HomeMy WebLinkAboutLINCOLN STREET 15195_04-00002500 r
t Ci of Lake Elsinore
PERMIT 130 South Main Street
PERMIT NO: 04-00002500 DATE: 9/20/04
JOB ADDRESS . . . . . 15195 LINCOLN ST
TENANT NBR, NAME UNIT 2
DESCRIPTION OF WORK REROOF
OWNER CONTRACTOR
STEADFAST LSA ROYAL ROOFING
20320 SW BIRCH ST STE 300 150 NETTLETON RD
NEWPORT BEACH, CA 92660 VISTA, CA 92083
760-806-1100
LIC EXP 0/00/00
A. P. # . . . . . :379-111-015 4 SQUARE FOOTAGE 0
OCCUPANCY GARAGE SQ FT 0
CONSTRUCTION . FIRE SPRNKLR
VALUATION 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 & CONDITIONS
Re-roof 800 sf over existing asphalt
shingles .
Fite: 9/20% 20 }dirt fry: 1S70
2A ZSC0
2P B=D,G FER1IIT 1 $40.52
TYam f uTbEr: Wj-A9-
Tra-F, date: 9/aj/4 Tife: 9:47:17
13 1i 1 to `• ��I h` 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
Po,t In c11nspiCut)u, IflaLe 2 1 asow-neroftheproperty ormy emplo,,eesw/wages as their sole
compensation will do the work and the structure is not Intended or
on the loh offered for sa!e
3 1 as owner of the property am ex(lusively contracting with licensed
contractors to construct the project
P1 ,P'\iI [ \( \iEi{ .1i1. iii. _ 4 Ihaseacertiricateof consent toselfinsureoraceruficateo(Workers
Compensation insurance or a certified copy thereof
5 1 shall not employ am person In any manner Boas tobecome subject
[OP to\korkers Coompcnsation Laws in the performance of the work for
tli which this permit is issued
Note If}ou should become subject to Workers Compensation after
making this ceruficauon you must forthwith compty with such pro-
visions or this permit shall be deemed revoked
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Cote Pcz 5 S.Ja 4,azeo a S Da e trs`R`ae OTHER DEPARTMENT RELEASES
-e is -- = Gepartrnent Approval required prior iD the
�,4 °ac S e? ❑e.- F, s budding being released by the City
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Da•e Ins cror
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City of Lake ]Elsinore
130 South Main Street
APPLICATION FOR
AP IONf
APPLICATION REC EIVEBUI DING PERMIT
DATE
VALUATION CALCULATIONS
BUu nIN . ArnnPESS 2
1st FLOOR SF s •z- c= ��
RAC BLOCKIPAGE LOT/PARCEL
2nd FLOOR _ SF _
NAME
3rd FLOOR SF O /, _,�.r /`•- ? _ / ��'�•�=
W AILING PHONE
GARAGE SF N ADDRESS 4)-L-t
E CITY TATEIZIP `
STORAGE SF R S,�/ /�'/, Cr C•
I hereby affirm that 1 am licensed under provisions of chapter 9(commencing
DECK&BALCONIES SF with secbon 7000)of division 3 of the business and professions code,and my
C license is in full force and effect
OTHER: SF O LICENSE# CITY BUSINESS
N AND CLASS TAX#
T NAME
VALUATION: R
— --_--_i— A MAILING
— -
C ADDRESS
FEES T CITY STATE/ZIP PHONE
BUILDING PERMIT $ R CONTRA T R I NATPRE DATE
PLAN CHECK NAME LICENSE#
A
PLAN REVIEW R MAILING
C ADDRESS
SEISMIC H CITY STATEIZIP PHONE
PLAN RETENTION ❑ NEW OCC GRP I CONST
❑ADDITION DIVISION TYPE
❑ALTERATION NUMBER OF NUMBER OF
❑OTHER STORIES BEDROOMS
Q SINGLE FAMILY ZONE
0 APARTMENTS
❑1 certify that I have read this application and state that the ❑CONDOMINIUMS HAZARD YES
above information is correct I agree to aunply with all city ❑ TOWN HOMES AREA? NO
and county ordinances and state laws relating to budding ❑COMMERCIAL SPRINKLERS YES
construction,and hereby authorize representatives of this ❑INDUSTRIAL REQUIRED? NO
city to enter upon the above-mentioned property for insp- ❑REPAIR PROPOSED USE OF BLDG
bon purposes ❑DEMOLISH PRESENT USE OF BLDG
JOB DESCRIPTION
Signature of Applicant or Agent Date
Agent for contractor ❑ owner _
Agents Name ��i•�. i �� G"' i � Z
Agents Address
�'. G-),
Street City State Zip