303528 (SFD)DEPARTMENT OF BUILDING 8`SAFE:TY FIELD OFFICE
BUILDING PERMIT
J F M A M J 1 A S O N D'
*-PERMIT3,03: NO.
_
-
�.VVI`I I i Vr RIYCR>t1YC
�'
VALUATION`/�
'DST
'CONSTRUCTION ESTIMATE. "'.
OFFICE .
NO".ELECTRICAL FEES-
!� 44 i.M.41'V
NO. PLUMBING -FEES
iI'
• LST FL. 1
2ND FL.
POR.
GAR.
CAR P.
WALL
ESTIMATED CONSTRUCTION
SQ. FT. @_t Is '
�78
UNITS
-
?
SQ. FT. @ YARD SPKLR SYSTEM
FC,
SQ. FT. @ Q + ' MOBILEHOME SVC.• BAR SINK
PERMIT
SQ. FT. @ POWER OUTLET ROOF DRAINS,
SQ. FT. -,@ ♦ x DRAINAGE PIPING
SO. FT: @ >w DRINKING FOUNTAIN
SQ. FL @ URINAL
VALUATION . • $ • ""400WATER PIPING
23-
NOTE:, Not to be used as' property tax valuation
COPIES
SWIM POOL, PVT
FLOOR DRAIN
MECHANICAL FEES
SWIM POOL, COMM
`MECHANICAL FEE
WATER SOFTENER
$ •
VENT SYSTEM FAN., ❑ -EVAP. COOL , HOOD -SIGN
ZONE SET BACK I LOT SIZE I
'.
PE CK BY
HER(AUTO)(DLcH
.-
^G✓
APPLIANCE [DRYER
i L
-S^•
GARBAGE DISPOSAL. -
PLAN CHECK FEE
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR (:]SUSPENDED
BOND AMT.
PLAN NO.
LAUNDRY -TRAY
FINAL DAA_TE. INSP
OR • ,
AIR HANDLING UNIT CFM
IDLE METER
KITCHEN SINK
�G
ABSORPTION SYSTEM L� B.T.U.
TEMP USE PERM SVC
'DBL
WATER CLOSET
NAME OF CONST. LENDER'
COMPRESSOR HP
+"..
POLE, TEMP/PERM'
AVATORY
p
HEATING SYSTEM ❑ FORCED . ❑ GRAVITY
O&MIAMPERES SERV ENT
DBL
SHOWER
c
BOILER B.T.U.
STATE
SQ. FT. @ 4
BATH TUB
,
SQ. FT. @ a
WATER HEATER'
OWNER/AGENTS SIGNATURE
CONTR CTOR
'fw o
'INSTRUMENTATION FEE,
Q.FT. RESID @ ' 1 I/ad
Y
SEWAGE DISPOSAL
�y
r
SQ.fT.GAR @ 1/a¢
HOUSE SEWER
"SPECIAL INSP '.
$-
GAS PIPING
ADDRESS,
ADDRESS
PERMIT FEE,
�®
PERMIT FEE
PERMIT FEE
DBL.
TOTAL FEES
MOB.HM.FEEJ
MICRO FEE
MECH. FEE
L
PL, GK, FEE
CONST. FEE
ELECT. FEE r ,
SMI FEE
, FEE
-PLUMB. FEE
tile
J F M A M J 1 A S O N D'
JOB ADDRESS - SP N(?
I O
a'Z •► a
OWNER } '
,�•�
C. e7
76
77
COMMUNITY
VALUATION`/�
DA E
DST
OFFICE .
a
!� 44 i.M.41'V
iI'
'1
�78
M H PERMIT FEE
-
?
USE OF PERMIT/ -
FC,
SUPP. TO�.PERMI
PERMIT
NO. '
q
23-
'MICROFILM FEE
COPIES
$
BOOK PAGE PARCEL LEGAL DESCRIPTIO
773`- 1 ' 42,. / its �s7- /71.
`MECHANICAL FEE
DBL
$ •
USE NO.
ZONE SET BACK I LOT SIZE I
PE CK BY
^G✓
`.w�
/4. s.I 1 S ,ri S Ra IL+"J/
-S^•
PLAN CHECK FEE
$
BOND AMT.
PLAN NO.
PLAN CHECKER
FINAL DAA_TE. INSP
OR • ,
7,74
CONSTRUCTION FEE
'DBL
$
NAME OF CONST. LENDER'
BRANCH OFFICE
NO RINVOLVED
p
.ELECTRICAL FEE
DBL
$
ADDRESS
Cm
STATE
,
STRONG MOTN -
IO
$
OWNER/AGENTS SIGNATURE
CONTR CTOR
'fw o
'INSTRUMENTATION FEE,
r
"SPECIAL INSP '.
$-
ADDRESS,
ADDRESS
"DEMOLITION
FEE
REGISTRATION
IPLUMBING'FEE
DBL
$ *+'�9
Clry ZIP CODE
CITY ZIP CODE
too
„
` TOTAL FEES,' $ `
TEL. NO.
AREA CODE -
TEL. NO. AREA CODE LICENSE C
,CASH❑CHECKO.❑N.C.❑ s�
/
f
� �• %/ "F' f -t
`RECEIVED BY • TREES REQUIRED -
IT. SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF
20 DAYS SHALL,ALSO CAUSE PERMIT TO BECOME VOID. 4
�HAGREE THAT ALL WORK IN CONNECTION•WITH THIS PERMIT WILL BE DONE IN ACCORDANCE
SEWAGE SYSTEM
T
��'
LL
P mob^WS
OFERSIDE COUNTY AND THE STATE OF CALIFORNIA, I ALSO AGREE TO CARRY
IIIwI Iwlcl t'
y' CALIFORNIA COVERING CONTRACTORS IS -.ALSO GUARAND,TEE'
I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE
SO 1N ACCORDANCE. WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE
FORM 204-208 (REV. 6-761 . OF CALIFORNIA. _ +