169451 (BLCK)DEPARTMENT OF BUILDING & SAFETY
� COUNTY OF RIVERSIDE � FIELD OFFICE
CONSTRUCTION ESTIMATE
ELECTRICAL FEES
PLUMBING FEES
1st FI.
2nd F I.
Par.
Gar.
Car P.
Wall9 ♦
✓�
♦/
Sq. Ft. @
NO.
NO.
Sq. Ft. @,
ZONE
�'
Sq. Ft. @
DATE
-'I&
Sq. Ft. @ POLES
CHLbCKED BY
Sq. Ft. @ SIGNS
DRAINAGE PIPING
S Ft. TRANS. AND/
q, @ 6/ OR T. CLK.
DRINKING FOUNTAIN
Sq. Ft. @ MOTOR H.P.
URINAL
MOTOR H. P.
WATER PIPING
ESTIMATED VALUATION Is S .
1, 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
FI%TURES
GARBAGE DISPOSAL
>- FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
OUTLETS
LAUNDRY TRAY
J
Z AIR HANDLING UNIT
O
SUB-PAREL
KITCHEN SINK
-I GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
SPEC. INSP.
WATER CLOSET
Q
U COMPRESSOR ��HP
RANGE AND/OR OVEN
LAVATORY
Ir
W APPLIANCE VENT
WATER HEATER
SHOWER
i ABSORPTION SYSTEM O B.T.U.
SPACE HEATER
BATH TUB
O
U INCINERATOR DOMESTIC ❑ INDUS. ❑ COMM.
CONSTRUCTION POLE
WATER HEATER
HEATING SYSTEM ❑ FORCED ❑ GRAVITY
SERVICE ENTRANCE
SEWAGE DISPOSAL
BOILER ::1 B.T.U.
RESID. 1Q SO. FT.
HOUSE SEWER
RESIDENTAL FEE 5Q.FT.@
GARAGE iQ SQ. FT.
GAS PIPING
PERMIT FEE
I PERMIT FEE
PERMIT FEE
PERMIT NU E REN. DBL. TOTAL FEES
HEAT & VENT FEE PLN. CK. FEE CONST. FEE
ELEC. FEE PLUMB. FEE
SET BACK
LOT SIZE
USE 11
JOB ADDRESSOWNER /
/ • L
5
R�
PLAN CHECK FEE
ZONE
�'
USE OF BUILDING •
t ve - Z1 7,0 4 6- .
DATE
-'I&
CHLbCKED BY
COMMUNITY DISTRICT
F.C.UNITS
VALUATION
OFFICE '
MECHANICAL FEE
♦�
�. /
'7
by
/
GRAUP
YPE
I`+"^'
LEGAL DESCRIPTION
1PERMIT
NUt�]8_ER
66 99 51
CONSTRUCTION FEE
j
% 6
(//1!'a
SPEC. INSP.
SUPP. TO PERMIT
ELECTRICAL FEE
C�
PLAN CHECKER
BOND $
BOND
CASH
PLAN FILE #
FINAL DATE
INSP CTOR
PLUMBING FEE
I
TOTAL FEES
$ & t"
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.
1 HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS
PERMIT WILL BE DONE IN ACCORDANCE WITH THE LAWS OF RIVER-
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 IS ALSO GUARANTEED.
CASH CHECK M. o. N.C.
�ECEIVED BY
SEWAGE SYSTEM
T
ILL
IP
+�`
�C%.ms at Construction Le>Ilder:
OWNER
CONTRACTOR
.'I#r:. runt Ot fice
ADDRESS
ADDRESS '
--.
�dti.re4s
City s to
lith tender ixwolved
TEL. NO.
TEL. NO.
LICENSE NO.
84-08 11/87
A