HomeMy WebLinkAbout200 GRAHAM AVE_i! 7,
t c.
y Elsinore
PERMIT X130 South Main Street
RMZT NO: 9Qri 9001
DATE;: 11/14; 9O
JOB ADDRESS 2001W GRAHAM AVE ofTENANTNBR, NI- ME KNOWN AS ,>109 s. ice', DESCRIPTION Or-WORK ADD OR ALTER RFSIDENTIAL, ' -
OWNER _ _ CONTRACTORRDAVIDBULE+i ,.'IN.5 NGE AGENCY 0%'NER -
A.P.# 374 -3(1 -002 SQUARE _ OOTAGE' 0OCCUPANCYDWELLINGS', LODGING ROUSE; GARAGE SQ FT. 0CONSTRUCTION, TYPE 'V- NON RATED FIRE SPRNKLR : VALUATION .. 11000 ZONE . NA
BUILDING PERMIT 7r -
QTY UNIT CHG ITEM CHARGE.'
BASS: FEE 15 . Qt15.00 X -. 2.0000 ,VALUATION 10.00
EL CTRICA.L PEPUMIT
QTY UNIT CHG
BASE FEE
ITEM ejL"GE "
4: 50600.00 X .0350 NEW RES. SINGLE :FA14 /SQFT 21 ".001.00 X 3.0000 RES "FIXED APQL:OR OUTLET ?.001.00 X 18. 0 -00 10D- 200AMP SERVICE<600VLT
1
MEt "HANICAi. PERMIT
QTY IMIT CHG I!I'EM tiHARGE -1 11
BASE FEE 4.501.00 ,X /6-5000 EXHAUST HOOD
PLUMBING k'ERMIT&
QTY -UNIT CHG '
BASE FEE
ITEM CHARGE,, \` - -- =
3.00 X 5.0000 FIXTURE OR TRAM - 04o.
50
1.00 X 7. 5000 WATER HEATER OR VENT 7.50
1,
1.00;X 3.0000 INSTALL/ALTER OR REPAIR': 3,.00
FEE SUMMARY - THIS Is YOUR ImEl"
CHARGES_ PAID ID ' PE FEE$ I
14 -1990,, 1:29 PMr,;.42. BU7'ZDING PERMIT 25.00 25.00 ACCT#1100-9401-
EIXCTRICAL PERMIT PT4802- 11741IV.F. SRI
CHANT( AL' PErZMI'I'
4 •0 (1 47 00" PLAN CHLCF - F,,E-°B1go1f.00
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Please RW,,cnd Inmol:
City of bake Elsinore 1. lont'Llcon"d under fho/*., and Profasslonol -4iIslonsat, Dual
Buildin Safjty bivisio; Cod* seedlan ' 7000 at soq,.!tncl my license if th IVII
I. as owner of the /property, *r my w/V age
olrtole compensot
09Postincdhg " Ian wI0 do thit w;/ picuous Place t',.d the, structure 10
not lr:endod.or offerfA for sale.
on the job 3 1. as owner of the property, am exclusiy,dr-contracting with
licenodd controcio,s to construct the PrDiocf,
You must furnish PERMIT NUMBER A. I have a certificate of consent to 341flowro or a certificate .
and fae-JOB ADDRESS for each of Workers Componsnilon Insurance at- a co tilled copy thereof. 01M S. I sholl rot #,,t"ploy any person In any, to bewos'
respective inspection: subject to Wcri o•s Compensation L.•wis in 0.1 the
Appi ovittd plans must be on job work for which this permit is Issued.
atoll times: Note: If ycAj should become subject tq VA, knio ',:'.3Aipqmf;otIon
after maklin-,, hils cor,'Ification, you must fo,-,e,,,jJflV comply with
such provisioas or this permit shall be dome l :1,
Code Appr., nte InspectorD
EL01 !'omp i;loc Sotv.tas
i PLO) Soil Pipe Under ground
EL02 Elac Conduit Underground
OPOI tinr
EPW
I
I Grout
SP04 Slob Grade
PLOI Underground Wat n-l-L —
SSQI Rough Septic System
SWOT On Site Sower
P103 Rough Plumbing
EL03 Rough Electric- Conduit
FLO4 Rough Flectric-Wiring
ELOS Rough Electric -T•Bor
MEOI Rough Mechanical
ME02 Ducts, Ventilating
PL04 Rough Gas Pipe -Test
PL02 Roof Drains
BM Floor Joists
SP06 Floor Sheathing
SK7 Roof Framing
OPOO Roof Sheathing
13PO Shear Wall & Pro-Loth
3?10 Framing A Flashing
8PII Lathing & Siding
8P12 Insulation
OP13 Drywall Nailing
Pl."
EL"
Final Plumbing
Final Eloorltal
E" Final Mechanical
OP" Final Building
adCode Pool A Spa Approvals Dolt Inspector
P001 Pool Steel UK /Forms
PP002 Pool Plumbing/Pr*ss. Test
P003 Pro•Gunito'
P004 PW4 Pool Fenc'7g/Acc4"$
llnspoclo,
PPWSODS Pro-Plaster
iaugWP_._I ii".—ItricEL06
pn"- Final /SIM
SL"_ Final Solar
Sub List Approval
i,.'V Oct
i7,
k•, dlk
77-
77'
p
ity of Lake s pore
130 South Main StreetPERMIT
v r w svar
PERMT.'r, NO: 90- 00000117 DATE: 11/14%90
PAGE 2
JOB ADDRESS 200 W GRAHAM AVE
TENANT' NBA?., NAME KNOWN AS 109 S. MAIN .ST. -.
DESCRIPTION;,OF WORK ADD OR ALTER - RESIDENTIAL
PLUMBING PERMINS 33.00 31.00 .00
OTHER FEES _
PLANNING REVIEW FZE 10.00 10.00 .00
PLAN RETENTION FEE' .15 .15 .00
SEISMIC GROUP R .50 .50 .00
PLAN CHECK FEE 16,25 16.25 .00
TOTAL 1,12.90 142.90 .00
Y -
Please Read and Initial• -
City of Lake Elsinore
Building Safety Division
Fast in conspicuous oface
on the job
You must furnish PERMIT NUMBER
and the JOB ADDRIESS for each
respective Inspection:
Approved plans must be on job
atoll times:
I pm Licensad under the ?i ovisions of Business oind Profe"In, 'ta t
Cody section 7000 et seq. and my license is in full force.
2. t, as• owner of the property, or my estspioys'es w /wagaa as
their sole compensation will do the vrork and the ottuctu» Is
not in!ended or Offered for sole.
3. 1. as owner of the property, am exclusively contracting with
licensed contractors to construct the project.
d. 1 have t certificate of consent to selfinsure or a certificate
of Workers Compensation insurance or a cartified copy thereof.
S. 1 Ault not ampf q any person In any manner so as to became
subject to Workers Compensation Laws in the performanze of the
work for which this pbrmit ho issued.
Note: If you Should 'become subject to Workers Compensation
offer making this ceilification, you must forthwith comply with
such r rovisions or this psrmit shall be deemed revoked.
OM Pre - Platter.
EM Rough Pool Electric
Pon °inal Pool /spa
I" Final Solar
listApprgvul _ ....
e
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v• r' << .... .,... . .. _. t '[°, °- ':., i` .`il,.w. ' .. .u•n ad.d".w.a s.:•ecsle._
EL0l
PLO]
Tamp'lec Sery _es
Soil Pipo Underground
EM
fk°01
Eloc Conduit Underground
Footings
ISM Steel Reinlorv-ement
BP03 Grout
BP04 Slab Grade
PL01 Underground Water Pipe
5501 Rough Septic Sys_•tum
SWOT An Site Sewer
14M Rough Plumbing
EL03 RoughEiectric- Conduit
EL04 Rough Electric- Wiring
ELOS Rough Electric -T -Bar
M6B01 Rough Mechanical
AK02 Dads. Ventilating
Pi04 Rough Gas Pile -Yost
PLO Roof Drains
BPOS Floor Joists
BPV6 Floor Sheathing
WV7
IVAS
Rod Framing
Roof Sheathing
ilIM Shtror Wall B Pre -Lath
SPIO Framing & Flashing
SP11 Lathing & Siding
l2
13
Insulation
Drywall Nailing
99
9
A0&J'n99
Final Plumbing
Final Electrical
Final Mechanical
1 Finol Building
Code
00 0
Pool & Sp`, Appro mis i Dr:: 3 Inspector
PWI Pool Steel Rein. /Forms
PM Pool Plumbing /Press. Test
FM Pre- Gunitst
am P-1 Fencin /Access
OM Pre - Platter.
EM Rough Pool Electric
Pon °inal Pool /spa
I" Final Solar
listApprgvul _ ....
e
N ... . .w....„.. : -. .. ... . « r....Jr/JM11.4^..• ,.o-,yu .v..•, <.:..f
v• r' << .... .,... . .. _. t '[°, °- ':., i` .`il,.w. ' .. .u•n ad.d".w.a s.:•ecsle._
PF'LICA,TION I' OR
BUILDINGPERMIT
VALUA1ION CALCULATIONS
i.
ILA T Elorlinoiet- Cif L' akeve
13f FLOOR SF
2nd FLOOR SF
3rd FLOOR SF
GARAGE SF
STORAGE SF
DECK & BALCONIES SF
OTHER:
GRADING
SF
CJT CY
VALUATION.-_
4/
1 G —.,--.--FILL CY
FEES
BUILDING PERMIT
PLAN CHECK
ADDITIONAL PLAN CHECK
r
C7`.ADWG PLAN CHECK
MICROFIU VI
COPIES
IMPRO FEES L7 SCHOOL FEES 0
130 South Main Street
APPLICATION NO.
r -
goo., ergt rrer nc«u., is M ton brn
SPRINKLRS Rmmorno
PAID `-"`. vww^ wm LANDUSTRIAL
PRESENT USE rv: ai in nee,r -.
DATE
JOB Dr:se.RlPr.N
I certify that I have read this application and state thot the
above Information is correct. I agree to comply witti all cityandcountyordinancesandstatelawsrefalingtobuildingconstruction, and hareby authorize representatives of thiscitytoenterupontheabove•mentiom9d property for inspec• lion purposes.
Signature of Appllco or Agent D to —`--
AGENT FOR 0 CONTRACTOR t OWNFR
AGENT'S NAME,
AGENT'S ADDRESS
r
srRl? .,Cfy 57ATf
1
YES
YES NO '
City of Lake Elsinore
130 Suuth Main Street
t- a!okPLICATION FOR
I.1<J —MBINGPLUMBING PERMITi
it'IEC'rANICAL
i t Car tily That I have rood this application and state that the
abovrl, fr.'ormatiun is correct, 1 ogres to comply with all cityand !:ounty ord!nonces o:.: state lows relo`ing to building
construcron. and hereby cutha•ize representatives o} this
city to en-Or upon the above-mentioned property for inspec-
tio'.T purpc•ses.
tir,nvture of Appfican Agent Vote
GE'' NT FO U CONTRACTOR 4' 0- WNf
AGENT'S NAME
AGFNT'S ADDRESS
e
C
STREET CITY STATE ZIP
BUR DING PERMIT NO.
es Ite
ELECTRICAL Quart
New Residential Mufti Family Or, i Ixruro or Tr
No" Residential Single Family iAidding Sp
P. irate S'almming Pools Rcin Water S
Switches / 1st 20 _ Private Septi
Switches / Over 20 Water Heot`,
Recpt, Outlet / 1st 20 Gas Piping S
Rrcpt. Outlet / Over 20 Gas Piping iP $'
Lighting Fixtures / I st 20 _ Dishwasher
Res. Fixed Appliance ' Outlet f/o Solar Tank
Non•Res. Appliance / Ouilst Solar Collect
100 200 Amp Service s 600Y Grease Trop
200 -f000 Amp Service a 600V Install, Alter
Service Over 1000 Amp or 600V Lvwn
Mist: Apparatus /IPparotus, Conduits, ETC Backflow Devi
Signs
i3ockFlo r Devi
Sign Branch Circuit
Flcor Drain
Busways / EA 100 It _ Floor Sink
Temporary Power Service Water Service
Temp. Powor Distri buf1cn Sys. Altar or Repair
MOTORS / TRANSFORMERS Fire Sprinklers
Motors up to 1 M.P.
Motors / T: an..rmers 1 • f 0 H.P.
Motors / T- onsformers 10 -50 H.P. -
Nolon / Tronsforrnors 50•I00 FI.P.
Motors / Trandorrnrn 100 H.P. Replace Piping
APPLICOON NO.
APPLiCATjO RKvi,iv D
DATE 77 (—_i L
by
KvcE •rwcF
NAME
FOr PAIL t —'
MECHANIC /1
AOMSS rllOf s
srArE,a r
ohw., am 4emed under a ana:om
i] r+ Ihr.sion J d !!,e lus:rNSS N. P •ol
a1 elLrrr. Code. •nd n r Ilcenr+ is in lull !
u r
AND ntss city BUSINESS
TAILi
V YJNAME
4WLWG
ADOeESS
CITY - IfATE•L3' pt r
COl1riACTUS S SIGlIA"URE
DATE
PLUMBING QQuart M MECHANIC /1
op, 3 3 — Furnace up to _100,000 BTU s
SWIMhIING POOL
Swimming Pool / Public
Swimming Pool / Private
Water Healer / Vent
MISC. Replace
e._.... Gas Plpin{I
AliV.ippTEfit•iti0 !
L
CxTY Of LAIC us= 0
WIZIMO DMXXON
Q NS•vszaa e °t ax
i-a city or county, which to requived to give notice pursuant to
Section 108340 shall attach to such notice, l*%O, as a condition -precedent
to issuing a building permit, require the eccmpletlon and require e slty -.n
Of an owner builder verification.>
Attention Property Owner:
An *owner builderO building rmit bas been a plied for in lour name
and bearing your signatura. Xg bQfi ag goon XLU7 IS JUAW naM x
tieatian In
3. 1 parsonally plan do provide the major labor and materials
Paz construction of the psoposod property immpwovament.
f. 1 (have/have not) Ii'F signed a :i .'Application for a
building permit for tEa propON'R work.
3. 1 have contracted with tha following, person (firm) to.
provido the proposed eon truction:
Name C.,
Address - E ,S
Phone (77/C e. , ?
d. T plan to provide portions of the vox,k, but 2 have hired the
folloving Vernon to coordinate, supervise, and provide the
major vorks _
Name . ss V•
Addra'.'ss
Ph r,° (7 , 4) itra °nor • LIE
T wZ11 provide 1110me Of the Work but t bave contracted
hired) the following vaxoons t a provids- this work indieeteds
at x2a
Lt. r
if i L oval xpaee s slqu ;a`' is s . • cot. iao osc o .
i hereby affirm Oat S 'have teecolved a coppyy of the information set
fo =.tPs in aer tion 19230 of the at.ats six Chilffornia ROAM and dafety Codeareahave ,complete the above Snforngtion to, the best of my personalWnfrledge, in complianess with this ftate \Ystr.
Gatti 1 S
Same:
Drivers Lie d or loc. d ;Re. 1 . b 0 rd 6 6/
a ;
NOTARIZED STATEMEti ' OF RESPONSIBILITi[ Bldg. )Permit
TO WHOM IT ConcERN:
This permit
109 SPRING STREET, LAKE ELSINORE CA. 92330 - - - —
Street Address
AP P3umber
A
I, R. DAVID BUZ+Et1
as gainer in VUle, of the above
referenced property, do hereby authorize.
C.F. BRIGHT
Name `- (714)674 -942
Telephone Number
13._ E- LAKESHORE DRIVE #S, _
S_reetAddress
LAKE ZLSINGRE _ r.;A 01330CityStatE=
Zip
to obtain permits in my behalf, 'I's owner /builder, foie the construction, alteration, moving, demolition or repair of the above referenced property.
Should any person become as F o9ee engaged in the improvement of the property, IshallImmediatelyprovideWjr_ker's Compensation Insurance coverage and cause acertificateofthatcoveragetobefiledwiththeBuildingDivisionoftheCityofLakeElsinoreasrequiredbyStateofCalifornia )laws.
As owner /builder in fact, I understand and accept that my responsibilities do nottransfertoanyothe. person, company or corporation.
I agree to indemnl-y and hold the Cit ofharmlessfrY Lake Elsinore and its employees or officers ' om any claim resulting in damage or persozial injury to myself or anyotherparties.
R. DAVID BULEN _
OCT 3, 1990Pri,tted N
Date
Signature
Erate of California
ounty of Riverside ) SS
i City Of take Elsinore j
iln this day of +•.
personally appearedbeforeme
known to me (or proved to me that on the basis of satisfactory evidence) to be the
person whose name is subscribed to this .instrument, and .acknowledged that he /sheexecutedit.
In Witness Whereof, I hereu o set jh nd of seal
BARBAF3A J. OAKER
MRRAftr
MY CO. l l
v / _
r__*I
r \si L IG.4,r.0 r.Mr.N _e4/ ,.f )'w..... -. :_IWdY• .. .i _a .. iC..V'l.`l r._u
JtA)R2'LED STATEMENT OF' RESPONSIi3XLI "l'Y % -
Bldg. Permit #
TO ilgCH IT MAY CONCERN:
This Permit #
109 ISFRING STREET, LAKE ELSINORE CA. 92330
St treeeeAddress `— --
AP Number
d, R. DAVID Br EN
as Owner in Title of the above
referenced property, do hereby,auttiorize:
C.F. BRIGHT
Name (714)574 -9452
Telephone Number
150 E. LAKESHORE DRIVE . }5,
rStreet Address
CA 92330CityState
Zip
to obtain permits in my behalf, as owner /builder, for the construction, alteration, moving, demolition or repair of the above referenced property.
Should any jerson become an a!1 to ee engaged in the improvement of theshallimmediatelyprovideWb;ier's Compensation Insurance coverage
Property, I
certificate of that coverage: to be filed with the Building Divisionaof the
se
of Lake Elsinore as required by StatF: of California laras.
As owner /builder in fart, I w- derse.and and accept that my responsibilities do nottransfertoanyotherperson, comPally or corporation.
I agree to indemnify and hold she City of Lake Elsinore and its employees or officersharmlessfromanyclaimresultingindamageorpersonalinjurytomyselforaayotherparties.
R. DAVID BuiEN
Printed N• a
OCT 3, 1990
Date
Signature
State of California )
County of Riverside
City of Lake Elsinore)
On th3.s _ -:!5
Personally appearedbeforeme
known to me (or proved to that on the basis of satisfactory evidence) to be thepermonwhosenameissubscribedtothisinstrument, and acknowledged that he /she" executed it.
Xn Witness Whereof, I h3reu o set ' nil of ae.r 1
kl
OFFICIAL SEALi
to Noury pWN1C (;0 0M1 ;
RIVCMIDE OOUNT.y
Ar My cwft ev
17 ,'
t
777777