146768 (PLBG)DEPARTMENT OF BUILDING & SAFETY
L a COUNTY OF RIVERSIDE
FIELD OFFICE
CONSTRUCTION ESTIMATEolp'
ELECTRICAL FEES
PLUMBING FEES
1st FI.
2nd FI.
Por.
Gar.
Car P.
Wall
Sq. Ft. p
NO.
NO.
SUPPLEMENT TO PERMIT
Sq. Ft.
LOT SIZE
Sq. Ft. (i
FINALED DATE
_ _
Sql Ft. (i POLES
GROUP
Sq. Ft. @ SIGNS
DRAINAGE PIPING
Sq. Ft. OR AT.S CLK.D/
DRINKING FOUNTAIN
MOTOR H.P.
Sq. Ft. @
URINAL
MOTOR M.P.
WATER PIPING
ESTIMATED VALUATION $
MOTOR H.P.
r
CONTRACTOR ( U A r
LICE NS�TY �.•.•Fr !`
FLOOR DRAIN
O. MECHANICAL FEES
MOTOR H.P.
WATER SOFTENER
HEAT APPLIANCE
MOTOR H.P.
WASHER (AUTO) (DISH)
INLETS - OUTLETS
FIXTURES
GARBAGE DISPOSAL
M. SO. FT. - UNIT HEATER
OUTLETS
LAUNDRY TRAY
M. SO. FT. - PERF. CEILING MAT.
SUB -PANEL
KITCHEN SINK
APPLIANCE VENT
WATER CLOSET
GAS PIPE
RANGE AND/OR OVEN
S
LAVATORY
REPAIR OR ALTER
WATER HEATER
SHOWER
VENT SYSTEM ❑ HOOD ❑ EVAP. COOL ❑
SPACE HEATER
in any manner whatsoever as to be- Article 3, Sec. 3800 of the Labor
come subject to the Workmen's Com- Code, and a certificate or certified
pensation Lows of the State of copy is on file with the Riverside
California. Count Li ng De r nient.
Owner Contractor��f9'
Address Addre s "
Telephone Tel.���Lt...�
BATH TUB
COMPRESSOR
CONSTRUCTION POLE
SEEPAGE PIT
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WATER HEATER
COMPRESSOR
SERVICE ENTRANCE
SEWAGE DISPOSAL
COMPRESSOR
RESID. 11 So. FT.
HOUSE SEWER
GARAGE LitSO. FT.
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
E MI
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REN
JDBL
JPLN ;HK AEECONSTR.
FEE
HEAT & VENT
ELECT. FEE
PLUMB. FEE
L
TOTAL FEES
P
PLAN CHECKER
J F
J F M A
J J A
M J J A
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BUILDING INFORMATION
JOB ADDRESS
VIA1
I OWNER
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WOOD
CONCRETE FIREPLACE
CONCRETE
PIERS
MEMBRANE
USE OF B ILDING
t
DATE
BLOCK
FRAME STUCCO
BRICK CONC. METAL
OTHER
COMMUNITY DISTRICT F.C. UNITS VALUATION OFFICE
PLASTER DRY WALL ROOF COVERING BD. RMS. A A i� )/ ,��y// 1.411
ONE - ZONING-
_ �•
SET FRONT SIDE
BACK
PLAN CHECK FEE
IMECHANICAL FEE
II CONSTRUCTION FEE
It ELECTRICAL FEE
PLUMBING FEE
TOTAL FEE
CASH I I CHECK
ECEIVED BY
[ATER-VOLUME SEPTIC TANK
.117 GAL.
[ETTER F] FILE ❑
LEGAL DESCRIPTION
PER IT
fI676 8
.VE/pp7`��4(,;;gY
PERMIT USE NO.
�C�� ��� � � �
SUPPLEMENT TO PERMIT
REAR
LOT SIZE
FINALED DATE
_ _
INSPECTOR
GROUP
TYPE
BOND
BOND
CASH
$
r
CONTRACTOR ( U A r
LICE NS�TY �.•.•Fr !`
RELEASE BOND
DATE
$
In accordance with Sec. 302•D of the Uniform Building Cada, this permit shall
if work is not commenced within 60 days. If work is suspended or abon-
donod far a period of 120 days, this permit shall automatically become null
$expire
and void.
This permit is issued, and shall continue in effect, pursuant to the terms and
$
conditions of Sec. 3800 of the Business and Professions Code and as a condi-
tion of the issuance hereof the following certificate is executed.
OWNER -BUILDER CONTRACTOR
I hereby certify that in performance I hereby certify that in performance
of the work for which this permit is of the work for which this permit is
issued I shall not employ any person issued I have complied with Title 8,
S
$ 1i
in any manner whatsoever as to be- Article 3, Sec. 3800 of the Labor
come subject to the Workmen's Com- Code, and a certificate or certified
pensation Lows of the State of copy is on file with the Riverside
California. Count Li ng De r nient.
Owner Contractor��f9'
Address Addre s "
Telephone Tel.���Lt...�
M. 0. N.C,
PLAN FILE
#
LEACH LINE
Fr.
SEEPAGE PIT
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