HomeMy WebLinkAboutDIAMOND DRIVE 250_03-000020924r
Cityof Lake Elsinore
130 South Main StreetPERMIT
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 Initialf3L1111j1i1,' '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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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
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PCn;3 P•e u_- e
Dare Inspector
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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
7PMON1'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
unitsMINIUMSunitsSPRINKLERSREQUIREDYESNO
OMES units PROPOSED USE OF BUILDINGPAIDRCIALOINDUSTRIAL
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