164811 (SPIN)DEPARTMENT OF BUILDING & SAFETY
Mk COUNTY OF RIVERSIDE Am
CONSTRUCTION ESTIMATE
1st FI.
Sq. Ft. @
2nd FI.
Sq. Ft. @
Por.
Sq. Ft. @
Gar.
Sq. Ft. @
Car P.
Sq. Ft. @
Wall 7 �
Sq. Ft. @
..t�
\�
r
(('ESTIMATED
Sq. Ft. @
VALUATION $
MECHANICAL FEES
NO.
ELECTRICAL FEES
POLES
VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD
SIGNS
WASHER (AUTO) DISH)
TRANS. AND/
OR T. CLK.
APPLIANCE
MOTOR
H. P.
MOTOR
H.P.
MOTOR
H. P.
MOTOR
N.P.
FIELD OFFICE
PLUMBING FEES
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
FLOOR DRAIN
WATER SOFTENER
ERMIT NU
VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD
MOTOR H.P.
WASHER (AUTO) DISH)
APPLIANCE
FIXTURES
GARBAGE DISPOSAL
}
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
OUTLETS
LAUNDRY TRAY
J
Z
0
AIR HANDLING UNIT
SUB-PAMEL
KITCHEN SINK
J
GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
J
WATER CLOSET
Q
COMPRESSOR �HP
RANGE AND/OR OVEN
LAVATORY
V
J F M A M J J A S
O N D
W
APPLIANCE VENT
WATER HEATER
SHOWER '
R
LO I SIZE
USE #
JOB ADDRESS
'
ABSORPTION SYSTEM D B.T.U.
SPACE HEATER
BATH TUB
0
U
INCINERATOR DOMESTIC ❑ INDUS. ❑ COMM.
CONSTRUCTION POLE
WATER HEATER
HEATING SYSTEM ❑ FORCED ❑ GRAVITY
SERVICE ENTRANCE
SEWAGE DISPOSAL
CHE KED BY
CO UNITY ,DISTRICT
F.C.NITS
BOILER E::� B.T.U.
RESID. 19 SO. FT.
HOUSE SEWER
��
r
RESIDENTAL FEE Sp.FT.�@
GARAGE zQ SO. FT.
GAS PIPING
Ft
PERMIT FEE
PERMIT FEE
PERMIT FEE
ERMIT NU
E
REN. DBL.
TOTAL FEES
HEAT & VENT FEE
PLN. CK. FEE
CONST. 'FEE
ELEC. FEE
PLUMB. FEE
J
J
J
J F M A M J J A S
O N D
J F -M A M J J A S
0 N D
SET BACK
R
LO I SIZE
USE #
JOB ADDRESS
OWNER -_
r +,
S
ZONE
USE*CFF BUILDING
PLAN CHECK FEE
CHE KED BY
CO UNITY ,DISTRICT
F.C.NITS
OFFICE
rFI
MECHANICAL FEE
��
r
IVALUATION
CONSTRUCTION FEE
Ft
TYPE
LEGAL DESCRIPTION
PERMIT NUM
648
ER
1
ELECTRICAL FEE
SPEC. INSP.
`
1� _ 4
SUPP. TO PERMIT
F
PLAN CHECKER
BONDjO
BOND
CASH
PLAN FILE #
•PMMN-�1lT 1'ee
INSPECTOR
PLUMBING FEE
I
TOTAL FEES
J
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
PERMIT WILL BE DONE IN ACCORDANCE WITH THE LAWS OF RIVER-
CASH CHECK ,;,f M. 0. N.c.
ECEIVED BY
SEWAGE SYSTEM
IT
LL
FP
SIDE COUNTY AND THE STATE OF CALIFORNIA. I ALSO AGREE TO
CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLI-
ANCE WITH LAWS OF THE STATE OF CALIFORNIA COVERING CON-
TRACTORS
TRACTORS IS ALSO GUARANTEED.
INFORMATION
OWNER
!
CON RACTOR
ADDRESS -
ADD RE5S
fj
go
4
TEL. NO.
TEL. HO.
•
LICENSE NO.
884.208 11/67
/. 4+� 1 5/