HomeMy WebLinkAbout570 CENTRAL AVE_ (3)f
Projorct Add-ossent ral b4GriA*W -_
Assessur'sParcel No. 377-1511-076-Q81.
Owner's Naitrr, Con t ral _3usiness Pk Inv( tne — 674-7823
Address :'.0. Lai,e_Elsino eCA
66
Arch Eng..—
C- ---_ unC:IC _1Zle'E L censr NA, --_
Address
Contractor's Name1 an 1F j7bre -F[ + 2 3
Address Imailing) Q• C3X _939,__iralct _.—CA --9233 :
City License No.-
LICENS-0 CONTRACTOR DECLARATION
1 herery affirm that I lm IK-nsrd 'A e• CrLv'Swri u' Ct_ar ter 9 (commencing
wrtn section 7000) of Drv.s.on 3 ,7 ane' Pruressrnns Code, .tad
My license is in tun force and effect. F5043$6
L.rcenY. C s _--.
B - Ll r;nsa N .
Date •?
WORRS COMPENSATION DECLARATION
rlDy aff'.rrrl that t have a cclllf'Cate '7' C_J-jsenl to self -insure or a CHtrl rCdte ,
Wdrl<!ri- Compensation Insurance, Oreo
lhere0f (Section
O. t.AD. C.)
Policy rm. __1003L4 03 Company
Ceflifi! cop rf heretly furnished. '
Certih c ii titers w'•^ the city B• 9
Date.
APpllcant -"-•--—
EXII ION FROiA WORKEZS' COMFENSATfON QEGL.ARATIdNThisSe.tion need not De completed if tre -:1 fI is Is flcr one •)undrea (S100) of
lass;.
1 •'.cr7,1fy th5t in the OCrf,,ante C' ire .•. 7'•- r•.' -v lll_n Utt5
toQlrmrti5rSRt t
shall riot emplos any oc s In any C:.'1iis:7 to a :u De:OTE %uD,CCt 'inC
WprkCr S' CompensA:can Lav,s nt Ca ... ,
1 - -- -- fiOTICE:if, after making this dee rat. J S.1-011611 Uecnn•C st.DJeCt if, !ire
syorsers' Compensation Drov,sirns " t'e ;7 r f --'de. ,''r= .nr=-t forth :.'th
comply withSut.h prov.s.Q,s n• iP.S perm,;
Tiled lie deemed revs LPi.
COr-STR11CTION LENDING AGENCY
hnnr
tnr PCrfn•n.Ane
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O( the vvorY for ,%h,r, 7",s p
cnder'S Name -
Lender'< %"'es. -
OrvNER P tLDLR DECLAPATIOL'a •
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CITY OF LAKE ELSINORE CONSTRUCTION PERMIT
Central &G4934ier I
Project AMfeas V - - - --- - - Ap,phca It Tn fill in all spaces except those with%a heavy border lines and sign all appropriate declarations
Assessor.-. Porcel 140. 6747823 PER7A1 T_rsr0. ,r
TRACT N0. # LOT NO. UfilT NQ.
clutter's 'i9mr Cent. Cit ). 13tts:;nc ::S .Pk hnVeS,One - --`/ ,.,^=/
Ot-'\ =t'3y+ Lii1`-tlsinore- CA 12330 _
1YPf0*4 tSTRtXt>nR hEr ADD ALTERATION Z REPAIR
Arct, Et
0766 A_P. a# ILnr+it! ii l Ll r _L era•':n --- =p:: y _ DEi+Ol15 OTHER
I adsr.'s 1_T9:;.'. :ik - r' circle, --Irvine-, CA_271-- = )%c1Fb!tar,•USFofBL -- -- --- -- S Main Building:
67_4- _% Ccancrete-i11>`lip- " ' ' E
art+kSS01iS ll2VPlUpO?2n nne _- --- Front
t
r 923 ()TYI'E F PERMIT 6 GINS FOU'ii'ATI.ON SiP.UCiU3Al T
at7arc'iS'rrV7:ilnd` •()+ _DQY,-9 .LFke_G1SinRrel-_,.A--` A ReCt•i ELECTRICAL PLUMBING MECI+A.'lICA1
C:IV I_•cet-se N.) 74 i8 -- - - - - - - --- O - -- - -- - r - -
c
C Right
LICENSED CONTRACTOR DECLARATION=PJ.[_'._„.^T!!C Sr. F1 - --376 ---- '':[aanr-1 _
j t 70'; S1) g Left1r:erebY zfllrw Ir,ar Ian, r.: rnSm, n^ 1r• p'• '- ”"S •.• rrny.:Cr (r.n rr c.,?::c r•
M1- . -_ _ -- lostm jc •"fl Acres til -+-_-Ll
rr r':, St:;Inn Jvpu) n! 1 „v,un 3 9"i -res" a,C ano #.`
Pcg Ping. REf.
rr., p!tnse ,: ,,, rW• lorr r' arra effect._ C/1/ •}O r. -a•
L _enK c, , __ _,rte _ Planning Notes
011e _/ C•.:rvture '`-------- - - ---- Remarks .__-` -----.—_-- -
WORKERS' COMPENSATION DECLARATION
reDY all•-. n, that It a cera, l,cah Of con -c : .:rC-rlt,.:C r•r J •. ef!I'Kd;e —_ _- _.--_--_-.-- __
lYur[.ers Cumpbntaln,n !nsu-a:ICt. r"f J _er::!rM C_ -P1
00.
hC:•`,".1 rSCCaon `
ao, Laa. C.) -
avlt.cy No. _.-__Q03.4 3_-- cnTo-Y
G.Cirtrt,ed cop n Iler t,y r•ynsr eJ. --.--
F
t:)',O O) Is /IM,1 MII f: IF.e city /n6+''i IwS•r.n-
AP
WOEM10FRGM RKERS' COMPENSATION DECLARATION
EXtTn:• kctron Weep not Ue cams, Teter. ,f ,ne of-I'T Is ' r n:,r •IungreJ :ST00) r
assT. ,EES EL'tf,TRICAI FEES MECHANICAL FEES
cer:rlY r:ar ,n t,c prrrn„-,.,:::...
r :nr .., ., •.:,; •, :r,s c: -n,.- , ,s,to tic _ PLUF(BI%IG ---- ' - - ---
sra'I na: employ any rrs ^ ,n ar,y r.Un •r; ., : : r.co e t •Ft- t' _ - .._
i„
t..s ,f - t! , . a Alter,Peau } Generator C 5KY1 G 5 15K6H i3oiler
w -.•vers Ccmpc•aatlo '
rn•e _ _ _ _ -
s ,•+. c
r I •e A, n aru:^ _ Construct -s-, Pole Sub. _ .rct•Urder Ground I
l NOTICE: 1• af•rr m.'[,r , Ines Jec , 1 ,
t •'+ - - -- - _ t DUet•$trIrC LUfa{ I
PCnSAYnn n:,l s n^t 't t -c t- !/!`!, COoki1 L nll
tr rr n, a c ,Fu I ]arkfl, . PrevPnter it
Pole LI r.t Fan •Ventilatin
CJ NST RUCTION LENDING AGENCY Iiatk` ,•. Iry gabon _ 3— r `I
revers atfnm drat InCn. $ A „ ns:n:rt,n - -
i _ - -- - _
r part ^,ar .) - --_' __ - -y} t Exhaust System_ -
r,,, wrtcr :nu pc••nY .•
4t.^n ?6^- C+. C.l t,artfl.•; —1__-- DTI efS.JGaS E.ectric .3 .---
Ine wor%- Fan ?”, Eva Tativt Cctiler _,
Lr .Cer*% Namr. 1.
I - •- _ // -_-_ - Hearing System & DuctinD rFIxr(e Trz ed_ 1 `i F A il.
WNER BUILDER DECLARATSON ,t!.
t "
0.100,000 J DSG0,000 BTU f
a• I , , c , t •n., ,, v r L, - Floc. era 'is _. -- _ ! --- }FI\'tufei >
rrc : alf F • r t i.; t' - ,_ __ --- - !'
w , rca 1 trt 7(,i I' •, -t L, Hood or Canopy _
my wlilCt. re r•t prrr•n iu n,r t, I• 'I 'A' F{(1('r C •lar 1 DUIfeiS
r
s:r ,It L Type l O Typa fl
y,y :•arc n. • t .s ts.,u,ca afu> sot Ga S_S C' QUtlets - i_-:.liL Switches _ -
c. c S ,
It - - n a t17..cr! s •, rrc t••,I -
tc , •(1001 - -' - ' _ Io 10Q am s ^ Rehigeratian System
t:.e C n -.tam'; l': cn,c v.•.
ICnapicr
C.. tna t sI, ,s cvr.np: Inte•CZ DTCIfi i - _ I: MeleT UG p `J
t,.,n 3 11 it; e nutlnest .1'.0 r•.,1es , s,;C., •I: - -- - - - ; Meter a.er 2 0 amps J0100.000 BTU L7100 OSO BTU '
co•,n• and tfre nas,s F. • the al r' r t.;C,plrrA : • ' a uvr P -Trap -
31. oY any ppl,cal,t rrr l s '• t 1 - -- - --` - .
r Fire I/Fact. Blt. ICBG
I Walt) nl nut -.,!Ire roan Irv-. nix 1, J 1 Roof D'a -ns --. _ - $llh Palley-_ _ _ —
nc p! •rr '
s "' - f , 15-50KW System Repair/Alteration _
I As .,wnCr .• nr• : e , ., 1 r. Tray or S••vver
r - Transfnnner --- -- 4 - cnI*•pe,sat, r.rn at, tl,r ,,
nes.
s
s., or - ,_ a •4
n C 50i -KW fire Dampers
r sale!n:». Gu' .•'. •t
r :.t t I so I u $ sSF:r aU - i _ - _ _ — -
c!•'•se taw a,c o t ap[1IIrt'
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I :• e•con, anti wt .. r -
Sr -:-r Ca,n2clian Bldg.X/• ` Motors . O-1 HP .1 rJ 9
rr,.r t A••` ,. a -. - _ + r', Incinerawr
rrn [. ,yne;. p. w L •, 1L, S c• ` , , ,1 cnm - •
i RIC. 11, rIn vcver, ,r, t , In „ r c r ,n fr, r - r : I r , „ r e $nlaf i'I?cI0rS - - - - _
t r bur(f C•,r ,,. rn, t tint C - -n It hunt •.r In,• - - - - ....
Inc.I•lcSolar X19-15 H /
0 rt•ur. tt,c. ,wnr•
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prOVe I- the p rp•,s 9 -
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L Ins nr MIT-, •r,r , r a 1. , , i.. is f n iJr. - _ _ -- -. -
a •'nrs) I,centr p;.•sLan r c ', .rAc:.,r•s i I.r se i.ay.i 1 ,. •, v.nrr nit %• Watar HFater - - ! 1 / ISSUE
J The" .. r^cr'r C•'•'Lc.l..•, n,. v,t ,•AbU. t.,r .,ut t.•. pr•,ndrn 'r• nIP, / _ _ - -
D +, o, (;, rr•r In,: reason Water Arv,ce } •i7'. 7'
art 'f Clr. ,- _.^_ _ /• _
accessory Building: Z
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ACCT A GRADING FEES
r•tncctlr•n pur;t.,.cs. tet¢- 711" Al ! : t.t•.1 - j ISSue -- V7.5 -
111,41 1
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1 a• •• Bulbing (' rc C r •" —yam
Buodrrg
C!,t - - C9 Farcf
Saprc_Si;Fem__ _- 1- --
Mise_— _ _ --
I,6
S?o0. iii) Pia. Ch•_u Fee S
3300-3312 Peed Fee :
ti6^,33t5
Totalfe•_s $
3300•3312 SummagolQermitr
BuildingAppfoved8 -J --':'"`
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BLking
a -r: state t rr',
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ser troves I,r ,n tv .,t el tc. uhrtn t!`e A.'•ave•mrntin,: g pn erty for ApplicalitinIssuedBy --_-_ --. _: ----
Date
Methamral T
Other $
1:0 31 SMIF Re.. S I
iri731 SFSIPCom $
33603310 Summar of Pun Choc! Fees
r•tncctlr•n pur;t.,.cs. tet¢- 711" Al ! : t.t•.1 - j ISSue -- V7.5 -
111,41 1
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Buodrrg
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DEVELOPMENT SERVICES IItA EN L .
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Date
r•tncctlr•n pur;t.,.cs. tet¢- 711" Al ! : t.t•.1 - j ISSue -- V7.5 -
111,41 1
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Qr.ir. s ".amt a..r lL.iar- DW. r_e6_Y71VeS A 674-7823
Address SC21S 939___.a}syE1*jnwe _ -- -
Arch Eng __ _j(ojj ad_P`c''jger—_L.,cense No. _ --
A
l:,!
tcss.,.,7"k{-C2rC1_Ii'Y.LT1.: •]•
y 7e -stn/-
con:,actc-'s Nzm—r drY t1. nejDC cp__ _. ph.ne _-67-47 —V3
Af3rtIMS,ma,hr p_n 939.,--i,a-Elsi>:nre _
C ly C.Censlv':n 7412— — -- -- ---- ---'
LICENSED CONTRACTOR DECLARATION
I area. .•tlrm !rat 1 am rcersto untler prn.+S:ons of cnarter 9 (com menUnq
with trQ,on 'Ouo) of Division 3 of the l3us•.-:_ss and Professions Code, and
r•tv : r.•_rse -.s ,n tuiifoice ana eflect_
L.i_rnse Class
1---- — re5943$--
a:e-----
WORKEraS' COMPEOSATION DE=!_ARATION
I neleby alltrpl that t have a Lcrtrf,Cate ut corkers: to scif-insure or a certel,cate
of w,vncrs• Compensation InsOrance, or a cerf•t,ed caps- thereof (Section
3900, Lao'
n •7 n r SS y.,, T1,,.
PdhCY No_ 0340 _0 ._--- Cr,mpa y State FUrld
1p C^_rh'+ed c-py'% hereby lvrntshed. -,,//
r CerCrf.-+s COP, s flied wit'• the city17—FiQK_
P
t-_ i:Ppticart --- -L
EXEMPTION FROM WORKERS' COMPENSATION DECLARATION
i h6 sect nor need nllt tie- corttpletce if t40 pernvt IS for one h,•ndfed (S)Co) or
Incl.
r •.rrt:fv :nz! the pOff „ rzr. G of the w:n fur tt,rcr.'his p.!rm': , .ss:r¢e, I
raft r•:-: r -W.:': any pert.,n ,n any manner so as to t:ecome subicct to tilt
r:.r•:' C-mpensa:,cn Laws ..f Cahfcrr.ta_
S,gnalwe - - --- -
NOTICE::'. slier ,n—r•14 ih,t Cerjarat,; you S -ou10 beton.¢ subject to the
yort•C's' C. PCn,anon Prnv,arnr•t "! the t_abn• CneC. Vnu mus! 1rrih rt.th
pt .v•:•} Lien pr nt s,o•,: or Vn; Oerm•t 5,111' tic deen•e(l rev-•Y1tC.
C HSTRLCTI ON LENDING AGENCY
nrecy aff!,r• :h 1: 1!7Cre ,s con5:luUc,n n C'n: a enCy o, the Performance
it c r:o't run which _I's Dorm:t •s ss;,en r•Scct.nn 3097 ..:r. C.)
LenC"'S Name __ ______. ------ -------
eLe r•.... s Aoc•css -- - - -
OWNEk BVILOER L,ErLARAT'ION
rrr'•y affv•n'ha: 1 aro C.Cmpt ilii, Cir Ciro:laC:hr's L c.enSc Law ::: 'hr
real. (Scct,nn 7031.5 E3ur.r ast and Profess. ,nal Cock: Any r,:v or
oft :.tlich requires a permit :n cr.nstruct, a':^.r, improve• een,nl,sr% nr '00;W
ant ,trot:yri. 7r.O in ,Is :ssnance• also-enulreS the aPPI'Cant ((it Sri Cr, PCrnit
I . n c a s,ghcd s:ateme-it that he;ahe ,s I.Censen pLit,:lilt to the vc—'s.nas of
ihr C. ntrac:e,'S License l.aw LCna Dier ? "1 1 5,ectum 7000) of
a, • .n 3 )r t:.c 9us,ness end Prltess,pns C0 Ie) Al Ina! hetshe ,, cyem'
iticr efrJm and +ne basis rnf he a!:ege(1 exe. ,ptrnn. Any v,:;Iatlon n ,n
7031.5 ry any aDDi,cant r •+ a prrnut suhir '.Is :nr apuficant
malty -J not morar¢ •••i five nundrea rl -jusrs (1.500).
solefile,, t• r a . t C S v 1m , nocrt i m C O Y 7c .nrr of it:e D v Yiasv
rnmpensatrin, rr,• Inc _)r6. artl tnc sir xr, r¢ is , -¢hard or nrfu¢e
for sale (SCK:,o•, 10.4, ijvt'ncss Inc, Ptofefa,r C ,l,n Contrartnr•s
l •Cense Law tl+.rS not aPp-y tel an ov nen ,,( a r- Y 011.1.is Ir lmpf—cl.
c•en•,, artl wh , d t 1 -7 r1 v.WW. mr.s' ',"••, t^lt .,r '•vovgn h ; or i1Cr own
imp ,,gees. O:,lv,Cerl ilai urn mprnvcnlrn;t .Inc ,111 ,ritenop.d ,v offe,ed of
arc 1f, nowe,le,, the D ... lc,r.; nr ••nC uvemen' ,. ;old :.loon one vear of Com•
on, 'LC owner w,' r'avc :I,c :,u•••rn .,! mmnml hc,:hr din not bona ,•r lm•
prove 'r.. tic Purprsr 1 r).
i
1 as owner ..^,f :, r jf t exr,nsr,.fry r,lr ;tar' • wr I,rr :Sed one.
soon•:, ra,si,o,' .r „•n,_.i rSccir,n 7r 7., H„s'ness a•,U porCs,nns Cone.
Thr C.)hlf,100 ' .cntr L.•w d0us not aPply to an oil"C' of pfopertq who
11't:t r.r ,, an() :.nn (.nn11-cts fr.: $11", wole"ls w0h. a Cnn•
t,aclor(s) ,sr pwl,jant to the Contracth-'S L.,cr^SC L lw), I am aware tnaI
yriorl-efes Cnrnp¢nsal,on insurance st odd hr provided to Inc
7 it cr.0 no: tinder Sectfnn U. G P. C. for th,s reason
r,..nc,
t t c shy rrrPA, I—,•fall nus apo cation ane State toil• Inc above
Mn 1 1s C.1rref.t, t anrce t . cvnlply w •'' all City a1;4 C:,tint/ rrrl.nanceS
ato :d ws Wat'rlg t:, bu'Idn,q Contin .r',n, and herebyauthnnlC reprC•
Sint':,ves •,f-Ih's U' o en cuer, r pc `w,vr•n,ntn C(1 of or1Y fof
ntneu„ln Outposts
t
6-26-90
UhVera. License of S5 ! - '------
ttn,Ie BulUrng Canrrylercpotary frit Copy. Pink A StSSoi, Gobenroe A.;!cant
CITY OF LAKE ELSINORE CONSTRUCTIONS PERMIT
Applicant to fill in all space, ±xcept those within heavy ber3er tines and sig., all appropriate declarations
PER"T NO. TRAFT N0. LOT NO. UNIT NO.
T:TECTrARSTL11CTi0tt X_ NEty AM ALTER00N
lT'WEP.SIGN ID(MOUSH D'HER--.-_-_---
DESCPiP1I0N Ci WOW USE Of PLiIG
TFPEOFP kMtT GRAOI:L TO11Ni,Ati".'J _TRIJXTLRAL
T1 NANT ELECTRICAL PLUMSttlti M;CSiXS CAi
f 7gER -- --..
PROIrr r L'ESCRIPTio.s Sq. Ft __-_---
r tat+s.ihcn iJpt _ lone
Remarks
P.E^AIR
Acre:
3 )_6('IY
FEES ELEC7RICA_L_ _ FEES_. PLUMBING_
Alter. Repair _
Si in Building: -
Generator0.5KW - `,-15KW _-
Autc Wash
T Front
Construction ' Sub. - ! _-
Ba4flow Prrtventer-- I
B
I R:a*
J
I Cook,
Backflow irrigation ,-_-
C.Right
Yf --
e L:ht ^ __- --: _
Clarifiers r Dryers r. Gas LElectric -
Dlshwasho, I Fan ---
Fixture Traps ea. - F.A.U.
Flosr i _ I I Fixtures
1----------
Floor S :iks Outlet=
AAs Ser ce Outlets I Switches
up to 200 omaIntrceiars-
P•T a i Meter (_I over 200 amps
T---_
Roof Drains
I}
I Sub panelP
Trailer wer_ Se-- ----
T
Transf orm r
El 15.50XN
Sevie, slap
Y'immory of Pfan Check
I r1 50+KW
rfPSewerCnnntrtion •Bldg.
S
T Motors ( 0.1 i ,1'h •-- fl
Solar rollectnrs ^--t -- Inc. Solar ";9.15 HP C. --
Solar Piping -1- -- i Sing/Fam. Res.
j Solar Tank- - Masi Fam. Res.
Swimming Pool/Spa t-S fimmin Poo;/Spaa
1
C!he+
Water Heater
Is -tip EPP
otic System ---j
h_ DEVELOPMEMTSERYICESREQWREMEIfTS:
6u__ ssu_------ _.--
A.P. w I cont
Si in Building: - Accessory Buildfng: Z
T Front i U
B
I R:a*
J N
t
C.Right
Yf --
1 N
5 Lefi
Mechanical
1 R
Ping. Ref. = Parki tg RQq.,`Pravided = E
fanning Notes
i
2301
Tis
Ouct-Under Ground -
Ducl-strlfcturai
Fail •VentilatLn
EvaporatiY_e Cooler _
Heating System & Ducting
0_100 400 BTU O 00.000 BTU _
Hood or Canopy
TYPe--
Refrigeration System
0.100,000 BT_U_10090_0 BTU
Firepl/Fact. Ell. ICBO
iSystem RepairfAl(eralion_
Fire Dampers-
Registers - - - _-- -- -
i Incinerator
Misr,. --- --- - - -
i Issue- -- -- - r
10nn1l AQtXO'i168T .-_--- _ _--
BrlildingAopowl--
Application lnwd By -
Date
Dalt
Dalt
ACCT. aF I GRADING FEES
I Cut _ _ ---- —Cu Ta'dS
FIN - n yards
3101 I Plan Chec! fee s -_--_---_
3115 Pe-mrt Fee s
Tow Fees $----
Simmary of Permit Fees
3229 Ruwldirg
3221 Piumb 1j-_-.--
3127 Eltctncal
3223 Mechanical S
3721 Neter: or S i
2301 SHIP Res
230? S)AIP Com
3225 nthot S
Y'immory of Pfan Check Fees
3401 91111ding S
Plumb•ng
br!wa, f
Mechanical f
3403 C!he+
Total Feet Dot f
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Pro c1 Address _may C!•"'sC/•L_y __ _ 1
CITY` OF LAKE ELSINORE CONSTRUCTION PERMIT
sasu s Parcel No. __ 377_]_50-077 Applicant to fill in all spaces except thole within heavy border hues and signal! appropriate dr:ciarations
Oslo .'s Neese Central Bust. ParkIn Tes grS 674-7823one
PER IT NO_ TRACT N0. LOT N0. UNIT NO. I
A•idress Q,x _ 93 L.E. -- -- - - -
Mechanical
AT h E:r. d Re (-C Cl 7GGg. K411i i----Lrren a No. - --
iTPE[R CDNSTRUCT(ON L. NEW [' ADD = ALTERATION Li REPAIR
Retention
Addres< L7982 kysCL e Irk in.e , C. C INVERSION :_' DEMOLISH C; OTHER _ --.—._ A.P. #
ConlracIor's Name__BrgQk5tgpe. DeyeLOj)Dtent Phone 674-7823
DE97tIPT101lOFWORK /USE 0F8LD(i.- -- -
S Main Building: g-
AW,ess imiliamm _P.Q. TTPEOF PERMIT GRADING C- FCUND41ION a STRUCTURAL
E
T Frart
Citi _•.•rase No.._7 $- __---- -- — TS:NANT ELECTRICAL :: PLUMBING MECHF,NiCAL e
BA Rear
LICENSED :ONTFACTOR DECLARATION
3;HER __- -Trash-FaxCl su3re —
PROJECT0ESCP,IMION: Sq. Ft Occupancy R Right
I ne•eos z1firm that I am lice ssed under prowsrors of Charter 9 (commencing
Ruildng
venin section 70f'0) of D.visian 3 of the Business and Professions Code, and Coo:truction type -- Zone Aues - S left
res •-cense is in rul fou and effect. / }
Lice_:_-. Se N 04386 valuai«xl" —P!:r± -- Ping. '?ef. # nu crass _
M:*'b -'
Ic
Date __ 63261-91- Sig utcre _- Remarls Planning Notes
WORKERS' COMPENSATION DECLARATION -- - ---- -- --
I r. trezy affirm that I have a certificate of consent :o ;elf -insure or a certificate
c! rKers Compensatic.n Inwrance. or a certiffe7 copy thereof (Section-
3aoo, Lab- I d03403-90 - S tate Fund -- --- - Poncy r:o. _: company - _ .
ti Certrf,e(r ropy Is hereby furnished---
GeLrtfj red co rx is tiled with the city I dif leri
Da:c S•tli sl--- Appticant•!i-- ,.••
rr_- -_ -- •-• - - --
EXEMPTION FROM. WORKERS' COPAPENSATION DECLARATION
T n.s:ectwn need not be comps6ted It fbe-permit Is Cot one hundred ($100) or
certify coat n tna performaneb of One v OrY for v,hich this permit is Issued. I
snaII not empty any person in adv manner so as to become subtec, io the PLUM111NG FEES _ ELECT91CAL FEES MECI-!ANICAL _
La•r_
Lomr'enwtion Lvs of California.
Signature Geherator ,:10 - 5KW 11 5.15KW !;oiler
NOTICE: ir, alvei making t; -s declarahort, you should bp.ome sublect to the Auto Wash ' Ground
A;f:c,:' CnntaOosatrnn prr•v,sions of the Lanor Cooc, you must forthwith -
Construction Pole Sub. I R:,ct•Urider -----+-- - --- - Gr -
r"MP:y -in111c') provistns or :his permit sr.au be deemed revoked. Backflow Pre renter Cooking Unit _ Duct -Structural _
CONSTRUCTION LENDII IG AGENCY BSCkfIOW (Irl• 41100 I role Light — fan-Verl(ilating — i r 7rer prti• n trial there is a corstructian :enomg agency ft, 'he performance _ ...t:.-__ --{ _- .-----
o' •• c _01a for worth cols permit IS issu3d (Section 3097 Civ. C.) Clarifiers _]Dryers 0Gas ElectriL Exhaust System_ -
Oishwashe. I Fan ; Evaporative Cooler
C-/
Accessory Building: 1
Z
I
N
I- N
f-- G
Parking Reg./Provided _ a") ?
4
L•_ ta_ S
ACCT. rf { GRADING FEES
Cut—cu,- —___ yards
Fill cu. y'.rds
3401 I Plan Check Fee $ - _ -
3225 i Permit Fee $
Total Fees $
ndc s •.orf.,ss -
OWNER HUILDE R DECLARATION Fixtu:c Trans ea. -_ _ FI _A_.U. _- - Heating System & Ducting
I nerebs afar
o
that I
on exempt from the Contractor's f cense An for toe ForDrains Fixtures __ _C '_0_•100,000 BTt10 100,000 Bl U { season (Section 7031.5 Business a.itl Professional Code: Any city or ! 1 _—_ _
C.
r; .vruu, red urns a permit to construct, atter, improve, t for lishSuchor repair FIOOr Sines
l
A., st•dcwiC, poor to its issuance, also requires the applicant for such permit -_—---
I}-- Outieis -_.-_- Mood or Canopy
1n r s goed :Wlement that he/she is licensed pursuant to the provrsluns of IGasServiceMullets _ Swr!.:hes _ _ _ 1 I 1 C Type IIr,e C.n; actor's Liccnsc Lsw (Chapter 9 (Commencing with Section 7000) of ifs t___
3 of the n,siness and rrotes-ior'•s Code) or that he/she Is exempt Interceptors - ^- ;n?ier r t;(t to ZOO enter - !ie!rjgeratjun System I
thefe rem an.s .ne hasis for the alleged exzmption. Any srolation of SQction - - -
7031.5 y ons applicant for a permit suotects the applicant to a evil P•Trap_-- -- _ Meter L,' rne; 200 amps 1-_ I10-106,000 BTU 0100,000 B•rU
I __
f per•alty -.t not more Iran five hundred dollars ($500). -- ---•- - --_
1 I, as ov.ner of the pronefty o. my emoloyees with wages as their sole Roo! Orairs-_-_,_ _ Sub Inel _ _ Fjre I Faet_Blt_ICBO # _-_• _
pensation, Will do 'lie work, and the structure is not Mended or offered Trailer SeNBr T - System Re air/Alteration
sale (Section 7i 4, ausiness and Professional Coda The Contractors -__ - _ Transfarrte' _
0 15 :iOKW ___- P
L.cc• se taw does not apply In an owner of a property who builds or improves _ Sewer Ca _ _ _ _t----_• __ _ -- __ _ _ _Fie Dampers
Ncb^, and who of sucn wore. h iiiselfiherself or Irirut,gh his or her own
D J 50••i<W I p- j..-.__,..-.., _ __-
n,;• o;ees, ofov,dcd fiat sucn improvements are not mienled no offered for Sewer Connectiwt • Bldg. ; __ MOl irs F,, 0.1 HPr V/, - 8 r R:eijsters
save 1!, however, IN ruddinq or Improvement is sold within one year of corn- -_-oG__ -- ^--'- F19-15 ------------'--'--' ---'" ple:o r, tnc owner v.,ll have the burden of Proving he/see (I d nr,t build or Im• SOlar COIItct Sfs
YV
Inc. Sour HP i_116.15+ _ _ µ
Incinerator prove'• in e pn:ons: o saki. S013r Piping Sin/Fars. 7t;s. 14
sc as -.l ner of Inr o,naerty, an, ex Liusivcly contracting with licensed
con _ -. ac:ofs:n ronslruct flit protect (Section 1034, Business and Professions Code: Solar lankL3wiummianti•Fm
Rls_- Thc CJntracldr's L,cense Law lines no' .apply to an owner of rrnoorly
who -}-- -- - ---- ----- ^------ -----^ Dur,3s of improves 'r,ercan, and won contracts for such protects wild a con- I $yyjfpfKm 0;11I:i a r Pcoi/Soat•acl..,(Sl i:ccnse pu^suant to the Contractor's Lirense Law). I am aware
that their Worker's Cornpens line insurance should be provided to n,e. - Water Heatef_--_ _...- •--^_----- •-- _-- I_
SSlie I ;,m exempt under Seetrnn . - ..._.._ _. __-__ B, it P. C. fui this reason Water
Service Date ._ _. ._ _..__ __ Owner Septic
System i ne-eb Zettify that t have read MIS application any state mat the above --_--- -
DEIFLOPMENTSIiIIVICESNEQUIREMENTS: dint • at on K correct. I artwe to comply will) all c .y and county ofdinarites rnfikie Apamd lb - - .
Dote -. and '.:ate laws relating to buil(hrig nn action, and hereby authorize rap
e• --_ senla:,ves of this to forcer up the above-mentlonod property for Buil6irtRApplrae118) _..._-._. ____._____
Date
signal
at
re par° 6 2690 --- —' _ — _----.,-- *
5spectiro
r ' _ rt c -_ Issue ADDgutionluuetfBF f .__ _
Daft Drivers• License or 55
5y - - --- While Building. Canary -Temporary file Copy Pink -Assessor, Goldenrod -
Applicant Summary of Permit
Fees 322 Building S
r 3221
Plumbing 3222
Electrical 3223
Mechanical 321114
Retention 301 SMIP
Res 2302 SMIP
Com. I
l 3'25
Other Summary of Plan Check
Fees 3401
Ruildng
Plumtang bear
cal Mechanical
S- 30. Other
S 3,112
Plinitq
7 Total Fees
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At
Pro lAddreass
1i6si°L',ir s Parcel No. 377-150-077
ow4ri r"s Name Central Bus. Park Inves gs 674-7823
Address p.0• Box 939 L.L.
y
Arch,Eng. $c1r&d_Reiger - _License No. C8766 —
Address 17982 Sk"ircle Irvine. CA _
Contre or'sName.-Dr-QkS1<=e-1 e.Ye10-RMentM,,ne 674-7823
AW, (n'S41ma) P.O. Box 939_
City a.•iens! No. -7418
LICENSED CONTRACTOR DECLARATION
1 hereov affirm trial 1 am licensed under provisions of Cnarte! 9 (commencing
With wction /AG)) Of Division 3 Of the BUsineSS and professions Code, and
MY license is in lul fo ce and effect.
License class =i_.— 504386 _
Date —532619.0— signature r _
WOR `(ERS'COMPENSAT!ON DECLARATION
1 hereby affirm that I cave a certificate Of consent to self4r.sure or a certi:icate
or viro efs' Compensa!ior InsuranG., or a certified copy thereof (Section
3600, ""NaD. C
Pt,.icy No. 1d03403-90 -CoMpa,y State Fund
Ce-irfred copy is hereby furnished. %A
Cert, red co Is filed wilt) the city g ipg 1pn
Date __ APptican!•
EXEMPTION FROM WORKERS' C.OMP NSATION DECLARATION
Tris section need not be comptRled lI ttt permit is for one hundred (Stool or
Ir -ss).
I . citify *hat in the perfo.manc of be %W rk for which this permit is issued, I
shall not employ any person In. any manner so as to become subject to the
W o'kers' Compensation Laws of Cali{nrnfe.
Da.., _-Sirnature
NO -,ICE- it, after making this d6ctaratlon, you SL.ould becorne subject to the
l':orke•s* Cnmponsati.,n provisions of the Labor Code, you ml.st forthwith
Com p'y with Such provisions it this permit shall be deemed revo Ked.
CONSTRUCTION LEND:NG AGENCY
iHerr[; affirm t .at there is a constructinn tending agency !or the performance
o• t^.e orofk for which the; permit Is issued (Section 3097 Civ. C.)
LenCe•'s Name -- ---------- ----
Lende''S Aor1ress
OWNER BUILDER UECLARATION
1 hereby affirm., that I am exempt from the ContraGor-s L.:en Sc Law for the
tr,ho. n rerson (Section 7031.5 Business and Profess:Onal O vde: Any city or
cnun:y o rilcl, requires a permit to construct, alter, imorove, :ftmolish or repair
auy st-jcture, or or to its Issuance, also requires the a;)p4.can! for such permit
to fi e a signed statement that he/she is licensed outsuant :n the provisions of
the Coni,aclor's License taw (Chapter 9 (c3mmencin9 will'. Section 7vOO) of
D•+",cn 3 of the Business and Professions Coac) or Ina: he/she is exempt
therefr Aro and the hails for the alleged ertrt.ption. Any orlatlun o,' Section
7031.5 DS any appirca .l for a permit s.injects the dpp,,l ar.t to a civil
penalty of not more than five hundred dollars (S500).
I. as owner of tut property or my employees wifn ^ages as their sole
cornot-,Salim, will on the wrrl , and the SlrjCture is not in!enced or offered
for sale (Section 7044, Business and Professional Code: The Contractor's
License Law does not apply to an owner of a propar:y"" 0ywoo bates or improves
thereon, and whO does SuCh work himSClf/her Sell Of tnrot.gh his or her own
enlplOyleS, provided that suCh improvement, we not inler.tled or offered fvr
sale. If, hbwnAever, the uildinq or improvement is sold rtnin Ane year of com-
pirtion, I" owner will have the burden of proving he/uric d -d not build or am-
p rove'or the Purpose of sale).
1, a, Uwntr of it property, ani exciusivnly C.',r.teacting with licensed Con-
iractofs!n cnn,!ruc: the project (Sertien 7044, Bt.siness and Pr OfeSSmnii Code:
The Contractor'; L'ctwe 41w (Inas not apply to an ovine. of properly v,hO
Uui: cls of i'rtpfnvCs thereon, and who contracts for su Ch projf!CtS with .l Con.
I, r. pursuant to tContractor's Licct.SwCLa). i am aware that
pr.
r. or(s) i;
Qf Of (
hhe
eir Worker's Compensation insurance Shouin be Provided to me.
1 am exempt un(!er Section _. _ _.___.___—____. B. b P. C. for this reason
Date owner
I hereby crrtify that I have read thus application ar d state that the dbnve
nine . It on is for recti I agree In comply with all city and county ordinances
and State laws relating to building Cc).n/*'llCtion, and hereby autnorite reore-
sonta:ivfls of thisto Ir/ Ct Ll p>.r, 1110 above-ment loved plopo,ty for
i.,specutle Dasa _
purpo—
ynature `_
6/26/90S__ _
Drivers' License or SS 9y
While -Building, Canary Tempotary File Copy. Pjnk-Assessor, Goldenrod•Appha:nt
CITY OF LAKE ELSINORE CONSTRUCTION PERMIT
Applicant to fill in all spaces except those within heavy bot der lines and sign all appropriate declarations
PERWIT NO. I TRACT N0. I LOT N0. I UNIT N0.
TYPE OF CONSTRUCTION A NEW
CONVERSION C DEMOLISH
DESCRIPTION OF WORK/USE OF BLDG.
17 AVO
fi OTHER _
At REPAIR
TYPF.OFPERMIT 71 GR.'DING FOUNDATION O STRUCTURAL
L] TENANT ELECTRICAL PLUMBING n MECHANICAL
C' OTHER Trggb Enclosure
PROJECT DESCRIPTION: Sq. Ft. _ Occupancy
Constluchar. type Ione — _ Acres _
Valuation $ PCN
R::marks
PLUMBING I
Alter, Repai:
Auto Wash
Backflow Preventer _
Backflow Irrioation
Clarifiers _
Dishwasher
Fixture Traps ea.
Floor Drains
Floor Sinks
Gas Service Outlets _
Interceptors
P -Trap--- _
Roof Drains
Trailer Sewer
v^
Sewer Cap _ -
Sewer Connection -Bldg.
Solar Collectors
Solar Piping
Solar Tank
Swimming Pool/SS a-
Water Heater
Water Serviq
giiic System
Issue
E1 E_CTRICAL_
ator 00.5KW 115-1
ruction Pole Sub.
F.A.U. _
hes _
or r7 iin In )nn amne
meter 1i over
Sub oanol
Transformer 1] 15.50KW
Motors n 0.1 NPO 1'h - 8
Inc. Solar 00.15 HP (]16.15+
Sing; Farn_. Res__—
II(i-Fam. Res.
Swimming Pool/Spa
E Main Building:
i Front
Al Rear
C1 RightK
I Left
Ping. Ref. #
Planning Notes
FEES _MECHANICAL_
Boiler
Ouch Under Ground
Duct -Structural
Fan -Ventilating
i Exhaust System
Eva orative CoGler
Heating System & Ducting
i_0-100 000 BTU 010G,[
I Hood or Canopy
Type 1 C7 Type II
Refrigeration System
010.100,000 BTU D i00,(
Fire I/Fact. Bit. ICBO #
System Repair/Alteration
Fire Dampers
Registers
Incinerator
Misc.
Accessory Building:
Park
I
DE11LOPMENT SERVICES RVIUIREMENTS:
7nninR Approvtd 11 .._ --- ------ --- -- —Date
BtddingApprowdBY -Date — _ .,•
Jlppfiut)on Isswd By .. _-L rte= _ -- Date
ACCT N GRADING FEES
Cut __cu yards
Fill cu. lards
3401 I Plan Check fee $
3225 Permit Fee S
Total Fees S _.
Summary of Permit Fees
3220 Building
3221 Plumbing
3222 Electrical
3223 Mecharkal S
3224 Relentlon S
2301 SMIP Res
2302 SMIP Com
3225 Other
Summary u: Plan Check Files
3401 Building S 1S( S
Plumbing S
Metrical
Mechanical
3403 Other
3411 Planning
TOW Fal" Due $
I I t
I
City of Lake Elsinore 1
PERMIT 130 South Main Street
PERMIT NO: 91-00000104 DATE: 2/08/91
JOB ADDRESS . . . . . : 570 CENTRAL AVE
TENANT NBR, NAME . . : BLDG I
DESCRIPTION OF WORK ; ADD OR ALTER NON RESIDENTIAL
OWNER CONTRACTOR
CENTRAL BUSINESS PARK INV 89 OWNER
2301 DUPONT DR STE 440
IRVINE, CA 92715
A.P.# . . . . . . 377-150-080 SQUARE FOOTAGE : 0
OC7,1PANCY . . . : RETAIL,RESTAURANTS,OFFICE GARAGE SQ rT 0
CONSTRUCTION . . . TYPE 'V— NON RATED FIRE SPRNKLR .
VALUATION . . . . 1,000 ZONE . . . . . . NA
ILDING PERMIT
QTY UNIT CHG ITEM CHARGE
BASE FEE 15.00
5.00 X 2.0000 VALUATION 10.00
FEE SUMMARY CHARGES PAID DUE
PERMIT FEES
BUILDING PERMIT 25.00 00 25.00
OTHER FEES
SEISMIC OTHER 50 00 50
PLAN CHECK FEE 16.25 00 16.25
TOTAL, 41.75 00 41.75
SPECIAL NOTES & CONDITIONS_
OCCUPANCY PERMIT
6-0&ifib 1/i 8 Wvr.
02-
1GACCT#
gT,T
s 100-3220—
L9
PERI! 81-1
1 AKE ELSINORF
AEV. DATE 11.1-01
City of Lake Elsinore
Building Safety Division
Post in conspicuous place
on the job
tf
You must furnish PERMIT NUMBER
and the JOB ADDIQESS for ?ach
respective inspection:
Approved plans must be on job
Ploose Read and Initial:
l . I am Licensed under the provisions of Business and Professional
Code Section 7000 of seq. and my license is in full torp,
2- 1, as owner of the property, or my employees w/wages os
their sole compensation will do the work and the structure IsA/ not intended or offered for sale.
3. 1. as owner of the property, am exclusively contracting withlicensedcontractorstoconstructtheproject.
A. I have o certificate of consent to sellinsure or a certificate
of Workers Compensation insurance or a certified copy thereof.
5. 1 shall not employ any person In any manner so as to become
subject to Workers Compensation Laws to the performance of the
work for which this permit Is i.sued.
at all times: Note: If you should become subject to Workers Compensation
after mokitig this certification, you must forthwith comply with
such provisions or this permit shall be deemed revoked.
Approvais late Inspector
Tamp EfacSarviass
Soil Pipe Unde:groundFElecConduitUnderground
Poolings I
SP02 Steel Reinforcement
BP03 Grout —
BP01 Slab Grcde
PL01 Underground Water Pipe
SS01 Roug`t Septic Sysiem
SWOI On mite Sewer
PL03 Ro rgh Plumbing
EL03 Rough Electric-Conduit
ELW Rough Electric-Wiring
EL05 Rough Electric-T-bar
MEf,I Rough Mechanical----
Mri02 Ducts. Ventilating
F L01 Rough Gas Pipe-Test
PLORoof Drains
OP05 Floor Jois's
BPOb Floo-Sheathing
BP07 Roof Framing --;—
t
BP08 Roof Sheath' ng —--
BP09 Sheer Wall EPre-Lath-
BP10 framing 8 Flashing
BPI I Lathing 8 SidingBPIInsulation
BP 13 D*yv:all Noiling
PL99 Final Plumbing
EL" Final Electrical
i
ME" Final Mechanical
BP99 Fincl duiiding
i
Code Pool & Spa Approvals Date Inspector
PO01 Pool Steel Rein. /Forms
P002 Poel Plumbing /Press. Test
P003 Pre-Gunite
P004 Pool Fencing/Access
P005 Pro-Plostar
ELOS 9'. Pool Electric
POW Finol Pool/Spa
SL99 Final Solar -
Sub List Approval
pity of Lake Elsinore
APPLICATION FOR
BUILDING PERMIT
VALUATION CALCULATIONS
1st FLOOR SF
2nd FLOOR SF
3rd FLOOR SF
GARAGE SF
STORAGE SF
DECK & BALCONIES SF
OTHER:
NG—
PHONIA1T. O
SF
GRADING _ CUT CY
A
L.TY lUSINFSSOCENSANDANDCLASSDAX /
FILL CY
VALUATION: 1 zw
ADDRESS .
FEES
BUILDING PERMIT $
PLAN CHECK
ADDITIONAL PLAN CHECK
GRADING PLAN CHECK
M?CROFILM
COPIES
IMPRO FEES iu SCHOOL. --EES
PAID __
DATE
I certify that I have rood this application and sfo,e that the
above information ?s correct. I agree to comply with all city
and county ordinonrus and state low; relating to building
constr:;ction, and hereby authorize representatives of this
city to enter upon the above., .entioned property for inspec•
tion purposes.
Sign of Applicant or Agent Dote
AGENT FOR i_) CONTRACTOR i OWNER
AGENT'S NAME _—
AGENT'S ADDRESS__
STREET City STATE ZIP
130 South Main Street
REQ. DATE 11.1.90
APPLICATION NO.
9/ i o
APPLICATION R COVE
DATE
Y —_—
AP k By
LUIIDING ADDRESS(
TRACT( BLOCK, PAGE tO1.PARCF(
r
NE
NG—
PHONIA1T. O VIDNESS
I
I h-mby affirm that 1 em lit.m d und.t pro„isiom of Ctgpt., 9 it—nt Int wah 5 ttioo
TOW) of D,vislon 7 of tM Eusinnt and Prolnswm rude. and my bc*m. it it, lull ford
A eff"t.
A
L.TY lUSINFSSOCENSANDANDCLASSDAX /
U NAME
MAILING
ADDRESS .
cm s E PttGNt
CONTRACTOR'S SIGNATURE DATE
NAME LICENSE r
vZ
MAI:ING
i ADDRESS
CITY STATE ZIP PHONE
NEW REPAIR OCC GRP., CONST.
DIVISION: TYPE:
ADDITION _:MOVE NUMBER OF NUMBER OF
STORIES: BEDROOMS: _ ALTERATION __:DEMOLISH
OTHER ZONE:
SINGLE FAMILY units
HAZARD AREA? YES NO
aPART.,IENTS units
CONDOMINIUMS units SPRINKLERS REQUIRED? YES NO
TOWNHOMES units PROPOSED USE OF BUILDING:
PRESENT USE OF BUILDING:
COMMERCIAL :.INDUSTRIA.
JOB DESCRIPTION
REQ. DATE 11.1.90
PrelectAddress
Assessor's Parcel No.
7 -'
Owner's Nni Cpr - Phot/ ne(42Tnz
Address rx O
ArchfEng. _
n
t.lcenw No. t Zip _—
Address
jr%V'
iCuif-LinfCJ(.IC 3- L N ,, _
Contractor's Nam ((e rS [. Phone
Address Imalling) ei5.7 ti -L_-
I City License No. t''t 1A
LICENSED CONTRACTOR CECLARAT1ON
1 hereby affirm that I am licensed un'1er corev,sions of Chaster 9 (commencing
with section 7000) of Division 3 of the Business and Professions Code, and
my license it In full force and effect.
I Licen I s ---License No._
Date Svinature _
WORKERS' C MPENSA'rION DECLARATION
1hereby affirm that I hava a certificate of Consent to self4nsure Or a certificate
of workers' Compensation Insurance, or a certified copy thereof (Section
3600, Lab- C.)
Policy No. 1.= 9P3 L.-Company Inw- F:i.Jn
LJ Certified copy Is hereby furnished.
L_J C I ed y Is filed with•thi city Bliihdirg Division.
Date Appllrant
EXEMWICA FROM WORKER Y COMPENSATION DECLARATION
This section need not be coma led t the'perrnit is for one hundred ($100) or
less).
I certify trial in the perforrmdnte ortne.work for which this permit is issued, I
shall not employ any person In any manner so as to become subject to the
Workers' Compensation Laws of California_
Date .—_ ---_Signature
NOTICE: If, after making this declaration, you should become subject to the
Workers' Compensation provisions of the Labor Code, yoti mull forthwith
comply with such provisions or :nos Dermot shall he d^emod revoked.
CONSTRUCTION LENDING AGENCY
Ihereby affirm that there is a construction lending agency fol the performance
of the work 10f Willem this permit is issued (Section 3097 Civ. C.)
Lender's Name
Lender's Address _ _ _ _ _-_.___----_-_
OWNER BUILDER DECLARATION
I hereby affirm that I am exempt from '11,! Contractor's License Law for the
forinwnlq reason (Seed,)" 7031.5 Bi4SmeSS and Professional Code: Any city or
ca unty Whlch redo:res a permit lC construct, after. Improve, demnlhh or repair
a•ry structure, prior t0 its i,.uance. alio reaui•es the dppl,cant for sl.ch permit
t0 file a signed Statement that fie'sht is licrnse.l Cursuant :.) the provisions of
the Contractor's License. Law (Chantel 9 (CC-nmenung •.viol Section 7000) Of
Dovisoon 3 of the Business and P•o.essions Code) or that he/she is exempt
therefrom and the nasi:: for the altegeo ene ption. Any violation of section
7031.5 by any applicant for a permit sub;ects the applicant to a civil
penalty of not more thar. five hurdr.eo dollars (5500).
I, as owner of the property or my empioyee% with wagCS as their Sole
compensation, Win do the work, ana the Structure is not intended or offeree
for safe (Section 7044, Business and Dfofess,onal Code: The Contractor's
License Law does not apr•ly to an owner of a property who builds or improves
thereon, and who (foe% s'1ch work hirtlself;rerself or through hos or her cwn
employees, provided that %uCh Improven,en:s a•e not intended Or offered for
Sale. If, however, the building or improvement is sold v.ithin one year of Com-
pleti )n, the Owner will hate the burden of proving he/she did not build or im-
JR.r,0v11 for the pu'Dose of sa'e).
1. a,. owner no Inc property, am exGusively Cnnlydctong with licensed Con-
lraclorS10 Construct the prosect (Section 7044, Busmess and Professions Code,:
The Contract Or's License Law does not apply to an owner of pronerly who
to T JOS or improves thereon, and whin contra Cts for Stich projects with a can-
tractor(s) license pursuant to the COntracl Or's License Law). I ail )ware that
proof of their WOr.ef's Compensation irsurance Should be neovided 1r me.
i_i 1 am exempt under S—tion = ._ _ _ BBS, P. C. for this reason
Date -- _.__---__ Owner -- - --
I hereny certify trial I have rears this appLcatlon and state that the above
onr,ir nation is CnrfCCt. 1 agree 1,, :.r)rnply with all city and county Ordinances
and %talc Taws rotatingto buiidin construction, and hereby duthurize repro-
sentatives of this city to onto upon the above -mentioned pri erly for
mSpeCtion purposesf
Signature , mate. Q
Drivers' License of SS
White BuildmR; Ctnary-Temporary lite Copy. Plnk•Asessor. Goldrnrod•Applicant
CITY OF LAKE ELSINORE CONSTRUCTION PERMIT
Applicant to fill in all spaces except those .vithin heavy border linos and sign all appropriate declarations
PE ITN TRACT NO. LOT NO. 1 UNIT NO.
TYPE OF CONSTRUCTION Ll NEW U ADD L7 ALTERATION C REPAIR
I CONVERSION DEMOLISH OTHER A.P.#
DESCRIPTION DF nORK%USE OF BLDG.
EMain Building: Accessonr Building: l
TYPE OF PERMIT GRADING L7 FOUNDATION G STRUCTURAL T Frunt i O
TENANT ELECTRICAL 1,7 PLUMBING E MECHANICAL Rear N
OTHER A
PROJECT DESCRIPTION -__.. Sq. Ft. _ Occupancy _ _ C Right I N
Constrection type - Zone Acres g Left N
valuation $ _ PCK Ping. Ref. # Parking Rt r,/Providecl
R
Planning Notes 161,
0Remarks
r70 T
PLUMBING FEES ELECTRICAL i FEES MECHANICAL FEES ALCT. x BRACING fff5
Alter, Repair generator 0.5KW 5-15KW I Boiler
Auto Wash
Cat -
Fill
cu yards
cu. yards
Construction Pole Sub. Duct Under Ground
Backflow Prev,nter 1----_ Cookin Unit Duct -Structural
Backflow Irrigation, Plan Check Fee S -
Permit Fee 1 _
Total Fees $ _
Summary of Permit Fees
Building
Plumbing 1
3401PoleLight - Fan-Ventdatin
Clarifiers _ i Dryers Gas Electric Exhaust System 3225
Dishwasher Fan_ Evaporative Conler
Fixture Traps ea. _ F.A.U. I
Fixtures _— -i-
footing System &Ducting
0 100 000 BTU 0100,000 BTUFloorDrains _I
Floor Sinks Outlets
Switches _ i
Hood or Canopy
Type 1 Type II 3220GasServiceO':tlets
Interceptors _ Meter up to 200 amps I Refrigeration System 22J
P -Trap _ Meter U over 200 amps _ 1 00.100,000 BTU 100,000 BTU 3222 Electrical 1
Roof Brains _ Sub panel Firepl/Fact. Bit. ICBO _#__
Trailer Sewer E)15.50KW jTransformer
System Repair/Alteration
g223 Mechanical i
Retention $ Sewer Ca 224
P 50+KW Dampers
SMIP Res $ Sewer Connection Bldg. Motors 0.1 HP 1%,. 8
Fire _
Registers 2301
Solar Collectors__
Piping_
Inc. Solar E19-15 HP 16-15+ SMIPC)m $
Other 1
Incinerator 1:02
Sing/Fain. Res. Misc. _ 3225Solar _ _ _
SolalTar.kI Summary of Plan
Building $
Check FeesMulti•Fam.Res. —
Swimming Pools Swimming Pool/Spa It 3401
Water Heater
t
Issue ----•--
y-- --
rte---
Plumbing $
1
Water Service Electrltal $
Septic SVSIZmT_
NT SERVICES REQUIREMENTS:
3403
Mechanical $
Othel $
ewd By --_-.
DaterthedSyFqh3412Planning
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i
CIYY OF LAKE ELSINORE CONSTRUCTION PERMIT
Project Address
Asse.sor's Parcel No. 377-15 -077 Applicant to fill in all spaces except those within heavy. border lines and sign ell appropriate ,declarations
Jwner's time _Ge_ztral Bus. Park InvesfrR. 674-7823 PERM; NO.— _ TRACT N0. LOT N0. UNIT NO.
Address _P.O, BOX 939, L.E.
Arch/Eng. Konrad Reiger License No
C8766
Address 1798 Sky Park Circle, Irvine, CA
Conti actor's Name Brook tone Development Phone 674-78L3
Address I met ling) P.C. EQ- 939s L.E.
City License No. _- 7418 -
LICENSED CONTRACTOR DECLARATION
I hereby afirrm that I am licensed under provisions of Charter tt (commencing
with section 7000) o/ Division 3 of the Business and Professions Code, and
my licer.se is in full force and effect.
Licens£ I s O _ B— se 504386
Date VL Signature''
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a rertrlicate of consent to self -Insure or a certificate
JI Workers* Compensatian InWrance, or a certified copy thereof tSection
3800, loll. `J? Policy NO. 0034_i3=9U — Cd y
State Fun.l
Certified c'=py is hereby f:jrnished.
Cart iye cy (Z filed with the citx g
Date. b O 11 Apolican +
EXEMPT; ;,4 FROM WORKERS.' COMPSATION DECLARATION
Tl ussection need not be complelted 1f the permit is for one hundred (Stool or
less I.
I certify that in the Performanee of the rk for which this permit is issued, I
shall not employ any person in any miler s0 as to become subject to the
Workers' ofr rryy {{on Laws N Cahforr!Ia.
Date _(_lT)I ii_— Syn,,.,,re
NOTICE: If, alter making ,ms declaration, you should become subject to the
Workers' Compensation provis:OnS of the Labor Code, you mus, forthwith
comply with such provisions or :his permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
1hereby affirm that :here is a construction lending agency for the performance
of the work for which 1^., permit is issued (Section 3097 Civ. C.)
Lender's Name
Lender's Address
OWN"i BUILDCR DECLARATION
I n"cuy affirm foal I am e:,emut f nm the Contractor's License• Law fnf thn
following reason (.Section 70'31.5 Business and Professional Ccde: Any city or
county which requires a cieiriit to construct. alter, Improve, demolish or repair
any Structure, prior to its is.uance, also equ-res the applicant for such permit
to file a signer, Stateme-t 'hat he'she Is fice'rSed pursuant to the provisions of
the Contractor's LlCeny Law (Chapter 9 (commencing with Section 7000) of
D.wsnnn 3 of the Bus, tress and Professions Code) or that he/sne is exempt
lherefrnm and the basis for the alleged exemption. Any violation of Sq Ction
7031.5 by any applicant for a permit subjects the applicant to a civil
penalty of not more than five hundred dollars ($500).
1, as owner of the properly or my employees wills wages as their SOIL
compensatiot:, will do the wor:., and the structure is not intended or offered
for sale (Section 7044, Busmess and rrafessit. 11 Code: The COrr/actOr's
License Law doe: not apply to an owner of a property who builds or improves
thereon, and who does sOcn a,nk himself/herself or tt• ough his of he own
mplovees, provided that such improvements are not Intended or offere'1 for
If, however, the t)u,jrlmg or improvement IS sold within one year Of COin"
plc"o^• ;he owner will nave the hurden of proving he/She did not build or im-
pf0•. he PUrpOSC Of tele).
I, owner of the prb Derty, am ex Uusively contracting wish Ince nSed con-
traclur> 10 construct the ciro;cct ( lection 7044, Business and Professions Code:
The Col•IractOr's License Law does not apply to an owner of property who
b.lrlds or :mar OveS thote On, ane whn contracts for Stich projectS with a con-
Irocior(s) .cense ou.•suant lO the Contractor's License Law). I an, aware that
proof of their wO•i!e..r's Compensation insurance Should he pruviged to m:
I am exeml.I under Section _- —_.-.- _ -..-- B. 6 P. C. for this reaSc n
Date ---
I hereby certify tv.,it I h,lve read 1111S appllr.etion and stale that the above
mlorination is currei'. I ag'ee to Cornply with a't My and county nldlnanceS
and State Id WS relatl V to budding c9 uUion, and hcropv auttlritl:e repre-
sontaLvos of lh:f t ` r u ihC above-mentioned property for
Inspectionpurpo ' ! 6/26390
Signature ---,— _ _ Date
Drivers' License or 5S 91 __ ------ ---
White -Building, Cenuy Temporary File Cady, Pink -Assesses: G.11denrod Appilcan:
of
PREOFCONSTRUCIION A NEW C ADD 1-1 ALTERATION REPAIR.
C CONVFRSION i_1 DEMOLISH C 07HER A.P. # Zone
DESCRIPTION OF WORK/USE OF BLDG._ S
E Main Building: Accessory Building:
Z
TYPE OFFERMIT ID GRADING C' FOUNDAYION STRUCTURAL T Front _ 0
i TENANT 1-11 ELECTRICAL 11 PLUMBING E. MECHANICAL A Rear
N
OTHER _ T•rac1T F.LLr 1 Da i _ _ _
PROJECTi.FSCRIPTION: Sq. Ft. --- — Gccupancy _ _ -- K Right 1 _— G
Consouctloi; type Zone Acres _ S Left
valuahor S _ PCM _
R
Ping. Ref. - Parkin Req/Pr11Tri d :': rl. t:=- E
Remarks Planning Netes M
J-%y (yam) ilLta Z#1e5t, f-d_ . OLT _ -
rs- -;-r-r "r.
F'_x i `• T
r
PLUMBING FEES ELECTRICAL FEES MECHANICAL SEES` AMT.0 GRAOINGFEES
Alter Repair - r Generator 0.5KW El5_15KW I Boiler
r- -- -t Cut: _ __tu yards
Atlto Wash Construction Pole Sub. I Duct -Under Ground
Flli -__ -cu. yards
Backflow Preventer CookingUnit I Duct -Structural _ -
i
Backflow
Irrigation Pole Light Fan -VentilatingI 3801 Plan Check Fee $ _
Clarifiers . Dr ers 0Gas Electric Exhaust System 3225 Permit Fee S -
Dishwasher Fart I Evia orative Cooler Total Fees $
Fixture Traps ea. F.A.U. Heating System & Ducting
Floor Drains - _! Fixtu/es ! _ 1 :10-130.000 BTU 0100,000 BTU f
Summar oiPermitFees
Fluor Sinks _ utlets I I Hood or Canopy
Gass Service Outlets I Switches Tyue 1 Type 11 _ 3120 Building$ i /-
Interceptor: _TSub 200 amps I Refrigeration System
P-Tra over 200 amps DO.100,000 BTU 100,000 BTU
3221 P)umbmg f
3212 Electrical SRoofDrainsnelFireel/Fact. Blt. ICBO #
Trailer Sewer 15-SOKW System Repa',1Alteration3223
Mechanical S3214Retenl.on SSewerCaRL! 50+KW Fire Hampers-`;
2301 SNIP Res. $ Sewer Connection - Bldg. Motors - 0.1 HP 01% • 8 Registers - - ----
I --- 1301 SMIP Com. f _. _.Z•__ _. Solar Collectors Inc. Solar v9.15 HP 18.15 i Incinerator
Solar Piping Piping _-_ -- — Sing/Fam. Res ! Wise. - -- 3225 Other f
Rolar Tank _ Multi•Fam. Res—. --__T _ _ _— _ Sum.aary of Plan Check Fees
I Swimming Pool/Spa _ Swi PommIdol/S a _ 3401 Budding $
Water Heater Issue Plumbing Plumbing S _
Water Service ` I Electrical $
l Se tDiCSystem _--_ Mechanical $ _
JDEVELOPMEN`TSERVICESREnI!REk!E"S: 3403 Other
Zoning Apgroeed By . --Date — _—_ _
BuildingAWowdBf3412 Planning S
Issue Application Issued Ry
y6j,
f
Tobi fees but f
Project Address — o
Assessor's Parcel No. 377-150-077
Owner's Name - Central_Bus. Park InvesgRX 674-7823
Address P.O. Box 939, L.E.
Arch/Eng. _ Kgnrad Reiger __ C8766
7982
SLicense
No. --
Acdress ky Fark Circle, Irvine, CA
Contractor's Name Brook tone Development Phone 674-77823
Addres; snarling) P.O. Btax 9.39, L.E.
City License .ilo. 7418
LICENSED CONTRACTOR DECLARATION
I hereby affirm that 1 am licensed under provisions of Charter 9 (commencing
with section 7000) of Division 3 of the ftisiness and Pe'ofes:tions Code, and
My license is in full force and effect.
Lis- IA .B—I
L O
se —5041 fl.--
Dateven.
Signature _L y s
WORKERS' COMPENSATION DECLARATION
Ihereby affirm that I have a certificate of consent to self4nsure or a certificate
of Worke's' Compensation Insurance, ;or -a certified copy thereof (Section3800, U.b. C,)
Policy 140_ 1003403-90 -
CorAVqy State Fund _
CerUfied copy Is hereby furnished.
Certigr cDf)y b filed with Lha City g —
Drte_ ((3 OO/ii(uJ APPlican _
F•XEIAPTION FROM WORKERS- COMPET4SATION DECLARATION
TnV, section need not be complated It the permit is for one hundred (5100) orlest),
I CC;lily that in the Performance of the v%brk for wh•ch this nerm-t rS issued, I
shall not employ any personin any malaler so as to become suo:ec! to the
nY/or Nib s' "ll La vis of California.
Dile _ _V Signature - 7--- —_._ NOTICE: II, allef making this declaration, you S.lould become subject to theWorkers' Compensation prOv;SionS of the Labr,r Code, you must forihwitrtcomplywithsuchprovisionsorlh:-: perm;t shali be deemed revoked. CONSTRUCTION LENDING AGENCY
I nerebv affirm that there is a constructior, lending agency for the performance
of the work for which this permit is wued (Section. 3097 Clio. C.)
Lenders Name'
Lender 'S Address
OWNER BUILDER UECLARATION
J —
I hereby affirm that I am exempt from the ':ontractor's License Law for the
foliowmg reason (Section 7031.5 Business ant: PrcfeSSionai Code: Any city or
county which requires a permit to construct, 01. or, improve, Cemolisn Or repair
any structure, prior to its issuance, also req, ret t; -.z appliCan, for such permit
t0 hie a signed statement that he/she is license'l pursuant to the provisions df
It:e Contractor's License Law (Chapter 9 (commencing with Section 7000) c'
D—sion 3 of the Business aria Professions Code) or that he/she is exer .pt
therefrom and the basis for the alleged exci:,ption. Any violation of Stiction
703i.5 by any aper,cant for a permit s,ibjects the applicant to a civil
penalty of not more than five hundred dollars ($500).
1, as owner of the properly or my employees with wages as tries; sole
compensation, will do the work, and the struclore Is nol intended Or offered
for sate iSection 7044, Business and Professional Cnde: The Contractor's
License Law does not apply to an owner of a property who bu11CS or improves
thereon, and who noes Stith work himself/her Self Or through his mr her own
employees, provided that Such Improvements ere not intended or offered for
sate. if, however, the building or improvement is sold within one year of com-
Pielion, the owner will have the burden of ',)loving he/she ora not build cr im•
prove for the purpose of sale).
as owner o1 the property, am exciotsvelii contracting volt" licensed con.
iracto s to construct the project (Section 7044, Business and professions Code:
The Contra Ctor's License Law does not apply to an owner Of o,00erly wh,)
builds or mlpioves thereon, and who crritracts for Surh prole=:5 +n:h a cnr-
1,aClor(s) license pursuant tit the Cnnlractor's License Law). I ar- ar+are that
pr Par o Ihry Worker's Compensation insurance should be pfr—cieci to me.
r 1 -in' cxrmpt under Section .__..-- __-. B. & P. C. fnr in,s reason
Da: t, Owner .------- -_
t hereby certify that 1 have read tills appli alion and State that the above
information Is correct. i agree tin comply with all city and county ordinancesandstatelawsreiatiInbu, amg co uCtimn, and n,crehy authnrire repre-
sen!at,ves of this t r u file above-mentioned property forInspeGunnpurpo /
Signature _ D.,, 6/26 90
Drivers' license or SS W _
While -Building. CanvyTemporary File Copy. Pink•Acsessu. Goldentod•Appllcant
CIrf OF LAKE ELSINORE CONSTRUCTION PERMIT
Applicant to fill in all spaces except those within heavy border: lines and sign all appropriate declarations
CRM N0. TRACT NO_
9;n
MEO CONSTAWIWN - NEW i_ ADD
L] CONVERSION DEMOLISH a OrHER _
DESCRIPTION OF WORK; USE OF BLDG -
LOT NO. UNIT N0.
ALTERATION CT REPAIR
TYPEOFPERMIi=i GRADING FOUNDATION STRUCTURAL
lJ TENANT i ! ELECTRICAL -' PLUMBING - NECF`:4NICAL
i -,OTHER trach FnringlirQ
PROJECT OES^RIPTIGN. Set Ft _ (kcupanq
Construction Igoe __ lone Acres _
Valuation;_ PCp
emarks —
PLUMBIN
AlterLRe apit
Au?o Wash
Backflnw Prever
Backflow Irriaat
E Man Building:
IT Front
A Rear
C Right
K
Left
Ping, Ref. #
Planning Nhte_
ELECTRICAL FEES ME
ator 00-5KW 5-15KW I Boiler
ruction Pole Sub. Duct -Under
nq Unit I Duct-Structt
ight Fait •Ventiin
i ulsnwasner I
Fixture Traps ea. _
i Fan l
f F.A.U. —
Floor Drains Fixtures
Fln^ Sinks _
i Ivice Outlets
Outlets _ — --
Switches
t interceptors — Meter E up to 200 amps
P-Trak_A _ Meter C over 200 amps
Roof Drains _Sub
1 TraderSerni-—
panel_
co.o cin
0 15.50KWTransformer
Swimmin
Nater He
IC_
nectian Bl6ng. J_ 7Motors L] 0.1 HP 1%a • g
ctors _ Inc. Solar 119-15 HP 016.1.5+
9 _ — Sing/Fam. Res. ,
I - Multl•Fam. Res.
DEVELOPMENT SERVICES REQUIREMENTS:
7oaial Approlied By
Baifding ApproveiJ By
Appliatim Issued By .
Evaporative Cooler --!
Heating System R Ducting
10.100.000 BTU1;100 000 BTU
Hood or Canopy
Type 1 [J Type 1 _ LI
Refrigeration System
L=10.100,000 BTII 0100,000 BTUIJ
Fireal/Fact. Bit. ICBM # I
Dampers
ncinerator-
Oats --- - -----
Accessory
Z
N
G
Parking,RezZdProvided :4. 1, f
HC:Tail:
ACC1. A I GMING FEES
I Cu!: _ cu yards
i
Rif: cu. yards
3401Plan Check Fee S
3225 Perant Fee ;
Total Fees $
3115
Summary of Permit Fees
3120 Bmldwg L
3221 Plumbing
327.' Eiectf:cal
3-11
3223 Mechanical
3124 Retention
2301 SMTP Res11302SMTPCorn
3115 Olhri $
Summary of Plan Check fees
3401 Building
Plumbing ;
Electrical
Mechanical
3403 Other ;
3-11 Planning ;
yTotalFeesDaex _
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Project Address _ 0 e
A..raesdrs Pdrrsl No. — 377-150-077
r,'_ nwer'sName .Central Bus. Park Ines —&4674-7823
Address _P& Boy, -939, L.E___
ArchiEnd. S+?iT>~ad_ l;f; Iger _License tis. x8766
Address 2 -5kyltulk Circle, Irvine, CA
Contractor's Name-kOIgne DeveIO McTlfphone _ 674-7823
Address (mailing) P.O. Box 939,LE. E. -
City License No. ___7418
LICENSED CONTRACTOR DECLARATION
I hereby affirm that 1 am licensed under provisions cf Garter 9 (commencin?
wish Sect ip,l 7000) of Division 3 of the Business and P ofession5 Code, and
my license is in lu t ce and effect.
C1acense Cl a ssts_
rsr1
86
rise
Date —_-f-++a--y+z— Signature
WORKERS' COMPENSATION DECLARATION
1 hereby affirm that I have a certificate of consent ,o self -insure or a certificate
Oj workers' CJmpensation Insurance, or a certified copy thereof (Section
3800, Lar.. CA
Policy No. 1003403-90, c,r,;p,ny S:.ars Fund____
Certified copy is hereby furnished.
Cer}i}i qc x Is filed with the qtly n
rate _b[ b il — APDf(
Cnl _
EXEMPTION FROM WORKEgqi' QMPF.tISATIO DECLARATION
This section need not be completeddl thg permit is for one hundred ($100) pr
less).
Icertify that in the DerfornlanCt Of'the work for ••. niCh this permit is issued, 1
st:atl not employ any person In am manner so as to beccme subject to theWorkerI67""(pion L_ws Of Ca ilorma.
Date __ ___ Signature
NCj ICE: 11, alter rna:.rng this declaration, you should become :,inject t0 the
WCM ers' Compensation provisions of the hbdr Code. you must forthwith
Comply with such prnv,sto IS or this permit shall be deemed revoked.
CONSTRUr'TION LENDING AGENCY
1 hereby affirm, that there is a constructs ,n lending agency for etre Otrforr"ance
or the work for which this permit ,s issued (Section 3097 Cry. C.)
Lender's Name
Lc,1de.'s !Address
OWNER BUILUER DECLARATION
i hereby affirm that I am exempt from -he Contractor's License Law for:he
innnvnng reason (Section 7031.5 Business and Pro'rssocnal Code: Any City :.r
county which requires a permit to Construct, atter, improve, demous:l or iepair
any structure, prior to its issuance, also te0unes the appl:cant for Such permit
hic a signrd slatemeat that he/she t<. Iiccriwd pursuant •o the provisions of
TiIY. GonlydClar'S License Lay: (ChaDter 9 (commer.,inq with Se..tton 7000) of
Chvsio°t 3 of the Business and crotess:ons Code) o• that hersne is exempt
therefrom and the basis for the alleged exr- piton. Any violation of sgction
7031.5 by any applicant for 1 permit s.._;rcts the applicant to a civil
penalty ,f not more than five hundred rtotlars (S500).
I, as i ner of the property or my cmpsovees with wages as then Sole
com..ensativo will do the work, apd the str„rture is not intenced Or offered
fe.. sate (Section 7044, Business and Pro'"sional Code: The. Contractor's
L.,censn Law docs tint apply it) an owner of a property who huilas or improves
Incic`(, n, and wro does soc.h wr•rl. h,rnseli,horsel' or thro'ign h.S O' her n -r
cr-lployees, nrnv dcc' that such Imprnve.r.ews are not intended nr offered fir
sate. If, however, lr, bu,ld,nq or rroprovemene. ,s sold within one year of Com-
pletion, the owner will have the burden Of pro,nlq he;The oral not bund nr im-
i
D , ,for fhe P , 0”" Of Sale).
as owner ;f he prnoerty, am exc.-Sisriy (nntractulg ?,M' licensed con-
t•actun Cons.,UCf 1118 proll.'Cl (Section x0.4. Bu;,ness and Profess,:)ns Coca:
The _ontractnr's L,censr Law doe, not apply to an owner of property who
is or lrnpimes !livreon, and who c. ntracls fm such proletts wittl a Con•
it'aC%Arts) :;;Cense norcuanl to the r:nn ra.toe's License Law). 1 am aware that
Fr-oof M loci, `-V,, 'er's CO m rienSation ul5uranCC Sh011ln be Provided i0 me.
I_.i I am e.rmoi unr.--r Section B. & P. C. for this reason
Jztc ._ bi%y_ owner -^ -- --
I hereby cerl,f), that I have read tois application and state that the above
mlo•r»at,nn is Correct. I agree to Cor^ply with all city and county ordinances
and stale laws relalm n building con c:,n,), and hereby authorize recire-
sentattyes t'r phis C. to ,r7rt rJ'up .hc above-mentioned6
mroa y6for
insotctiun pur Ose ! / 9
Signature ._.__ t// Oate
Dnvars' License or SS W _
White flu1'dmg, Canary Temporary File ropy. Pink Assessor Goldenrod -Applicant
CITY OF LAKE ELSINORE CONSTRUCTION PERM;T
Applicant to fill in all spaces excpnf tiht,s .thin heavy border lines and sign all appropriate declarations
PERMI, G f"RACT NO. i %GT NO. I UNIT NO.
I
TYPE OFCt2NStRUCTIOd L$ NEW F ADD CI ALTERATION Ci REPAIR
CONVERSION !-_ DEMOLISH i- OTHER _-- - A.P. #
DESCRIPTION Of h'ORK/USE OF BLDG.__-
0.100,000 BTU El 100,000 BTU
S Main Buildi
j
E
TTPEOFPERMIT Q GRADING 1- FOUNnaTION L STRUCTURAL T Front
C TENANT CJ ELECTRICAL L' PLUMBING MECHANICAL B Rear
OTHER r;;_Enclosux A
PROJECT DESCRIPTiON: Sq. ft. Occupancy ^ K Right
COnstfuct'O'- It'_ Ione Acres _ S Left
uaticnS._ _ PC# — Ping. Ref.
Remarks Planning Notes
C'?
TRegisters
Incinerator
ACCT p
3401
3215
GRADING FEE`;
Cat. __
fill: ,_
Plan Check : ee $ _
I Permit Fee S —
To!al Fees S
Mise.
Flectncal
PLUMBING
Alter, Repair
Auto Wash
Backflovi Preventer
Clarifiers
Dishwasher
Fixture Traps ea.
Fl_i,r Drains
Floor Sinks
Gas &:4ice OB
Roof
sevie r trap _
Sever Connection - Bldg.
01ar Collectors
Swim,ning PooUSpa •_
Water Heater
M- _
Nater Service -_-_
FEES ELECTRICALFEEShniGenerator0.5KVit G 5-1 5K 4 L,oiler
Construction Pole Sub. - uct-
i Pole Light
Dryers OGas OElectric
i Fan
F. A_ U. -
Fixtures
I Outlets
Switches— -
Mete, up to 200 amps
hReter C over 200 amps
Sub panel
Transformer
CJ 15 50KV
I U 5U+KW
Motors 0-1 HP C 1%, • 8
Int. Solar [19.1_5 HP FJ16.15+
SingiFam. Res.
L ___.__.__._.---
I MuIU-Faro. Ices.
Duct -Structural _ I
Fan -Ventilatingi--- -i
J Exhaust System_
Evaporative Cooler_
Heating System & Ducting
0.100,000 BTU El 100,000 BTU
Hood or Canopy j
Parking 1Re13 'Provided s
Refrigeration System
E
kelenitcn
1 FJOAPO 000 BTLI __ 100.000 BTU
Firekl,Fan-Alt. 1C80 x
1302
J System Repair!Alieration
3125 Other
1 Fire Dampers
TRegisters
Incinerator
ACCT p
3401
3215
GRADING FEE`;
Cat. __
fill: ,_
Plan Check : ee $ _
I Permit Fee S —
To!al Fees S
Mise.
Flectncal S
Mechancal
j - Issue - -- - -'--Y - - -
It'alp Fein
w
DEYELOPMENTSERVICES REQUIREMENTS:
Ia irta AP, tltl Rf--______ _.. ..-- --- -_- _ _ _..__._ _. —._Flit'• -- -- -
dnilass Ap ,all By _— --- ,[ _ _Dale
i
www I., BF .--- - -- l -- - - ------ .__ _.Diu
Accessory Building:
Summary of Permit Fla
3220
I
NlV
N
3122 E!ectlical
G
Parking 1Re13 'Provided s s ; _ E
kelenitcn
S
SMIP Res.
1302 SM!P Com
3125 Other
Summary or Plan Chcck Fees
3401 fludcing
ACCT p
3401
3215
GRADING FEE`;
Cat. __
fill: ,_
Plan Check : ee $ _
I Permit Fee S —
To!al Fees S
cu. yards
cu yards
Summary of Permit Fla
3220 8,jllding
3211 Plutrh,ng
3122 E!ectlical S —____--
3223 Mechanical S
3224 kelenitcn
30i SMIP Res.
1302 SM!P Com
3125 Other
Summary or Plan Chcck Fees
3401 fludcing
Plumbing
Flectncal S
Mechancal
3403 Other
3412 Planning
Ifoul Fee, a,t
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Project AddrAss
Assessor's Parcel No. 377-130-077
Owrier's Name Central Bus. -Park InyfL%RAs 674-787.3
Address P.O. Box_939, Ls L.
r
ArchrEng. Konrad Ruiger License No. C8766_
Address 17982 SkvPark Circ. -Les Irvine. CA
Contractor's Name Brookstone o,e 674-7823
Address(mu,ling) P.O. Box 939, L.E. _
City License No. _7418 _ _—
LICENSED CONTRACTOR DECLARATION
1 be•cl y aftirm that I am licensed under provisions of Charter 9 (commererrg
with section 7000) of Division 3 of :he Business and Professions Code, and
my License Is in fua force and effect. r
Licerase las B-1 ice rvb. 504386
Date.YI 2— Signature—
r — --
WORKERS' COMPENSATION DECLARATION
1 hereby affirm that I have a cestlfica'.e of consent to self -Insure or a certificate
of Workers' Compensat:on insurance, or a certilit-d copy thereof (Section
3900, Lab. "b03403-90 State Fund
Polity No. _._ Company __--
tkCertified copy is hereby furnished.
18Date_---
CCegiy:
gb "b is filed with the C-ty B D n.
D/LOQ 7V Applicatlt—
EXEMPTION FROM WORKERS' C MPENSAT10o DECLARATION
Thissection need not be completed R the perm.: is for one hundred ($100) or
I ssa.
1 certify that in the performance 31,the •vrirk for which this permit is issued, 1
snalI not employ any person in any manner So as to become subject to the
Workes' g pensation Laws of Califorrla. r)at, A b --- Sig -lure — _ ---
NOTICE: 11, atter makmq tris df:cleration, you Should become subject to the
Workers' Compensation provisions of Inc Labor Code you must forthwith
rnrnply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENC`.'
I nereby affirm Ilia- there Is a construction lending agency for tht performance
of the work for which that permit is issued (Section 309. Civ, C.)
Lender •S Name
Lender's Address
OWNER BUILDER DECLAFIATION
I hereby Srfirm that I am e.ernpt from the Contractor's License Law for the
r,nswrtln reason (section 1031.5 Businrss and Proless,onal Code: Any city or
county Whlct. ICq In res a permit to construct, aft Cr, Improve. demolish or repair
any structure, print to its iisuance, also requires the applicant for such p2mill
to fe a signed statement that he/she is licensed pursuant to t'ie provisions of
the Ci nlractoLr's License ,w (ChmChapter9 (commencing with Section 7000) of
D 1,nn 3 of the nulme!.S and Pr0'ell,oni : Odr.i o, thdl fie/she is exempt
herefforn and 1!-,e basis for Ino. alleged exemptr,n. Any violation of Section
7031.5 by any apohCan' for . oern,-t subjccls the applicant to a civil
penalty of not more than rive humtr" dollars (S_-00).
I, as own.^.r of thr: property • r my ernployeeS v,ith wages as their sole
COMPCri Salmn, will do •he •Aork, and the Stiuc!a•..s not intended or n.f fered
for Sale (Seddon 7044, Business and ProtesSlonal Code: TI -.e Contractor's
License Law does lint apply loin owner of a property whe builds or impri,ves
hereon, and wl,o doe, such work himself i her self or through his or her owe
employees, ctinvid ed trial Such improvements ate nut intended or offered for
Sale. If, however, the auildino ur impruventt lit is sold within one year of com•
pletion, the nwner will have the burden Of proving he/she did riot build or im•
prove for the purpose Of 'sale).
1, a, owne, of it,., prrbe,ty, ar' exclusively contracting will, :iCenSed con.
tractors :(, COnsliur t the project tlr !ion 104.1, Business and ProteSSinrs Code:
The Contractor's L.cen dSCLaw ' CS nr,t apply to an owner M properly who
hullos or Improves there -v, an -1 :.r, , ct•ntract5 for such projects with a con-
Iraclortslicense pursuant b'" '•.e 1 n WaCfnr's L,,:Cnse I-aw). I am aware that
proof o their Wrrker's COm ocos.l Lion insurance Should ne provided 10 me.
am exempt under Sectir:. _ _-.. __. y, y P. C. for tars reason
Date— ---
I hefCby Certify that I havC read Ibis ap1•lir Minn and state that :ne above
in fnnna:ron isGur•:CI. I agree In(,, rip' r. in all City a.td County Jrd,nances
and State lags tela,! 10 building C. truc:rnrl, and hCr4by dUthbflZC rCpfp-
sentatives of this ttY ter the Acinve•mentinnen Property for
InspeChnn purpu
Signature y Dale —_.
Orrve,s' License or SS 'r —_
Whlte•Pmlding. Canary temporary File Copy, Pink•ASS^5101. Goldenrild•App! cans
CITY OF LAKE ELSNORE CONSTRUCTION PERMIT
Applicant to fill in all spaces except'those within heavy border lines and sign all appropriate declarations L/
PERMIT NO. __7TRACT NO. LOT NO. UNIT N0.
TYPE4FQ7lISTRUCTION -N NErI C ADD C ALTERATION r REPAIR
L CONVERSION n DEMOLISH C OTHER – — A.P. # ZoneDESCti:PTION OF WOkt;/USE OF BLDG_ _
T"EOFPERMIT GRADING C TOUNDATION STRUCTURAL
E main Building:
T Front
Accessory Building:
Z
TENANT ELECTR!CAL ; PLUMBING MECHANICAL B Rear
O
N
L OTHER Trash Enclosure A
PROJECT DESCRIPTION: Sq.Ft. __ Gccupancy K Right N
Construction type Zone Acre, _ _ g Left
Valuation PCp
Ping. Ref. #
R
Parkin Req./Provided E
Remarks Planning Notes c ` '-"' ' '_ ! - t t 3'' _ .
M
y
fp s YifC'h ezy, C7 — T
PLUMBING _ FEES _ ELECTRICAL i FEES MECHANICAL FEES AMT.# GRADING FEESAlter, Repair I Generator 00.51(W 5.15KW Boiler
GIC _ —cu. yardsAutoWashConstructionPoleSub. Duct -Under Ground
FIJI: Cu. yardsBackflcwPreventer 'Cooking Unit_ _ Duct -Structural
Backflow Irrigation _ _ Pole_!ighl, 1 Fan -Ventilating 3401 Plan Check Fee$
Clarifiers - I Dryets DUas ["Electric Exhaust System 3125 Permit Fee $
Dishwasher ( i Fan I Evaporative Cooler _ Total Fees S
Fixture Traps ea._ I I F.A.U. _
I Heating System & Ducting
Floor Drains _ i Fixtures CO 100,000 BTU .100 000 67 0 _
Floor Sinks Outlets ( Hood or Canopy + Summary of Permit Fees
Gas Service Outlets I Switches _ i _ 4T e 1 Type II 1]
I
f- Y 3220 Bultfing S,rInterceptors - ' _ Meter D up to 200 amps _— I Refrigeration System 3%21 Plumbing fP -Trap Meter over 200 amps _)_Cj0.100,000 BTU _000,000 BTU _
3212 I Electrical $ _ Roof Drains Sub aanel _ _ Fire I/Fact_Bit. ICBG =
p
3113 Mechanical S .. Trailer Sewer _ I 11ecanica15-50KW System Repair/Alteration - - -- -
Sewer Ca lrans ormer ------ 3224 REtention $ 50+KW _ fire Ltampers _ _
Sewer Connection - Bldg. I Motors 0.1 HP n 1'l, - 8 - Registers
V
1301 SMTP Res $ _ r
Solar Collectors j Inc. Salaf 09.15 AP 016.15+ Incinerator _ 2302 SMIP Corn
Solar piping - Sing/Fam. Res_ -- -- Misc. 3215 !liber f
Solar TcnkMulti•Fam. Res. Summary of Plan CheckFea
Swimmir, gPoolrSr, Swimming Pool/Spa / 3401 Pudding f _. • ../.
Water Heater - r _ Issue Plumbing =
Water Service-- -- _ Elec;t:cal $
Septic SyLstem Mechanical T — —
jrr,„- DEVELOPMERTSERVICES REQUIREMENTS:
3403 Other $ Zoning A.WoeedBy . -Date _..-
BuildingApprewd By ._ _ _ _ _pat, _ 3412 Planning $
Issue Apitkabon is wd By - -'
Total Fees Due $ ____
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