HomeMy WebLinkAboutDIAMOND DRIVE 250_03-00002092 4�r
Cityof Lake Elsinore
130 South Main Street
PERMIT
PERMIT NO: 03-00002092 DATE : 10/23/03
JOB ADDRESS . . . . . 250 DIAMOND DR
DESCRIPTION OF WORK . MISCELLANIOUS
OWNER CONTRACTOR
ATLANTIC RICHFIELD CO PETRO BUILDERS
10609 PAINTER AVE .
SANTA FE SPRINGS, CA 90670
562-946-2285
LIC EXP 0/00/00
A. P. # . . . . . 363-171-004 5 SQUARE FOOTAGE . 0
OCCUPANCY . . . GARAGE SQ FT . . 0
CONSTRUCTION . . FIRE SPRNKLR . .
VALUATION . . . 4 , 800 ZONE . . . . . . NA
BUILDING PERMIT
QTY UNIT CHG ITEM CHARGE
BASE FEE 63 . 00
3 . 00 X 12 . 5000 VALUATION 37 . 50
1 . 00 X 5 . 0000 PROFESSIONAL DEV FEE 5 . 00
PLUMBING PERMITS
QTY UNIT CHG ITEM CHARGE
BASE FEE 30 . 00
1 . 00 X 5 . 0000 PROFESSIONAL DEV FEE 5 . 00
2 . 00 X 8 . 7500 FIXTURE OR TRAP 17 . 50
FEE SUMMARY CHARGES PAID DUE
PERMIT FEES
BUILDING PERMIT 105 . 50 . 00 105 . 50
PLUMBING PERMITS 52 . 50 . 00 52 . 50
OTHER FEES
PLAN RETENTION FEE 3 . 50 . 00 3 . 50
SEISMIC OTHER 1 . 00 . 00 1 . 00
PLAN CHECK FEE 75 . 38 . 00 75 . 38
TOTAL 237 . 88 . 00 237 . 88
SPECIAL NOTES & CONDITIONS
UPGRADE ADA REQUIREMENTS
Oper: COUNTER Type: OF Deaver: 1
Date: 10/23/03 23 Receipt no: 2125
2N3 2092
BP BUILDING PERMIT 1 $237.88
Trans number: 71554
CK CHECK 16741 SM.88
Trans date: 10/23/03 Time: 9:34:42
Cw. (->; l.l;e El 1nore A .
�_� Please Read anS Initial
f3 L1111j1i1,' �'t.[� [�I�till ril I I am Licensed under the provisions of Business and Professional
Code Section 7000 et seq and my license is in full force
Pint in conspicuous place 2 1 as owner of the property,or my employeesw/wages as their sole
compensation will do the work and the structure is not intended or
Ili the,job offered for sale
3 1 as owner of the property am exclustvely contracting with licensed
_ contractors to construct the project
I!1 111 }1 PE R�lll �1_ \1BFF .ln�j the �Z ; Iha�eacertiflcateofconsenttoselflnsureoracertiflcateofWorkers
Compensation insurance or a certified copy thereof
S 1 shall not emploN any person in any manner so as to become subject
��l rl 'y c j nl ltl Ill J i lc lilt lob to Workers Coompensation Laws in the performance of the work for
i ,11) Ilflle, whkch this permit Is issued
Note- If vou should become subject to Workers Compensation after
making this ceruficauon you must forthwith comply with such pro-
kisions or this permit shall be deemed revoked
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BP 19 F-.a B-•c-q ( y
Coae Poo.S SDa ADyOra s Da'e Irscec'ar OTHER DEPARTMENT RELEASES
C•ea rs- o• Department Approval required prior to Ihe
Prx Poo S ee 11e•^ Fo—s building being released by the City
X Pao P--o,-, P-ess Tes;
PCn;3 P•e u_- e
Dare Inspector
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P1_:1_1 Pcn r-e-•_ Access
Finance
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City of Lake Elsinore
130 South Main Street
APPLICATION FOR [APPLICATI N NO
BUILDING PERMIT
APPLICATION RECEIVED
DATE
VALUATION CALCULATIONS AP# By
1st FLOOR SF BUILDING ADDRESS ;5�v` / (lfa ew�
2nd FLOOR SF TRACT C//J'f /BLOCK/PAGE LOT/PARCEL
3rd FLOOR SF
GARAGE SF NAME
STORAGE SF z
DECK&BALCONIES SF o
OTHER:
SF 1 hereby affirm that 1 am licensed under provisions of Chapter 9(commencing with Section
1000)of Division 3 of the Busin; s Professions Code and my license is to full force
and effect T,rt /�•r/v!�
LICENSE 0 � ITY BUSINESS
j AND VALUATION: s�VL/ O NAME ASS (/� TAX M
FEES MAILING
ADDRESS Xt
BUILDING PERMIT $ cl �. TATErZIP HONE
f l i . 77U
CONTRA R S SIGNATURE DATE
PLAN CHECK �
ADDITIONAL PLAN CHECK ICEN EA
- - � "ram �E:�' Ei �� ��, ,� • C`-3�'/��
Z) MAILING
v ADDRESS / I ,i ���/��) fi(,/> �f f( •
fAA
I) STATZI � 7PMON�1'qL OREPA R OCCGRP./ �}(�f/ CONSTDIVISION / '( TYPE
MICROFILM N ❑MOVE NUMBER OF NUMBER OF
TION CDEMOLISH STORIES. BEDROOMS
COPIES ZONE
FAMILY unitsHAZARD AREA? YES NO
IMPRO FEES ❑ SCHOOL FEES ❑ ENTS unitsMINIUMS units SPRINKLERS REQUIRED YES NO
OMES units PROPOSED USE OF BUILDINGPAIDRCIAL OINDUSTRIAL PRESENT USE OF BUILDING P� 1A���
��/J ���tttR
DATE
JOB DESCRIPTION � � &���
❑ 1 certify that I have read this application and state that the
above information is correct 1 agree to comply with all city Q�cl�.� , r✓A� ����
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-
tion purpos
Signature of Applicant or Agent ^ Date
AGENT FOR CONTRACTOR 11//OWNER
AGENT'S NAME
AGENT'S ADDRESS
STREET CITY STATE ZIP REV DATE 11 1-90