HomeMy WebLinkAboutBIRCH STREET 535_16-00000415CITY OF int
LAIIE 0,1_,SINOIL BUILDING & SAFETY
DREAM EXTREME TM 130 South Main Street
1 Lake Elsinore Ca. 92530
PERMIT
PERMIT NO: 16-00000415
JOB ADDRESS • 535 BIRCH ST
DESCRIPTION OF WORK . : OCCUPANCY PERMIT
OWNER CONTRACTOR
SIMMONS, BARBARA
A.P.## . . . . 377-150-022 0
OCCUPANCY . .
CONSTRUCTION .
VALUATION . .
DATE: 2/25/16
OWNER
SQUARE FOOTAGE . .
GARAGE SQ FT . . .
FIRE SPRNKLR . .
ZONE NA
0
0
OCCUPANCY PERMIT
QTY UNIT CHG ITEM CHARGE
BASE FEE 30.00
FEE SUMMARY
PERMIT FEES
OCCUPANCY PERMIT
OTHER FEES
PROF.DEV.FEE 1 TRADE
TOTAL •
CHARGES PAID DUE
30.00 .00 30.00
5.00 :00 5.00
35.00 .00 35.00
SPECIAL NOTES & CONDITIONS
OCCUPANCY PERMIT FOR ATM SPECIALTY
SERVICES, INC.
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City of Lake Elsinore
Building Safety Division
Please read and initial
1. I am Licensed under the provisions of Business and professional Code Section 7000 et seq. and
Post in conspicuous place
my license is in full force.
2. I,as owner of the property,or my employees w/wages as their sole compensation will do the work
on the job and the structure is not intended or offered for sale.
3. I,as owner of the property,am exclusively contracting with licensed contractors to construct the
You must furnish PERMIT NUMBER and the
JOB ADDRESS for each respective inspection:
project.
4. I have a certificate of consent to selfinsure or a certificate of Workers Compensation Insurance
Approved plans must be on job
at all times:
or a certified copy thereof.
5. I shall not employ any person in any manner so as to become subject to Workers
Compensation Laws in the performance of the work for which this permit is issued.
Note: If you should become subject to Workers Compensation after making this certification,
Code Approvals Date Inspector you must forthwith comply with such provisions or this permit shall be deemed revoked.
EL01 Temporary Electric Service
PLO 1 Soil Pipe Underground
EL02 Electric Conduit Underground
BPO1 Footings
13P02 Steel Reinforcement
BP03 Grout
BP04 Slab Grade
PLO 1 Underground Water Pipe
SSO 1 Rough Septic System
SWO 1 On Site Sewer
BP05 Floor Joists
BP06 Floor Sheathing
BP07 Roof Framing
BP08 Roof Sheathing
BP09 Shear Wall & Pre -Lath '
PLO3 Rough Plumbing
EL03 Rough Electric Conduit
EL04 Rough Electric Wiring
EL05 Rough Electric / T -Bar
ME01 Rough Mechanical
ME02 Ducts, Ventilating
PLO4 Rough Gas Pipe / Test
PLO2 Roof Drains
BP 10 Framing & Flashing
BP 12 Insulation
BP 13 Drywall Nailing
BP 11 Lathing & Siding
PL99 Final Plumbing
EL99 Final Electrical
ME99 Final Mechanical
BP99 Final Building 2.2/4 13
Final Signatures are Certificate of Occupancy for Single Family Residence
Code Pool & Spa Approvals Date Inspector OTHER DIVISION RELEASES
SPO 1 Electric Conduit UG Depat tment Approval required prior to the
SPO2 UG Gas Piping building being released by the City
SPO3 Pool Steel Rein./Forms Date Inspector
SPO4 Pool Plmb./Pressure Test Fire
SPO5 Pre-Gunite Approval • EVMWD
SPO6 Rough Pool Electric Finance
SPOT Pool Fence/Gates/Alarms Engineering
SPO8 Pre -Plaster Approval TUMF
SP99 Final Pool / Spa Planning/Landscape
C ICY OF
LAKE LSITYOPJ±
D REAM EXTREME TM
APPLICATION FOR
BUILDING PERMIT
VALUATION CALCULATIONS
1st FLOOR SF
2nd FLOOR SF
3rd FLOOR SF
GARAGE SF
STORAGE SF
DECK & BALCONIES SF
OTHER:. SF
VALUATION:
FEES
BUILDING PERMIT $
PLAN CHECK
PLAN REVIEW
SEISMIC
PLAN RETENTION
I certify that I have read this application and state that the
above information is correct. I agree to comply with all city
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 insp-
tion purposes.
Signature of Applicant or Agent Date
Agent for contractor owner
Agents Name
Agents Address
1
i
130 South Main Street
APP CATIOt 4 7.I 4.7r
APPLICApCN CE,)_VEDJ
DATE — — l t/ )j
AP # BY
t --
BUILDING ADDRESS —
5 n „rs., , y f/
TRACT BLOCK/PAGE LOT/PARCEL
O
W
N
E
R
NAME
iAlake "PA .‹f 04 440 ,
I hereby a irm that I am licensed under provisions of chapter 9 (commencing
with section 7000) of division 3 of the business and professions code,and
my license is in full force and effect.
LICENSE # CITY BUSINESS
AND CLASS TAX #
tJO-OD7JHZOO
NAME
MAILING
ADDRESS
CITY STATE/ZIP PHONE
CONTRACTOR'S SIGNATURE e. -PAPE
A
R
C
H
NAME LICENSE #
MAILING
ADDRESS
CITY STATE/ZIP PHONE
NEW OCC GRP. / CONST.
DIVISION: TYPE: ADDITION
o ALTERATION NUMBER OF NUMBER OF
STORIES: BEDROOMS: o OTHER
SINGLE FAMILY ZONE:
APARTMENTS
CONDOMINIUMS HAZARD YES
AREA ? NOoTOWNHOMES
COMMERCIAL SPRINKLERS YES
REQUIRED ? NOINDUSTRIAL
o REPAIR PROPOSED USE OF BLDG:
PRESENT USE OF BLDG: DEMOLISH
JOB DESCRIPTION
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