HomeMy WebLinkAboutLAKESHORE DRIVE 505_04-00001231 'N 1
ity of Lake Elsinore
10 PERMIT 130 South Main Street
PERMIT NO: 04-00001231 DATE : 5/10/04
JOB ADDRESS . . . . . 505 LAKESHORE DR
DESCRIPTION OF WORK ELECTRICAL
OWNER CONTRACTOR
WOLFE CINDE OWNER
OTTOSEN DONNA
505 LAKESHORE DR
LAKE ELSINORE CA 92530
A. P. # . . . . . 374-253-008 2 SQUARE FOOTAGE 0
OCCUPANCY . . . GARAGE SQ FT 0
CONSTRUCTION . . FIRE SPRNKLR
VALUATION . . . ZONE . . . . . . R-1
ELECTRICAL PERMIT
QTY UNIT CHG ITEM CHARGE
BASE FEE 30 . 00
1 . 00 X 16 . 2500 MISC. WHERE NO OTHER FEE 16 . 25
1 . 00 X 5 . 0000 PROFESSIONAL DEV FEE 5 . 00
FEE SUMMARY CHARGES PAID DUE
PERMIT FEES
ELECTRICAL PERMIT 51 . 25 . 00 51 . 25
OTHER FEES
PLAN RETENTION FEE 1 . 00 . 00 1 . 00
TOTAL 52 . 25 . 00 52 . 25
SPECIAL NOTES & CONDITIONS
REPLACE AND UPGRADE ELECTRICAL WIRINGS
, IN THE KITCHEN ROOM.
Date: 5/10/64 19 Receipt no: 5479
2N4 1231
BP BUIL)IKG PERMIT 1 $52.25
Trans nunber: 76406
CK CNECK 1171 $52.25
Trans date: 5/10/04 Tire: 15:53:34
\ Ple au_ Read and Initial
1 I am Luc rased under the pro%Ivnns of Business and I'rolesamnaI
Code S< iion CM ei seq and my hce'nsc is In full lorre
��111t III ((I1-111,1M IIOLIS I)I.ICU 2 1 aso-nerol t he property or my emplovecsw/wages as l he lr sole
compensation will do the work and the structure Is not intended or
(III the *Oh � offered for sa!v
b 3 1 as owner of the property am exr Iustvely contracting with hrensed
contractors to construe t the project
I",1 I'I h\11I V \11;J R '11.1 OIL _ 4 Iha�r•arenlficateolconse•nttoselOnsureoracerurrral(-ofWork<rti
kM \J)I IRI ;, ,i1 i.• '..tl` I11�4 �.i .`i, Compensation Insurance,or a certified cop\•thereof
5 1 shall not emplo%din pe rson In any manner so as tohe•<omr subject
to Korkers Cuumpensation laws In the perfonnamt of (he work for
whleh t}us permit is issued
tiote II%ou should bet ome sit hJer t to Workers Compe'nsa Lion alter
making this r'erttticdunn you must forthwith comph'with such pro
vi,00ns or Ihrs pe rmlt shall be dec mid r'%oked
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C.oce PoD 5 S:�41+o.as De e rs ti OTHER DEPARTMENT RELEASES
r-e ` Cepartrnent Approval required poor to the
DuiJdunc being rc4eased by the=City
Dave Inspector
Pia--
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P'N- -
Finance
Enarneennq
City of Lake Elsinore
130 South Main Street
APPLICATION NO
APPLICATION FOR 04- 1 2_3
ELECTRICAL APPLICATION R CEIVEDy-�/ (
PLUMBING PERMIT AP a By
ATE /C_�� {
MECHANICAL
I certify that I have read this application and state that the BL li!yD RE s
above information is correct I agree to comply with all city ��((JJ ,
and county ordinances and state laws relating to building TRACT ^ �`OCK/PAGE LOT'PAR
construction and hereby authorize representatives of thiskP- ff
city to enter upon the above-mentioned property for inspec- h! NA
tion purposes Fo:
Z MAILING ,/ ,I PHONE
0 ADDRESS O 5'v
zu
STATE,ZIP
21J1�t• ti � v�v�1
Signature of-Applicant or Agent Date I hereby affirm that 1 am licensed under provisions of Chapter 9(commencing with Section
y 1000)of Division 3 of the Business and Professions Code and my license is in full force
and effect
AGENT FOR 0 CONTRACTOR IYOWNER a, LICENSE q CITY BUSINESS
Z AND CLASS TAX it
0 NAME
AGENT'S NAME
MAILING
ADDRESS
AGENTS ADDRESS CITY STATE/ZIP PHONE
STREET CITY STATE ZIP
CONTRACTOR S SIGNATURE DATE
BUILDING PERMIT NO.
ELECTRICAL Quart PLUMBING Quart MECHANICAL Quan
New Residential Multi Family Fixture or Trap Furnace up to 100,000 BTU's
New Residential Single Family Building Sewer Furnace Over 100,000 BTU s
Private Swimming Pools Rain Water Sys per Drain Floor Furnace/Vent
Switches / 1 st 20 Private Septic System Unit Heater/Wall Heater
Switches/Over 20 Water Heater/Vent Install/Relocate/Replace Vent
Recpt Outlet/1st 20 Gas Piping System 1.4 Outlets Ventilating Fon
Recpt Outlet/Over 20 Gas Piping 5 or More Outlets Exhaust Hood
Lighting Fixtures/1st 20 Dishwasher Fireplace
Res Fixed Appliance/Outlet Solar Tank Commercial Incinerator
Non-Res Appliance/Outlet Solar Collector per Panel Air Handler► 10,000 CFM
100-200 Amp Service-4 600V Grease Trap/(Interceptor) Air Handler-4 10,000CFM
200-1000 Amp Service-4 600V Install,Alter or Repair System Fire Dampers
Service Over 1000 Amp or 600V Lawn Sprinkler System Registers
Misc Apparatus,Conduits,ETC Backflow Device Smaller than 2" Boiler/Compressor to 3 H P
Signs Backflow Device Larger than 2" Boiler/Compressor 3-15 H P
Sign Branch Circuit Floor Drain Boiler/Compressor 15-30 H P
Buswoys/EA 100 ft Floor Sink Boiler/Compressor 30-50 H P
Temporary Power Service Water Service Boiler/Compressor► 50 H P
Temp Power Distribution Sys Alter or Repair Drain or Vent Repair/Alter Misc HVAC Equip
MOTORS/TRANSFORMERS Fire Sprinklers per Building
Motors up to i H P SWIMMING POOL
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 IN, 100 H P Replace Piping
Replace Filter
Misc Replace
Gas Piping
REV DATE 11 1 90