189705 (SFD)DEPARTMENT OF BUILDING & SAFETY
COUNTY OF RIVERSIDE ^
FIELD OFFICE
CONSTRUCTION ESTIMATE
ELECTRICAL FEES
PLUMBING FEES
1st FI. i f+F t'
2nd F I.
r•
Par.
Gar. r
Car P.
Wall
Sq. Ft. - %
Sq. Ft. @
Sq. Ft. @
Sq. Ft. @ / '
Sq. Ft. @
Sq. Ft. @
Sq, Ft. @
�!' A
NO.
NO-
..
/ `r _•O
POLES
SIGNS
DRAINAGE PIPING
TRANS, AND/
DR T, CLK.
DRINKING FOUNTAIN
MOTOR H.P.
URINAL
MOTOR H.P.
WATER PIPING
ESTIMATED VALUATION Is
MOTOR H.P.
FLOOR DRAIN
MECHANICAL FEES
MOTOR H.P.
WATER' SOFTENER
VENT SYSTEM ❑ FAN ❑ EVAP. COOL HOOD
r, y�
MOTOR H.P.
WASHER (AUTO) (DISH)
APPLIANCE
r
FIXTURES
GARBAGE DISPOSAL
�•
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
OUTLETS
LAUNDRY TRAY
AIR HANDLING UNIT
SUB -PANEL
KITCHEN'SINK
R
!
GAS PIPE ❑ NATURAL ❑ L.P.G. ❑ OIL
WATER CLOSET
t
COMPRESSOR HP
? �1
RANGE AND/OR OVEN
LAVATORY
`
ill
APPLIANCE VENT
WATER HEATER
SHOWER
ABSORPTION SYSTEM B.T.U-
SPACE HEATER
BATH TUB
INCINERATOR DOMESTIC ❑ INDUS. ❑ COMM.
CONSTRUCTION POLE
WATER HEATER
HEATING SYSTEM ❑ FORCED ❑ GRAVITY
lJ
J
oo
SERVICE ENTRANCE
i(a
SEWAGE DISPOSAL
4
BOILER B.T.U.
RESID. 1Q SQ. FT.
-
HOUSE SEWER
PERMIT FEE
GARAGE yQ Sp, FT.
GAS PIPING
!F1
PERMIT FEE
!;1
PERMIT FEE
PERMIT
N
LLIBER
�RFN. DBL.
J
TOTAL FEES HEAT 6 VENT FEE PLN. CK- FEE
�CONST, FEE
ELEC. FEE
PLUMB. FEE
A S
J F M A M J J A 5
O IN
O N O
SET
LOT SIZE
USE $
JOB ADDRE55 J
OWNER
BACK
PLAN CHECK FEE $
ZONE
USE OF BOTLDINC
r �1 �.
,
DATE
/J
MECHANICAL FEE $
CHECKED BY
r
CO MUNITY
-
JDISTRICT
F.C-
J!T-s
E.
VALUATION
4.
OF ICE
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y
CONSTRUCTION FEE $
GROUP
�
TYPE
�
LEGAL DESCRIPTION
f
fr r/ i � �• r -� � �
1891
PERMIT NUM ER
/O
ELECTRICAL FEE $ 0. 4L_�
SPEC. INSP.
'
f t / �+
SUPP. TO PERMIT
PLUMBING FEE $ �j �/
PLAN CHECKER
BOND $ BONG
CASH
PLAN FILE A
FINAL DATE
-l6• I
INSPECTOR
ul�
TOTAL FEES / E Cf
/
SHALLTHIS PERMIT BECOME I RIS NOTCOMMENCED
WITHIN 0 DAYS.CES CESSATION OF WORKFOR 120DAYS SHALL ALSO
CAUSE PERMIT TO BECOME VOID.
I HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS
PERMIT WILL BE DONE IN ACCORDANCE WITH THE LAWS OF RIVER-
SIDE 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-
TRACTOR IS ALSO GUARANTEED.
S f
CASH CHECK M.O. N.C.
RECEIVED BY
'L•�
SEWAGE SYSTEM
T /,YIa �[tJ ILL
P
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NAME OF CoUST Rl,IC7ION LEN DERF _`�� I F
.� -_
BRANCH OFFICE
OWNER
-•/ / - ;r //
CONTRACTOR
ADDRESS
CITY STATE
OCFRESS
ADDRESS
NO LENDER INVOLVED
INFORMATION
284-208 12/BBky'
'
TEL. NO.
TEL. NO.
LICENSE No.