186193 (AR)DEPARTMENT OF BUILDING & SAFETY
COUNTY OF RIVERSIDE 0
FIELD OFFICE 1
CONSTRUCTION ESTIMATE
ELECTRICAL FEES
PLUMBING FEES
1st FI. n.
2nd FI.
Por.
Gar.
Car P.
Wall
Sq. Ft. 6,
eg O.
NO.
Sq. Ft. @
LAUNDRY TRAY
Sq. Ft. @
SUB -PANEL
Sq. Ft. @ POLES
GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
Sq. Ft. @ SIGNS
DRAINAGE PIPING
TRANS. AND/
Sq. Ft. @ OR T. CLK.
DRINKING FOUNTAIN
Sq. Ft. @ MOTOR M.P.
URINAL
MOTOR H.P.
WATER PIPING
ESTIMATED VALUATION $
MOTOR H.P.
FLOOR DRAIN
MECHANICAL FEES
MOTOR H. P_
WATER SOFTENER
VENT SYSTEM ❑ FAN ❑ EVAP, COOL ❑ HOOD
MOTOR H.P.
WASHER (AUTO) (DISH)
APPLIANCE
FIXTURES
GARBAGE DISPOSAL
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
OUTLETS
LAUNDRY TRAY
AIR HANDLING UNIT
SUB -PANEL
KITCHEN SINK
GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
WATER CLOSET
COMPRESSOR HP
RANGE AND/OR OVEN
LAVATORY
APPLIANCE VENT
WATER HEATER
SHOWER
ABSORPTION SYSTEM D B.T.U.
SPACE HEATER
BATH TUB
INCINERATOR DOMESTIC ❑ INDUS. ❑ COMM.
CONSTRUCTION POLE
WATER HEATER
HEATING SYSTEM ❑ FORCED ❑ GRAVITY
SERVICE ENTRANCE
SEWAGE DISPOSAL
BOILER B.T.U.
RESID. IC 50. FT. (
HOUSE SEWER
PERMIT FEE
GARAGE yC SO. FT.
GAS PIPING
•
PERMIT FEE K':
PERMIT FEE
PERMIT NUMBER REN.DBL. TOTAL FEES HEAT & VENT FEE PLN. CK. FEE CONST. FEEELEC. FEE PLUMB. FEE
I- J 18619.3
F M A M J J A S_. _ .0...1!_ D_-.4
J F � M A M J I J _ A — S __ O N -. D
SET BACK
ILOT SIZE
USE A
JOB ADDRESS OWNER
�I
F
5
R
f5d/I VA
ZONE
BUILDIN
bATE
PLAN CHECK $
,'
?— } ��-/
FEE
o+ f.� �
ix'
CH ED BY
'Crll'f:A' I- Y -
S I'
U I + V ATION
OFFICE
MECHANICAL FEE $
:Q
/+
/r E� —�"'
GROIPP TYPE
LEGAL DE CR PTION PERMIT NUMBER
CONSTRUCTION FEE $
'
I
1
p
Q`1:z-e2or 4*apnx 186193
SPEC. INSP.
46Z
' - SUPP. TO PERMIT
i
ELECTRICAL FEE $
-:;32 en
PLAN CHECKER
SO&D $
OND
CASH
P AN FILE
INAL ATE INSPECTOR
PLUMBING FEE $
1
TOTAL FEESA,�:,WITHIN
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED
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.7 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
s
T
LL
P
CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLI-
ANCE WITH LAWS OF THE STATE OF CALIFORNIA COVERING CON-
TRACTORS IS ALSO GUARANTEED.
NAME OF CON`SION
LENDER
I
OWNER
CONTRACTOR I,
BRANCH OFFICE
ADDRESS
ADDRESS
ADDRESS
CITY
STATE
�r
NO LENDER INVOLVED
INFORMATION
ZI rr
TEL. NO.
TEL. NO.
LICENSE NO.
284-208 12/88
(oma N/
'