HomeMy WebLinkAbout200 GRAHAM AVE_ 99-00000539200 W GRAHAM AVE 99- 00000539 1 OF 1
I .
Citv of Lake Elsinore
PERMIT 130 South Main Street
PERMIT NO: 99- 00000539
JOB ADDRESS . . . . . 200 W GRAHAM AVE
TENANT NBR, NAME ARCO AMPM
DESCRIPTION OF WORK SIGN
OWNER
SEYEDGAVADI ALI
SEYEDGAVADI MAHBOUBEH
A.P.# . . . . . 374- 261 -002 1
OCCUPAfi ^Y
CONSTRUCTION
VALUAT ON 2,000
ELECTRIC PERMIT
QTY UNIT CHG
BASE FEE
1.00 21.0000 SIGNS
1.00 X 5.0000 PROFESSIONAL DEV FEE
SIGN PERMIT —
QTY UNIT CHG
BASE FEE
15.00 X 2.7500 VALUATION
CONTRACTOR
OWNER
FEE SUMMARY
PERMIT FEES
ELECTRICAL PERMIT
SIGN PERMIT
OTHER FEES
SEISMIC OTHER
TOTAL
56.00
86.25
50
142.75
DATE: 5/10/99
SQUARE FOOTAGE 0
GARAGE SQ FT 0
FIRE SPRNKLR .
ZONE . . . . . . NA
ITEM CHARGE
30.00
21.00
5.00
ITEM CHARGE
45.00
41.25
AID DUE
00 56.00
00 86.25
00 50
00 142.75
99 539 $142.75 bV
Date: 5/10/99 10 Receipt: 00051%
CHECK 1375
00000000000000
City of Rake Elsinore
Building Safety Division
Post In Gti7 spic om placle
on the abJ
You must furnish PERMIT NUMBER
and the JOB ADDRESS for each
respective inspoetion:
Approved plans must be on job
at all times:
please Read and Initial: '
1. 1 am Licensed under the provisions or Business and Piok4mlonal
Cade Section 7000 et seq. and my license is In full force. ' 5 2. 1. as owner of the property, or my employers w /wages as their sole
compensailon will do the work and the structure Is not Intended or
offered for sate
3. 1. as owner of the property. am exclusively contracting with licensed
contractors to construct the project.
4. 1 have acertUteateof conaenttoselfinsureora certificate ofWorkers
red copy thereof. Compensation Insurance or a cc. tifi
5. Ienallnotempi' yanypersonIn any manner moms tobecomesubject
which
Workers Coompensatlon laws in the performance of the work for
which this permit Is lamed.
Not.. If you should become subject to Workers Compensation alter
making this certification. you must forthwith comply with such pro-
visions or this permit shall be deemed revoked.
Code ApffovaJs Date Inspector
EL01 Temp Else Services
PL01 Sod Pine Undergmund
EL02 Elec Conduit Underground
BPOI Footings
BPO2 Steel Reinforcement 1 tr•
SM Grout to
BPO4 Slab Grade
PLO1 Under ours! Water Ape
SSOI Rough §Rlic System
SWOT On Site Sewer
BPO5 Floor joists
fL(00)
5
Rou h Electric -Wiri
Ro h Electric -T -Bar
Rouah Mecha rrcal
ME02 Ducts. Ventilating
W Rough Gas Pioejett
P1.02 Roof I)r&ns
Pi insulation
BP13 wall Nailing
BPtt Lott-ing BSdrn
PL99 Final Plumbing
EL99 Finai Electrical
ME99 Final Mechancal
BP99 Final Building
Code Pool & Spe AMovels Date Inspector
OTHER DEPARTMENT RELEASES
for
DeFarUrtent Apprwal required prior to the
bidding being released by the CityP00tPoolS ;eel Rein./Forms
P001 Pool PluftinglPress, Test
POOH Pre Gunite
Date Inspector
EL06 Rough Pool Electric
Planning
Sub List Atmrovel
Landscape
P004 Pool Fend Access
fin n
P OOS Pre-Pa stet
En ineerin
P009 Final PooVSDa
PPLICATION FOR
BUILDING PERMIT
VALUATION CALCULATIONS
1 st FLOOR SF
2nd FLOOR SF
3rd FLOOR SF
GARAGE SF
STORAGE SF
DECK & BALCONIES SF
OTHER:
SF
GRADING CUT CY
FILL CY
VALUATION: `-'vz00
FEES
BUILDING PERMIT
PLAN CHECK
ADDITIONAL PLAN CHECK
91-EMOL-
G7R*Dft4GTrA"4,"eeK
4 - g
5 ca
City of Lake Elsinore
130 South Main Street
MICROFILM
idam--- • 75
IMPRO FEES SCHOOL FEES [
PAID
vnTc
G 1 certify that I have read !his application and stole that the
above information is correct. I agree to comply with ail city
arvi county ordinances and state laws reioting to building
construction, and hereby authorize representatives of this
city to enter upon the above-mentioned property for inspec-
t n purpos".
lure o or Agent Dote
AGENT FOR CI CONTRACTOR. D OWNER
AGENT'S NAME
AGENT'S ADDRESS
STREET CITY STATE ZIP REV. DATE 11.1.90
APPLICAPeIrV.
APPLICATION RECEIVED
DATE =7—
AP X3 r By "
v7JlI
cr
BUILDING ADDRESS ,
W . 64g Y? r 11 E vLli N fl,
TRACT LOTIPARCELPPAAGE/ BLOCK
NAME
n
OMAILING
r PHONE
ADDRESS
CITY STATE ,ZIP
z
I hereby off— that I am li(IMed under provmam of Chapter 9(c —smin9 with sftw,
7000) of DMsion 3 01 the Business and Professions Code. isM my liunse is In full force
and effect.
NSE r CITY BUSINESS
AN S TAX e
O NAME '-
MAILING
ADDRESS
CI *Y STATE ZIP HONE
CONTRACTOR S SIGNATURE DATE
L }
NAME U SEs
W
x
V
MAILING -
ADDRESS
CITY STATE ZIP PHONE
NEW REPAIR OCCGRP. CONST.
DIVISION: TYPh:
ADDITION MOVE NUMBER OF NUMBER OF
STORIES: BEDROOMS: ALTERATION DEMOLISH
O HER ZONE:
SINGLE FAMILY units
HAZARD ARFA YES NO
SPRINKLERS REQU'7ED? YES NO
APARTMENTS units
CONDOMINIUMS units
TOWNHOMES units PROPOSED USE OF BUILDING:
r RESENT USE OF BUILDING: P
COMMERCIAL_INDUSTRIAL
JOB DESCNIPTIOtrN
AGENT'S ADDRESS
STREET CITY STATE ZIP REV. DATE 11.1.90