157226 (BLCK)DEPARTMENT OF BUILDING & SAFETY FIELD OFFICE
COUNTY OF RIVERSIDE
CONSTRUCTION ESTIMATE
ELECTRICAL FEES
PLUMBING FEES
lst FI.
2nd FI.
Po I.
Gar.
Car P. _
Wall _ ._
Sq. Ft. 0
Sq. Ft.
Sq. Ft.
Sql Ft. @
Sq. Ft. @
Sq. Ft. a' f 1
Sq. Ft. g
NO.
NO.
POLES
SIGNS
DRAINAGE PIPING
l C
ORAT gCLK.D/
DRINKING FOUNTAIN
MOTOR H.P.
URINAL
MOTOR H.P.
WATER PIPING
ESTIMATED VALUATION $ (� d C_
MOTOR H.P.
FLOOR DRAIN
NO.
MECHANICAL FEES
MOTOR H.P.
WATER SOFTENER
HEAT APPLIANCE
MOTOR HIP.
WASHER (AUTO) (DISH)
INLETS - OUTLETS
FIXTURES
GARBAGE DISPOSAL
M. SQ. 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
LAVATORY
REPAIR OR ALTER
WATER HEATER
SHOWER
VENT SYSTEM ❑ HOOD ❑ EVAP. COOL ❑
SPACE HEATER
BATH TUB
COMPRESSOR
CONSTRUCTION POLE
WATER HEATER
COMPRESSOR
SERVICE ENTRANCE
SEWAGE DISPOSAL
COMPRESSOR
RESID. 10 SQ. FT.
HOUSE SEWER
GARAGE iQ SQ. FT,
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
PE
M M ER
REN DBL
PLN CHK FEE CONSTR.
FEE
1 y
HEAT & VENT ELECT. FEE
PLUMB. FEE
TOTAL FEES PLAN CHECKER
r, 6 G
- J F M A M
J F M A M
J J A
J J 1 A
S O N D
S 0 N D
BUILDING INFORMATION
JOB ADDRESS i NER D./
z �� f r I I /
WOOD
CONCRETE
FIREPLACE
CONCRETE
PIERS
MEMBRANE
>JSE OF BUI LOI NO% /
il%/ - �� +
DATE
7
�C /4 '• _ ��
BLOCK
FRAME
STUCCO
BRICK
CONC.
METAL
OTHER.//�
COMMU Y DI
`� UhY
T CT
F.C. (1
,�L V
UNITS
/
VALUATION
�f'1/S
OFFICE
PLASTER
DRY WALL ROOF
COVERING
BD. RMS.
J
Lr DESCRIPTION �j roc'
D C"
PER
ZONE _
SETFRONT
BACK
ZONI G 'HEfCKED BY
_ £ /REAK
.1 E
PERMIT USE NO.
LOT SIZE
SUPPLEMENT TO PERMIT
y
FINALED DATE
INS.P CTOR GROUP
TYPE
BOND BOND
$
GASH
PLAN CHECK FEE
$
`""
CONTRACTOR �/ if, C /'� f_ ))JIB
-
LICENSE -TYPE r - �� G�-
RELEASE BOND
DATE
MECHANICAL FEE
$
In accordance with Sec. 302-D of the Uniform Building Code, this permit shall
expire if work is not commenced within 60 days. If work is suspended or aban-
doned for a period of 120 days, this permit shall automatically become null
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,
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
Fe —, ian Laws of the State Of copy Is On file with the Riverside
California. County Build' g gpartment.
Owner Contractor ' /
Address Address
T-1e..h....e TeI.f,)t
CONSTRUCTION FEE
$
ELECTRICAL FEE
$
PLUMBING FEE
$
TOTAL FEE
ay
$ ` }j
CASH CHECK M. 0. N.G.
J
RECEIVED BY
WATER VOLUME SEPTIC TANK
GAL.
PLAN FILE
#
LEACH LINE SEEPAGE PIT
SQ. FT. GAL.
j LETTER FILE �.