AL DATE
INSPECTOR,
PLUMBING FEE-$
I
("l'70,�,
TOTAL FEES
db
THIS BECOME VOIDNOT COM
Rt'
>
01
WITHIN 60ERMIT DAYS.SHALL CESSATION OF WORKI FOR DAYS S HANCED ALSO
CAUSE PERMIT TO BECOME VOID.
I HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS
CASH C_'H:ECK I PT M:O: IN.C.
RECEIVED BY
SEW'A,GE SYSTEM
PERMIT WILL BE DONE IN ACCORDANCE WITH THE LAWS OF RIVER- {'
SIDE COUNTY AND THE STATE OF CALIFORNIA, 1 ALSO AGREE TO ti
T
LLP
CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLI-
ANCE WITH LAWS OF THE STATE O C:ALIF'ORNIA COVER -Nd) CON-
TRACTORS IS ALSO GUARANTEED. - t
NAME. OF CONSTRUCTION LENDER
a
-
OWNER-
Ir,i
BRANCH OFFJCE
ADDRESS
.yi
CITY STATE
NO LENDER INVOLVED
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'IN FO RM-'
ION
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TEL. -N6.
TEL. NO. '
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