HomeMy WebLinkAboutKANSAS STREET 30752_04-00000614 Ci of Lake Elsinore
v PERMIT 130 South Main Street
PERMIT NO: 04-00000614 DATE : 3/09/04
JOB ADDRESS . . . . . 30752 KANSAS ST
DESCRIPTION OF WORK ADD OR ALTER - RESIDENTIAL
OWNER CONTRACTOR
ROSILLO CARLOS OWNER
30752 KANSAS ST
LAKE ELSINORE CA 92530
A. P. # . . . . . 378-284-014 1 SQUARE FOOTAGE 672
OCCUPANCY . . . DWELLINGS, LODGING HOUSES GARAGE SQ FT 0
CONSTRUCTION . . TYPE V- NON RATED FIRE SPRNKLR
VALUATION . . . 1, 344 ZONE . . . . . . NA
BUILDING PERMIT
QTY UNIT CHG ITEM CHARGE
BASE FEE 45 . 00
9 . 00 X 2 . 7500 VALUATION 24 . 75
1 . 00 X 5 . 0000 PROFESSIONAL DEV FEE 5 . 00
FEE SUMMARY CHARGES PAID DUE
PERMIT FEES
BUILDING PERMIT 74 . 75 . 00 74 . 75
OTHER FEES
PLAN RETENTION FEE 1 . 00 . 00 1 . 00
PLAN CHECK FEE 52 . 31 . 00 52 . 31
TOTAL 128 . 06 . 00 128 . 06
SPECIAL NOTES & CONDITIONS
LATHING OVER PLYWOOD 544SF EXTERIOR
BACK SHED AND 128SF AT FRONT PATIO. TO
APPLY STUCCO COAT.
Date: 3/09/84 89 Receipt no: 4383
Total tendered $128.06
Total payment $128.06
1 I'Ieise•Read and Initial
I I am I.—nse•e1 under the- provisions of I3usmrss and Troll�sIonal
Ccnit Sew uon 0(C1 el srcl and tin he rose•is in full fon e
1)Utit in Conq)Ilumis place 2 1 aScmmcrofthe proprty orfm eniplovet-sw/wAge, is their soly
enrnpensation will do the work and the, siren lure is not intc nde d or
Ilfl l�)e �1)�) 3Ih red for sIv 3 I asouc rot the,propem amcxetusheh•mntradmkuvfhUrrnstd
contractors to construct the pm)ec t
vl''U 11 R\111 VPI R .'11,1 4 Ihavracrrltftcdttofe rinse ntto wlfinsun•orarerhficatrofWorkcrs
1P iri• '. tl,` 1 /�7-;z�7Compensationinsuranceoraeumfic•dcopvthereof
5 1 shall not employ any per on In anv manner so as tobe•e orne•subjc•c t
o µorkrrs Cmmprnsauon taws in the p•rfornianee of the work for
which this fx rmit is issutd
Note If you should tx-romv suhlcsn to Worke rs Cornpe nsanon after
making this re ruficannn you must torthwith romph with sue h pro-
vi.ions or thin pavlmi shall hr de-emed re%nkeel
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ADc+a.'al requires prior to the
-- S e-e = Lx Jcinc t},nq rcleas- by the City,
PJ.3 ?U e
Da•e Instiector
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City of Lake Elsinore
130 South Main Street
APPLICATION FOR APPLICATION NO.
BUILDING PERMIT 04 - 04
APPLDATE ATIO�I CEJ� J
DATE .:J�� �
VALUATION CALCULATIONS AP s By
1 st FLOOR SF BUILDING ADDRESS S L/�('e /e e.17 S 3a
2nd FLOOR SF TRACT BLOCK/PA E LOT/PARCEL
3rd FLOOR SF
NAME
GARAGE SF
STORAGE SF Z MAILING PHONE
ADDRESS
DECK&BALCONIES SF
CITY
OTHER•�^` ///��� c �
�` —' SF I hereby affirm that t am licensed under provisions of Chapter 9(commencing w'th Section
1000)of Dtvis,on 3 of the Business and Professions Code and my license is to full force
and effect
w LICENSE 0 CITY BUSINESS
Z AND CLASS TAX N
VALUATION: ` g NAME
FEES MAILING
ADDRESS
BUILDING PERMIT $ CITY STATE ZIP PHONE
CONTRACTOR S SIGNATURE DATE
PLAN CHECK
ADDITIONAL PLAN CHECK NAME LICENSE
u
w MAILING
= ADDRESS
U
K
Q CITY SIATE,ZIP PHONE
❑NEW ❑REPAIR OCC GRP / CONST
DIVISION TYPE
MICROFILM ❑ADDITION ❑MOVE NUMBER OF NUMBER OF
❑ALTERATION ODEMOLISH STORIES BEDROOMS
COPIES ❑OTHER ZONE
❑SINGLE FAMILY units HAZARD AREAS YES NO
IMPRO FEES ❑ SCHOOL FEES ❑ ❑APARTMENTS units
❑CONDOMINIUMS units SPRINKLERS REQUIRED? YES NO
❑TOWNHOMES units PROPOSED USE OF BUILDING
❑COMMERCIAL C7INDUSTRIAL
PAID I
PRESENT USE OF BUILDING
DATE
JOB DESCRIPTION z /!�� vC✓
certify that 1 have read this application and state that the
above information Is correct. 1 agree to comply with all city
and county ordinances and state laws relating to building
construction, on ereby authorize representatives of this
city to enter t above-mentto d property for inspec-
tion
Dote
AGENT FOR ❑ CONTRACTOR ❑ OWNER
AGENT'S NAME
AGENT'S ADDRESS
......
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