HomeMy WebLinkAboutLAKESHORE DRIVE 16491_07-00000766 City of Lake . Elsinore
PERMIT 130 South Main Street
PERMIT NO : 07- 00000766 DATE : 7 09 07
JOB ADDRESS . . . . . 16491 LAKESHORE DR
DESCRIPTION OF WORK NEW RETAIL STORES & CUSTOMER SERV .
OWNER - CONTRACTOR
----------------------------- ------------------------------
PRPInvestors Lake Elsinore , LLC OWNER
4152th St .
Newport Beach, CA
NEWPORT BEACH, CA 92663 y
949 - 723 -9500
A. P • # . . 379-241-057 4 SQUARE FOOTAGE 172 2
OCCUPANCY . . . 91-RETAIL, DINING.OFFICE GARAGE SQ FT 0
CONSTRUCTION TYPE V- NON RATED FIRE SPRNKLR
VALUATION 870 , 509 ZONE . . . . . UN
-------------------------------------------------------
BUILDING PERMIT
QTY UNIT CHG ITEM CHARGE
BASE FEE 2855 . 00
371 . 00 X 4 . 7500 VALUATION 1762 . 25
1 . 00 X 5 . 0000 PROFESSIONAL DEV FEE 5 . 00
----------- -- - - --- --------- -----------------_-
ELECTRICAL PERMIT -
QTY UNIT CHG ITEM CHARGE
BASE FEE 30 . 00
20 . 00 X 1 . 0000 SWITCHES / 1ST 20 20 . 00
20 . 00 X 1 . 0000 RECPT, OUTLET / 1ST 20 20 . 00
45 . 00 X . 4500 RECPT,OUTLET / OVER 20 20 . 25
20 . 00 X 1 . 0000 LIGHTING FIXTURES/1ST 20 20 . 00
340 . 00 X . 6500 LIGHTING FIXTURES/OVER 20 221 . 00
75 . 00 X 4 . 2500 NON RES . APPLIANCE 318 . 75
8 . 00 X 21 . 0000 SIGNS 168 . 00
8 . 00 X 4 . 2500 SIGN BRANCH CIRCUIT 34 . 00
1 . 00 X 4 . 2500 MOTORS UP TO 1 HP 4 . 25
17 . 00 X 11 . 0000 MOTORS/TRANSFMER 1 - 10 187 . 00
5 . 00 X 22 . 0000 MOTORS/TRANSFMER 10-50 HP 110 . 00
1 . 00 X 5 . 0000 PROFESSIONAL DEV FEE 5 . 00
---------------------_- ----------
------------------------ ---
MECHANICAL PERMIT
QTY UNIT CHG ITEM CHARGE
BASE FEE 30 . 00
4 . 00 X 13 . 2500 FAU/FURNACE/DUCTS/VENTS 53 . 00
1 . 00 X 13 . 2500 UNT HEATER/WALL HEATER 25
4 . 00 X 16 . 2500 AIR HANDLER > 10000 CFM Dai*m. 7/1:;/uABO0it2[Sipt no: 393
1 . 00 X 13 . 2500 COMPRESSOR/HEATPUMP-3 HP -jr
tal ten[ " 25lT11b .6C}
3 . 00 X 24 . 2500 COMPRESS/HEATPUMP 3-15 HPTatal pCj - 2 . 75 $"1?31�.�
wn
1 . 00 X 5 . 0000 PROFESSIONAL DEV FEE 5 . 00
---------------------------- ------------------------------------- --
PLUMBING PERMITS
TY UDII T CHG I��EZ CHARGE
City of Lake Elsinore Please rea and initial
Building Safety Division 1.1 am Licensed under the provisions of Business and professional Code Section 7000 et seq.and
my license is in full force.
Post in conspicuous place 2.l,as owner of the prol",or my employees w/wages as their sole compensation will do the work
on the job and the structure is not intended or offered for sale.
3.],as owner of the property,am exclusively contracting with licensed contractors to construct the
You must furnish PERNUT NUMBER and the project.
JOB ADDRESS for each respective inspection: 4.1 have a certificate of consent to selfinsure or a certificate of Workers Compensation Insurance
Approved plans must be on job or a certified copy thereof
at all times_ 5.1 shall not employ any person in any manner so as to become subject to Workers Compensation
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,
Code Approvals Date Inspector you most forthwith comply with such provisions or this permit shall be deemed revoked.
ELO1 ITemporary Electric Service
PLO 1 Soil Pipe Underground
EL02 Electric Conduit Underground
BPO1 Footings
BP02 Steel Reinforcement
BP03 Grout
BP04 ISlab Grade
PLO I Underground Water Pipe
SSO I Rough Septic System
S W O 1 On Site Sewer
BP05 Floor joists
BP06 Floor Sheathing
BP07 Roof Framing
BPO8 Roof Sheathing
BP09 Shear Wall&Pre-Lath
PL03 Rough Plumbing
EL03 Rough Electric Conduit
EL04 Rough Electric Wiring
EL05 Rough Electric I T-Bar
ME01 Rough Mechanical
ME02 I Ducts,Ventilating
PL04 Rough Gas Pipe/Test
PL02 Roof Drains
BP 1 O Framing&Flashing
BP 12 Insulation
BP13 Drywall Nailing
BP I 1 Lathing&Siding
PL99 Final Plumbing
EL99 Final Electrical
ME99 Final Mechanical
BP99 IFinal Building
Code Pool&Spa Approvals Date Inspector OTHER DIVISION RELEASES
Deputy Inspector Department Approval required prior to the
POOI Pool Steel Rein/Forms building b ing released by the City
P001 Pool Plumbing/Pressure Test
P003 Pre-Gunite Approval Date Inspector
EL06 Rough Pool Etectric Planning
Sub fist Approval Landscape
P004 Pool Fencing/Gates/Alarms Finance
P005 Pre-Plaster Approval Engineering
P009 JFinal Pool/Spa
City of Lake Elsinore
130 South Main Street
PERMIT
PERMIT NO : .07- 00000766 DATE : 7/09/07
** PAGE 2
JOB ADDRESS 16491 LAKESHORE DR
DESCRIPTION OF WORK NEW RETAIL STORES & CUSTOMER SERV .
BASE FEE 30 . 00
1 . 00 X 5 . 0000 PROFESSIONAL DEV FEE 5 . 00
12 . 00 X 8 . 7500 FIXTURE OR TRAP 105 . 00
1 . 00 X 22 . 0000 BUILDING SEWER 22 . 00
1 . 00 X 8 . 7500 RAIN WATER SYSTEM 8 . 75
1 . 00 X 11 . 0000. WATER HEATER OR VENT 11 . 00
4 . 00 X 11 . 0000 GAS PIPING SYS 1 -4 OUTLET 44 . 00
2 . 00 X 2 . 0000 GAS PIPING 5 OR MORE 4 . 00
2 . 00 X 8 . 7500 FLOOR DRAIN 17 . 50
2 . 00 X 8 . 7500 FLOOR SINK 17 . 50
1 . 00 X 8 . 7500 WATER SERVICE 8 . 75
---------------------------------------------------------------------------
FEE SUMMARY CHARGES PAID DUE
PERMIT FEES
BUILDING
-PERMIT--�� _~ 4622 . 25 . 00 4622 . 25
ELECTRICAL PERMIT 1158 . 25 . 00 1158 . 25
MECHANICAL PERMIT 252 . 25 . 00 252 . 25
PLUMBING PERMITS 273 . 50 . 00 27.3 . 50
OTHER FEES
------------------------
CITY HALL/PUBLIC WORKS 1865 . 38 . 00 1865 . 38
CITY FIRE PROTECTION FEE 8446 . 01 . 00 6446 . 01
MSHCP-COMM . MIT . FEE/ACRE 7602 . 44 . 00 7602 . 44
PARK CIP FEE 1727 . 20 . 00 1727 . 20
PLANNING REVIEW FEE 923 . 45 923 . 4'5 . 00
PLAN RETENTION FEE 75 . 00 •. 00 75 . 00
SEISMIC OTHER 182 . 80 . 00 182 . 80
TUMF RETAIL COMM/SQ FT 146984 . 72 . 00 146984 . 72
PLAN CHECK FEES 3466 . 69 3466 . 69 . 00
TOTAL 177579 . 94 4390 . 14 173189 . 80
SPECIAL NOTES & CONDITIONS
---------------------------
The applicant shall pay Transportation
Uniform Mitigation Fees (TUMF) in
effect at the time prior to Certificate
of Occupancy .
City of Lake Elsinore low Please read and initial
Building Safety Division I.I am Licensed under the provisions of Business and professional Code Section 7000 et seq.and
my license is in full force.
Post in conspicuous place 2.l,as owner of the property,or my employees w/wages as their sole compensation will do the work
on the job and the structure is not intended or offered for sale.
3.I,as owner of the property,am exclusively contracting with licensed contractors to construct the
You must furnish PERMIT NUMBER and the project.
JOB ADDRESS for each respective inspection: 4.1 have a certificate of consent to selfinsure or a certificate of Workers Compensation Insurance
Approved plans must be on job or a certified copy thereof
at all times: 5.1 shall not employ any person in any manner so as to become subject to Workers Compensation
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,
Code Approvals Date Inspector you mast forthwith comply with such provisions or this permit shall be deemed revoked.
ELO I Temporary Electric Service A0 I`rlWJNL fh)H C•> A G) kc-
PLO I Soil Pipe Underground R
EL02 Electric Conduit Underground d /L
BPOI Footings 41 4y � 2W5 7M` YLL tL (�vt to f. -7
BP02 Steel Reinforcement L
BP03 Grout $`Ll�i`i /44 15T, S c K 'n-a5 r • 7
BP04 Stab Grade I Sr` L44- FK.o o C 3 J6• IS-
PLO1 Underground Water Pipe Qj 0 x- 74
SSO I Rough Septic System
SWO I On Site Sewer -) '
BP05 Floor Joists /t.r vQ-,-`" :P7 LZ S 1/ "7
BP06 Floor sheathing
BP07 Roof Framing E`Q1 y4Vlrt -{f
BP08 I Roof Sheathing
BP09 Shear Wall&Pre-Lath
PL03 Rough Plumbing
EL03 Rough Electric Conduit 0- ( t jTof
EL04 Rough Electric Wiring ce
ELOS Rough Electric I T-Bar a�
MEOI Rough Mechanical tj Q TI,/h't u Z 7
W02 Ducts,Ventilating' cit OAL 1-0 e�y 4-23-7
PL04 Rough Gas Pipe/Test I. 7 8 /4 s � /-8-fr
PL02 Roof Drains •"1 l fl 14 -1
BP I O Framing&Flashing 10 1
BP 12 insulation t t- 5
BP t 3 Drywall Nailing To wt, 19-
BPII Lathing&Siding 4- 4, — Q`
PL99 Final Plumbing
EL99 lFinal Electrical G - ff.
ME99 I Final Mechanical
BP99 JFinal Building I
Code Pool&Spa Approvals Date Inspector OTHER DIVISION RELEASES
Deputy Inspector Department Approval required prior to the
POOI Pool Steel Rein./Forms building b ing released by the City
POO 1 Pool Plumbing/Pressure Test
P003 I Pre Gunite Approval Date Inspector
EL06 Rough Pool Electric Plannipg
Sub]list Approval Landscape
P004 Pool Fencing/Gates/Alarms Finance
P005 Pre-PlastcrApproval Engineering
P009 JFinal Pool/Spa
03/2612007 M N 13: 37 FAX 951 471 0052 City of L ka Elninora 1QJ001/001
City ' o Lake ,Elsinore
y� 130 South Mom Street
APPLI�A7iQJ1
APPLICATION FOR
�
;paREC�tVED
BUILDING J4rJtJ►iI1 DATE
•Hr 4 by
v,a1.uP:rlc�s CA.(�.L;e . rcr.s 3-1°l — -LA 1— 05-4 $ 0516 (/�---
pl n,nl ADDRESS
titFtpot �"i,?'t2 sr• RtMA-tip �,q�cG sNoa oct ,
7 EiLPtGE Pp,� L
2nd FkV(YH F
NAMG
3rdFLOOR sF o PRQ yt rves-)Rs L^v-lF
--� W i1AAILIN PIT
H NEW T
GARAGE SF N ADDRESS 1115 2q}"' St, 141 . `123,OL5D0 .
---~ E ITV - ETA]I=1 .c'
STGRAGr- sr NEW?LlP'C prcfkc-H i.CA. �12c�c�3
1 hereby affam that I am licensed under provision:o ch3p:C' ((;Ommcnar_;
OI:CK W OALCONIES _SF with section 7000)of dnision.1Ot the business and protessions CM0. nd•,?Y
C license im in tuff furr;e and eff-
SF . O LICENSE f- 01 ti'DSO,��IEaS
r;i FtER: `� '
N AND CLASS TAX i�
T NAME — - -- —
A WILIM
C ADDRESS ---/ -__ _—NLcS T MySl'A7FJlIP PIdOPIE
O.
8UILDING PEPWT R. (OT-�T NATURENAME
Ls:hTr'
Pr_AN C- ,,r.i':K' LICENSE 4
pLAll-:atl5Cs1 Y _ — R .,flAfUN6 —
Q''� ,C Aoor��ss2� 52 k-�cl.y1N• .p+-v� .
SElsmic 1!►Orr !f 'CITY
• ---! C�' � � 1r1� GA_olz.rvl�_ g4q.hg3_�c�7ro
PLAN KEITENTION 1 NE111 OGG GRP.I " CONST- V N
0 ADOPTION DLYLSION: 1 YPE: -
0 ALTERATION NUMBER OF NUMBER OF O
OTlI�R STORIE 6EDRQOMS: -
SIN(a FAMILY ZONE
0—APARTMEN'i•S PAR_ iL
Ll I cerlifylhat I.hk ve'lead rhisapplintkm ar4 State that tier Q CONDOMINIUM( HAZAND YES
above in.'xmariat is corrett.1 agree to amply with ark City Q TOWN HOMES AREA? NO
artid cauai;ord.'vtances and:state tawz ro gbn to bai[dfrtg C]C<"ERCtAL SPRLNKLERS E i
constrtidon,and hhrebyarirhorne fppresentatrves of this El INDUSTRIAL' REQUIRED? NO
cirytoentervpontheabov---motionedpropertyforinsp- ❑REPAIR PROPOSED USE OFBLDG: (�,' TAi� �'1p1fARNd+cY
Con 'poses_ 0 DEMOUSH PRESENT USE OF,81-04�: -4 PAC Pk w rY
JOB DESCRIPTION _
tree TI Q L4 N s trvv C,-born o 01 r1 e v_J_
igna#dte bf Apply nt:orAgent, slate \`1., 2`i 2 .5 F. t Ri} 2 Arl 4y
—► . -To .
Agent for
Agents ddress LU/ Ic
Nf- -- : "CIS ni lv ; �• T 4
Stmek ri4�/ State zip
4 5]E'.T
-7 T c
0'6/19/2007 TUE 1.3: 40 FAX 951 471052 city of Lakp Eleinore 003/003
ROLE 7
City , of
aEtsinore
jI30 0U .atn , treet
APPI,[ed�1�11/
APPLICATION FOR PERMIT APFLICA'rrONDAT13:
APJ! a ;
ELECTRICAL !PLUMBING/MECI t+INICAL Y`j `�-�p o$ f2�> err '1 t0
dTJfLDiNG ADDRESS
I hfftby CtItlfy thl t bAYi read tkiS application and atntt that the
abort information is wnxl.l amw to eoruply v"all city and county TRACT DLOCKIPAUE LO
ordutances and stale laws relntlnS to building caosuttctio4 led twreb},
authortro mpaa-catntins of thiscity to enter upon the abUVV-U"tinned M'ML
pruj far umpmhon purposes. W L 1P t I�'t.tc /� �/�C E ��-f/n-•i��c' L Z L
I L LIY�
! R CITY AT- W �+
Signature ofAppliaal or Agent Dato x1c- Ar 13 L% .,f
I h=bY tt that I eat I undo flit provisions oft Upter 9 oomnracM
C with Section 7000)oflavision 3 ofthellusinasy and Profp4ionaCodcq and my
(circle one) O liomac i5 iu full fmm and aiZbd.
AGENT FOR: CONTRACTOR OWNER N LICTiNSB U CITY FIUSINSSS
T AND CUSS TAYUY
AGHNT'S NAME R N
A
AGENT'S ADDRESS C ING
street crty ltaTO zip T ADDRESS
O _I'ry STN1' /,IP P110
R
NTRAG ' 'S S Q A7(1tN
CLEC'FRICAL uan PLUM 1MG Quin MECHANICAL f1 inn
New Res.Multi Family/S .FT. Fixtwe or Tr 'L F.A-U./T-)Jrnu t/Duels/Vents
New Res.Single Family/S .FT. B1311ding Sewer F.A.,U.i PtsrnaceI Kist.I>100000
Pool Eleatic System,Private limn Water System r 1)rWD Floor Furnace/Vw
Switches/I St 20 'ZD Private S lie System Unit Recces!Wal1(Ieluer _
Switdles I Over 20 Water Beater/Vent 1nsW1!Rclowte/Re Iace Vent
R.ale Outlet/lat 20 'L o Gas Piping Syst 1-4 outlets Venlllatingran
Pcccptadc Outlet/Over 20 S Cris Pi ing 5 or More Outlets Z I;vapomliyc Cooier
Lighting Pixrures/1 at 20 2•D Dishwasher Ventilating. tem
g,ghting Pixtures!Over 20 D Solar Tank Exaust Hood
R%ld.ntiaf Fixed fiance/Gullet Solar Collector per Panel Fireplace
Non-Residential Appliance/Outlet I Orcase Trap! tetceptar) Commercial Incinerutor
100-200 Amp Scrvice<600V Install,A1lor 0,Repair System Air Handler> 10000 CFM
200-I000 Amp Service<600V Lawn Sprinkler System Air I lendlcr< 10000 CFM
Miac.Apparatus,Conduits,Etc. Hackflow Vevicc Smaller Z1 ri 2" Fire,Dam crs
Signs 4 ftaMow Device Larger than 2" Rcpjsters
SlEp Branch Circuit R IFloor Drain 2 Compressor/Hca ump-3 H.P.
B o3ways/EA 100 FT Floor Sink j- Compressor/1lca1 ump 3-15 HY,
Tcun orary Powcs Service Water Servict Compressor/Heat um 15-30 H.P.
Tr4nporuq Power Distribution Syalem Alter or Rz 'r Drain or Vcnt Cora ressor/Heatpunlp 30-Sp H.P.
Motors/Transformen Firc Sprinklers per Building R.e air I Alter Misr-HVAC
Motors vp to I H.P, swimming Pool Compressor I Hcatpump Ova 5G H.P.
Motors/I'rauforme n I - 10 H.P. I 7 Swimming Pool/Public
Molor2/Transformers 10-50 71.P. Swimming Pool/Private
Motors/'ftansforrn=50-100 H.P. Water Heater I Vent
Motrai/Transformers> 100 H.P. Rjcpl=Pi ing
Replace Filicr
Misa Replace
Crz Piping
JUL-03-2007 TUE 10:05 AN RIU FIRE P&E FAX N0, 951 955 d886 P. 01
Riverside County Fire Department O,,-Z Fire Protection Planning Section
rtivera{da Offlta,2300 Merhat 91„Ste.160,RlvaMr do,CA 62t1G1 Ph.f961)9t1&4777 Fa.(961)B66.4656
Mu1rICSa Of icq:39493 hoc Algmoa Rd,Sic A,Mutdatq,CA 92603 Ph•(961)600-6160 Fax(061)M0-6164
India OlOcw 62-d76 Hwy 11 i,Fm.2160,Illdlo,CA 02201 Ph.(760)66:-WO Quy(76p)9G3 7A72
Fire Department Clearance/Release
Date: 6
To: surveyor's Office
S-N-of e Building and safety
Tract/Parcel Map
PermltlLat#: '"6- -�7 LD
Job Site Address:
Final For Recordation
Release For Building Permit(s)
Shell Final Only(No Tenant)
Final For occupancy
Final Occupancy Temporary Expiration Date
Building Plan Check Fees Paid
Mitigation Fees PAID
Mitigation Fees NOT PAID
Fees Not Required
If you should have any questions, please contact the appropriate Riverside County Fire Protection
Planning office for further assistance.
Tracy Hobday
Chief Fire partment Planner
Auth zing Signature For Release
Form C—Revised 111012007
I
ENV HEALTH MURRIETA Fax:951-461-0245 Jun 12 2007 04,00pm P002/002
RIVERSIDE COUNTY COMMUNITY HEALTH A6r;NCY
DEPARYIV[l=NT OF ENVIRONMENTA1.. HEALTH
FOOD ESTABLISHMENT PLAN APPROVAL NOTICE
Plan Check# 0844 Date 06/12/07
Project Name Rite Aid Address 16491 Lakeshore Dr_ Lake Elsinore CA 92530
Plans Submitted by Serenity Ajawara Phone (949) 223-9533
Owner Rite Aid Corp. Address 300 Goddard Way STE100 Irvine CA Phone
The plans are now approved subject to the conditions listed below and the attached compliance sheet.
1. Provide from Sewer District a Grease Interoeptor size requirement letter or waiver letter.
2. Provide ceramic file CT-1 and cove base CT-1 in mezzanine.
3. Provide air curtain is installed above roll-up delivery door, pg. E102.
CONSTRUCTION INSPECTIONS: Contact the Plan Checker for a PreliminM Inspection when construction is
approximately 809/o complete,with plumbing, rough ventilation, and rough equipment installed. Request for
inspection should be made at least five(5)working days in advance_
A FINAL INSPECTION MUST be made upon completion of ALL work including finished details.APPROVAL to
operate shall not be granted, or remodeled areas approved to operate, until the facility has passed the FINAL
INSPECTION, and"APPLICATION TO OPERATE" has been completed and PERMIT FEES have been paid.
Request for inspection should be made at least five(6)working days in advance.
PLANS CHECKED BY Richard Martinez REHS ill Phone __(951)481-0284
1 acknowledge the corrections noted herein and as indicated on the plans and agree to incorporate them during
construction:
Signature Bate
Company Name_
1-SAi3.178 ev
Carona Hemet Indio Murrieta Palm Springs Riverside
2275 S.Main St Suite 8005.Sanderson 47-950 Arabia St 38740 Sky Canyon Dr 2500 H_Palm Canyon 4o65 County Cir
204 (951)766-2824 "A" (951)461-0284 Dr (951)3M-5172
(951)273-9140 fax(931)766-7874 (760)863-8287 Fax(951)461-0245 (760)320-1W Fax(951)358-
Fax(951)520-8319 Fax(760)863-8303 Fax(760)320-m7U 5017
05/16/2007 10:45 9512455946 EVMWD OPERATIONS PAGE 01
f-W PARTNERS a48 753 7070 0S116107 10:4Sam P. W1
MAIMM tlMn,4�k�1 If�hR EkhYt
lE;lsiigore Vallaey Municipal Water District Pretreatment]Program Section
PO Box 3000
Lake Elsinrne,CA 92531-3000
Telephone(951)674-3146 Fax.(951)243-5946
Glr ga Were ptor 'ton ' tiaacL
1, am; Oro tGhi a,r1
(Business Representative's Name Printed)
Rcpresentins �it8 Ri� b491 LOOM _Ors,yQ. AAA
(Business Name and Address Printed)
certify,that at no time shall any fats,oil, grease (FOG), or solids be discharged to 13VMWD's collection system in
quanntites that may irr►pair ws$tcwaW flow or violate EVNrWD()rdinancc No. 160.
I also agree to put into effect at all times EVMWD hood Service Facilities Best Management Practices(33WS).If at
any time the business listed above is found to discbarge FOG or solids in quantities that impair flow or violates
FVMWD Ordittaticc Ito_ 160,1 understand that I must install,witbin ninety (90) days of receipt of notification by
EVMWI), a grease mtcwTtor system of sufficient size and design to be acceptable to the EVMWD's Pretreatment
Program Sectirm,
I
I certify under penalty of law that this document and stll uttachrn=s were prepaTed under my direction or supervision
in accordance with a systems designed to assure that qualified personnel properly gather and evaluate the information
submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly
responsible for gathering information, the information submitted is, to the best of my knowledge and belief, true,
accurate,and c0u plete.I am av am that there are sigmific►int penalties for subnrtitting false information,including the
Possibility of fine and imprisonment for kmowing violations_
The Grease Interceptor installation Conditional Waivcr is non-lrarrsfcrablc.
The person signing this waiver warrants that it has obtained the necessary consent and authority to exceute this waiver
and to matte this waiver binding upon the facility owners)and/or operator(s)of the 7-Z
irm�.
Print Name: H RMl = f ►iA h Signature: �'�^
Date: b Contact l'bone Number: 3- v�
fii7ppartt daci,rmentahtltt al .otig tivith fi.iil-act,bl`-Fariiity pans ttmr6at Uc sulimiliec,"with this xF,plictivn farttL .
Do Not vV,tite Below This Line
E MWD ERMI
APPROVED: . MQ(` 1Y)eL DATE: � !
Print Signature
RELEASE FORM • Page 1 of 2
Nicole Fields
From: Carolyn Speight
Sent: Wednesday, June 13, 2007 122 PM
To: Nicole Fields
Subject: A release form
RELEASE FORM
City of Lake Elsinore
Engineering Division
To Issue a Building Permit
THE OWNER OR DEVELOPER IS REQUESTING A BUILDING PERMIT FOR CONSTRUCTION
AT: 16491 Lakeshore Dr.
APPLICANT: WD Partners
ADDRESS: 2852 Kelvin Ave., Irvine, CA 92614
PHONE NO.: (949)753-7676
CITY PROJECT: Rite-Aid -07-766
The Conditions of Approval have been reviewed and all applicable conditions were checked off on the
attached Building Permit Checklist form. Those applicable conditions were also checked off once
completed by the applicant. All Engineering Division conditions of approval triggered at building permit
issuance for this project have been met and the Engineering Division now AUTHORIZES THE RELEASE
TO ISSUE BUILDING PERMITS.
Checked and reviewed:
t
__//3 C)
DA E ENGIN EKING STAFF
Approved:
0 o 3 e 7 4 d-dam...
DATE CITY ENGINEER
NOTE TO BUILDING DIVISION: Attached is a Fee ReceiRt for the fees due for this project. Applicant
should provide a check in the amount of $ -7 5+(y 1 prior to the issuance of the building
7i 3f2007
LAKRLSINORE UNIFIED SCHOOL DIACT
Facilities Services
545 Chaney Street
} Lake Elsinore, CA 92530
(951)253-7015
CERTIFICATE OF COMPLIANCE
Monday, July 9, 2007 Type of Permit ICity of Lake Elsinore Permit # 7-766
Receipt # 2006-07-433
Owner Name I PRP Investors Lake Elsinore LLC. Thomas Guide
Job Site Address 16491 Street Lakeshore Drive Page #
City Lake Elsinore Zip 92530 Grid #
APN # * Tract # I N/A Lot # I N/A
Type of Development Commercial No. of units 0 Sq Footage 17,272
Comments
Rite-Aid
APN #: 379-241-057 & 058
It has been determined the above-named owner is exempt from paying school fees at this time due
to the following reason: Exemption does not apply
This certifies that school facility fees imposed pursuant to: Government Code 65995 & Ed. Code 17620
in the amount of 0.42 x 17,272 or S7.254.24 have been paid to L.E.U.S.D. for the
property listed above and that building permits and/or Certificates of Occupancy for this square
footage in this proposed project may now be issued.
Fees Paid By: PRP Investor-Lake Elsinore LLC Telephone 949-723-9500
Name on the check/voucher
By: Sue Roberts, Director Fiscal Services
7/9/2007
Fee collected/exempted by: Karla Meza Payment Received
Signature °-'
*NOTICE* - Pursuant to Govern me Code 66020, this will serve to notify you that the
90-day approval period in which you may protest the fees has begun to run immediately.
Collector: Attach a copy of County or City plan check application form to District copy.
Original-District 2 embossed copies - Developer
CALL DA
SURVEYING INC
TO: NOBLE DEVELOPMENT Date: 07/09/07
2013 West Commonwealth Ave., Unit C, Fullerton, CA 92833
Phone (714)680-9975 Fax (714) 680-0712
ATTN.
Building Department Inspector of the City of Lake Elsinore
BUILDING PAD ROUGH GR4I)ING CERTIFICATION
Tract/Project No.: RITE AID—LAKE ELSINORE
(Address: 16491 Lakeshore Dr., Lake Elsinore,CA 92530)
This is to certify that the Building Pad for the Rite Aid Building, accomplished the required
elevation in accordance with the final approved grading plan(s), submitted to the City of Lake
Elsinore at the time said grading permit was obtained.
L.S.778O
Exp. 12-31-0',
r�
LAND SURVEYOR:
P.L.S. 7780 EXP. DATE: 12/31/07
1
JN07418
7/9l2007 RG
411 Jenks Circle, Suite 205 •Corona,CA 92880-1782 •Office 951-280-9960•Fax 951-280-9746
RELEASE FORM Page 2 of 2
.r permit.
Revised 3/29/05
1
7/3/2007
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New Retail Stores Commercial 07-766
Use Classification
Bldg. Permit No.
-Non Rated N/A
Group
N/A Type V
—Type Construction Zone
PRP Investore(Rite-Aid) Building Address16491 Lakeshore Drive Owner of Building
Owner's Address 415 29th St.
—Lot Block Tract
City Newport Beach CA
State Zip 92663
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Assessors Parcel No. 379-241-057
Date_ February 21, 2008
By:
Building OF
ficial
POST IN A CONSPICUOUS PLACE