HomeMy WebLinkAboutKELLOGG ST 104 S_00-00001265C City of Lake Elsinore
130 South MainPERMIT
PERMIT NO: 00- 00001265
JOB ADDRESS . . . . . 104 S KELLOGG ST
TENANT NBR, BLAME . . HORIZON CHURCH
DESCRIPTION OF WORK REROOF
OWNER CONTRACTOR
FAITH TABERNACLE
A.P.# . • . . . 374- 242 -004 4
OCCUPANCY . . .
CONSTRUCTION . .
VALUATION . . .
OWNER
REROOF PERMIT
QTY UNIT CHG
1.00 X 5.0000 PROFESSIONAL DEV FEE
6.00 X 6.0000 REROOF
FEE SUMMARY
PERMIT FEES
REROOF PERMIT
OTHER FEES
PLAN RETENTION FEE
SEISMiIC GROUP R
CHARGES
41.00
1.00
50
TOTAL 42.50
SPECIAL NOTES & CONDITIONS
PARTIAL RERF 6 SQ COMP SHINGLE TO MATCH
EXISTING. REMOVE OLD ROOF
DATE: 12/14/00
SQUARE FOOTAGE
GARAGE SQ FT
FIRE SPRNKLR
ZONE . . . . . .
ITEM CHARGE
5.00
36.00
PAID DUE
00 41.00
00 1.00
00 50
00 42.50
fU
H
2000 1265 842.50 BP
Date: 12/14/00 14 Receipt: 0003139
CHECK 11569
00000000000000
City of Lake Elsinore
Building Safety Division
Past in oo picLms place
on the ob7
You must furnish PERMIT NUMBER
and the JOB ADDRESS for each
respective Inspection:
Approved plans must be on job
at all times:
Please Read and Initial:
1. 1 am IJcensed under the provisions of Business and Professional
Code Section 7000 et seq. and my license is in full force.
2. 1. as owner of the property, or my employees w /wages as their sole
compensation will do the work and the structure is not Intended or
offered for sale.
3. 1. as owner of the property, am exclusively contracting with licensed
contractors to construct the project.
4. 1 have a certificate ofconsent to selfinsure ora certificate ofWorkers
Compensation insurance or a certified copy thereof.
5. ]shall not employ any person In any manner so as to become subject
to Workers Coompensation 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, you must forthwith comply with such pro-
visions or this permit shall be deemed revoked.
Code Approvals Date Inspector
EL01 Temp Elec Services
PL01 Soil Pipe Underground
EL02 Else Conduit Underground
BP01 Footi ngs
BP02 Steel Reinforcement
B 003 Grout
BP04 Slab Grade
PL01 Underground Water Pipe
SS01 Rough tic System
SW01 On Site Sewer
Floor Joists
Floor
RP09 Shear Wall & Pre-Lath
h Electric-Conduit
EL04 Rough Efectric-Wiring
EL05 Rough Electric -T -Bar
ME01 Rough Mechanical
ME02 Ducts, ventilating
PL04 Rough Gas R -Test
Roof DrainsPL02
BP10 Framino Flashino
BP12 Insulation
8P13 Drywall Nailin
BP11 Lathing & Siding
PL99 Final Plumbing
EL99 Final Electrical
ME99 Final Mechanical
BP99 Final Building
Code Pool & Spa Approvals Date Inspector
OTHER DEPARTMENT RELEASES
De p. fns for Departinent Approval required prior to the
building being released by dte CityP001PoolSteelRein. /Forms
Pool Pool Plumbing/Press. Test
P003 Pre -Gunrte
Date Ins for
EL06 Rough Pool Electric
Planning
Sub List Approval
Landsca
P004 Pool Fencing/Access
Finance
P005 Pre - Plaster
Engineering
P009 Final Pool/Spa
CPt C1i
4
Q r
1
APPLICATION FOR
BUILDING PERMIT
VALUATION CALCULATIONS
1 st FLOOR SF
2nd FLOOR SF
3rd FLOOR SF
GARAGE SF
STORAGE SF
DECK & BALCONIES SF
OTHER:
CITY STATE, ZIP
0-S C
SF
GRADING CUT CY
N_ E
FILL CY
VALUATION:
RAILING
ADDRESS
FEES
BUILDING PERMIT S
PLAN CHECK
ADDITIONAL PLAN CHECK
GRADING PLAN CHECK
MICROFILM
COPIES
IMPRO FEES SCHOOL FEES C
i
City of Lake Elsinore
PAID
DATE
Z] I certify that I have read this application and stole that the
above information is correct- I agree to comply with all city
and county ordinances and state lows relating to building
construction, and hereby authorize representatives of this
city to enter upon the above- mentioned property for inspec-
t- n purposes.
Signature of Applicant or Agent
AGENT FOR CONTRACTOR OWNER
AGENT'S NAME
AGENT'S ADDRESS
STREET CITY STATE ZIP
130 South Main Street
APPLICA_TJ,0N NO.
KIT —A
APPLIC TI RR CE_IVED
DATE
AP d By
BUILDING ADDRESS
TRACT BLOCK PAGE LOT /PARCEL
a
NAA:E
Z
0
MAILING
AQDRESSID -2 1
PHONE '
S-i--
CITY STATE, ZIP
0-S C
Z
1 hwebrr affirm that I am licensed under provisions of Chapter 9 (commencing with Section
1 0001 of Division 3 of the Business and Professions Code, and my license is in full force
omf effect
ItCENSE • CITY BUSINESS
ND CLASS TAX -
Ov N_ E
RAILING
ADDRESS
CITY STATE IP PHONE
CONTRACTOR S SIGNATURE DAT
v
NAME LICE E tl
Z
i
MATTING
ADDRESS
YQ CITY STATE ZIP PHONE
NEW :REPAIR OCC GRP./
DIVISION:
CONST.
TYPE:
ADDITION MOVE NUMBER OF
STORIES:
NUMBER OF
BEDROOMS: (;' ALTERATION :'DEMOLISH
OTHER ZONE:
SINGLE FAMILY units
HAZARD AREA? YES NO
APARTMENTS units
CONDOMINIUMS units SPRINKLERS REQUIRED? YES NO
TOWNHOMES units PROPOSED USE OF BUILDING: (
PRESENT USE OF BUILDING:
COMMERCIAL = INDUSTRIAL
JOB DESCRIPTION
K011Ire-TIlk, 7d
z pet ,DNC
REV. DATE 11 -1 -90
1
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