HomeMy WebLinkAboutROBIN DRIVE 802_04-00000943 Ci of Lake Elsinore
�(^v PERMIT 130 South Main Street
PERMIT NO: 04-00000943 DATE : 4/15/04
JOB ADDRESS . . . . . 802 ROBIN DR
DESCRIPTION OF WORK REROOF
OWNER CONTRACTOR
DELAROSA VICTOR OWNER
DELAROSA MIRNA
802 ROBIN DR
LAKE ELSINORE CA 92530
A. P. # . . . • . 379-171-060 0 SQUARE FOOTAGE 0
OCCUPANCY . . . GARAGE SO FT 0
CONSTRUCTION . . FIRE SPRNKLR
VALUATION . . . ZONE . . . . . . R-1
REROOF PERMIT
QTY UNIT CHG ITEM CHARGE
1 . 00 X 5 . 0000 PROFESSIONAL DEV FEE 5 . 00
18 . 00 X 3 . 0000 REROOF 54 . 00
FEE SUMMARY CHARGES PAID DUE
PERMIT FEES
REROOF PERMIT 59 . 00 . 00 59 . 00
OTHER FEES
PLAN RETENTION FEE 1 . 00 . 00 1 . 00
TOTAL 60 . 00 . 00 60 . 00
SPECIAL NOTES & CONDITIONS
REMOVE EXISTING ROOF, REPLACE PLYWOOD
SHEATHING IF NECESSARY, INSTALL FELTS
AND INSTALL ASPHALT SHINGLES .
Date: 4/15/04 15 Receipt no: 5018
Total tendered ow.00
Total payment sw.80
I'Icnx Road and Initial
I I am Lc ris-f undo r the provisions of Ilusincss and Prole ,sionai
Co to S.crion 7CYx"1 el sty and my hceose is in full fur e
��111t IIl (oll" lletillu" place I 2 1 asow-m-rof the protx•rs ormv emploveesw/wakesas[heir sole
compcncatinn will do the work and the strut turn is not inivnde d or
on thl jtlh oflcmd for salc
�3 1 asow-nerotthe-properti, amf`XrIUStLChrontracluikwuhhccnsrd
contractors to construct the project
�l�•'i �'�� •i il' 1'`il Pt RMI I M %Ilil I` 'il.' tli. V t 4 Ihi�enreniricateofeon� nttoselrinsureorareruficate ofWorkirs
1i \I f l l} t ` li l c` ' .f l•c Il`I`.'. '• I Compensation msuranev or a certified copy thereof
�.(5 1 shall not cmplos ant person in am manner so as to bce ome suhJecf
to tiorkt r< Ceumpensauon Laws in the pwrfonn+ncc of the work for
which this permit is issued
tole If you should fx•romv subjue f to Workers Conip msation after
mnhing this eirulle anon tou must forthwith eoniph,with sue h pro-
visions or this permit shall he deemed m%oked
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City of Lake Elsinore
130 South Main Street
APPLICATION FOR APPLICATION No.
BUILDINGPERMIT- 3
APPLIC7174'�IOL74
DATE
VALUATION CALCULATIONS APR By
1 st FLOOR SF BMORaG ADDRESS
!
2nd FLOOR SF TRACT ` IkOCK PAGE 4 EOT/►ARCEE S�O
3rd FLOOR SF
N AMf
GARAGE SF
r
STORAGE SF Z R40PIC
OTHER:
SF f$w by off r .f--I e...I.—.d wd—pw.. of Ompiw•kon�;.q—1.sRc+.a,
70MI of a—;.:oa—;.;..s of fe..w.—,vial.rd.as.aa Co&,*-it o.r tic.....:.I.fvR#wc•
GRADING CUT CY
and.ff«.
FILLCY = M9 Tcffyeusp*ss
VALUATION: ° N+
FEES MAKING
ADORESS
BUILDING PERMIT $ CITY STATE ZIP (NONE
CONtRACICW S SIGNATURE DATE
PLAN CHECK
ADDITIONAL PLAN CHECK NAME LICENSE
v
z MAILING
GRADING PLAN CHECK Z AOOREss
< CITY STATE ZIP MgNf
DNEW LIREPAIR OCCGRP./ CONST.
DIVISION TYPE:
MICROFILM L,AODITION LjMOVE NUMBER OF NUMBER OF
;ALTERATION !:DEMOLISH STORIES BEDROOMS
COPIES "OTHER ZONE.
CSINGLE FAMILY units HAZARD AREA? YES NO
IMPRO FEES ❑ SCHOOL FEES ❑ APARTMENTS units
CONDOMINIUMS units SPRINKLERS REQUIRED? YES NO
-TOWNHOMES units PROPOSED USE OF BUILDING:
COMMERCIAL i 'INDUSTRIAL
PAID PRESENT USE OF BUILDING,
DATE
JOB DESCRIPTION
❑ 1 certify that 1 have read this application and state that the
above information is correct,I agree to comply with all city CA /
and county ordinances and state laws relating to building
construction, and hereby authorize representatives of this
city to enter upon the above-mentioned property for inspec evp
-
tion purposes.
Signature of Applicant or Agent Date
AGENT FOR ❑ CONTRACTOR ❑ OWNER
AGENT'S NAME
AGENT'S ADDRESS
STREET CITY STATE ZIP REV_OATE11-1.90