HomeMy WebLinkAbout1108 SUMNER AVE_ (2)
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ss"T t Adduce
Asaesss iv Pored No. CITY OF LAKE ELSINORE CONSTRUCTION PERMIT
Address name Applicant to fill in all spaces except thosz within h
Atldress /�U s � �----;hone is�4 2 PERMIT envy border lines and gr
��-- TRACT +all appropriate declarations
Arch+t rig- N0. LOT N0,
Acid(osl, License No- �_ mEOFCON$TRIICTION UNIT N0.
Contra,1,,,5 Name 1l CONVERSION ( NEW E` ADD
— ( IPiERSOf DEMOLISH L ' r' ALTERATION
Addreulnsad,ngl__ Phone WORX,USE F LOG
.REPAIR
C,tylrccnseNo. TTPkGF/E1fMR ,�� A.P. #
f.ICENSEO CONTRACTOR•7Er:1-ARATION GRAD kG 1-, FOUNDATION--�t��` � E Main Building
I hereby atlirm _ TENANT C' ELECTRICAL -�
gnat I PLUMBING r. RUCTURAL
with section am I'CO^sea order ❑ OTHER _ MECHANICAL T Front �-- Accessory Building:
7000) of Division pro,r.s,ons o!Charter 9 com0
MY license 1s In full force 3 of the t;us,ness and Pror ( me.and PROIECTOESCRI:TION: _ �---__ 6 R��—__
o ce and effect. ess,ons Code,and 2
License Cl,g Cmstructron Ft
--occupancy --� A
Date_ ur License No, hDe ---�—_ Zone D r C p
S17nature Valuation j___ �� Right -"�-- N
WORKERS,COMPENSATION DEC -- �r� K
t hereby affirm to LARATION —�-PCF ��_ S Left .— �!__ f
of reby a f at I have a certificate or consent to selNnsure or a Rem - N
3800. C4'nP_ensatlon Insurance, or a cer?!tied co cerlficate Ping. Ref.#
LaD. C.1 PY thereof (Section
Po No. _ -_�__ Planning Notes Parkin Req./Provided R
Cer t+h¢If copy Is hereby Company E
Car I11'e Y furni,ned
Date d copy Is filed with the City BuildingI Q
Applicant Division. M
EXEC+tPTION FROM WORKERS' -------
(Tnli etction nefftr not be com I COMPENSATION DE
less), _ P eletl it the Pecmrt,s for one h RATION �-
I r SNIP
nofFY that ip the PerfGrmance of the wOlk , died(S300j pr
shall not art d an -��_�— _ _ y•-
y Y DCrsOn in an aftil d h Per t is•Slued 1
Workers'Co Y manner _
Ore _ en on Laws of California. or^ DjecI tp tl,e --
NOTICE:1 ,,r1 �¢,Trrra,��;,g this
y PLUMBING -Workers, cnmp¢nsa;,on s declaration, - — Alter `fie air FEES ELECTR��
cartiDlY will' such °`^v'sions of th or 11I.Se o^snuu° eco,ne subject to the Od FEES
CONSTRUCTION LENDING u-or to ¢ You must forthwith Auto Wash Generator 00-5KW MECHANICAL
perm;. snarl De deemed revoked. 0 5.15KW -'�----- _i�EES
I f the Work that trier¢s a construction lendin a Construction P Boiler
Of ilia work for wri, BackflowPreventer -�_oleSub. ACCf.x 6RAOiNSFEE$
Lender Name �n t^'s permit Is ,ssuea giS�Ct'on!Or`he Performance Backflow Irri lion COOkin Uriit OOct•U------ round Lend•)rie Address —` -- �"'• �•j Pole Liah DuC_Structural
OWNER -_-- -- _._ _ �-`—"-- -- Clarifiers t
_ ct'
9UILDER DECLARATION u.yards
Dish 0 ers OG„—�--- Fan .'/entlla fill:
I hereby affirmreason
that I am exempt from the Contractor's Vt/dSaeF Electric Y401 Cu.Yards
t°I+owmg reason (5¢ct+on '031.5 Eirom tsand Pr O1 Fan Exhaust S slam Plan Check fees
Coun'v which requires. er License Law for the Fixture T
an s„ s mil c constr ess:onal Codc:qr s ea. 3225
y vctur¢,poor to its rssuarte,al uct,ai•.er,Im , y city or Floor F•A.U. - Eva Permitf
to file a signed statement that he/shy is requir p OvV'demOlis^Or repair Drains orative Cooler
licen a ihr,ppl,Cant for Such Permltness Floor Sinks S --���--
Me&-priCon 3rof t Licensusie O pursuant t:;:he FIX1UrQS Heating S Total fees j
therelrn 3 OI the Basis andhPpofes9,ons Codec�o9 with Section?000)ofat
Gas SeryiC DUtlets �-" Ufl 100 0 gem R Ducting -��
'031.5 p and the b o the alleged exem ) that he,•,he is a Outlets 000 BTU 0100 000 BTU r
y ally apOlirant farPerm.t .'ec's +tnY violation or exempt {nterce tor, Switches_ Hood or Canop.yvo_
s�¢r131Ly•nt not more t'lan five hunrired ollarsb'ec!s th¢ SQctler
I. as owner I (SS00). aPPtic,nt to a civic Meter f U to 200 am $ T eYp 1
P Tra �+mmiry of Permit let s
fo sale (Sect
1 the a walk
pr fth Cmuctures with wages as their sole Roof Drains a II u for sal¢ will do t^¢ wmk and the structure rf not i ages d Or a rt¢,¢d Meter Refrl
(Section 7044, Business and Processional ❑ OYet a"00 amps Refrigeration SySte 3710 Building j
License Law does not apply to an owner of a ore _
thereon, and who does such work himself herself Code. "lie Contractors Trailer$ewer r Sub pane'1 00.100 000 BTU 0100 000 B
empl0 CBS, Deity who builds or i -•�-_ BTU f^Proves •'�721 O
sale, I PrOr.the
[her Sonq ;r„mov¢m¢nts are not �nt¢nded or ofr¢r¢d for Sewer�'-'—'� Fire I/Fact.Blt.ICBO ,'sueBT Plumbing �/� �
/ Or ^rough his or her own j --/�
MS.
w ffhaveiq or improvement �f sold within p Transformer 15.50KW 3222 Electrical _
PIC11On, the Owner will have the burtlen or proving he/she did not build Or Corn.
Sewer Connection-Bid _ $Vstem Repair/Alteration j
prove cot the Purpose or sale), one year of com• I 0 50+KW 3223
`i I.as owner of the Solari Collectors--g-4-- Motors[]0.1 HP Fire Daniperss Mechanical
tractors to construct tneTprojey.am axe cnntract,rg with licensed con• 01�i $
Inc. Solar Re isters 3224 Retertlon j
The Contractor: °`Oje.1(Section 7044,Business and Professions Solar Piping - C19.15 HP 016.15+
o,r,ICS or Improves inereon sa a who not
far such o essions Code: 2301 SMIP Res.
Ir proof
D°lt fO"^°N^er of property who Solar Tank — Sing/_. Fem__Res. - Incinerator j
PrpOf (ft license pursuant to the Contractor• Pr( with a Co _ 2302 `"—
o((their WOrker'9 Cnmp¢rs,tion msurencicense aw I SWifnmin POoI MUlti•Fa Mise. SMIPC0.T, j
). am aware the! /S a __`
L I am exempt under Section.--- $no la be 3225
_ _ Ovided ea me. Water Heater Swimmin PoolIS a Other j
Date .j/�,, /'� - & P far rn,sreasrn — --- —_ SYmmaryolPlanChtekFitas --:
�'/'�'-r-+-�- Owr•.er _ grater$._ Q- rv� iC,-e_ -
I hereby CerhlY that t naive read tt,it( r-- ISSUE -�— - 340{
r,iformat,on Is co Ito apol,cati $2 tip stem Building s and state law$ vela I +r COrnp,a with ,i and state !hal the _ .-_
:elicit Ives of 9 „I n9 construction,andYne a count above millPlumbin ,--"--'
ins pection this it v oizeroare.ances MWLOPMENYStE
Purpof Y e er upon trio above• Y authorize roPre- RYR SRE l Electrical -—` —
I
Signaure _ �j' ^�=ntibn¢d pro oil for QUREMENTS: j _
Drivers'Licens 7cnindAPofowefT M cA1nlcal '�`—-
r ss t► Date /r yv
Building+ Whrtt•Btoldmg ' Aptravil IssueCanerT•irm
---- — M0q 3403 Other =oenrod ADa ryFile CoDY P:nAssessa: 1wfr
Dh ant 3412 Planning j _----'-�—"`—_—
—
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S
CITY OF LhKE ELSINORE
BUILDING DIVISION
O W N E R - B U I L D E R V E R I F I C A T I O N
A city or county, which is required to give notice pursuant to
Section 19830, shall attach to such notice, and, as a condition precedent
to issuing a building permit, require the completion and require the return
of an owner--builder verification.
Attention Property Owner:
An "owner-builder" building permit has been applied for in your name
and bearing your signature. No building permit will be issued until this
verification is received.
1. I personally plan to provide the major labor and materials
n
peos nstruction of the proposed property improvement.
No
2. 1 (have/have not) "v , e-- signed an application for a
building permit for the proposed work.
3. I nave contracted with the following person (firm; to
provide the proposed construction:
Name _
Address
,gyp Phone ( ), Contractors Lic. #
4. I plan to provide portions of the work, but I have hired the
following person to coordinate, supervise, and provide the
major work:
Name
Address
Phone (714) Contractor's Lic. #
5. I will provide some of the work but I have contracted
(hired) the following persons to provide the work indicated:
,name Address Phone TLme of Work
(If additional space is required attach subcontractors List. )
I hereby affirm that I have received a copy of the information set
forth in Section 19830 of the State of California Health and Safety Code
and have complete the above information to the best of my personal
knowledge, in com is a//�it4 this State Law. /
Signed. � Date: __���
Name: er✓ �r.y
(Pr nttbd or Typed)
Drivers Lic. # or Soc. Sec. #
. t
' alwaoor ..
Prn^ecI Aridro,,i _ �
CI i Y OF LAKE ELSINORE CONSTRUCTION PERMIT T lL��a-_
Assessor's Pore yr No. __ _ Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations '
Owner's Name 1 L , , ;•-
�11.�t1�• 1�..--� 4 a1/l__Pho e -_-"--- -- FNQ. ,. �. ,:-t, �f �/ ' iRACi NO. I lQ. NO. UNIT NO.Addrress �y��G� L " L _/� ��VArchlEfg. L,cerse No. _ _ ODIISTRWrR?N HEY+ ADD Address 0!YtERSIOh DEMOl15+1 ALTERA'14.1 REPAIR
OTHER Contractor's Name-__ RIPTION OF WORK/USE OF 6LDG - —- A.P. aa: Z e
----. Phone -- _ E�Main Bui�ding:
Address imaiiing! _._ _ TYPE FERMR GRADING FOUNDATION STAL4 TL!41(L - ACCessop Building:
LICENSED
License No. iENAhT :] ELECTRICAL 1 PLUMBING �1 MECHANICAL
j F Front -�^ - -�Z
ILICENSED CONTRACTOR DECLARATION OTHEk A Rear N
I hereby affirm that I am licensed under prov sions of Cnarter 9(comm, in : 'ECT DESCRIPTION: I
with section 7g00) or C-vision 3 of the Business and Protessior.s Code.and OCCupanLi Rignt
my license is in full force and effect. CC'sbu=Iran type ZoOe _ K _ r I N
_ ACttt n -I!G
License Crass `•a��, _ g Left
------- Ltcrnsc No. f __Is,
Cd
Date—_---. s+gnature — Ping. Ref.r R
I WORK`eR5'COMPENSATION DECLARATION Remarks �.� _ �7 - �n Beq, rrItyided ,n 'E
I hereby affirm that I have a certificate or consent to self-instire nr a certivcate /� - Planning Notes
Of Workers• Compensation Insurance, a- a terrified co
- C.) Ry thereof (Section 3d00• Lab
Policy No. Company-_ _ _
8 Cerdfletl cnpy IS hereby furnished. .. ;
Certified copy is filed With the city Building Div lion. - - - ,
- Dale-- ---- Applicant_ - ._ - -
AKE I-
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION _(7h
less)•K section need not be co,*lpleled rt the permit is IN one hundred(S100)or - -
i certify that in the performance of Ilse worn for which this perrr•il is isSued I shall not employ any person in any manner so aS t0 become ;ttblect t0 the PLUMBING _ FEES
bvorkers• Compensation Laws of CJrisorni2. ELECTRICAL FEES _ __ MECHANICAi_
flat¢ --_____-----signatdrC ___ Alter, Re air Te�erator CO 5KW Cl 5.15KW FEES p GRADIR6 FEES
No,ke If,after making this decide dtiO n,you sr'Ou,d become sub,ect to The , — :B Boiler
' %
workers' CnmpenSatiOo Drovismns of the Labor Cnde, you must forthwitri Auto Wash Construction Pole Sub. I
CONS w.th such pr.iv,sr.Snt or this permit shall be deemed revoked. I S - _ _ Duet-Under GSound 1 Cut' _Cu yards
coNsrRucTloN LENDING AGENCY Bacl; low Preventer Cooking Unit -f' ---r- -
I hereny affirm Inal there,s a construct,nn lending agency for the pCrte:malice _1 DUCt-SIfU[tUfal I ill _Cu.yards
M the wcrx for which Iris permit as issued (SectioP 3,a7 civ_ e•) -.� Baekflowlrri lion POIe Light r Fan -Ventilating ; 33603310 PIar.CheckFref
Lenders Name Clarifiers —. Gr 2rs Gas LODI Electric I -Lenders Addres _ ___ _ Dishwasher Exhaust S ;rem ��- 330C-3312 Permit fee f
OWNER BUILDER DECLARATION - - - — ---I Fan Evaporative Cooler _I hereby alfir,n that t Jnt exempt from the Conira[tor•s KCnSe Law to+the L FIx1Ure Tra s ea. , Total Fees ;
F.A.U. + Heating System& Ducting
1.,uowinq reason (SCCtion 7031.5 Business and Xtractsronrt Code: Any city or Floor Drains
CJun1Y which reyu,res a permit to cc.^.struct.actor,intpro,e,demolish or repa,r Fixtures �:0-100.000 BTU C 100 000 BTU 1 __
Joy structure,Prior to its issuance,also rertu ci•ehe applicant for such permit Floor Sinks --- - l-"-
to foe a s,ctor statement 'hat hC;ihe is ficci.(commencing
ring with
to the provisions o7 �- _ Outlets }- Hood or Canopy 3300.3312 Sitmmagofpermitfees
the Contractor's License l.Jw(p;apter 9(commencing rirth Section 700r.)of ems.,Gas Service Outlets SWIiCIteS I �)
Divaion 3 0l the Business and Professions Code) Or that he/she is exempt nn Type 1 ( � Ty a II r
USCreffom and the basis for the a11C9Cd exemption. Any violation of InterCe 1gr$ Meter❑ U t02013 a1 $- Building ;
7o31n ny anv applicant for Section _ _ p ___ I Refrigeration System
05 Ve-m,t subjects the applicant to a civil mere r
pet Icy of not more than five hundred dollars($50o). 1 Meter LJ th!ei Z00 E30.100 000 BTU L1100,000_BTU Plumbiq ; --
•�L. I, as ow;'e' of the proPcrty "I my VITIDIOyees with wages as their sole Roof Drains Met and —��
Compensation, will d0 the work,and the slrurWre is not intended or offered _ _ Firepl/Fact.Bit.ICBQ •i Elci.trltal f _.Or sale (section 70•;4 puniness and DrntesNpnal Codc: The Contractor's ' Trailer Sewer _P C3 15 )I( —
Lrcensa Law 00"n0l apply In an owner of,t prnper:y who builds or improves Transformer '� System_Repair/Alteration�_ Mechanical f
tnCf^_Oh, and who rtotr3 Such work h,mSelf,'hCrSCIf Or through his or her Own Sewer Cep (�'50+F_VY _ _ -'•--
ernptrM�•ees,PrOvi.'ied that such improvements are not -tended or offered Inr Sewer Connection-Bldg. _ Fire Dampers -' other S _sale. If,however,the htl,ldin(j Or,mprOvtiment is SOld within one_C:v of tom• 9• Mo10rs 0.1 HP❑1y, ii Registers_ ___ •-_-- I10231 _
orova!, the owner will 'save the Durdfln Of provlh9 t1C/She did not tv,ifd or irn• I Solar Collectors _ SMIP Res f _
prove!or nc�purpose o1 sale). Inc. Solar 1 A-15 HP(.-;16.15+' Incinerator-' _ '- 11.232 -
I,a, owner o1 use Solar Pi is - - _ SMIPCom f _
pr project
Sc unn 7 vcly cn inoss rng Prof Issi nscd con* _ p B _ Sing/Fain. Aes.
tractors to c9nsU UCt the prnleCt(S^_cttr.n 70.14,Business and Professions Code+ -"- Mist:. r --
Th¢ COrtfaclor's License Law dues not apply to an owner of property who solar Tank Multi Fam. Res ----_ 3360.33i0 SummaryotP{mChecMfetp
tiuilos ur improves Marenn,and wnn contracts for such Prolocts with a Cnn� - - _ -~--_-�_tsactnr(S) lir•¢nse pu,suan: In the Contra,lor•s t_Icrnse aw). I din Lware that Swinminq Paol/ a Swimming 1001/� a .- —�-
prouf of their Wof'(Wl CnmlyCn Sa Don inilrrdrt[¢ Sho Itl bC providedm;,w to mil. _ Water Heater _ �"-��• _
Bulking ;U 1 Jm exempt under Section ____. _ ._ G P. Inr this lease: - - _ Issue
_ _ Water$grvicspop
P6;mh nj f
Ga•n fi 'O f (),net '-•--- - _- �_SP�,c steltL��- - fkchical f _.
1 Heil.., eC,l,fy Ittdl 1 hhvC lea chi ape a1, n and 59a1C -That Ina above
�-
and st anon rs coif I dgr¢0 tr comply Plth I city and county nrd,nancos �i�' CEVELOPMIENT!EAKASREQUIREMIENTS: Mocha heal and Slate laws rot t boil nq cor.struttir anq hcr¢by duthorixe there- b4ing Approts►,d fir_
santativCS of Uhl rr(V O e, er T n the d bove•m¢nfinned 1►a� - Dtket ; - -_
nspect,nn pulp / 'Pry' ony Inr _ _ 8tl{Win�Apptogdsr __.'�-
s,naf.nC . vale - 1��J! Issue Appficatiol;ISMd R -� - DaN `r 3360 3315 Planning ;
[)r_Qrs_LrCenterrS5yt{ . S:-� --- --,Dale = - �
hdcBulki:ng Green Temporary File Copy:CanaryAssesmr, Pink Apil!cant:Goldenrod-Accounting To41 Fees Out S • ' ��-^
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CITY OF Lmm ELSINORE
BUILDING DI7ISION y
A city or count J
Section.15830, shall attach which
his required
to
to issung a , shallto M-ildin give notice pursuant to
of an owner-builder verification.�2re the Completionaandore wire precedent
q' 'fie return
Attention Property Owner:
and bearing"Owner-builder" building permit
Your signature. no ul d.n has been applied for in
veri-icat_ion ece'v�ed. 3 ermi wille sued Your ,lame
un� t_ his
1., for personally plan; to provide
�cnnstruction of the r� the major labor and materia?s
VYes No p posed property improvement.
2. I (have/have not) `
building permit for the proposes signed an application for a
3• I have contracted with tha
provide the proposed constructiorfollowing person (firm) to
Address
Phone ( )
Contractors Lic.
4• I plan to provide porn-.
followingdons of the worY_, but I have
person to coordinate, supervises hired the
major work: , and
Name provide the
Address �!
Phone ('l4
T ) Contractor's Lie.
5• will provide some r
(hired) the following o� the work but I have cont_
acte
name Persons to provide the work indicatedd
s�v ddress one Type o3 Wo•-
(If additional space is re ,...
required a"ach subcontractors list.)
I hereby affirm that
forth in Section 19830 of I have received
and have complete the the State of Califoia Hea Of lthe information set • .
knowledge, in complianc wove information to the bestnd0.Smfety Code
1 ..his State Law. Personal
Signed.: �� . .
Name:
Date:
��-
(Pr i ted cr Typed)
D-rivers Lie. or Soo. Sec.
1