HomeMy WebLinkAboutLINCOLN STREET 15187_04-00002505t
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PERMIT NO: 04- 00002505
of Lake Elsinore
0
PERMIT 130 South Main Street
DATE: 9/20/04
JOB ADDRESS . 15187 LINCOLN ST
DESCRIPTION OF WORK . REROOF
OWNER
STEADFAST LSA
20320 SW BIRCH ST STE 300
NEWPORT BEACH, CA 92660
CONTRACTOR
ROYAL ROOFING
150 NETTLETON RD
VISTA, CA 92083
760 - 806 -1100
LIC EXP 0 /00 /00
A.P.# . . . . . 379 -111 -016 5 SQUARE FOOTAGE
OCCUPANCY . . . GARAGE SQ FT
CONSTRUCTION . FIRE SPRNKLR
VALUATION ZONE . .
REROOF PERMIT
QTY UNIT CHG ITEM CHARGE
1.00 X 5.0000 PROFESSIONAL DEV FEE 5.00
75.00 X 3.0000 REROOF 225.00
FEE SUMMARY CHARGES PAID DUE
PERMIT FEES
REROOF PERMIT 230.00 00 230.00
OTHER FEES
SEISMIC OTHER 52 00 52
TOTAL 230.52 00 230.52
SPECIAL NOTES & CONDITIONS
75 sq comp shingle over one layer same
Late: 9/20/04 20 FL:celpt ru: 1570
XY-4 if
2p a= DG G FM-R7 1 x.57.
Tn m tB.nber: 80 A
GtOff{ 9--c4 $2 .,.70
Tram date: 9/2u/44 Tire: 9:47:17
0
0
R -3
Late: 9/20/04 20 FL:celpt ru: 1570
XY-4 if
2p a= DGG FM-R7 1 x.57.
Tn m tB.nber: 80 A
GtOff{ 9--c4 $2 .,.70
Tram date: 9/2u/44 Tire: 9:47:17
i tit I. • Cl n,il.
PW,t ill Lon pICtl11l1N place
oil the fob
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Please Read and initial
I I am Licensed under the provisions of Business and Proiession it
Code Section 7000 et seq and my license is in full forre
2 1 asow•nerolthepropert) ormy employeesw /wages as their sole
compensation w ll do the work and the structure is not intended or
offered for sale.
3 1 as owner of the property am exclushely contracting with licensed
contractors to construct the project
4 I ha%e a certificate of consent to selflnsure or a certificate of Workers
Compensation insurance or certified copy therrof
S 1 shall not emploN anN person in any manner so as to become subject
to porkers Coompensauon Laws in the performance of the work for
v. hich this permit is issued
Note If %ou should become subject to Workers Compensation ailer
making this certification you must forthwith comply with sui h pro-
visions or this permit shall be deemed rex•oked
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Coce P--.D s Sx 4D-vo:as Da e Ir s ^r: z• OTHER DEPARTMENT RELEASES
2,-- t -5 Z: - L,eaar7nenl Approval required prior to the
bLAciiN being released by the CityPSCP =' S'=e ;;t--
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APPLICATION FOR
BUILDING PERMIT
VALUATION CALCULATIONS
1st FLOOR _ SF
2nd F=LOOR SF
3rd FLOOR SF
GARAGE SF
STORAGE SF
DECK & BALCONIES SF
OTHER: SF
VALUATION
FEES
BUILDING PERMIT S_
PLAN CHECK
PLAN REVIEW
SEISMIC
PLAN RETENTION
1 certify that I have read this application and state that the
bove information is correct 1 agree to comply with all city
and county ordinances and state laws relating to building
construction, and hereby authorize represent3tLVes of INS
city to enter upon the above - mentioned property for insp-
bon purposes
Signature of Applicant or Agent Date
Agent for Contractor owner
Agents Name >!Jfy i •. L/ %. G"
Agents Address
Street City State Zip
City of Lake Elsinore
130 South Main Street
i
APPLICATION 1
r 2
APPLICATION RECEIVED
DATE
AP By
6 11 (7!N _ AnnpES
TRACT BLOCK/PAGE LOT/PAR EL
p
NAME
W
N
MAILING
ADDRESS
PHONE
a -L- Z'
E
R
IT1'_ STATEOP
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0
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I hereby a irn that I am licensed under provisions of chapter 0 (commencing
with section 7000) of division 3 of the business and professions code,and my
license 1s in full force and effect-
LICENSE S – _ CITY BUSINESS
AND CLASS ' " TAX ff
T NAME
A
C
MAILING '
ADDRESS
T CITY STATE/ZIP PHONE
R CONTRACTOR'S SIGNATPRE DATE
A
NAME LICENSE
F
C
MAILING
ADDRESS
H Z IT1' STATEJZIP PHONE
NEW OCC GRP / —
DIVISION
CONST
TYPEADDITION
ALTERATION NIPARER OF
STORIES
NUMBER OF
BEDROOMSOTHER
0 SINGLE FAI"ILY ZOfkE
O APARTMENTS
O CONDOMINIUMS HAZARD
AREA -2
YES
NOTOWNHOMES
COMMERCIAL SPRINKLERS
REQUIRED ?
YES
NOC1INDUSTRIAL
C1 REPAIR PROPOSED USE OF BLDG
PRESENT USE OF BLDGDEMOLISH
JOB DESCRIPTION
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