164768 (PLBG)DEPARTMENT OF BUILDING & SAFETY
COUNTY OF RIVERSIDE A1111111111L FIELD OFFICE
CONSTRUCTION ESTIMATE
1st FI. 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
r VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD
APPLIANCE
FURNACE 11 UNIT❑ WALL❑ FLOOR SUSPENDED
J
Z AIR HANDLING UNIT
0
I
t J GAS PIPE 11 NATURAL ❑ L.P.G. 11 OIL
t Q
U COMPRESSOR D HP
WAPPLIANCE VENT
r
I ABSORPTION SYSTEM D B.T.U.
0
U INCINERATOR DOMESTIC ❑ INDUS. ❑ COMM.
HEATING SYSTEM ❑ FORCED ❑ GRAVITY
BOILER D 8.T.U.
RESIDENTAL FEE SQ.FT. �@
PERMIT FEE
ERMITM�R4 6 8 REN. OBL. TOTAL FEES w
J 1.2
F M A�
ELECTRICAL FEES
POLES
SIGNS
TRANS. AND/
OR T. CLK.
MOTOR
MOTOR
MOTOR
MOTOR
MOTOR
FIXTURES
OUTLETS
SUB -PANEL
RANGE AND/OR OVEN
WATER HEATER
SPACE NEATER
CONSTRUCTION POLE
SERVICE ENTRANCE
RESID. IC SO. FT.
GARAGE 10 SQ. FT.
PERMIT FEE
PLN. CK. FEE CI
0
PLUMBING FEES
NO.
LEC. -FEE (PLUMB. FEE
w 4..flll
S IO IN ID {
DRAINAGE PIPING
DRINKING FOUNTAIN
H. P.
URINAL
M.P.
WATER PIPING
H. P.
FLOOR DRAIN
H. P.
WATER SOFTENER
H. P.
WASHER (AUTO) (DISH)
f
GARBAGE DISPOSAL
LAUNDRY TRAY
US E OF BUILD G - - ,f Y'•
KITCHEN SINK
PLAN CHECK FEE
WATER CLOSET
LAVATORY
SHOWER
CH ED BY
BATH TUB
MECHANICAL FEES"Fr
WATER HEATER
SEWAGE DISPOSAL
HOUSE SEWER
LEdXALLDIffCAIPtION � r PERMIT7618CONSTRUCTION
164
GAS PIPING
FEE
PERMIT FEE
LEC. -FEE (PLUMB. FEE
w 4..flll
S IO IN ID {
SET BACK
LOT SIZE
USE it
JOB ADDRESS OWNER
5
R
f
ZONE
US E OF BUILD G - - ,f Y'•
PLAN CHECK FEE
w►
CH ED BY
COPAAU ITY D TRICTI If. If. fo u N Or S VALUATION OFF
MECHANICAL FEES"Fr
TY E
LEdXALLDIffCAIPtION � r PERMIT7618CONSTRUCTION
164
FEE
SPEC. INSP.
SUPP. TO PERMIT
ELECTRICAL FEE
'?
PLAN CHECKER
ONO $
BOND
CASH
PLAN FILE V
FINAL DATE
INSPECTOR
I
I
PLUMBING FEE
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/Ga S-lLa3
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` TOTAL FEES
{
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
CASH CHECK M.O. N.C.
RECEIVED BY
SEWAGE SYSTEM
PERMIT WILL BE DONE IN ACCORDANCE WITH THE LAWS OF RIVER-
SIDE COUNTY AND THE STATE OF CALIFORNIA. I ALSO AGREE TO
T / ;
LL
P f
CARRY COMPENSATION INSURANCE UPON MY EMPLO EES. COMPLI-
ANCE WITH LAWS OF THE STATE OF CALIFOR LA. VERING CON -
`
INFORMATION
INFORMATION
IS ALSO GUARANTEED.
Yi!M
OWNER
CONTRACTOR
.I �y
A R tS S
ADITRESS
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EL. NO.
- EL. N
.2 84-208 11/87
LICENSE NO.
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