HomeMy WebLinkAbout570 CENTRAL AVE_ (2)l rolictAddress 570 Central Avenue --unit IJ 1 CrMOF LAKE ELSINORE CONSTRUCTION PERMIT,
i Asisso: s Parcel No.3-7 7-150-080. " Applicant to fill in a6 spam eXcept t1XIM- itithiri heavy border linis and sip all appropriate durations
Orlmly'sName genj loess Parkf Mb74-7823 PERMIT ,/2 =,_.RACT_ NG. LOT NO, UNITNO. Addreu ,P: #:mor , CA `-9233(2
Arch/Eng. --KQIIa ed R_ i ggr _License No. Sr Z 2 _ , TIPEOFMOMMM NEW 1 1 hDO t] 11lTERATT01t O REPAIR - atidreu_ i 7982 Sk n (Yrs CA3E. a--ILYjne D CMERs" Ll f?EMOEISH G IFs
Contractar•sNan.a Brookstt ae Develovtnentphone6t4-7823 0iXR!PTIN OF WORKnM OF 8=. Q XP'
Zone
Addrefs (^,air ) P.O.: ROx 91--9, ft9 _Lake Elsinore,CA 92330 TtTE0rMMR GRAOIf G :C fiwNrJATION -
fi
A. Building:
Gly License No _ A18 = EtfIMT_ 0 ELECTRICAL
STGUCTU.w -_
PLUMBING MECHANiru
T
FMaintBuiding
Z
CO:iTRACTOR DECLARATION OTHER ALICcNSE7
NI-tvdeby affirm t"at I am licensed under provisions of Charter 9 (commencing4111section7000) of Division 3 of the Business and Professions P-3gJECTOESCAIPTION: SQ.FL. _ —' A Right t
COCIt. andDiY !license is In full force and elect- ! - - : r
CpKhcttite type tape - Ades Leh
N
iican _ .._ 04386 varuabae s.. _bAl G PCI
S G
oats signet Lae .. . g 'e'l
WORKERS* COMPENSATION DECLARATION - -
I hereby affirm that
Rerilarks , :--R n _C r f
PI Ret_
Planning Notes
Parkin H
i
have a certihCato of Consent to sea -Insure or a CertificateofWorkers• Comr-insation Insurance•
J OJ
CITM--OF LOW M i of a certified COPY twOreOT (SraCtlor 3800; Lab. 4
Y)0034_03-Rol P01iCj No. t ompsny Sfate Fundw 7.7 S L, Lr1kEEK-IIARIF!
r'•::San COPVT1 hereby furnished. . '- ':,!
Ll icer i r
s filed with the city
Date Applicant y,
EXEMPTION FROM WORKERS' COMPENSATION DECLARATIONThitsectionneednotbecompleteditthepermitisforOMhundred (i»4) kss)•:: -
r! • !
1 cerli(y .that In the perfornunre of the work for which this permits nfhetl, f ` Shall C.) employ any person in any manner s0 as to become
J _
subject to meWorkefi' Compensation Laws of California.
Mace _signature
PLUMBIkG-. FEES
Alter Re it
ELECTRICAL _ FEFS MECHANICAL FEF..S
NOTICE: If, atter making this
ideclarationnsof ; you Should become subject to tMWorkers' Compensation .Provisions of the Labor. Code, you must forthwith Airta Was11
Gsltentor 0.5KW O 515KY - Boiler
Coflstruction Pale
Al -I GtriON GFM
comply with such provisions or thisCONSTRUCTIONLENDINGAGENCY txrmit shah be tleemed revrxf d. Backflow Preventer
Sub.
Cookin Unit
t _ _ 1?uct•Uttder Ground ca•Aros
t nerehy affirm that there Is a construction lending agency for the `,erformanceo! the Work for which this permit Is issued (section 3ob7 Civ. C.) _ Len,Qers !w,'ne
Backflow Int tion
Clarifiers
Pole Li ht
oua Structural
fal'i • tientilatino 3101
Fill:
cu. Ards
Plan CAxA Fee=
Leri %efNE Address Dishwasher
0 ers 0Gas CElectrie I Exhaust System - 3225 amitFte j
OWNER BUILDER DECLARATION
f hetet y affirm that I am exempt from fire f•.Ontraclor•i License for
fiXtuR Traps ea.
fan _
F.AU.
c Eva orative Cooler Total Fm 3
Law the
10110wrr:g reason (Section 7031.5 Business anJ Professional Code.- Any city OrCountyrequires Drains _ fixturm -
i Heating System &Ducting1whichapermittoconstruct, 31ter, Improve, demolish or repair
any structure, prior to its Issuance, alto requires the applicant for such permit
F)oor
Floor Sinks Outlets
00-103.000 BTU 100.000 BTU
30 file a Signed Statement that ht/sht is licensed pursuant to the provisionsOf--
the contractor's License Law (Chapter 9 (Commencing with tion 7000) ofDivision Gas Service Out i Switeha Hood' or Canopy 3ataalagdPwl effa
3 d: the Bushes: and PrWass,ons come) or that he/sno. a exempttherefromandthebasisfortheallegedexemption. Any violation, of Section
9031.5 by Jn). applicant for J permit subjects the applicant"l0 a civil
Inte[ea tort
11=TIg -
Meter U to 200 am sS
T •0 :YAe II
R• trigeratian System
3110 BslWifr1 %j. _
Knalty o! not more than five hundred Dollars (5500). p Meter aver 2 amps f 3211 Pk7f11rA118 j
Ai ..wirer c! the Property or my employees with wages as their sole
Compensarinn wilcGo the work. And the structure rI not intended offered
Roof Orairr. Sub panel
100070 BTU 100 000 BTU
hir_ep,.-
N.
Bit. fC60 # 3_22 Ekc." jor
ro•-sale- (Section 7.044, Business r,nd Professionat Code: The Contractor•:
Lir_nte Law does not apply •••'.. owner of a property who builds or improvesthereon,
irailer'Sem
SeynfCap -
Cl 15.50KW- Transformer System Repan/Alteration T2?S MedwirAl i
and who docs such wrrk'himsetf/herself or through his or her own
employyees, provided that such Improvements are not Intended or offered for
sale• If, however, the building Or improvement is Sewerrrnnnection •. Bldg• Q 50+Kyy
Motors 00.1'. 5 o i
Fir_e_Oampers 9221- Aatertion j L_5` _
sold within one year of com•
plet:On, The owner wilt have the burden OI Proving hvJshe did not build O! im• prow IOr the purpose of sale). Solar Collectors
ig • 0 Rtglfteft
Inc. Solar 039.15 HP 16.15+ incinerator
1301 iMiP Res. jIcontractingwithlicensed1, Js Owner tr the property. im excltioneraconstructthe
SOlaf Pi Inp 9 inf/FaIThRtS. Wisc.
302 S;AIPCem. j ._
7iveWBusinesspr
Law (
Section
no
7044,
tosin
o
and Professions Coda: C* t L Coca:
Ti7e COntNCIOt's License Law dots not apply to an owner o/ prOWrly who olar Tank '-'jMull -Film. RES. r 3215 01Ler _
Wallas ( improves thprern, mild Wr10 COnlraClf for such projects Wlth a Con•
totractor(sl license purswnI to it,* Contractor's License Law). I am aware that.' sod!" 011 a _ t Swimmin Pool/S a SIMMOln'et IFou
Proof O then Worker's ,on insurance should be Provided to m..
iJ Water Heater _ 4 Baildigt j -
1 am exempt under Section __,`\ 13. d. P. C. for this reason Wat r
ISSoe
P)vejbjnj i
Data Owner :\ septic System EIKtrical j
1 ht7ebyy Certify than 1 have re40 Ire(; apoliC-110n acid stale that the abovein0wmatiOniscorrect. 1 Agree In comp:y With a,1 City and county ordinancesandEfatelawsrelAtinqt0buildington •ruCtion, 7 3r03 tMeban.:a1 :
and h4 eby authorize repro. - fentatiWs JI illi ty t0 for up rhe above•rflantioned property for
f;8/WNWof J (/r/ ate OlMef j inspection pure
Siggaturu OJ[e Issue
4
I11/aMall!aired "-" aha O 1112 Planning s
Ori(fs' I,Ianse or SS 7f
Whih•Buildirg, CoWlempaary fik COW Pinli Asstssaf: Gol6tnuod•ApplicaM lowFM1011a •r le • f%%
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Assessors Parcel No. _
0-ho"s None Central is. -Pc" rk- Irm. ._-rs ry__ f?A 7Q77
Arch/Eng. __KQnrad_"9__Limmse Mo. jM26
Address
H++
contractor'$ pan Phohe 674-7823
Address („r-rng) _ P.0. BaK 939 L.E.
City License No. 341$ _
L[CCNSEO CONTRACTCR OECLAPNTION ...
1 he+cDy affirm that 1 am licensed u'.aer provisro•rs of Chatter 9 (commencingwithucti;:a 7000) of Division 3 -:d the Busir.ess and Prafessiens Code, andmyIrctr..e Is in I) t'Qjrirte and effect.
Liconse Class Na.SQQ__
Date .Q— Srgnat+, e
WORK R LOIPMENSATION G£CLARATION
I neleby affirm that I have a certificate of consen, to self -Insure or a certificateOfWarens' Compensation Infura , or a certifted COPY thereof (Section3800, Lab. C.)
wPali --y IVo. yri03.— Ccrm iany
Certified COPY is hereby furnished. —
Aftihed COPY is filed wi-lh. the City
Date.
j- ApphcarA
EXEM r1 N FR M WORKERS- COMPENSATION DECLARATIONJThlssectionneednotbecompfited.ff thepermitis for one hundred (6100) or
less). 1 ctndy teat in the performance claht.wotri for which this permit is issuedshai, 1 - l not employ any person in any manner so as to became subject to theworkers' Compensation Laws of C&Hfdrnia.
Date _ Signature
NOTICE: If, alter ma..Ing this a ciaration, You shoulcr become subjKt to [ratWorkers' Compensation provisions of the Labo:"Cep:, yon. .rust forthwithcomplywithSuchprpvifrOnsor :nis PeNn•tt Shall be deemed revoked. CONSTRUCTION LENDING AGENCV
1 nentry affirm that Mears IS a construction lending igency for the PerformanOftheworkforwhichthisPermitis
issuece
d (Section 3097 Civ. C.) Lender's Name .
Londe,'S Address
OWNER BUILDER DECLARATION
1 hereby arfhfm trial I Am exempt from the Contractor's License Law for triptOliowinqreason (Section 7031.5 Business and trufe:Sicnal Code: Any ci!y orruntywhichrequiresapermit :o construct, atter. Improve, demolish or repair
drily Strutt 4rC. Qr:a; :u res iffuanM gr tO 7 ,.+5 iiia aPPrrcAOl fat SUih "pt/rT+I- tr• f::a a srgnetl ;ta!_;-„,rrir tna(-n! rfAt s licenfea pursuant to trier provslOns OIintCont.isr's 4cense Law (Chapter 9 (commencl-,„:; ; Section 7000) ofC+•vis•Gn 3 Of Ili! BufinllS aria PrDltisin^: i Otle) or that h!/ahs ff exemptthatelrOmandtheOafiSfortfl! alleged exensp[iOn. Any violation Or S Ct Ion7031.5 Dy any apDlfCant tOr a plfri:il SuDjeclf Iia applicant to a civil
taenalty of not more than five Hundred tlntlais (5500). __
1, of owner of the p. aOtrfv m my n:.!.aLsEe; wrt0 w;gas JS thtirfOI@
asirun, wnn po the work, and the st,utl care is not intsnOetl or ot(ered
Licenseeaerie ( w oe
704+. Business ar+tl Proressmnni r..: _C:
thereon. Law dots not aQ t-:o..."urrner fsf prCptrly whO builds or improvesthfrtOn, and w^.,,-JofS fuCri W.••k himtelfr n*Melf of through his Or her own
emplO tw.> pf07ided that such i•,proverhOWS are not intended or o.iei art for -
safe. 11, however, the building or imoroverrrenl is sold within one year of com•
pletion, the owner will have the burden of (•roving he/She did not build or im• prove for the purpose Of sale).
U 1, as owns, Of the property, am exClmively Contracting with licensed can.
tract Ors t0 construct the protect (Section 1044, flusrneff Arid Professions Code:
The Contractor's License LAW does nal apply to an owner of gropsfiy who
bar ids Or improves thereon, a•:d who :onlracil for SuCh projects with a COT
fraClI (V IictnH pursuant to the Contractor,, L cCnSP Law) 1 am aware IhatorDoto// Inea Worker's COmoen Satior insurmce should be protid0d to rite.
a in exempt under Sectinn __ B. L P. C. for this reason
Dale Owner ,
I hereby Certify that 1 have read this application and state that the aboveinformationisCOfreC1. I agree Ia Comply with all city and county Ordinance$ and state laws relatrn 10 building con ('Ion, .Ind hernby authorize repro. entatives Of this . to elft r up he abOvt•mentioned properly for, inspection purpo 7 ,
Sfgnaturo Data _ 6-26-90
Drivers' License or SS
Canar)•Tifttpfiraq ilk Cope PInII•Ass AV; SolOenrod-Applfcant
CITY OF LAKE ELSINORE CONSTRUCTION PERMIT
Applies” to fill in ale spaces exc"" those within, heavy. border Infers and sign all appropriate declarations
PFA_ fT RIG - TRACT N0. LOT N0. UNIT N0.
BTPEOFODIfsFBBLM . •N NEM
C CMERSION '7 D Lamm
DESCPJPTION OF MUM OF BLU
cel RTIC ALTERATI011
TM OFPERNIT 0 GRANNG IF,14OWNWT10N URAL
C 11:If4NT D ELECTRICAL C° PLUMBING C MEOMICAL
0 0M
rinimci utgA1FTlOR: Sq. FL Otctpapq.
Lgast:ttOoa tip' Zone AtrK
watt: /, poo - Pea
Remarks
PLL
Alter, Re
Auto Was
Backflow
Backflow
Cluifiers
Dishwashl
Fi.•!-i,-T
FloorjDra
tLtUHIGAL FE
Generator 00-SKW n 5.15KW
Construction Pole Sub.
Cooking Unit
Pole Light
Overs OGas CElecirit•.
Fan
I 1 I meter u Over
ransformer ,^u- i5.50KW
Illog Motors O 0.1 HPC 1!5 • R
Inc. Solar 09.15 HP 0 16'15+
KVFLOPNEBT SER110Es Rtlivatuffs:
h t MMOW of
BaiMlq AWmd By
AIICit+AM leaded BP
13 REPAIR
A.P. *
E Main
T rront
e Rens
Left
i. Ref. #
He ng S' rom CL flartine
00.100,000 BTU 171100.1
Hood or Canopy
Type 1 O Tvoe ll I
Refrigeration System
00-100 000 RTU 01000
Firepl/Fact. Bit. Iden at
zone
Accessory Building:
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Parking Rell.ftevided R
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EES ACCT. ems, t mv. FEES
i Cat cu. pills
Fill: - ._cm pros
3401 Plan Checll Fee S
3225 PernutFee s — —
Total Fees s
Saatla" of Perlait Fps
3220 Building rr
3211 Plumbing S
3112
3223 Mechanical s
3224 Reteptwil
2301 SNIP Res. i
2302 SMIPCom. s
3125 Other
heel d Plea Ded F 1Z• 5
7(6: 3401 Building s
Plumbing s
Electrical
Mechanical S
3403 Other s
3412 Planning s
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Assessor-* Porcoel No.-
4saner's Nine 3r•U..• — S _}.-.re 4t.... ' —.
A lrTrcis–.Q._ st—wti–rV; • ._ io-7 L. '2._.:w r[
Arch' Enq_ _ License No. -
Adiress –
Cdntrxtor'r.Name =14 .4 LAvtbc,. tlax i PhOnt- _st ask-a
Atidress frrrsiling) ~ /
I '
L•. a .=c_`'i..
7 , —
City License No.
LICENSED CONTRACTOR DECt.ARAT.ON
I hereliv [turn that 1 Am licensed uaae, wcvrsrer s Of Charter 9 (Commenc,eg
mth section 7000) of D,rasron 3 of the Business and Professions Code, Arid
my license IS In full fci:t lord effect.
L)cen See{Cis% –.:tLiccnseNo 9 i9Q
Cate-biha.>s,gnai use ` --
WORKERS' COMPENSATION DECLARATION
1 hereby Asfirm that 1 have a certificate of consent to selt4n•.ure or a certificate
Of WOF"Cls' Compensation Insurance, or a Certified Cory tnereof ;StU:On3800, Lab. {
y Q 7PrI'CY NO. C L.i- Company –i -==t t e `:-
Ceslthed copy )s hereby furnished.
Ccrit ira c Is filed war the cit Burtdrng Division.
Cate _
IU35c —.
Apo,,canf all,_•'3tJ US,,_;
EXEMPTION FROMWO COMPENSATION DECLARATION
This teC:.,r. need nn: be Comv elect ,f the refmrt IS for O:ie hundred (SI00) Or
1 :S). cCCLrly InA' an the perfq•ma^Ct '+ ae wJr: in, which falls peem•f ,s 3S¢ ea t
nail not employ any person ri ar.y n–roner So as to ""'Come SUO+ect e1th
taut, els' Compensahnn LAPIS of CAuf0;n,A.
Oat' — __ -- __ Sr;nr.c.•c _ _ ___
NOTICE: 1% aper mas.:nq :flat dot:araas.a, you thou.] becomot SubaeC: ill the
icari.ers' Cmmpensatton 0rov%,nri •,f :he LAhnr COO!, you .Hast fcrtnwsth
rnn•.pty wait; wen tiro• tiLns 7• ;•t,S permit Shan be .7Cem Car revoked
CONSTPUCTION LENDING AG£NCY
Ir.ereby affum that there If A :Cn%: uCto n rending a ncy for Pre C, rforman Cc
cif the work for vm.cn t;s cern,; o; issusar (Seelin7. 3097 Ct' C.,
Lender's Name _: _. ----• '_------ . '---
Lcndcr'S AddrtSs
OWNER BUILDER DECLARATION _
1 hNchy all -fm that 1 am exemPf frl-ni :r'a C0n•f ACf Or'S Lir, ' Lat•. for the
fnllovriny reason (Saection 703:.5 Bui-ness and Prnf'Ssoonai _vele: Any coy or
County w'liC , regraies a permit t 1 co.',struct. alter.•riff•^'. we. demnti%n or repair
any sir u Ctur prior in its issuance, 41sr, rota utres i, 'Uphtdnl ;or such v rant
tar file a sign Ld S:31cmc at that Ha'st'e IS IiCCriseC ,Mt ,ant to the prov ACrl: •;f
the C•)ntrActor'1 L,rense LAW (Ch.Oler 9 :Comme,,cing with Secc,!)n 7000; of
O, vision 3 of Ute flus,ness and Frotessicns COCC) or that he/she .• evempt
the; efrOm and file hat's fdf the alle;eo ext .•ptin'1. Any vi Ulatr.• o' Srstion
7031.5 by any Applicant for . subactts Isle asipl:_ant :o a civil
penalty of not mnre than five h ..:]red collars (Sr,Oo).
1, as Owner of the property .r my emoloyees '-Illi wages as Inert sale
Crim pCnSAliUn, will do the wort., 4110 :he StruCtv'e is not intend. -(l Or vfefrd
for %ZIC (Secl,n 7046 1lus,ness aha Profe,,+ona: CnCc: The Cnnt,actr,•'s
t_,renv Lav dne t apply :n an nwn4r r: ,r prnperty who bt;ads or imprr,veS
hcic`, . ! 4 wit•; 'file; suCM wnr- rl-n,• -:f,herS'I! 11 !hrh,.:gh las r.r her "wn
empf ,y Cts. „tfl , jcd :hat such Im Jrovcrilenls are toot ,n!cnne.l •.r nf•'red fo•
slot^ it. however, Inc bu .d riarrt±spi,emen: ,S Solid . Ilion unc ,,ea, r : Cnnt•
p,ten, the owner wall Ila' a Inc bt,, lien of provtnq he/she Clod not Ula In for am-
ruve `or alie purpnse rf sale).
1 as owner a,I :n!. property, am cxcl.Mva ly cnut,ac-,ng with laceased cr.,,.
Iraq ofsla f0f".ruC1 Isle ProicCt (Section 7044, Business and p n:csf,ar•: COOe:
rhe Con If Icilrr•S 1_icense Law (last' not apply to 4n owner of prof.1ty who
builds 'f rsnprnvls thetenn, aid whO ColslraCI% for Such prolec•:.v•tn a con-
tracinr(s) licenpse ufsuan. III the C!1fAfaCtof's L•cehSe !_lour'. t Am as+are that
Irnof O// the• -r Wnfter's Cnm:lentation insurance shnn•a be provoo*d fn me.
i_1 1 am e.xempl under Secimn - =-_.-- —_—.- Is. P. C. ,nr that oason
nate--
I hereby Call" ly feat I nave ;can inis appoCation and %talo U.al Ine above
rrltn(matoon is Cnrrlr), f Allier:n ch MI) V wolfs an City and county Ordinances
and state .awl relal,roc •,o Lu,,7,r,; COnsifuctinn, and hereby autnbfiac •*Ore. tentative% Of t c.•: to fenlc upon the above•menlinnod prnperlfor
inSpeClion our
CiigMturc - _- µms_ tLs...r DA:•:
Drivers' ..,C*PH or $5 y1• _
Wndrdu ldmE Gnary Tem(aary file Copy. P(nk-Assessor. Gnklestrod Applicant
J16 ,
C" OF LAKE ELSINORE CONSTRUCTION PERSiE"!T
Applicar:t to fil! in alt spaces exccp: those within heavy bolder firms and sire all appropriate dedaratiers
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PEPJA T
CCN%RAL SIL-sp4ESSMAK /\S70 p ,
Project Address —.s/ / U &.Al SQL /5rl aL r/iV /T r
Assessor's Parcel No.
t74vnsr's Namt, x 41 it __Phone
Address
ArclVEng. License No.
Address + -
Contractor's Name- Phone _— Z_
Address (mailing) 1 _
Cly License No.
LICENSED CONTRALTO D LAR TION
t he,eby affirm that 1 am I con d er provisions of Cha e comrnencingw,th section 7000) of Div Sion 3 of fhe Business and ofessions Code, andlicenseIsInfullforceandeffect.
L:.cense Class - LiC se NO.-
Oate Signature
v —
wORKERS' COMPEsISATION DECLARAT N
I hereby affirm that i crave a certificate of nsent to salf4nsure or a certificateo' Workers* Compensa?ion Insurance, r a certified Copy thereof (Section3S00, Lab, C.)
P fity No. Company
t Cerhlietl Copy Is hereby fur shed.
Certified copy Is filed wi lite city Building Division. -
Date. _ _ _ Applicant _
EXEMPTION FRO i1 RKERS' COMPENSATION DECLARATIONThussectionneedbecompletedifthepermit45firOnehundred ($100) orless)_
I certify !hat i4 a performance of the work for which this permit is issued, i
snarl -not Body y any rerscm in any manner so as to become subject to theW:.rFe•s' Co pensatirm Laws of California.
e — --Signature
NOTiC . If, alter ,raking this declaration, you should become Subject to fileY.Cri.. Compensation pr9visions of the Labor Code, you must forthwithccywithsuci, provisions Or this permit shall be deemed revoked. C STRUCTION LENDING AGENCY
ereby affirm that Inert is a construction lending agency for the performanceo' the work for which this permit Is issued (Section 3097 Civ. C.)
Lender's Name_
Le doer's Address
OWNER BUILDER DECLARATION
ereby affirm that I aril exempt from the Contractor's Lrcefise Law for ther.:a ying reason (Section 7031.5 Busine;c and fProfessionalCode: ny City ortctm!y ,,hich reou.res a permit to construe(, after. Improve, demon s'r or repair
my structure. prior to its issuance, also requires the applicant for ;,ch permit
f:•e a signed statement that he/she is licensed parsuant to the 01.;visions of
C•>ntractor's License law (Chaplar 9 (commencing with Section 7000) ofO•. s•:-" 3 of it;( Guiness and Professions Code) Or that he/she ,s exemptMeref. om and tht:• DMif for the alleged exemption. Any violation of Sattion703;.5 by any 30pheant for a permit subjects the applicant to a civil
Vty of not nose than five hundred dollars ($500).
as 3wner of the pro PCrty of my -employees w•th wages as their sole
campenfaaon, will do tine work, and the structure is not intended or offered
of safe (Section 7044, Business and Professional Code: The Contractor's
L,cense Law does not apply to an owner of a properly who builds or imr+roves
r+ereon, and who does such work himself/herself or through his or tier own
employees, provided that such Improvements are not intended or offered for
Sale. If, however, the building or improvement if sold within one year of cOm-
p'e:,on, lbC owner will have the burden of proving he/she olid not build or Im. glove for the purpose u! sa!e).
i, as Owne, of the property, im exclusively contracting with licensed can-
aClors to construct the project (Sett,nn 7044, 0us,ness and Professions Code: T fe Contractor's License law du. s n— 'Ppiy Ni an owner of property whoDu, Is or improves Marlton. and . in cn:,tracts 'Or such projects with a can.
tractor(si license pursuant to the COi:r tCl u, ' License Law). I am aware that
pG of OI their worker's COmper!salion Insurance should be provided to me.
t a—
mr
e,
Lx
tmpt under Sectio:u -___. —..--_ 13 6 p .0for thug reason
P1 4_ -- —
nertDy CCrl i!y that 1 haul a Itig application and state that the Soo VOrnrWmattOr! is correct. 1 agree o comply with all city and county ordinancesandstat. laws relalrng to bu+ldmq construction, and hereby authorize repro• sent31.rves o rs city to ante upon the above- m nlhmed properly forrn5oerhon
Dr.
vrigna
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atc PAO-k_ Dr'A'f' • Bose or CC
ai -Building. Canary -Temporary Fde Copy; ink -Assessor: Goldenrod -Ar nl,r,et
r r, -
CITY OF LAKE ELSINORE CONSTRUCTION PERMIT
Applicant to fill in all spaces except those within heavy. harder lines and sign all appropriate declarations '
PER 0P. 47 U TRACT NO. LOT_NO. TU NIT N0.
l
TMIDFOOFISTAKI' T1 - NEw C' ACD ^ ALTERATION Q REPAIR17CONVERSIONDDEMOLISHLOTHER _
DESCRIPTION OF WORK/USE OF BLDG. - /e .Ub A.P. #
11 S _Ore
E Mair: Building: Accessory ButTYPEOFPERMIT0GRADING0FOUNDATIONSTRUCTURALTFront - r' TENANT L) ELECTRICAL 0 PLUMBING (3 MECHAN)CAL BCOTHERA Rear —
PROJECT DESCRIPTION' t OccuCa11 C Right --
Construcvon type lone Acres g LeftValuation $ Q0 t» ' PCM
Remarks — Ping. Ref. # Parking Req./Provided
Plann!ng Notes
PLUMBING FEES ELECTRICAL FEES M
Alter, Re air MECHANICAL FEE! AM.M GRhilasFEESi? Generator OQ 5Kla! ( 5.15KW , _ BoilerAutoWashConstructionPoleSub. Duct -Under Ground ( Cut --__Cu. yardsBackflowPreventerICookinUn!,, Fill _-_ 9 Duct -Structural cu. yardsBaekfSoKirrigation _ Pole l;ght fan .'jentilatino Plan Check Fee $ 3401Clarifiers _ O rcrs GGas GElectricI Exhaust Svstem __ 3225 Permit FeeDishtliasterTan-
Fixrfre fEva orative Cooler _ iotas Fees $
Frailu
inis ea. F.A.U. Heating System & Ductingloorrj. Gixtutes f 00.100.000 BTU, i_1100.000 RTUFloorSinki _ Outlets _ —_ t
I Hand or Canopy Summary of Permit finSasSetvicEDutletsSwitchesTet, Q Tvpe II 0ntercautoFsMeterU1atacit3mSr
3110 I Budding j 57, i i
t_ - _ ,efrigeration SystemTra_p Meter; over 2 0 amps — _ (00100 000 BTU 0100,000 BTU 3221 Plumbing j _
ioof. Orfiins Sub anel _ Fire I/Fact. Bit. IC
11 0
3222 Vactncaf $ _ -
railef 3t t4r -, rJ 15.50KW +_ System Repair/Alteration 3223 Mechanical $ _
ieVyrr Cod. Transformer
327.4 Retention _1__ _ - O 50 -KW Fire Dampers j _ e"kyr r+. ei;iinn Bldg. — n Molars i_ry ;)-: HP 1%, • 8 Re colors _ — 1301 SMIP Res f -- Olaf C-Iiivr,(Ors _ A ;nc, 5nl,rr CJ9"i5 HP 01615+ _ Incinerator 1392 SMIP Com,
T t2_Sin_. i n_ Res. I Miscue _ ?trier jRes. __ --- -- 3115iMahl•F$m. - ----
wima.in3. Pool/Spa , Swim ding POOL/a - - —" -- - Seminary of Plan Check F.
7iatorHeater` { + - 3401 Building S
1SSUe
Later Seiti ii: _ ! _ Plumbing t
P.pticSystc-Al __. ...
Y
Electrical S
USE_ DEVEWMENT SERVICES IREMEMTS: Mechanical j __._
3483 other j
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Issue Apliliratinn land Ry
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CITY OF LAKE ZLSINORE
BUILDING DWISION
OWNER- BUX LDER VZ- RX F' C A. T I ON
A city or county, which is required to give notice pursuant to
Section 19830, shall attach to such notipe, and, as a condition precedent
to issuing a building permit, require the completion -4nd require the return
of an owner -builder verification.
Attention Property Omer:
An "owner -builder" building permit ha* bion applied for i,-, J,,ur name
and bearing your signature. EL' Q building 1-:8yt V,,. k! issued :'.'1 xhis
verification 4,n received.
1. I personally plan to provide the major labor tnd materials
for i nstruction of the psopoaid proper:;y'improvement.
tries No
2. I (have/have not) signed an application for a
building permit for the propoci—ed work.
3. I have contracted with the following person (firm) to
provide the proposed construction:
Name
Address
Phone ( ) Contractors Lie.
4. I plan to provide portions of the work, but I have hired the r
following person to coordinate, supervise, and provide the
major work:
Name
Address
Phone (714) Contractor's L c 4
5. I will provide some of the work but X have contracted_
hired) the following persons to provide the work indicated:
Name Address MUS z= 2z Work
If additional space Is required attach subcontractorslist.)
I hereby affirm that I have received a copy of the information set
forth in Section 19830 of the State of California Health and Safety Code
and have complete the above information to the best of my personal
knowledge, in eon li*nce with this State Law.
Signed: Dater 9._.
Name: _ o uil Ja•n-C
Printed or Typed)
Drivers Lic. # or sac. Sec. #
LAKE ELSINORE UNIFIED SCHOOL DISTRICT545ChaneyStreet
Lake Elsinore, CA 92330
714) 674-7731
CERTIFICATE OF COMPT- ANCE
Date 9
TypeotPermit fi ofL te:inoreEl
Permit s
Owner Name Cen ral Business Park Investments Log #
sob sits Address No. gtzeet Central Avenue
City Lake Elsinore zip 92330 study Area
APN • 377-150-076 Tracts 12475f ----I
Type of Development Commercial
Lot s square Footage 43057
Comments .I II T ,+ —
No. otunits 10
s l -til
At the present time, the Lake Elsinore "'ini& School District does not collect feesgarages/carports, covered patiosJwaikways, residential additions under 500 square feet, detached accessory structures or replacement mobilehomes. It has been determinedtheabove-named owner is exempt from paying school fees at this time due to thefollowingreason:
i
EXEMPTION NOT APPLICABLE J
This certifies that school facility fees imposed pursuant to Government Code 5x080intheamountof .26 X 43,057 or $ 11,194.82 have been paid. ;,o L.E.U.S.D. _ forthepropertylistedaboveandthatbuildingpermitsand/or Certificates of Occupancy forthissquarefootageinthisproposedprojectmaynowbyissued.
Type of Payment I Check
Fees Paid By Brookstone Develo went '
Name on the check or voucher i Fa t+P 1$cab1e Telephone 67¢7$23
By Michael T. Ih[cCarty
Ass oe: superintendent, Business
P" cointea by Marcia Schmitt
Signature I. n A / ._1L- .
Couector. Attach a coP^unty or City pian ch"k application form to District copy. Bin+'!vie c- t 2 embossed copies - developer
LAKE ELSINORE UNIFIED SCHOOL DISTRICT545ChaneyStreet
Lake Elsinore, CA 92330
7141674-7731
CERMICATE OF COMPI,UNCEDate1 $9
No' 890155 Type of Permit eC_y of Lake Elsinore
Permit N
Owner Name Central Business Park Investments Log— Job Site Address No. 571 met Cr,9ne Street
City Lake Elsinore Zip Study &-ea ;dAP37.7-15076 Tract s
Lot #**
Square Footage 430{j$ T•p of DevelopmentO= erCi
No,. ofCommentsA _ T.ntn t t _ unite 10
At the present time, the Lake Elsinore Unified School Districtgarages/carports, coverlet patios/walkways, residential
additionsriot
does
n
not collectlls fees ondetachedaccessory- structures or replacement mobilehomes. It has beentheabove-named owner is exeffipt fromPaying
square feet,
following reason:
n determined
0 school fees at this time due to the
MMPTIOPd SOT APPLICABLE
This certifies that school facility fees imposed pursuant to Governmeintheamo?Ant of .26 X43 058 $ nt Code 53080or11,195.08 have been paid to L.E.U.S.D. forthepropertylistedaboveandthatbuildingpermitsand/or Certificatesthissquarefootageinthisproposedprojectmaynowbeissued, of Occupancy for
Type of Payment Cheek
Fees Paid By Brookstone Develo ment
Nameon the check or voucher if apPlicable Telephone 674-7823
By Michael T. McCart
AssisEnPerintendent, Bndner.
Fee calledP by Marcia Schmitt
Signature , .
Collectors ,,•,}
sj spy a• yyorCitPlanqtapplicationforatoDistr:et copy. 2eembossed copies -Developer
Planning & Engineering offiice
46-209 Cusis Street, Suite 405
Indio, CA 92201
619) 342-88815
DATE:
TO:
RIVERSIDE COUNTY
FIRE DEPARTMENT
IN COOPERATION WITH THE
CALIFORNIA DEPARTMENT OF FORESTRY
AND FQE PROTECTION
RAI' HEBRARD
FIRE CHIEF
Pknnin8 & Fnine ring Ofim
4080 Lemon Street, Suite 11 L
Riverside, CA 92501
714) 787-6606
PLANNNING DEPARTMENT
SURVEYOR'S OFFICE
BUILDING & SAFETY
The Riverside County Fire Defirtment he:-ehy releases
Located at:
CHECK ONE:- -
FINAI. RECORDATION
FURTHER DEVELOPMENT
FINAL FOR OCCUPANCY
CHECK ONE: _
FEES PAID
FEES NOT PAID
FEES NOT F.EQUIRED
If you should have any questions regarding this matter, plep.se do not hesitate
to contact the Planning and Engineering staff.
RAYMOND H. REGIS
Chief Fire Department Planner
L A R E E L S I N O -R E
BUILDING DEPAR.'MENT :
FEE RECEIPT
NAME:
PLAN CHECK
JOB ADDRESS: .C '(/ j',p ` /
j C+e009NE
3224) 100-3324-000 Plan Retention io
3412) 100-3412--000 Planning Division
Rem
vew-10
3401) 100-3401-000 Building Plan Check
3403) 100-3403-Go0 Grading Plan Check
3403) 100-3403-000 Overtime Plan Check
3225) 100-3225-000 Special Inspection
3220) 100-3220-000 Reinspection B
3222) 100-3222-000 Reinspection E
3223) 100-3223-000 Reinspection M
3221) 100-3221-000 Reinspection P
3821) 221-3821-000 Paris Capital Improvement
3811) 211-3811-000 Storm Drain Capital Improvements 77.P3801) 201-3801-000 Street Capital Improvements
3440) 100-3440•-000 Sale of Maps and Copy Fees
3461) 100-3461-000 Admin. Fee (including Tb Book!
3831) 231-3831-000 Library Mitigation
r
Miscellaneous
NEUE IVEJ
YF:
6255.
NE ELSINOE y
rT:C..G522biBP?t'Y.STVf E QESJELOPMENT
8-4-89
CIVIL ENGINEER CERTIFICATION FORM
City of Lake Elsinore
130 South *fain Street
Lake Elsinore, CA 92330
Attention: Building Department
GPC No.
Project Name:
BUTTERFIELD ENGINEERING &
Froin: SURVEYS/THE KEITH COMPANIES
P.O. Box 1049
Lake Elsinore, CA 92330
Date: NOVEMBER 20 1989
Parcel 4 PM 23710 x
Tract/Subdivision/Lot Nc. Rough Final
BANK SITE, PAR 4 PM 23710
Project Address: Casino Drive. Lake Elsinore CA
Owner/Developer: BROOKSTONE DEVELOP14ENT
Type of Project: BUSINESS
Tract Drainage
Commercial X_ Other
Industrial — RECEIVED
Yardage for Project: J 1989
Cut _ Borrow Dept. of Bldg b 6afey
Fill X Export _
I hereby certify that the grading for this project is in
compliance with the lines and grades as set forth or. the City'saP-1 roved grading plan. Any de riations from the plan are setforthbelow. I further state that all areas exhibit positive
surface flow to public ways or City approved drainage devices,.
Description of Changes:
This verification is for line and grade of pad only,
Conpany_Butterfield Fncrineering & Survey Name: FRED W. CROIJE
License No.: 3698 (RCE/LS) Signature:_`
i
CIVIL ENGINEER CERTIFICATION FORM
City of Lake Elsinore
130 South Main Street
Lake Elsinore, CA 92330
Attention: Building Department
GPC No.
Project Name:
BUTTERFIELD ENGINEERING &
From: SURVEYS/THE KEITH COMPANIES
r.O. Box .1049
T,akcElsinore CA 92330
Date: NOVEMi3ER 27 , 1989
Parcel Map 24751 x
Tract/Subdivision/Lot No. Rough
CENTRAL BUSINESS PARK
Final
Project Address: S.E. COR. CENTRAL & COLLIER Lake Elsinore CA _
Owner/Developer: BROOKSTONE DEVELOPMENT
Type of Project: INDUSTRI:XL
Tract _ Drainage
Commercial Other
Industrial X R E C L E V E U —.
Yardage for Project: `1
1
1989
Cut Borrow DWI of B49. & Safety
Fill Export
I hereby certify that the grading for this project is in
compliance with the lines and grades as set forth on the City'sapprovedgradingplan. Any deviations from the plan are setforthBelo:.:. I further state that all areas exhibit positivesurfaceflowtopublicwaysorCityapproveddrainagedevices.
Description of Changes:
The Pads were built to 0.5 below finish floor + 0.1.
Company: Butterfield Engineering & Survev Name: FRED W. CROWE
License No.: 3698 LS) Signature: