HomeMy WebLinkAboutSUMNER AVE 905_04-00000978 4 Citof Lake Elsinore
PERMIT 130 South Main Street
PERMIT NO : 04-00000978 DATE : 4/20/04
JOB ADDRESS . . . . . 905 W SUMNER AVE
DESCRIPTION OF WORK DEMOLISH SING FAM RES
OWNER CONTRACTOR
SALDANA, DANIEL & EVELYN OWNER
A. P. # . . . . . 374-082-017 2 SQUARE FOOTAGE 0
OCCUPANCY . . . GARAGE SQ FT 0
CONSTRUCTION . . FIRE SPRNKLR
VALUATION . . . 1, 000 ZONE . . . . . . NA
BUILDING PERMIT
QTY UNIT CHG ITEM CHARGE
BASE FEE 30 . 00
1 . 00 X 5 . 0000 PROFESSIONAL DEV FEE 5 . 00
FEE SUMMARY CHARGES PAID DUE
PERMIT FEES
BUILDING PERMIT 35 . 00 . 00 35 . 00
OTHER FEES
PLAN RETENTION FEE 1 . 00 . 00 1 . 00
TOTAL 36 . 00 . 00 36 . 00
SPECIAL NOTES & CONDITIONS
DEMOLITION OF EXISTING SFR. PRESENTED
ASBESTOS SURVEY REPORT NONE DETECTED ON
MAJORITY EXCEPT FOR ONE SAMPLE WHICH
WAS HAULED OFF SITE BY BRICKLEY
ENVIROMENTAL (EPA # CAD981400518) .
4/26104 28 1Pt no:
Date.. ae
Total tendered mil
Total payment
\ I l please Brad and Initial
I i ani l.uvnsed under (he provisions of Business and professional
(_cxlr&vntin 71OO e( se and my hcense is in full fort e
J"(lst Ill Lflll'�J)IC11(111S J)J.ICC 2 1 asoµnerot the prnprnx ormc t.mplovet_-sw/wagtsasthefrsolt
compensation will do the work and the s(ructurr is not Intended or
im the p)h OIIc R`tl for S9:c
3 1 as ou-n,r of the props rtc am t xrluslveIv contracting with hccnsed
contractors to constru(f the proyct
�, i• h\I11 V \11)1 k .,t,l ,' _ 4 Ihaccareniffca(cofronsenttoselfinsun•oraceruficateofWorkers
Compensation msuranrr or a certified colic• thereof
5 1 shall not t mplov anv person in am manner so as to lrtx orne subject
---r- to Horken Ca+m[xmsauon Laws in the Ixrtnrminct of fire work for
which this FK•rmit is issued
%o(e If cou should htYomt subpt i to Workers<ornptnsation utter
makln;,(his n rci ii aeon you most lorthwith romph,with sus h pro-
vision,or(his Ix rnul shall be deemed rt coked
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C-Jae s S_�-:_. .a s a e t-sc.>_ , OTHER DEPARTMENT RELEASES
' ,.ar7rk•nl APD(oval required poor to the
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Date Ins -c'or
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Finanee
Encineenne
,
- L City of Lake Elsinore
130 South Main Street
APPLICATION FOR APPLICATION
BUILDING PERMIT 7
IE�
APPLDATE ATjQN,RE_ EIVEDi�
DATE //
VALUATION CALCULATIONS AP a By
Ist FLOOR SF BUILDING ADDRESS /�C ►V '
2nd FLOOR SF TRACT BLOCK/PAGE LOT/PARCEL
3rd FLOOR SF
GARAGE SF NAME
STORAGE SF T *'h-"
3
DECK&BALCONIES SF o
CITY
OTHER:
SF m"celled under provisions of Chapter 9(commencing with Section
7000)of Division 0 of the Business and Professions Code and my license is in full force
and effect
CENSE p CITY BUSINESS
VALUATION: g NAME
FEES MAILING
ADDRESS
BUILDING PERMIT $ CITY s E z1 PHONE
OCONTRACTOR S SIGNATURE DATE
LAN CHECK
ADDITIONAL PLAN CHECK NAME LICENSE
u
Z MAILING
= ADDRESS
v
0
Q CITY STATE,ZIP PHONE
rNE ❑REPAIR OCC GRP / CONST
DIVISION- TYPE
MICROFILM TION ❑MOVE NUMBER OF NUMBER OF
RATION LLIDEMOLISH STORIES BEDROOMS
COPIES ❑OTHER ZONE
❑SINGLE FAMILY units HAZARD AREA) YES NO
IMPRO FEES ❑ SCHOOL FEES ❑ ❑APARTMENTS units
❑CONDOMINIUMS units SPRINKLERS REQUIRED? YES NO
❑TOWNHOMES units PROPOSED USE OF BUILDING
❑COMMERCIAL ❑INDUSTRIAL
PAID PRESENT USE OF BUILDING
DATE
JOB DESCRIPTION
❑ I certify that I have read this application and state that the lJ
above Information is correct I agree to comply with all city
and county ordinances and state laws relating to building
construction, and hereby authorize representatives of this
Ity;toente upo he above-mentioned property for inspec-
ss2-6 �Anature of - Live,
plicant or Agent Date
AGENT FOR ❑ CONTRACTOR ❑ OWNER
AGENT'S NAME
AGENT'S ADDRESS