HomeMy WebLinkAboutRIVERSIDE DRIVE 29151_04-00002452 CitV of Lake Elsinore
PERMIT 130 South Main Str et
PERMIT NO: 04-00002452 DATE: 9 4
JOB ADDRESS . . . 29151 RIVERSIDE DR
DESCRIPTION OF WORK REROOF
OWNER CONTRACTOR
LAKE ELSINORE SELF STORAGE HOUSETOP ROOFING
18152 STRATFORD CIR 31760 BRIGGS
VILLA PARK CA 92861 MENIFEE, CA 92584
909-679-8369
LIC EXP 0/00/00
A. P. # 377-050-073 4 SQUARE FOOTAGE 0
OCCUPANCY . . . GARAGE SQ FT 0
CONSTRUCTION . FIRE SPRNKLR
VALUATION . . ZONE . NA
REROOF PERMIT
QTY UNIT CHG ITEM CHARGE
1 . 00 X 5 . 0000 PROFESSIONAL DEV FEE 5 . 00
31 . 00 X 3 . 0000 REROOF 93 . 00
FEE SUMMARY CHARGES PAID DUE
PERMIT FEES
REROOF PERMIT 98 . 00 . 00 98 . 00
OTHER FEES
PLAN RETENTION FEE 1 . 04 . 00 1 . 04
TOTAL 99 . 04 . 00 99 . 04
SPECIAL NOTES & CONDITIONS
RE-ROOF OVER EXISTING WITH ASPHALT
SHINGLE 3100SF.
Lgte: 9/16/CA 16 Raceipt m: LSSS
Total teed $99.04
Total pWHtt $99.04
lili`forY
Pie ase Read and Initial
I I am Licensed under the provisions of Business and Professional
Code Section 7000 et seq and mV license is in full fore
Po-:t in concpicuouti place 2 1 asowneroftheproperty ormy employees w/wage9as their-Ole
compensation will do the work and the strurture is not intended or
on the Jot) offered for sale
3 1 asowvieroftheproperty am exclusively contracting with licensed
contractors to construct the project
'100 M"L ili,h \L \tBEK .'od ih, _ 4 IhaseacertificateofconsenitoselfinsureoraceruficateofWorkers
i-I1 Compensation Insurance or a certified copy thereof
5 1 shall not employ any person In anv manner so as to become subject
to Workers Commpensation Laws in the performance of the work for
al ill 11111:- which this permit is!%sued
Note If Nou should become subject to Workers Compensation after
making this cerufirauon you must forthwith comply with such pro-
visions or this permit shall he deemed re%oked
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Coce Poo 5 Soa anryo.-a s Da e Ir s =of OTHER DEPARTMENT RELEASES
De^ rs' = Ceparment Approval required prior to tfie
pro S" e e F bwlding being released by tfie City
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Da-e Inspector
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Finance
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PCZ19 F a Pam;.Soo
.Ok-- Cityof Lake Elsinore
130 South Main Street
APPLICATION FOR APDTO G`'"rJZ
BUILDING PERMIT APPLICATION RECEIVED
DATE
VALUATION CALCULATIONS ^� ^C)73
8UI ixN�/s 401;?/D� �e.
1st FLOOR SF p�
TRACT BLOCKIPAGE LOT/PARCEL
2nd FLOOR SF
NAME
3rd FLOOR SF 0
W MAILING PHONE
GARAGE SF N ADDRESS
E CITY STATE/ZIP
STORAGE SF R
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 cWe,and my
C license is in full force and effect-
OTHER: SF 0 LICENSE of CITY BUSINESS
N AND CLASS C— TAX#
T NAME
VALUATION: R
A MAILING
C ADDRESS 3/-76,U
FEES T CITY STATEOP HONE
0 /mil � � C f-- 92s G?9 —Fri
BUILDING PERMIT $ R CONTRACTOR'S SI NAT RE DATE
PLAN CHECK NAM LICENSE
it
A
PLAN REVIEW R MAILING
C ADDRESS
SEISMIC H ITY STATMP PHONE
PLAN RETENTION ❑NEW OCC GRP-! CONST
❑ADDITION DIVISION. TYPE:
❑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? 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 4�7 &V�c Ge/YJ/ev
gnature of Applicant or Agent Date
Agent for Q contractor ❑ owner
Agents Name
Agents Address
Street City State Zip