167080 (SFD)DEPARTMENT OF BUILDING & SAFETY
COUNTY OF RIVERSIDE FIELD OFFICE
CONSTRUCTION ESTIMATE
ELECTRICAL FEES
PLUMBING FEES I
1st FI.
2nd FI.
Par.
Gar.
Car P.
Wall
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Sq. Ft. @
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NO-
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No-
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POLES
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SIGNS
DRAINAGE PIPING
OR Si LK.D/
DRINKING FOUNTAIN
MOTOR H.P.
URINAL
MOTOR H.P.
WATER PIPING
ESTIMATED VALUATION Is 1Z alt
MOTOR H.P.
FLOOR DRAIN
MECHANICAL FEEt
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MOTOR H.P.
WATER SOFTENER
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VENT SYSTEM [IFAN ❑ EVAP. COOL H000
APPLIANCE
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MOTOR H.P.
FIXTURES
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WASHER (AUTO) ISH)
GARBAGE DISPOSAL
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FURNACE L5iUNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
OUTLETS
LAUNDRY TRAY
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AIR HANDLING UNIT
SUB -PANEL
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KITCHEN SINK
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GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
WATER CLOSET
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F
COMPRESSOR E::� HP
AN GE AND/OR OVEN
LAVATORY
h
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APPLIANCE VENT
WATER HEATER
SHOWER
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ABSORPTION SYSTEM B.T.U.
SPACE HEATER
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BATH TUB
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U
INCINERATOR DOMESTIC ❑ INDUS. ❑ COMM.
CONSTRUCTION POLE
Idol
WATER HEATER
SY
SYSTEM FORCED ❑ GRAVITY
SERVICE ENTRANCE
SEWAGE DISPOSALILER
PHATING
B.T.U.
'1�.[
RES111. 12 SQ. FT.
✓
HOUSE SEWER
S ID EN TAL FEE SQ. FT. @
GARAGE iQ' SQ. FT.
/i0
GAS PIPING
PERMIT FEE -
PERMIT FEE
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PERMIT FEE
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ER MIT
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REN. DBL.
TOTAL FEES
HEAT B VENT PLN. CK. FEE
FEE
ELEC, FEE PLUMB. FEErr`
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M J J A 5
O N D l
SET BACK
LOT SIZE
USE #
JOB ADDRESS
OWNER
147
S
R
ZONE
USE OF BUILDING J
DATE
PLAN CHECK FEE
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CHECKED BY
COM UNITY f5 I T
VALUATION
OFFICE .I
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JUNITS
_
MECHANICAL FEE
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TYPE
LEGAL O CRIP710N
PERM T N[y y}��IM ERaa/+
16
CONSTRUCTION FEE
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SPEC. INSP.
SUPP. TO PERMIT
I
I ELECTRICAL FEES
41 yIC7
PLAN CHECKER
OND ff
BOND
CASH
PLAN FILE #
FINAL DATE
INSPECTOR
PLUMBING
FEE
TOTAL FEES
$
-15
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED
WITHIN 60 DAYS. CESSATION OF WORK FOR 120 DAYS SHALL ALSO
CASH CHECK
M.O.
N.C.
CAUSE PERMIT TO BECOME VOID.
O rCEIVED BY
SEWAGE SYSTEM
I HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS
[
PERMIT WILL BE DONE IN ACCORDANCE WITH THE LAWS OF RIVER-
r
I
SIDE COUNTY AND THE STATE OF CALIFORNIA. I ALSO AGREE TO
10 y
r
LL
P
CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLI-
ANCE WITH LAWS OF THE STATE OF CALIFORNIA OVERING CON-
INFORMATION
TRACTORS IS ALSO GUARANTEED, r•
EAKE OF C 33iSTRUM
Xi + V14 3-Y"I
aWNLF[
CONTRACTOR
' -
T"J".)
ADDRESS
ADDRESS -
TEL. NO.
284-208 11/67
TEL. NO.
LICENSE NO.
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