HomeMy WebLinkAboutLINDSAY STREET 110_04-00001991 J
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Cily of Labe Elsinore
I PERMIT 130 South Main Street
PERMIT NO: 04-00001991 DATE : 7/27/04
JOB ADDRESS . . . . . 110 S LINDSAY ST
DESCRIPTION OF WORK REROOF
OWNER CONTRACTOR
SHAY PAUL AMBER ROOFING
SHAY JOYCE 21026 PALOMAR
WILDOMAR, CA 92595
909-245-2672
LIC EXP, 0/00/00
A. P. # . . . . . 374-251-021 7 SQUARE FOOTAGE 0
OCCUPANCY . . . GARAGE SQ FT 0
CONSTRUCTION . . FIRE SPRNKLR
VALUATION . . . ZONE . . . . . . R-1
REROOF PERMIT
QTY UNIT CHG ITEM CHARGE
1 . 00 X 5 . 0000 PROFESSIONAL DEV FEE 5 . 00
50 . 00 X 3 . 0000 REROOF 150 . 00
FEE SUMMARY CHARGES PAID DUE
PERMIT FEES
REROOF PERMIT 155 . 00 . 00 155 . 00
OTHER FEES
PLAN RETENTION FEE . 26 . 00 . 26
TOTAL 155 . 26 . 00 155 . 26
SPECIAL NOTES & CONDITIONS
INSTALL 50 SQUARES OF AC SHINGLES ON
EXISTING.
Date: 7/27/04 27 Receipt no: 482
2864 1991
BP BUILDING PERMIT 1 $155.26
Trans number: 78585
CK cum 4976 0155.26
Trans date: 7/27/84 Time: 8:45:57
1{ - \ t_ 1,1• 1'Icasc Brad and Initial
1 I am Lnt nst-d under the provisions of Business and Professional
Cc.1e Section 7CX-)O et seq and mY license is in full forte
III l'LI lsplCliou'� place 2 1 asow-neroftheproperty ormy emploveesw/w•ag(saslhrirs)lt-
compensauon will do the work and the structure is not intende d or
tlll the joh I offered for sale
3 1 as owner of the prolx•rty ain exrlusneh•rontractinfi with he ensed
contractors to construct the project
4 1ha%eaecrrifcateofconsenttoselfnsureoracertifieaieofWorkers
It .i,,, ,I' ; ,,,, Compensation insurance or a certified copy thereof
5 1 shall not employ am person In any manner so a s to become subject
to tiorkrr,Coompensation laws in the pe•rfonnance of [be work for
which this permit is issued
Nota It I.ou should become sublet t to Workers Compensation alter
making this certification you must forthwith cornph,with such pro-
visions or this permit shall be deemed re%oked
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'a` Da e ' ` OTHER DEPARTMENT RELEASES
C,e^,arn-ent Apotaval required prior to the
'-- 0.iticing eeinc r6eascJ by the City
Da•e Inspector
La-c�ca�e
Finance
Engineenn
J _ r
City of Lake Elsinore
130 South Main Street
APPLICATION FOR APP(.ICATION NO-
BUILDING PER1VgIT 024 lP6) 1
• APPUCATfON (VE%�
DATE 7/ Z
VALUATION CALCULATIONS AP!3,74 �-2� — {12 ' BY �/►
1st FLOOR SF twa004G `ADDRESS /
2nd FLOOR SF TRACT atOCK RAGE LOT&ARCEE
3rd FLOOR SF
GARAGE SF
STORAGE SF z PHONE
DECK&BALCONIES SF z ADOREss
Orr YTArE.7fe
OTHER:
SF t h...br eftw,...ho.4 s 1. —4«dw ao••.•w..d C(.opt.r•kw-w...C-V—0.f—q—
GRADING CUT CY POWs d o..:.• 7.t 0..(4nw..a...d R.ele..;.m r.�..e.M•6-c• �M f„q#.Kk
..d L — 1
FILL CY EKENiE. ��) Tcffv AXI tyEss
Z ANO G/ iAK.
VALUATION: o «
FEES MAILING /
BUILDING PERMIT b arr �Z'']Ccy ATE ZIP^ 5
CONTRA ATURf 7 22
OAfE
PLAN CHECK _ x
-2622
ADDITIONAL PLAN CHECK NAME IKENsf8
_ u
Z wtAlurtG
GRADING PLAN CHECK '= ADoaEss
V
< CITY STATE ZIR PHONE
,DNEW LJREPAIR OCCGRP./ CONST.
DIVISION, TYPE-
MICROFILM :-ADDITION !MOVE NUMBER OF NUMBER OF
t_7ALTERATION !.DEMOLISH STORIES- BEDROOMS.
COPIES "OTHER ZONE-
t2SINGLE FAMILY units HAZARD AREA? YES NO
IMPRO FEES ❑ SCHOOL FEES ❑ -APARTMENTS units
-CONDOMINIUMS units SPRINKLERS REOUIRED7 YES NO
-TOWNHOMES units PROPOSED USE OF BUILDING'
COMMERCIAL i -INDUSTRIAL
PAID PRESENT USE OF BUILDING
DATE
J06 DESCRIPTION
I I certify that I have read this application and state that the
above information is correct.I agree to comply with all city 30 ,-.
and county ordinances and state laws relating to building
construction, and hereby outhorite representatives of this
city to enter upon the above-mentioned properly for inspec-
teon pu"Pos
Sign ure o plicont or Agent pate
AGENT FOR [V CONTRACTOR 0 OWNER
AGENT'S NAME
AGENTS ADDRESS
STREET CITY STATE ZIP REV DATE tt-t 90