HomeMy WebLinkAboutLINCOLN STREET 15195_04-00002504 C
i of Lake Elsinore ]
PERMIT
130 South Main Street
PERMIT NO: 04-00002504 DATE : 9/20/04
JOB ADDRESS . 15195 LINCOLN ST
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
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
Date: 9/20/04 20 RKElpt nD: 15 70
2004 25C-4
FP H JI D G FEF41IT 1 .52
Baas aRber: 8DTS3
(Y.G-67< 93(A $2r 6.70
Tr'cr5 date: 9/2)/04 Ture: 9:47:17
f'IcascRedd and Initial
I I am Licensed under the provisions of Business and Prolessional
Code Section 7000 et seq and my license is in full force
Post in (onsplcuow. place 2 1 asow•nerofiheproptrt} ormy employcesw/wagesaslht•irsoi(-
compensation will do the work and the structure is not Intended or
on the jot) offered for sale
3 1 as oµ•ner of thv property am exclushely contracting with licensed
contractors to construct the project
V,tl t11L',t 'Le ,, P RVI I V- %IP)I-R ',i P: _ 4 1ha%ca certificate ofconsenttoselflnsureora certificate ofWorkers
ll lfi \DDRL.- 'i`i ;".11 ,: c': i1 tt c,i,e` Compensation insurance or a certified copy thereof
5 1 shall not emploN any person In anv manner so as to become subject
to Korkers Coompensation Laws in the performance of the work for
which this permit is issued
Vote If Nou should become subject to Workers Compensation after
making this certification Nou must forlhµ•ith comph•with such pro-
visions or this permit shall be deemed re%oked
Coce a xvw a s Da e
EL-' T,--:,E e<c Se-.-,:es
PL3 S;, P x U-ce•c o--e
EL-,2 =a:
11-1 =oa - s
BP;2 S ee e-
5y� Sac ace
PL- U--oe c'r:a e,Poe
SS= ra-c Se- -s,s e—
S:. -S e Sey-e,
Eli—
Y.
D - - Zas a-t• T es
Pi -
FP ' G a— --
BP ? --
BP D-...a
Sc
B?s F-a B
t-e s Spa A==r0:a Da e s e OTHER DEPARTMENT RELEASES
De- t-s--L_-
- veparvnertt Aaprpvdl requires prior to the
�111C -- 5 " cc."'-s budding oeing released by the City
Pri,3 P e v-- e
Da•e Inspeclor
Pla-
5-J
La-cscaoe
Finance
Enc,neenn
nv F a o-,v S:v
City of Lake Elsinore
130 South Main Street
APPLICATION FOR APPLICATIO�O_
APPLICATIONBgILDI G PERMIT RECEIVED
DATE
APZ BY
VALUATION CALCULATIONS
BUII ntN _ AnnP -S i
1st FLOOR SF /S! S
TRACT- BLOCKIPAGE LOT/PARCEL
2nd FLOOR _ _ SF
NAME
3rd FLOOR _SF O / "_/ -/., ' '?c' C. / i J
VJ MAILING PHONE
GARAGE SF N ADDRESS r f i J fJ /�• ,' % % - j
E ZITYSTATE/ZIP
STORAGE SF R ---c-
j
I hereby affirm that I am licensed under provisions of chapter 9(commencing
DECK&BALCONIES -SF with section 7000)of division 3 of the business and professions code,artd my
C license is in full force and effect-
OTHER: SF O LICENSE S _ _ CITY BUSINESS
N AND CLASS TAX 9
T NAME _
VALUATION- R %r 7: >% •''
A MAILING
C ADDRESS -
FEES T CITY STATE/ZIP PHONE
O
BUILDING PERMIT $ R CONTRACT R':,SIGNATuRE DATE
PLAN CHECK NAME LICF WN C r-
PLAN REVIEW _ R MAILING
C ADDRESS
SEFSfAIC H CITY STATE/ZIP PHONE
PLAN RI-TENTION ❑ NEW � OCC GRP / � CONST
❑ADDITION DIVISION TYPE
0 ALTERATION NllM8ER OF NUMBER OF
p OTHER STORIES BF-DROOMS
❑ SINGLE FAMILY ZONE
0 APARTMENTS
❑1 certify that I have read this application and state that the ❑CONDOMINIUMS HAZARD YES
above information is coned I agree to comply wdh all coy (] TOWN HOMES AREA? NO
and county ordinances and state laws relating Io building I]COMMERCIAL_ SPRINKLED, YES
construction,and hereby authorcze repfesenfat(ves of this 0 INDUSTRIAL REQUIRED? NO
city to enter upon the above-mentioned property for insp- ❑REPAIR PROPOSED USE OF BLDG
tion purposes El DEMOLISH PRESENT USE OF BLDG
JOB DESCRIPTION
Signature of Applicant or Agent Date
r
Agent for Y-14L contractor ❑ owner
Agents Name /)c
Agents Address
Street City State Zip