HomeMy WebLinkAboutHIGHLANDS ROAD 607_04-00002404 -�y cily of Lake Elsinore
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PERMIT130 South Main Street
PERMIT NO: 04-00002404 DATE : 9/13/04
JOB ADDRESS . . . . . 607 HIGHLANDS RD
DESCRIPTION OF WORK REROOF
OWNER CONTRACTOR
MARTIN RONALD RONALD MERCHANT ROOFING
MARTIN DIANE 35336 CHIWI CIR
607 HIGHLANDS RD WILDOMAR, CA 92595
LAKE ELSINORE CA 92530 909-515-7296
LIC EXP 0/00/00
A. P. # , , . , . 379-401-012 7 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
28 . 00 X 3 . 0000 REROOF 84 . 00
FEE SUMMARY CHARGES PAID DUE
PERMIT FEES
REROOF PERMIT 89 . 00 . 00 89 . 00
OTHER FEES
PLAN RETENTION FEE . 52 . 00 . 52
TOTAL 89 . 52 . 00 89 . 52
SPECIAL NOTES & CONDITIONS
REMOVE OLD ROOF AND CALL FOR RF
SHEATHING INSP. APPLY 28 SQ CLASS A
COMP SHINGLE- 30 YR
Cate: 9/13/04 13 fBapt rp: 1442
Total tam $89.52
Total p it $89.52
Please Read and Initial
I I am Licenserd under the provisions of Business and Professional
Code Section 7000 et st-q and my license is In full fon e
Post In con`picuouti place 2 1 asowneroftheprolx:rty ormv emploveesw/wag"As their sole
compaisauon will do the work and the struc_lun iv not intended or
on the job offered for sale
3 1 as ownerof the property am t•xclushe•ly coniricungwvh licensed
contractors to construct the project
t')I, J. PLR%111 \l V 131=l: .���.'� [h� _ s IhaveaceniticateotrnnsentioselMsureoracerti(icateofWorkers
W1 "JJ1 Compensation insurance or a certified copy thereof
5 1 shall not emplov any person in any manner so as tobeecome subject
to µorkers Coompe•nsation Laws in the performance of the work for
which this permit is issued
Note If you should become subject to Workers Compensation alter
making this c-ertificauon you must forthwith comph•with such pro-
visions or this permit shall be deemed rr%oked
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De t s
Cepar-rent Approval required prior to the
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Cityof Lake Elsinore
130 South Main Street
APPLICATION FOR APPLICATION NO. :2
BUILDING PERMIT APPLICATION DATE
DATE
AP# By
VALUATION CALCULATIONS — 12 / 1 9,(/
BUILDING ADDRESS
1stFLOOR SF 44 % LS
TRACT BLOCKIPAGE LOTIPAR EL
2nd FLOOR SF
NA
T.,
FLOOR SF O orin t (V\cir i n
W MAILING PHONE
GARAGE SF N ADDRESS (oo'l e-»d
E CITY _ STATE/ZIP
STORAGE SF R C"
I hereby affirm that I am licensed under provisions of chapter commencing
DECK&BALCONIES SF with section 7QN)of division 3 of the business and professions code,and my
C license is in fuff force and effect_
OTHER: SF O LICENSE# #t CITY BUSINESS
N AND CLASS L 3 ) 76 3 XI O TAX#
T NAME
VALUATION: R f,
A MAILING
C ADDRESS 3�33(o C�, �'� C,IrC(e
FEES T CITY STATE/ZIP PHONE
O W, IAo,ti.cr C S')S4�—
BUILDING PERMIT $ R COt4TRACTOR'S SIGNATURE DATE
f 7E,3a-70
PLAN CHECK NAME LICENSE tl
A
PLAN REVIEW R MAILING
C ADDRESS
SEISMIC HICITY TAT IP 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 tfvit 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 7 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 �ew.o✓e �oc� Sin eg `Ve
Signature of Applicant or Agent Date 1,A-\ 313 r- •o o St t
S
Agent for ❑ contractor ❑ owner
Agents Name
Agents Address
Street City State Zip