HomeMy WebLinkAbout29151 RIVERSIDE DR_ (4)
--, CITY OF LAKE ELSINORE CON; RUC?:JN PERMIT
Project Address`_
Assesto s Parcel No._-.-_T Applicant to fill in all spaces except those Within heavy.border lines and sign all appi opriate-;-darations (�!/
OwgWt N_�o•�,", LJ K� �� »us2�\` J t _�7 � PER F:C_C ;TRACT NO. LOT NO. U!idL'`i7f! 1
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1 Are I cotJ _ TTFt :CQRST?f` NEW _ ADO Tr
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Address __ �kCiERSI�N DE7�ii+arf "_ OTHER _7_�_�. s'_ �_ _ A.P.
--- - - -— 0ESCRiFT10h OF Wt1RK/USE OF BLGG -.__ /r .i l Cone
f Contractor's Name.-( �S+s_�_. '1� Phone -�� —- -- - _ $i Main Building. Acce;sory Building: -
t - - - Ei -
Addres;Ima:Iin91 xeZ�_LJ•L+4 >:���lc:c c TYPE _ GRAOIiI; FO'3Nb7 ;10" P.LICTURAL T; Front --t--
} City License No. -_ _ TEri.LNT Fi.ECTRfX1 PLUMBIT(ti _ W AL B�` -- ---- - -
_ -�-_- Rear N
i LICiENSED CONTRACTOR DECLARATION CEHER ---__ A
I hereby affirm that I am IrcenSea under rrov;sions of Charter 9(commencing PROTECT JESif7IPT:ON S.q F( C Right j(y
with sect-on 7000) of 0 S,Sion 3 of the Business ana Professions Code,and Cr,,tsh;:ct�a:1 K -'�'- --.----- --'{G
my ficense is irl full farce i o effect. QQ 'fry Cyr -•-- a -_ Acres $ Left
Lrceese Class--- --�. _ -- ucen o� �C_-_ ----- --- - - is R
O yalaat•c^f__�e� -P(9 -•--•�
� � 'f� �Q - Pin Ref. - Parkin R _
Date Lj=-��- s,Jnat•,rett-�� - ------- -- g. eq_/rrovided E
{ IILs _-_ Remarks - --
WORK ERS•CO MPENSAT(ON DE LA P.AT1014 Planning Notes ��� � �
s I he:,:y affirm that 1 ruvt a cc-t:f,cate of consent to self-Insure or a certificate r
PY tncrcot ( 7 _ T
.1 WnIk,!rs' Compensation Insurance, or a certified c0 Section
3800, Lab. C.y /J�C, V 7Tv 1 1'F�'lyg-� $
/- ..pf�nlrcY No. -_-__-.-_ _ __--_ Company
CCr t,hcd copy K nerebY 'utmsheil.
IJ .Lt t wJ•� e'4a.lw�w
j( Cc:(/�y}1¢O py i yl Ile the crtyy.$� tl g p,v, T - - _
PDh Car <,f- _.
1 EX MI3TION FROW. ORiC •C�ddMPENSATiON DECLARATION
q (Thrt s,c!,on need not t:;e com^Iesec,if the pernvt is for one hundred 1 (S'_o0)or less). --
1 certify that to the Der?,,-mince of tnc wnr4 for which;his cierrn;l is issued, I
shall nct emplr,y any pers.n on any rrenner $e as to become subset: t:,the PLUMBING FEES 61 ECTRICAL SEES hIEC�I!•NIQ;AL FEES I Wnr cis'Compensation Law:of r n'urnia_ - - - -- .. - - - �_ _ --._— )_- ACCT.0 GRAWS FEES
Date _ _^stgna: ,. ' AEter_Repair Generator�0 5KW❑ 5•l.5KW, _ Eoi19r _ _-
if, - ---- + Cu! cu ykrds
Wo Workers*
r_, alter ma-ir, -,is r1c deft ,:�,, you sr,n-1: -. ynulC st,.t to •r�¢ .-Auto-Wash Construction Pole Sub. - -
I workers' "tt. s nn ill prcv; - !r :fir Labor Cn:1e, e cl croci rnr;::-:fife, - - ---.. -__�.-- -- - .- �• �cet-Under Ground -' --
rnmply v+rth tuCn prat+�5 0•-; .r�.; perntit sttan be dCcrn ea rev
- Backflov Pleventer____ __ _ Cooking tJll:r l DUCt•Structural —_-F _Fu yards
( COe:S•TPUCTION LENDING AGENCY BackfloW Irr! at10n _ _ I Pole Li_ht i _ Fan Van(;la(ing 33603310 PLtnCrieckfee$
I ncirry a'f,•m that there 's it.••r•S!r,n!- n fenCtfnq ag•2nCv f,,r the Derformance - _`�_ -- l-L----- -__ _ _--------__
of th, v,'Jrk f", v.h•cn :n.s nCrm.t I•, tSSUCd (Se_lion 3097 C". C.) i•r)- .
Lender's Name Clarifier-, r ors :)Gas CE!ectrlr. __ Exhaus'S stem _ j - 3300-3312 Permit Fee i
-- -- - - - - - 1--- - y----- --- - - i - -Y
Lcnrlcr'S A011fe'S _ __ _ -� •--•• •_�----- DISl1W8SI1Cf_--__-- i Fan ' Ev'a�Gfaliy0 COOIef--------� Total Feez f
OWNER BUILOLH DECLARATION - -- - --- - - - -- ----- _-- -� I Fixture Traps ea.-- -� • F.A.U. Heating- ._t ..-_ -
I hereby at,um that I e t.xemp• fr,ufn the Contra?.:nr's L-arise f_.)w lo. the - - --P----- -__ __--__ I .,ySiem$Durting
1 fcpn ri n•r'.un Scctrr, !- f a _ Floor Drain i----- ---- - ---- r-- s - - . .
v'Aq ( �31.: 6hs�n�•:anft Pen ff•s:�'�, I C:otlC: A�•y ufy r,r � S FIx•urc: � r , � 1
cot.nty vn,c•, reat,�,es a pe,fr, cc'' •n:ct,after,itwos,-,demnlW,or rcpa�r - �0 .0�,(00 BTU ` 100 000 BTU
i an st"'.0 I-c, poor to cis :ss a,,ce. 1111,reoa,reS the appl,•_i.,t for such!7ermit Flrnr Sink s I ' 3300.3312 Summa of Permit Fees
v -t —_-________. , Outlnts ^ Hood or Cano
to I a ct�illl ttatc,n1ot •na,. ,arc'inz is'�cPn56.^..Pwivani t:,(ne prnv,slnns Or G _ PY S `
the Con;rat.t• t_�!cnsc Lae iC'.aa;•r n(cOmmenclr.f with Sect„t 7000,.,f _y as SefLICe -Out le'tS__-_- __--- SLVI(CheS _ i Type 1. - _Type II � � ��•�,^{,
Dt sn„, 3 „( Iht f3u;,ncss ar,n ;:.WeS00os Cdae) At tha( he/sh ,s a4e.a0t - j - --- T`-`-- - - - Bluidlnp f —
Interceptors Meter up to 200 amps _ i Refrigeration S stem -- - -
•nc,efrom ar,d,the nasts lot tnr ane,cd exernpl,)it. Any v,olaft„r, M 5.,c+,nr. �.- u_-_ _ {_ Y Plumbm f 7031.S by ante, apDltcant for a p�•n,, su^,Ccts life applicant :n A civil P•Tr3p _ Meter i over 200 amps ^0 t00 OCO BTU Gt 100,Og0 BTU ! g penally of not r,•iorc than five:h,,ndreo ftOI!a•s(SSnO). - ---------- } - -- --— -�- -r------- -- Eleiancal S
t 1, at q,anm (A life Drnc ffy nr ;.,, emp'nyce• v rth waft; as tnetr soft,, Roof Drains _- I Sub anel Foe I/Fact. 84.ICBO #__ - - --
1 co mpC n!ltinn,wth Vu the % and the struct Urc ,•.nrd mtenced r -Aferecl f --- - -- -� - -i --"�- -"--`" ----;----
for sale Section 7osa, at:vnE s and n•crn; TrailerServer ��-- �- - Mechanical f -- -T_
_ 15 50K11 : System Repair,( n sronai Cndc: The Cont iri,ov's -_ __- ,. Alteration •�(-
1 frcl"Itr! Law aCCS nntlj7ply i^on r,wner of.!prvpertY vA,u ttutlils O• m,prOveS Server CS - I Trai151UI'iTtef I -.i.-----_ _-_-'--'--'----.^+- -� Other
+ _ __p _�_ LI 50+KW Fire Dampers f -
tGC,CGn, .Vu] wt1» dGCt SUCK :.cat• 1'":n;alfrltClSYlt of through h,S n� her r,w��I - - -------. __ --__- -�_--,-„--_--__--_--_�- _�-
Cn1pIOyCeS,ft,,V11Ivd Ihl; to G, aro nut nderoec ,fr •,•fired fi;r Sewer Connection• Bldg. I , ------ �-
Molars 0 1 HP 01/�•a Re Inters lid 11 SMIP Res f _
talc. It,however, the nu`Ir,.n, or;m;,f�,.o,n nl is a�tltl wn m one car ,I enm• --r-:;--�------�-- � - i �t -----------
pl¢;ion,tnC uv,nCr non ndYC tnC Durtle1,Of prOvinr)hC;sho atri not b::Nt Jr Tell. aGlar Collectors Inc. SGIar(-19.15 HP E116.15+ Incino:atnr 110.23k SMIP Con` f
MoveMove for the pufnr,ft O'sa,b) -+-...__. _..-" _ �_---._- _I! _ _
I,as Owner of tf.,. t '.pcA,,.am exUU;,vely .,,tractiny „rr I,crrs:f1 con. _f Solar_Piping- --- - Sing/Fern. Res. 1-^ M;se.
trjctorsto co.,st,uct I-nrr.Ce( ,5ectior. 70-::,Ouslness:.0 Profess,w;Code: i Solar Tank - - - -- --- --- - -' 33003370 Summ:ryof Phir Check Film
The Cohnauc,r s L erns•: I_.,.,dues rr.t APPly :tt an (;wnet r;r prnocitt' who _ --- -- - -I MIf i•Fam.Res. -- - T` -- --- -_�.-
htl,lds n, impfovcs tn7-r n, tnfit%wno contrarlS for such protects w.t•, a con- � Swimmin Pool/S a �SWlmml1 Pool/S a _ __ _ --
tractn,(sl license pu•suent to :ire'Cnntfact01% Licensr t_aw). 1 am.iv.are that -i---g---/Ya -- -- -g--Sp----- _-- _ ' .--- BulkhnR f -
pfn•,f , tI^r tv•,r.gr': (.,:•+,pensdt,pr� „sprancc sh ultl be. prc,vttic�l to nit. Water Heater 1SSUe - --- 1 0 -��--
--r-.. - - - - ------- - -...- --- - - �._ ---- lumbin
L; I am exempt under Stc',r,, ._ _.:r..,.._- B. P.C.for 1,•,s reason I W8t_P.�S('.N�f�.___-.- _._r l ,leetneal f
D. e. -- r,wncf _4:�_ .•_ -- -..-_ gSeeP1t $mt§ff_L_-_ - MMhaoical S
I herenv Certify that I ha+e trap :n.s tap calit,n Drift state that Inc above - ,11t15C. __ --_- MYELOPMENTSERVICESREQUIREMENTS: other $
"-
Infnfmalmr, is ,•„rise!. I an' t- rr,rnP"/ wtt,all city,Ind county wrhnnncas Z#ailtgAwolledog.____ .Data _
and slate lava fin•; G, cu.1 tt:,n,end hereby authortle repro- f —_
�¢. _ _
J Inspection
„r city ;o cpt{r npNn rho ove•montibned Property for _ BuI1�RgApllroredBJ r _-----_ ,�1e _- /,�� 3360.3375 Plan,tfng --- -----
S gnat ttre . L,a;c �// 8 - -•__ _.-._ Application Issued BT Date
Z _ Issue _�.-----_--- //:
FJnvms'(.tconsc'1R•yti..,K - -•.----' ---- - --------- �6 ,).
Total FeG Doe s _
�` Whl e•Bwbrr,g Green•Tempv dry Fne Cop),Canuy Atsessnr, Pink Apphtaet Gel;enrod•Actnunhng _ -
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