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HomeMy WebLinkAboutGRAND AVE 29355 (2) CITY OF inkG°� cSE LAI-E LSIIYa E BUILDING & SAFETY DREAM EXTREME-rM 130 South Main Street PERMIT PERMIT NO: 09-00000534 Zg-3'6-6 %y DATE: 11/10/09 JOB ADDRESS . . . . . GRAND AVE DESCRIPTION OF WORK CELLULAR ANTENNA OWNER CONTRACTOR CITY OF LAKE ELSINORE BERLINER COMMUNICATIONS, INC. 130 N MAIN ST 14270 ALBERS WAY LAKE ELSINORE CA 92530 CHINO, CA 91710 909-597-8304 LIC EXP 0/00/00 A. P.# . . . . . 391-260-032 0 SQUARE FOOTAGE 0 OCCUPANCY . . . GARAGE SQ FT 0 CONSTRUCTION . . FIRE SPRNKLR VALUATION . . . 80, 000 ZONE . . . . . . R BUILDING PERMIT QTY UNIT CHG ITEM CHARGE BASE FEE 580 . 00 30 . 00 X 6 . 2500 VALUATION 187 . 50 ELECTRICAL PERMIT QTY UNIT CHG ITEM CHARGE BASE FEE 30 . 00 1 . 00 X 55 . 5000 200-1000AMP SERV <600 VLT 55 . 50 FEE SUMMARY CHARGES PAID DUE PERMIT FEES BUILDING PERMIT 767 . 50 767 . 50 . 00 ELECTRICAL PERMIT 85 . 50 . 00 85 . 50 OTHER FEES PROF.DEV. FEE 2 TRADES 10 . 00 10 . 00 . 00 PLANNING REVIEW FEE 153 . 50 153 . 50 . 00 PLAN RETENTION FEE 32 . 70 32 . 70 . 00 SEISMIC GROUP R. 8 . 00 8 . 00 . 00 GREEN BUILDING FEE 3 3 . 00 3 . 00 . 00 PLAN CHECK FEES 575 . 63 575 . 63 . 00 TOTAL 1635 . 83 1550 . 33 85 . 50 SPECIAL NOTES & CONDITIONS RELOCATION AND INSTALLATION OF A NEW 80 FT LIGHT POLE THE PROJECT WILL CONSIST OF A NEW 8FT CMU ENCLOSURE TO INHOUSE ,apev. CU_1111TER2 D te: i i,•iti1;;q 18 Receipt no: �3I3 *** CONTINUED ON NEXT PAGE *** Total ±e-nrered Tai•� �a;�en1 �58..4 r City of Lake Elsinore Please read and initial Building Safety Division 1.I am Licensed under the provisions of Business and professional Code Section 7000 et seq.and Post in conspicuous place my license is in full force. on the job 2.I,as owner of the property,or my employees w/wages as their sole compensation will do the work You must furnish PERMIT NUMBER and the and the structure is not intended or offered for sale. JOB ADDRESS for each respective inspection: 3.1,as owner of the property,am exclusively contracting with licensed contractors to construct the Approved plans must be on job project. at all times: 4.1 have a certificate of consent to selfinsure or a certificate of Workers Compensation Insurance Inspection request(951)674-3124 ext. 239 or a certified copy thereof. before 5:00 P.M.on prior workday. 5.1 shall not employ any person in any manner so as to become subject to Workers Compensation Laws in the performance of the work for which this permit is issued. Note:If you should become subject to Workers Compensation after making this certification, Code Approvals Date Inspector you must forthwith comply with such provisions or this permit shall be deemed revoked. ELO I Temporary Electric Service PLO1 Soil Pipe Underground EL02 Electric Conduit Underground BP01 Footings BP02 Steel Reinforcement BP03 Grout BP04 Slab Grade PL01 Underground Water Pipe SSO1 Rough Septic System SW01 On Site Sewer BP05 Floor joists BP06 JFloor Sheathing BP07 Roof Framing BPO8 Roof Sheathing BP09 Shear Wall&Pre uth PL03 Rough Plumbing EL03 lRough Electric Conduit EL04 lRough Electric Wiring EL05 Rough Electric/ T-Bar MEOI Rough Mechanical W02 Ducts,Ventilating PL04 Rough Gas Pipe/Test PL02 Roof Drains BP10 Framing&Flashing BP12 Insulation BP13 Drywall Nailing BPI I Lathing&Siding PL99 Final Plumbing EL99 Final Electrical ME99 Final Mechanical BP99 Final Building Code Pool&Spa Approvals Date Inspector OTHER DIVISION RELEASES Deputy Inspector Division Approvals required prior to the P001 Pool Steel Rein./Forms building eing released for occupancy by the City P001 Pool Plumbing/Pressure Test P003 I Pre-Gunite Approval Date Inspector EL06 Rough Pool Electric Planning Sub List Approval Landscape P004 Pool Fencing/Gates/Alarms Finance P005 Pre-Plaster Approval Engineering P009 I Final Pool/Spa Tumf CITY OFAlt 4 f LAKE Or--) LSllioR,,E BUILDING & SAFETY DREAM EXTREME,. 130 South Main Street PERMIT PERMIT NO: 09-00000534 DATE: 11/10/09 ** PAGE 2 JOB ADDRESS 29355 GRAND AVE DESCRIPTION OF WORK CELLULAR ANTENNA SPECIAL NOTES & CONDITIONS (CONTINUED) THE ELECTRICAL AND TELCO EQUIPMENT CABINETS NEW ADDRESS TO BE 293 City of Lake Elsinore Please read and initial Building Safety Division 1.1 am Licensed under the provisions of Business and professional Code Section 7000 et seq.ang Post in conspicuous place my license is in full force. on the job 2.I,as owner of the property,or my employees w/wages as their sole compensation will do the work You must furnish PERMIT NUMBER and the and the structure is not intended or offered for sale. JOB ADDRESS for each respective inspection: 3.I,as owner of the property,am exclusively contracting with licensed contractors to construct the Approved plans must be on job project. at all times: 4.I have a certificate of consent to selfinsure or a certificate of Workers Compensation Insurance Inspection request(951)674-3124 ext.239 or a certified copy thereof. before 5:00 P.M.on prior workday. 5.I shall not employ any person in any manner so as to become subject to Workers Compensation Laws in the performance of the work for which this permit is issued. Note:If you should become subject to Workers Compensation after making this certification, Code Approvals Date Inspector you must forthwith comply with such provisions or this pe sh 1 be deemed revoked. EL01 Temporary Electric Service t l Z y h PLO Soil Pipe Underground EL02 Electric Conduit Underground J/•�f L t BPO1 Footings - BP02 Steel Reinforcement BP03 Grout 1Z'7�� '� -L• -L BP04 Slab Grade b`L`-71 C1 PL01 Underground Water Pipe SS01 I Rough Septic System Z Z y SWO1 10n Site Sewer 13P05 Floor Joists BP06 Floor Sheathing BP07 Roof Framing EPOS Roof Sheathing BP09 Shear Wall&Pre-Lath PL03 Rough Plumbing EL03 Rough Electric Conduit EL04 Rough Electric Wiring EL05 Rough Electric I T-Bar MEO I Rough Mechanical ME02 Ducts,Ventilating PLO4 Rough Gas Pipe/Test PL02 Roof Drains BP 10 Framing&Flashing BP 12 Insulation BP13 Drywall Nailing BP11 Lathing&Siding PL99 Final Plumbing EL99 Final Electrical ME99 IFinal Mechanical BP99 IFinal Building Code Pool&Spa Approvals Date Inspector OTHER DIVISION RELEASES Deputy Inspector Division Approvals required prior to the P001 Pool Steel Rein./Forms building eing released for occu2ancy by the City P001 Pool Plumbing/Pressure Test P003 I Pre-Gunite Approval Date Inspector EL06 Rough Pool Electric Planning Sub List Approval Landscape P004 Pool Fencing/Gates/Alarms Finance P005 Pre-Plaster Approval Engineering P009 I Final Pool/Spa "htmf C I TY OF ifn LASE On LS I 1`�O1 ,E DREAM EXTRE M E sM 130 South Main Street APPLICATION#IF-171 APPLICATION FOR PERMIT BYPLICATIOIiiyATE:`�'G AP# BY: ,r Lt / ELECTRICAL/PLUMBING/MECHANICAL BUILDING ADDRESS Z 9 3 SS I hereby certify that I have read this application and state that the above information is correct.I agree to comply with all city and county TRACT BLOCK/PAGE LOT/PARCEL ordinances and state laws relating to building construction,and hereby authorize representatives of this city to enter upon the above-mentioned O NAME property for inspection purposes. W N MAILING PHONE E ADDRESS R CITY- STATE/ZIP Signature of Applicant or Agent Date I hereby affirm that I am licensed under the provisions ofChapter 9(commencing C with Section 7000)ofDivision 3 of the Business and Professions Code,and my (circle one) O license is in full force and effect. AGENTFOR: CONTRACTOR OWNER N LICENSE# CITY BUSINESS T AND CLASS TAX# AGENTS NAME R NAME A AGENTS ADDRESS C MAHJNG street city state zip T ADDRESS O CITY STATEIZIP PHONE R CONTRACTOR'S SIGNATURE ELECTRICAL Quan PLUMBING Quan MECHANICAL Quan New Res.Multi Family/SQ.FT. Fixture or Trap F.A.U./Furnace/Ducts/Vents New Res.Single Family/SQ.FT. Building Sewer F.A.U./Furnace/Misc./>100000 Pool Electric System,Private Rain Water System per Drain Floor Furnace/Vent Switches/1st 20 Private Septic System Chit Heater/Wall Heater Switches/Over 20 lWater Heater/Vent 11ristall/Relocate/Replace Vent Receptacle Outlet/1st 20 Gas Piping System I-4 Outlets lVentilating Fan Receptacle Outlet/Over 20 Gas Piping 5 or More Outlets lEvaporative Cooler Lighting Fixtures/1st 20 Dishwasher lVentilating System Lighting Fixtures/Over 20 Solar Tank lExaust Hood Residential Fixed Appliance/Outlet Solar Collector per Panel Fireplace Non-Residential Appliance/Outlet Grease Trap/(Interceptor) Commercial Incinerator 100-200 Amp Service<600V jInstall,Alter or Repair System Air Handler>10000 CFM 200-1000 Amp Service<600V ILawn Sprinkler System Air Handler<10000 CFM Misc.Apparatus,Conduits,Etc. Backflow Device Smaller than 2" Fire Dampers Signs Backflow Device Larger than 2" Registers Sign Branch Circuit Floor Drain Compressor/Heatpump-3 H.P. Busways/EA 100 FT Floor Sink Compressor/Heatpump 3-15 H.P. Temporary Power Service Water Service Compressor/Heatpump 15-30 H.P. Temporary Power Distribution System Alter or Repair Drain or Vent Compressor/Heatpump 30-50 H.P. Motors/Transformers Fire Sprinklers per Building I Repair/Alter Misc.HVAC Motors up to 1 H.P. Swimming Pool Compressor/Heatpump Over 50 H.P. Motors/Transformers 1 - 10 H.P. Swimming Pool/Public Motors/Transformers 10-50 H.P. Swimming Pool/Private Motors/Transformers 50-100 H.P. Water Heater/Vent Motors/Transformers>100 H.P. Replace Piping Replace Filter Misc.Replace Gas Piping J Ct+TY OF c + LADE LSI1 A0P-.,,E BUILDING & SAFETY DREAM EXTRE.METM 130 South Main Street PERMIT PERMIT NO: 09-00000534 DATE: 11/10/09 JOB ADDRESS . . . . . : 29355 GRAND AVE DESCRIPTION OF WORK . : CELLULAR ANTENNA OWNER CONTRACTOR CITY OF LAKE ELSINORE BERLINER COMMUNICATIONS, INC. 130 N MAIN ST 14270 ALBERS WAY LAKE ELSINORE CA 92530 CHINO, CA 91710 909-597-8304 LIC EXP 0/00/00 A. P. # 391-260-032 0 SQUARE FOOTAGE 0 OCCUPANCY . . . GARAGE SQ FT 0 CONSTRUCTION . . FIRE SPRNKLR . VALUATION . . . 80, 000 ZONE . . . . . . R BUILDING PERMIT QTY UNIT CHG ITEM CHARGE BASE FEE 580 . 00 30 . 00 X 6 . 2500 VALUATION 187 . 50 FEE SUMMARY CHARGES PAID DUE PERMIT FEES BUILDING PERMIT 767 . 50 . 00 767 . 50 OTHER FEES PROF.DEV. FEE 2 TRADES 10 . 00 . 00 10 . 00 PLANNING REVIEW FEE 153 . 50 153 . 50 . 00 PLAN RETENTION FEE 32 . 70 . 00 32 . 70 SEISMIC GROUP R 8 . 00 . 00 8 . 00 GREEN BUILDING FEE 3 3 . 00 . 00 3 . 00 PLAN CHECK FEES 575 . 63 575 . 63 . 00 TOTAL 1550 . 33 729 . 13 821 . 20 SPECIAL NOTES & CONDITIONS RELOCATION AND INSTALLATION OF A NEW 80 FT LIGHT POLE THE PROJECT WILL CONSIST OF A NEW 8FT CMU ENCLOSURE TO INHOUSE THE ELECTRICAL AND TELCO EQUIPMENT CABINETS f13er: C t# F; Tv re: DF Drawer' I Date: 11I10103 10 receipt no: 21c5 Ck t.HE�l 91,7 $'91i.i0' T, .s gate: i1!in/i' ime: i":1 :1; City of Lake Elsinore Please read and initial ' Building Safety Division I am Licensed under the provisions of Business and professional Code Section 7000 et seq.and r Post in conspicuous place my license is in full force. on the job 2.I,as owner of the property,or my employees w/wages as their sole compensation will do the work You must furnish PERMIT NUMBER and the and the structure is not intended or offered for sale. JOB ADDRESS for each respective inspection: 3.l,as owner of the property,am exclusively contracting with licensed contractors to construct the Approved plans must be on job project. at all times: I have a certificate of consent to selfinsure or a certificate of Workers Compensation Insurance Inspection request(951)674-3124 ext. 239 �✓ or a certified copy thereof. before 5:00 P.M.on prior workday. 5.I shall not employ any person in any manner so as to become subject to Workers Compensation Laws in the performance of the work for which this permit is issued. Note:If you should become subject to Workers Compensation after making this certification, Code Approvals Date Inspector you must forthwith comply with such provisions or this permit shall be deemed revoked. EL01 Temporary Electric Service PLO Soil Pipe Underground EL02 Electric Conduit Underground BPO1 I Footings IV BP02 Steel Reinforcement BP03 Grout BP04 Slab Grade PLOT Underground Water Pipe SS01 Rough Septic System SWOI On Site Sewer BPO5 Floor Joists BP06 Floor Sheathing BP07 JRoof Framing BPO8 Roof Sheathing BP09 Shear Wall&Pre-Lath PL03 Rough Plumbing EL03 Rough Electric Conduit EL04 lRough Electric Wiring EL05 Rough Electric/ T-Bar ME01 Rough Mechanical NIE02 Ducts,Ventilating PL04 Rough Gas Pipe/Test PL02 I Roof Drains BPI 1 Framing&Flashing BP 12 Insulation BP13 Drywall Nailing BP1 I Lathing&Siding PL99 Final Plumbing EL99 lFinal Electrical NIE99 lFinal Mechanical vtJ- BP99 lFinal Building - Code Pool&Spa Approvals Date Inspector OTHER DIVISION RELEASES Deputy Inspector Division Approvals required prior to the P001 Pool Steel Rein./Forms buildingbein released for occupancy by the City P001 Pool Plumbing/Pressure Test P003 Pre-Gunite Approval Date Inspector EL06 Rough Pool Electric Planning Sub List Approval Landscape P004 Pool Fencing/Gates/Alarms Finance P005 Pre-Plaster Approval Engineering P009 Final Pool/Spa Tumf CITY OF P LAKE E C DREAM EXT R-E M E TM 130 South Main Street APPLICATION FOR APPLICATION NO. BUILDING PERMIT APPLICATION IVED e�9 VALUATION CALCULATIONS 391-830-011 BUILM�G ADDRESS BY 1st FLOOR SF 29355 Grand Ave. Lake Elsinore, CA 92530 2nd FLOOR SF 3rd FLOOR SF O NAME City of Lake Elsinore Contact: Ray Gonzales W MAILING 130 S. Main Street GARAGE SF N ADDRESS 951-674-3124, x26 STORAGE SF E ICITY R Lake Elsinore STONE/Zip92530-4109 hereby affirm that I am licensed under provisions of chapter (commencing DECK&BALCONIES SF with section 7000)of division 3 of the business and professions code,and C my license is in full force and effect. OTHER: SF O LICENSE# CITY BUSINESS N AND CLASS TAX# T NAME VALUATION: $80,000 R A MAILING C ADDRESS FEES T CITY STATUZIP PHONE O BUILDING PERMIT 1 R u PLAN CHECK l� NAME Connell Design Group A g p PLAN REVIEW R MAILING C ADDRESS 4685 MacArthur Court, Suite 480 SEISMIC H CITY Newport Beach, TE'ZlP92660 949.753.8807 PLAN RETENTION ❑NEW OCC GRP./ CONST. ❑ADDITION DIVISION: TYPE: FIRE SERVICES ❑ALTERATION NUMBER OF NUMBER OF OTHER STORIES: BEDROOMS: SINGLE FAMILY ZONE: ❑APARTMENTS ❑1 certify that I have read this application and state that the ❑CONDOMINIUMS HAZARD YES above information is correct.I agree to comply with all city TOWN HOMES AREA? NO and county ordinances and state laws relating to building COMMERCIAL SPRINKLERS YES construction,and hereby authorize representatives of this INDUSTRIAL REQUIRED 9 NO city to enter upon the above-mentioned property for insp- ❑REPAIR PROPOSED USE OF BLDG: tion purposes. ❑DEMOLISH PRESENT USE OF BLDG: JOB DESCRIPTION Relocation and installation of a new So ft. light pole_ The Signature of Applicant or Agent Date project will consist of a new 8 tt. CMU enclosure to inhous the electrical and telco equipment cabinets. Agent for ❑ contractor ❑ owner Agents Name Sequoia Deployment Services, Inc (Mc nica Moretta) Agents Address I Venture Suite 200 , Irvine, CA 92618 01'er: F-OU TEF2 Type. ";F "^, ,,_. L4 aer: gp Lli?t nI1J� FEM '"9.13 Ch CHECL '3 720-13 Total tendered S729.13 -.17-a Tot,-.T payment �cJ,i_ City of Lake Elsinore 130 South Main Street APPLICATION# APPLICATION FOR PERMIT APPLICATION DATE: ELECTRICAL/PLUMBING/MECHANICAL AIV 391-830-011 BY: BUILDING ADDRESS I hereby ce dify that I have read this application and state that the 29355 Grand Ave. Lake Elsinore, CA 92530 above information is correct.I agree to comply with all city and county- TRACT BLOCKIPAGE LOT/PARCEL ordinances and state Eaves relating to building couskuctioa;and hereby authorize representatives of this c1ty to enter upon the abov&mn rationed O NAME, property for inspectionpu py City of Lake Elsinore Contact: Ray Gonzales N MAILING 130 S. Main StreeVONE 951-674-3124, x266 ;D ,- Lake Elsinore CA 92530-4109 I hereby affirm that I am licensed under the provisions ofChapter 9(commencing C with Section 7000)of Division 3 of the Business and Professions Code,and my (circle one O license is in full force and effCt. AGENT FOR- CONTRACTOR O WD1ER N' LICENSE# CITY BUSINESS T AND CLASS TAX# AGENTS NAME Sequoia Deployment Services, Inc. R NAME A AGENTS ADDRESS 1 Venture Suite 200 C MAILING meet city state tip T ADDRESS Irvine, CA 92618 O CITY STATEIVP PHONE Contact: Monica Moretta R 949) 241-0175 CONTRACTOR'S SIGNATURE ELECMCAL. Quan PLLIWi 1NG Quan MECHANICAL Quern New Res.Multi Family/SQ.FT. Fixture.or Trap F.A.U./Furnace%Duets/Vents :Liew Res.Singie"Family./SQ.FT: Building Sewer F.A.0/Fumacc/Ivtise./> 10000.0 PQol Eiettrie.S.Sem,Private Rant Watelr System er Drain _ Floor=Furnace l Vent_ . Swit+clres/Ist 20 Private Sc tic System ilciit Heater/Wall Heater - Switches/Over 20' Water Heater/Vent Install%Relocate/Replace Verit Re poptacie Outlet/Ist 20 Gas Piping System 1-4 Outlets Vepfilating Fan Receptacle Outlet/Over.20 Gas Piping 5 or More Outlets c Evaporative Cooler Ughting.Fixtures I Ist.20 Pishwasher Vcntitating'System Ughting Fixtures/Over-20 Solar Tank Exaust Hood . itesideatiaFFixed Appliance/Outlet Solar Collector per Panel Fireplace orAgsidential Apelidricie/.Outlet Grease Trap/(interceptor) Commercial Incinerator- 100-206 Amp Service<600V 1 Install,Alter or Repair System Air Handier>i0000 CFM- 200-I000 Amp Service<600V Lawn Sprinkler System Air Handler<10000 CFM Misc.Apparatus,C6nduits,Re. Backiloty Device Smaller than 2" Fire.Dampers Signs Backnow Device Larger than 2" Registers Sign Branch Circuit Floor Drain Compressor/Heatpump,-3 KP. Busways/EA 100 FT Floor Sink Compressor/Healpump 3-15 H_P.. Tetuporary Power Service Water Service Compressor/Heatp2 ,IS 30 H.P. Tmnporary Power Distribution System Alter or Repair Drairi or Vent Compressor/H p eatpump 30-SO.H.P: Motors/Transformers Fire Sprinklers per Building Repair/Alter Misc.HVAC Motors ug to I H.P. Swimmin Pool Compressor/Heatpump Over 54 UP. . Motors/Transformers L=10 H.P. Swimming Pool./Public Motors/Transformers 10-50 H.P. Swimming Pool/Private Motors/Transformers M-100 H,P. Water Heater/Vent Motors/Transformers>l00 HY. Replace Piping Replace Filter Miso Replace Gas Piping AUG-20-2009 THU 04� 19 PM FAX NO. P. 01/01 a�sAuiu �r RIVERSIDE COUNTY FIRE, DEPARTMENT F It) coopertttim with the Citli mil i DeparimeW of Forestry and Fire Protection 2300 Market St, Ste. 150 ♦ Riverside, California 92501 ♦ (951) 955-4777 ♦ Fax�951) 955-4886 77-933 Las Montafiae Rd Ste 201 ♦ Paim Desert,CA 92211 • (760)863-8666 • Fax(760)669-7072 John R. Hawkins Fire Chief .1 Proudly scrving the Unincorporated pgTE; Areas of Riverside County and the Citics of. FAX TO: LA ELSINORE ► 471-1418 Banning SURVEYOR'S OFFICE 13caumont BUILDING AND SAFETY Calimesa TRACT/PARCEL MAP NUMBER: Canyon.We PERMIT/LOT NUMBER: e/ — o° Coachcila JOB SITE ADDRESS- haven Hot Springs v Indian wt:ps FINAL FOR RECORDATION trtaio RELEASE FOR BUILDING PERMITS Like Elsinore SHELL FINAL ONLY (NO TENANT) FINAL FOR OCCUPANCY Morcno Vol icy FINAL OCCUP, TEMP. EXPIRATION DATE fi Paim Desert Perris BUILD PLAN CHECK FEES PAID Bch° imgC CONDITIONS OF APPROVAL San Jacinto RESULTS OF INSPECTION FAIL Temecula RESULTS OF INSPECTION PASS FogrdofSWPwroisor8 FEES NOT REQUIRED 13°b Buster, Distract 1 John 7bvaglionc, n,mrict2 If you should have any questions, please call Riverside County Fire Protection Jel�'Stnnc, uisirict 3 Planning at the number above. RQy Wilson, Tracy Hobday, BATTA ON CHIEF p151Rct � Mari Ashley, RELEASED [3Y; District$ S-30-7 aiw / CITY OF SAKE �,SI C) E BUILDING PERMIT RELEASE FORM V (Planning Division & Engineering) The Owner/Developer is requesting a Building Permit for construction at: 29355 Grand Ave.Cad McVicker Park for Royal Communications Eduipment (Site Address) Applicant: Sequoia Deployment Services (Monica Moretta) Address: 1 Venture Suite 200 Irvine, Ca 92618 Telephone: (949) 241-0175 _ CityEngineer. Ken Seumalo City Planner. Kirt Coury Date Sent: 11/2/09 The Conditions of Approval have been reviewed All Planning Division or Engineering conditions of approval have been met and the Planning Division or Engineering Division now authorizes the release to issue building permits. Date: P or Enginee ivis. Approv 6v���� OT TO B UILlLlI1�G UXU7Sl0 znov the fguo Local I?evelo megt tion Fees Xvrir�e6wtrzg�t; a. ❑ Exempt from MSHCP Local Development Mitigation Fees. ❑ Exempt from Affordable Housing In-lieu Fee ❑ Exempt from Library ❑ Exempt from Parr ❑ Exempt from DIF(City Hall,Comm.Center,Marina,&Animal Shelter) ❑ Exempt from Fire Facility ❑ Development Agreement:$ per SFR or Commercial xempt from'TUMMF xempt from TIF Exempt from Storm Drain Capitol Improvement Fund Fees Additional Comments: �" �� N V� z� f�. G � r17 ' Form No.PIS 60-Revised 12-31-07 Page 1 of 1