HomeMy WebLinkAbout29151 RIVERSIDE DR_ (4)29151 RIVERSIDE
M
Project Address`_ -
AssegaisParcelNo.
Ohs. ner's N_o•,",- 4 t" l J l2 \•Xl r? 1 _%
Are'): Cfig _ _.__. -_ _ Licensp Nu_ —
Address
Contractor's Name.— tirJLit_ 3 -- --
Address (ma:ling) 79_ W • 4A
City License No. -
LICLNSED CONTRACTOR DECLARATION
I hereby affirm that I am Incensed under rro,rsfous of Charter 9 (commencing
with sect-on 7000) of D s,s,on 3 of the Business and Professions Code, aria
my license is in full force i d effect.
Liceese Class —__ .— _ _ LlconWVo _ O —
Date
WORKERS' COMPENSATION DE LAP.ATION —
v
I he :. t affirm that 1 navt a Cc- tt!,cdte of consent to self - Insure or a certificate
of ,% Vvk!rs* Compensation Insurance, or a rertifted copy thereof (Section
38J0. Lab. C.)
IicY No.
copy
Company
r Cep tfaea opy is hereby utmihed.
IJ Cc: /y}1¢O py i yl ill, the c.t it g p,v,
atO • PDI, cart]Lrjl{J` <•_
EX MI TION FR 11. DRSC ' CO MPEraSAT10N DECLARATION
Th1S %Chon need not be ccfm. ^letee if the per n,ft is for one hUndrPd (S1color
less).
1 certify that ,n the pCrtO•mance of tnc wn,4 fur which lh.i perrnll is issued, I
Shal, nct employ any perf )n :n an/ rntnner $e as to become su D)eCt to the
Wnr' ens' Compensation Laws of CagfOmta.
sate ^S,yna:.,re
NOTICE: If, after mal in3 "'S dcr,ard:,,),,, ynu tliould become SllbJec: Io of
Workers* Comrensatn,)n prCV Vnrs of :ht Labor C.ld(-, yru mi ,.t .rr,r'i : :,•T
rnmply with Such pr.).,S -0• ; !h.; pcfrl,it Shall be deerned rev Ik[d.
CONSTPUCTION LENOING AGENCY
I Iteirby a'ft•m that there 'S d .• r- I!r,Ri - "n !enr;tnq agency fr,r the performance
o+ lh+ ts'.j,k for v.h•cn tn,•. norm,; t•, issued i5,' _l,nn '097
Lender's IVarnr __--
Lender's A,tdrest
OWNER BUILOLN DECLARATION -
I hereby ,atlun, that I a-, ,. xe Ta• fr,ln, the C.Ontra?,olf't Ln en5e Law lo. Me
is nnv'pgq n't •.un (Set!„ -. t;, 31.: 6us•n, and Prnfcs,, 'nAI Cotic: X-v city n,
county fh,C•i regw,ts a pe,r ,t ' co. ••r uLt,'liter. irnci,ov,, dCmnh sA or tepd,r
any st"'.0 re, prior t) nt 'SSUance. III,, reda,res the apply• :.u,t for Stich hermit
to File act iu) t!a;cment Ana'. ,"r'inz IS lteefM41. put Stanl t!i the ornv,linns of
the Con :rac.t • t_,v:nse Uor (cgrnmtnci • I with Sect„' 7000,
Div,sn,,, 3 it the bu,,mess ar.o ; :.WeSOCIIIs Cdue) At chat he /sh is a4e.,:pt
he,effom anrT the has's for !n(' an^_,cd exCmpl, r,,. Any v,Olatt„r, 01 S :cltnr.
7031.5 by an4. applicant fo, a ac•m , su ^;cots the applicant :n A civil
penalty of nn• elQre than 'rift n.mdrto dztpa•s (5500).
t. 1, at "'wrier oI\'life Pror . rtv rr 'If em0,41vec• vrth W.IGC; as !near suit"
nCo,penSatiOn, wth Vu the w',4 • anti the struct lfc ,s not ntenceci ,• ,fftrep
for sale (Sector, 7044, Bus • css and ci,efe Vona: Cnae: Tne C",otraclor's
l.,cenu Law does :^ an ,Iwner of -! prvperty vA,u builds O• mp,oves
thereon, and viho dGCt such :,Or• V- 1salf,her"If nr through it" — her t— I
em Ployces, w,wIled tht; su G, ,iriprnvenieo:s are nu: n.Ierr1nC ,)r •,Tread f „r
Sale. If, however, t',e nji1n. -7 or ,T,;,, ,.a,,l fit Is s•)In wnh,n One year it Com•
ple;ion, the uv.ner ,.,11 ,tare the burden of proving lac sne (1:,+ not b ::ilt or inn-
M--rove for the pufnr,e br sa,b)
1, as owner of tl.t' c,-pc A,. am exrws;vely i- .tfactinq vl,rh Items ^.'I con.
tr,,ctorsto co„stuct t ,^ Orr. CG( ,Section 711 < :, Ousineis. ,d Profess, )n; Code;
The CUttracl or't l_Kr cis•: L., .•. Ones net apply :n an ;wnet c;f prnomty wha
I,mICS I Ag,pfovcs ini- fin, tn.wno c,)n1wtrarl5r such pnitects w.t•, A con-
I tzr (f) license pu•tueol to :ne 'Cnntfacta,'s License t_aw). 1 am ay.are that
pfei,J , their t:'•rr Pr's (.,: •+,pan sdt,p r, I, surance st: ultl be. provide,l to nit.
L; I am exempt under St clw,.. .. ...... — •. .-_ B. P. r, for 1••,s reason
D.te. L.wncf
I nerenv CCrtfy that I hAIA rea0 :r•.s apbl,calit,n end state that Inc above
information it r.•,rrer t, I Jr. CC F rr,rnp,y wU, all city and tntmty wo'loOncos
any) slate lava Fin•; !r, bu,luiA Ik)n, er,tl hereby dulhorita rapre•
fed :ativas nr city .O c anon the p"a•mon tinned Pntperty for
mspoctinn n
S,Nnal ore __ C• _ UaIC I _I !! d
pnirels' I.rceffse'mr -ft AL '
WhCe•Bwblr,g Green• Tempt; aryTneCopt •.C•inuyAtsessnr..PlnkApphtaet G01;enrod•Actnunhng
CITY OF LAKE ELSINORE CON; RUCT:JN PERMIT
Applicant to fill in all spaces except those within heavy. border lines and sign all appi opriate - ;- clarations
PER Flt'. - ; TRACT NO. LOT NO. Ufldr`t1t! 1 -'
TV c CQNSTRiwwi - s :s .:a
ADO -, .- IiERitilCt( 1; r EP,IR
rim "_
EI.ECTRICAL FEES _ _MEiit2`NI^AL FOESACCT. itGenerator -0 -5KW 5KW --
Con_struction Pole Suh,- Ucct Under Ground
ERs ON DEt ii +sti OTHER
7_,,-/sT - - — UESCRiFT10S 0r W11RGiUSE OF BLC,G r
A.P.
3 L /
S i Main Building:
TYPE OF PERMIT _ CRf.OING ? FO'JNDA;10.1 ; P.LICTURAL Ti Front
TEIMT Fi.ECTRICAE 7 PLUMBIt(G M. A L B Rear
OTHER _ _ __
PROlECF OESif7IPT:ON _ $. Ft Zt — Occupancy _
A
C Right
Acres --
K -
Ri
S Left
yafas :c ^f °
Fan i Eva OraGve Choler - - - -
PC's --- - - - - -- -- Won Ref.
Remarks Pia
S r-
PLUMBING
Alter_ Repair
Auto Nash _
BackflowPleventerT_ _
BackfIow_.,_:.9 (ron --
Clarifiers_______.
Dishwasher _ _
I Fixture Traps ea.____-
Floor Drains
Fl r Sinks
Gas Sertice Outlets
Interceptors_______ -
Roof Drains_ _-
Trailer Server
Sewer Cap_ -- -
Sewer Connection • Old
aolar Collectors
Solar Piping
i Solar Tank_ -
I Swimming -Po ol /ya
i Water Heater __ _
Water S_P.N!f,L.__ --. _
Se*1 Sy(St9M— —_—
Issue —
rning Notes
L
Acca ;sory Building:
i - --
Z
O
N
Parking Rena. /Provided E
U
na
1i T
S
FEES EI.ECTRICAL FEES _ _MEiit2`NI^AL FOESACCT. itGenerator -0 -5KW 5KW --
Con_struction Pole Suh,- Ucct Under Ground
GRADIhE FEES
Cu! - cu yards
Cookin- Unit i ` Uutt•$huUura) rAli -- -- - -_ cu yards
I Pole LifLl— - i Fan Vantilating - -- ~ -- 3360 3310 Plan Cfleck fee f _ _--- _ -- -__
Dryers :)Gas CE!ectrir. i - E.xhaus'System 330033)2 Permit F”
Fan i Eva OraGve Choler - - - - Total Fees $
F. A. U.
Outlnts -• - - -i - - ^•
Switches I _ - -.
Me -.; up to 200 amps _ T
Meter , : over 200 amps
I Sub a2el -
I
C 15 50K11rTraiisfuriner
CI 50 +KW
Motors 1-10.1 HP O 1 yt • 8
I Inc. Solar ;79.15 HP El 16.15±_-
Sing /Farr. Res. 1- -- -
16luiii :Fain. Res. -. -- • - - •- - -..
1 Heating System $ Durting !
r- 0- 1.05,(.)00 BT U C 100 000 BT_ UI
Hood or Canopy !
T_ipe! - _.Type II G -
1 Refrigeration System
70.100 000 BTU- 100,0110 BTU
Fire l /Fact_Bit ICBO #__
System_ R_epair,Alteration__ - -
11 ire Dampers- - ` — -
Re Inters
Iircineratnr
3300.3312 1 Summar7 of Permit Fees
110.23'[
11
SMIP Cam. f
4 -•- --- -0 33003370 1 Summary of Phn Check Film
DEVELOPMENT SERVICES REQUIREMENTS:
Ialfng Approved By .- _ _ - - -- -- Data - - -
Bu"KIIAP1110114BT __ ,.Date._,L 1_1 j
3360.3375
Application Ismil By Date1 •- --- ^ - - -
Building $
lumbing $
lectncal $
Mechanical S
Other $ _ --
Planaing $ -
Total Fm Doe $
s
Plumb!ng
Electrical
Mechanical
Other S - _-
I10 731 SMIP Res
110.23'[
11
SMIP Cam. f
4 -•- --- -0 33003370 1 Summary of Phn Check Film
DEVELOPMENT SERVICES REQUIREMENTS:
Ialfng Approved By .- _ _ - - -- -- Data - - -
Bu"KIIAP1110114BT __ ,.Date._,L 1_1 j
3360.3375
Application Ismil By Date1 •- --- ^ - - -
Building $
lumbing $
lectncal $
Mechanical S
Other $ _ --
Planaing $ -
Total Fm Doe $
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