HomeMy WebLinkAboutLINCOLN STREET 15195_04-000025007)
City of Lake Elsinore
PERMIT NO: 04- 00002500
PERMIT
JOB ADDRESS . . . . . 15195 LINCOLN ST
TENANT NBR, NAME UNIT 2
DESCRIPTION OF WORK . REROOF
OWNER
STEADFAST LSA
20320 SW BIRCH ST STE 300
NEWPORT BEACH, CA 92660
A.P.# . . . . . ;379 -111 -015 4
OCCUPANCY .
CONSTRUCTION . .
VALUATION .
130 South Main Street
DATE: 9/20/04
CONTRACTOR
ROYAL ROOFING
150 NETTLETON RD
VISTA, CA 92083
760 - 806 -1100
LIC EXP 0 /00 /00
SQUARE FOOTAGE 0
GARAGE SQ FT 0
FIRE SPRNKLR
ZONE . . . . . . R-3
REROOF PERMIT
QTY UNIT CHG ITEM CHARGE
BASE FEE 35.00
1.00 X 5.0000 PROFESSIONAL DEV FEE 5.00
X 3.0000 REROOF
FEE SUMMARY CHARGES PAID DUE
PERMIT FEES
REROOF PERMIT 40.00 00 40.00
OTHER FEES
PLAN RETENTION FEE 52 00 52
TOTAL 40.52 00 40.52
SPECIAL NOTES & CONDI'T'IONS
Re-roof 800 sf over existing asphalt
shingles.
Fite: 9/20% 20 Peieir-t m: 1S70
27.x1 ZSC0
2P B=D,G FER1IIT 1 $40.52
T1-am fluTiEr: Wj-A9-
Tra-F, date: 9 /aj/ 4 Tore: 9:47:17
ft ,i ;l,•. •te.`. 1 1 i h`i
Po,t In cl1nspiCllt)u, IflaLe
1111 the loh
P1 ,P' \iI I \( \iEi{ .1 i1. ii
OP
it
Please Read and Initial
I I am Licensed under the provisions of Busmess and Professional
Code Section 7000 cc seq and my license is In full force
2 1 asow- neroftheproperty ormy emplo,,eesw /wages as their sole
compensation will do the work and the structure is not intended or
offered for sa!e
3 1 as owner of the property am ex( lusively contracting with licensed
contractors to construct the project
4 Ihas eacertifrcateol consent toselfinsureoraceruficateo (Workers
Compensation insurance or a certified copy thereof
5 1 shall not employ am person in any manner Boas tobecome subject
to \korkers Coompcnsauon Laws in the performance of the work for
which this permit is issued
Note If }ou should become subject to Workers Compensation alter
making this ceruficauon you must forthwith compty with such pro-
vi,;wns or this permit shall be deemed revoked
Cate 4,z,•y.- < Da e sZ*,: o•
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OTHER DEPARTMENT RELEASES
e is -- = Gepartrnent Approval required prior iD the
budding being released by the CityriacStt, °e- F, --s
r'5,'3 P-e u_- e
Da•e Ins cror
EL?6 Po_;- °x: E e,: • c
Planni
S_o L s• Aaeo•.a
La--cscape
P h P;i, Fe--c r Access
Finance
s5 PeP.ase
Englneennq
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APPLICATION FOR
BUILDING PERMIT
VALUATION CALCULATIONS
1st FLOOR SF
2nd FLOOR SF
3rd FLOOR SF
GARAGE SF
STORAGE SF
DECK d, BALCONIES SF
OTHER: SF
VALUATION:
FEES
BUILDING PERMIT $
PLAN CHECK _
PLAN REVIEW
SEISMIC
PLAN RETENTION
t certify that I have read this application and state that the
above information is correct I agree to mnply with all city
and county ordinances and state laws relating to budding
construction, and hereby authorize representatives of this
city to enter upon the above - mentioned property for insp-
bon purposes
Signature of Applicant or Agent Date
City of' sake Elsinore
130 South Main Street
Agent for contractor owner
Agents Nafnei` i •.. i G• -
Agents Address
Street City State Zip
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AP I TION,f
APPLICATION RREECEIVE
DATE
BUu nIN . ArnnPESS
TRXCT BLOCKIPAGE
2
LOT/PARCEL
NAME
W
N
AILIN _ PHONE
ADDRESS Z-
E CITY - STATEIZIP
C
O
N
I hereby affirm that 1 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
LICENSE S CITY BUSINESS
AND CLASS L` "^ ` TAX
T NAME
A
C
MAILING
ADDRESS
T
O
CITY STATE/ZIP PHONE
R CONTRA T R' I NAT)..IRE DATE
A
NAME LICENSE #
R
C
MAILING
ADDRESS
H CITY STATE/ZIP PHONE
NEW OCC GRP I
DIVISION
CONST
TYPEADDITION
ALTERATION NUMBER OF
STORIES
NUMBER OF
BEDROOMSOTHER
Q SINGLE FAMILY ZONE
0 APARTMENTS
CONDOMINIUMS HAZARD
AREA?
YES
NOTOWNHOMES
COMMERCIAL SPRINKLERS
REQUIRED ?
YES
NOINDUSTRIAL
REPAIR PROPOSED USE OF BLDG
PRESENT USE OF BLDGDEMOLISH
JOB DESCRIPTION
5 ---
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