HomeMy WebLinkAboutSCRIVENER ST 118_02-000009671, fA
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City of Lake Elsinore I CU
PERMIT 130 South Main Street
PERMIT NO: 02- 00000967
JOB ADDRESS . . . . . 118 N SCRIVENER ST
DESCRIPTION OF WORK REROOF
OWNER CONTRACTOR
AVERILL HALLIE OWNER
AVERILL JANICE
118 N SCRIVENER ST
LAKE ELSINORE CA 92530
A.P.# . . . . . 374- 183 -002 0
OCCUPANCY . . .
CONSTRUCTION . .
VALUATION . . . 500
REROOF PERMIT
QTY UNIT CHG
1.00 X 5.0000 PROFESSIONAL DEV FEE
19.00 X 3.0000 REROOF
FEE SUMMARY
PERMIT FEES
REROOF PERMIT
OTHER FEES
PLAN RETENTION FEE
CHARGES
62.00
1.00
TOTAL 63.00
SPECIAL NOTES & CONDITIONS
19 SQ COMP SHINGLE OVER 1 LAYER SAME
CLASS A ROOFING REQUIRED.
PAID
00
00
00
DATE: 5/08/02
SQUARE FOOTAGE
GARAGE SQ FT
FIRE SPRNKLR
ZONE . . . . . .
ITEM CHARGE
5.00
57.00
DUE
62.00
1.00
63.00
I nl
Operator: COUNTER
Date: 5/08/02 08 Receipt: X004932
Total Paycent =53.3'A
Amount Tendered 5:2.0?1
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l 111 0111 "
111vase Read and Initial
I am Licensed under the provisions of E4usmess and Professional
X'4 Code Section 7000 et seq and my license is in full force
2 1 as owner of the property or my employeesw /wages as theirsoie
compensation will do the work and the structure 1s not Intended or
0iTerrd for sale
3 1 as owner of the propertv am exclusively contracting with licensed
co ractors to construct the Project
Iha% eacertiflcateofconsenttoselOnsureora certificate o (Workers
ompensation Insurance or a certified copy thereof
S 1 shall not emplo% any person In any
manner
so as to become subject
to Workers Coomp.ensation Laws m the performance of the work for
which this permit is issued
Note If iou should become subject to Workers Compensation after
making this certification you must forthwith comply with such pm-
visions or this permit shall be deemed re%oked
Cooe A:c, o•. a,s Date I- Soe':'a'
ELO'. Te-o Ea_ Se^ ,ces
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C.oce POO, s Saa Aaa-oyais Da e or
OTHER DEPARTMENT RELEASES
De- L-s Department Approval required poor to the
building being reieased by the CityPh ' PaJ See Pe- FJ —S
PJO PsJ P_—ti ^ Pess Tes'
POC3 P e G_- e
Date Inspector
E L X Ra_;- cx E ec -
Pta n ti
S,_ z) L s A Dc, ,•.a
Lanascape
PJC-L PJ<; Fe-.- •,c Access
Finance
FID05 e Pas e-
Engrneenn
dyCy x P0.3 5=C
t
APPLICATION FOR
BUILDING PERMIT
VALUATION CALCULATIONS
City of Lake Elsinore
130 South Main Street
1 st FLOOR SF
2nd FLOOR SF
3rd FLOOR SF
GARAGE SF
STORAGE SF
DECK & BALCONIES SF
OTHER:
NAME
SF
VALUATION:
FEES
BUILDING PERMIT $
PLAN CHECK
ADDITIONAL PLAN CHECK
MICROFILM
COPIES
IMPRO FEES SCHOOL FEES
PAID
DATE
1 certify that I have read this application and state that the
above Information Is correct I agree to comply with oil city
and county ordinances and state laws relating to building
construction, and hereby authorize representatives of this
city to enter upon the above - mentioned property for Inspec-
n purposes
SlgXe of Applicant or Agent Date
AG T FOR CONTRACTOR OWNE
AGENT'S NAME
3 / 2 y „ter lyt . E'E•
AGENT'S ADDRESS
STREET CITY STATE ZIP
APPLICATION NO
0--Z - 0 ; 7
DATE
APPLICATION RECEIVED
7`9'
AP N
fi_3 12_ r 1 By
BUILDING ADDRESS /
U / e ^ /^ r
TRACT BLOCK•PAGE LOT /PARCEL
NAME
Z
O
MAILING PHONE
ADDRESS ) I / // nI 1/'• r--" L
CITY STATE /ZIP
C, / % D
Z
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
7000) of Division 3 of the Business and Professions Code and my license is in full force
and effect
SE q CITY BUSINESS
ANDC TAXN
NAME
MAILING
ADDRESS
CITY ST ZIP PHON
CONTRACTOR S SIGNATURE DATE
u
NAME
w MAILING
STATE/ZIP PHONE
REPAIRF OCC GRP ; CONST
DIVISION TYPE
MOVE NUMBER OF NUMBER OF
STORIES BEDROOMSALTERATIONAIDEMOLISH
OTHER ZONE
SINGLE FAMILY units
HAZARD AREA? YES NO
APARTMENTS units
CONDOMINIUMS units SPRINKLERS REQUIRED? YES NO
TOWNHOMES units PROPOSED USE OF BUILDING
PRESENT U/SE OF BUILDING
COMMERCIAL INDUSTRIAL
JOB DESCRIPTION
REV DATE 11 1 90