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Home My WebLink AboutKIWI WAY 16511_04-00002073 City of Lake Elsinore v + PERMIT 130 South Main Street PERMIT NO: 04-00002073 DATE : 8/11/04 JOB ADDRESS . . . . . 16511 KIWI WAY DESCRIPTION OF WORK PRIVATE SWIMMING POOL/SPA OWNER CONTRACTOR MONTEJANO ROSS CONNELL CONSTRUCTION HANSON KATHERINE DBA: PACIFIC POOLS & PATIOS 16511 KIWI WAY 17130 VAN BUREN #47 LAKE ELSINORE CA 92530 RIVERSIDE, CA 92504 909-485-1891 LIC EXP 0/00/00 A. P. # . . . . . 389-424-001 1 SQUARE FOOTAGE 0 OCCUPAITCY . . . GARAGE SQ FT 0 CONSTRUCTION . . FIRE SPRNKLR VALUATION . . . 10 , 140 ZONE . . . . . . NA BUILDING PERMIT QTY UNIT CHG ITEM CHARGE BASE FEE 63 . 00 9 . 00 X 12 . 5000 VALUATION 112 . 50 1 . 00 X 5 . 0000 PROFESSIONAL DEV FEE 5 . 00 ELECTRICAL PERMIT QTY UNIT CHG ITEM CHARGE BASE FEE 30 . 00 1 . 00 X 44 . 2500 POOL ELEC SYSTEM, PRIVATE 44 . 25 1 . 00 X 5 . 0000 PROFESSIONAL DEV FEE 5 . 00 SWIMMING POOL/SPA PLUMBING QTY UNIT CHG ITEM CHARGE BASE FEE 30 . 00 1 . 00 X 5 . 0000 PROFESSIONAL DEV FEE 5 . 00 1 . 00 X 54 . 2500 PRIVATE SWIMMING POOL 54 . 25 1 . 00 X 11 . 0000 WATER HEATER OR VENT 11 . 00 1 . 00 X 4 . 2500 GAS PIPING SYSTEM 4 . 25 FEE SUMMARY CHARGES- PAID DUE PERMIT FEES ^ Q BUILDING PERMIT 180 . 50 . 00 18 . 5 ELECTRICAL PERMIT 79 . 25 . 00 7 2 SWIMMING POOL/SPA PLUMBING 104 . 50 . 00 10 AN 1 1 2004 OTHER FEES i I PLAN RETENTION FEE 3 . 50 . 00 5 SEISMIC GROUP R 1 . 00 . 00 � . 00 PLAN CHECK FEE 131 . 63 . 00 13L.-63__.___ *** CONTINUED ON NEXT PAGE *** Please Read and Initial }. I I am tjcen_ad under the provisions of Business and Professional Code Section 7000 et se•q and my license is in full fort e Po,;t in l't nspicuouN place 2 1 asoA-neroftheproperi� ormv emplovee•sw/wagcsas their sole compe-nsduon will do the work and the structure is not intended or on the Joh ofTercd for sale 3 1 as o,--ner of the property am exrlusheh rvntractmg with licensed contractors to construct the project 4 ]have acertlticateofconst-tittoselfinsureora certificate o(Workers If i}� \f)f)?`} �� ' . :•.1 i'c'-u` i Compensation insurance or a certified copv thereof 5 1 shall not employ anv person In and manner so as to become subject " to µorkers Coompensation Laws in the performance of the work for which this permit is issued Note It iou should become subject to Workers Compensation after making this ceruficauon you must forthwith comps with such pro- visions or this perms shall be deemed revoked C:.ce Ax,7 D?e I^sz),-,J' �LC T e-o;:ea Se ies �L_2 a C?-c_ IJ^cr ro c �2 S'ee re-c ce—ee 3P:.3 u-J_ gPs S2_G are PLC.' IJ-Oe -c'ha e• :e SK, %_.- Seo•:S,s e— S" G-S-e Sep..y a•":_ 7 .. r f= L-t-__ a� as-- Coce °x s Sea 4,a:,c a s Da e ti^s:-r_ OTHER DEPARTMENT RELEASES De- )-s Lti e.3 r,7T1t'nt Azp rJVaf required Pf10f to I}'lE PO: moo Se- �;e,- F J—s outlaing o&N released by ttie City D!Dc Px P'_-y- o-eV Te5 P003 P e G_- e Da`e Ins ctor LLJE Aa_;-Px Eeti -c P,a S_7 L c Ayic••a I a-c, aDe DX_ PJu Fe,:- tee« Finance Dx,S �e as Enameenno PX13 F-a PJa Sx i _ fLakeElsinci oo e PERMIT 130 South Main Street PERMIT NO : 04-00002073 DATE : 8/11/04 ** PAGE 2 JOB ADDRESS . . . . . 16511 KIWI WAY DESCRIPTION OF WORK . PRIVATE SWIMMING POOL/SPA FEES : (CONTINUED) TOTAL 500 . 38 . 00 500 . 38 SPECIAL NOTES & CONDITIONS POOL AND SPA Please Read and Initial 1 I am l.rn•nsed under the provisions of Business and Professional Code Section 7000 et seq and my license is in full force Pwst in C LIIISI)iCUOUS I)kIC'C 2 1 as owner of the property or my cmplovers w/wages as lhelr sole compensation will do the work and the structure is not intended or tlll the jllh offered for tialc I as owner of property the project usheh cvnlracUngwathhcensctl contractors to construct the project Iha%earertiflcateolconsenttosel(lnsureora certificate ofWorker-, Il)t� \1)1 tkl �� i, r C•.h i t \i,` Compensation insurance or a certified copy thereof 5 1 shall not employ anv parson in any manner so as toberoine suhjt%ct " to corkers Coompt nsation 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 certlfirauon you must forthwith romptv with such pro- vi.ions or this permit shall be deemed rrsoked Cooe Anly .a s Dr a I-Szec o ELC' Te-o E ec Se-. :es Dt3 So- P y_U-ce•-c_-C ` EL32 E e_Co c- U-cr7o_Ic ? BP'3' FOO -.Gs BP1-2 See Re'o•ce—e— BFn3 G o_ B,'- San G-aee DLG' IJ--oe -a-c Y"a e,P,oe SSJ %, S,- c S.s e— S'::3 O'S e Se.e Q7-C PP -a�- BF 3 D-,via Jam ' \ r\� C, BP La Sc-ti V J\ \ ' e� -,�' ICE=3 -a Me -a',:.a --c Coce Poo s S.,a Aazxora 5 Da a b- J. OTHER DEPARTMENT RELEASES re^ is ` '' �} y Cep2rvne-nt Approval required prior t0 the PO Poi, S,ee De- Fo—s budding being released by the City FJC' P,,o P*_—rr--P*ess Tes cr 1 / POt?3 P•e G-- e ?j 6 Da•e Inspector ELJE Ro-g-Do e ' C --`y L c, E Pia-- S_oi_ •A,,,,,.a d La-csca-.e Pp;,:. DC-0 Fermi-r Access y Finance D w5 P e Pas e L Enoineenna "I'D, F—a Poo S243 City of Lake Elsinore 130 South Main Street APPLICATION FOR APPLICATION NO a0� BUILDING PERMIT APPLICATIO f 2DATEi-- / VALUATION CALCULATIONS 3� Y;;q-, �// BUILDING DR 1st FLOOR SF (/W/ TRACT BLOCK7PAGE /PARCE 2nd FLOOR SF NAN'3rd FLOOR SF O 5 QV W MAILINGP N GARAGE SF N ADDRESS I WI E IT T 1,�' r-0 STORAGE SF R f� �J hereby affirm that am-ficensed under provisions ot chapter 9(commencing DECK&BALCONIES SF with section 7000)of division 3 of the business and professions code,and my C license is in full force an effect OTHER: SF O LICENSE# CITY BUSINESS N AND CLASS /�4-n�rAX# U T N VALUATION: / R C ADDRESS FEES TO CITY V STAT I5� PH �G BUILDING PERMIT $ R CONTRA SI NAT R T PLAN CHECK CENS A PLAN REVIEW 35'- w R MAILINGj� C ADDRESS 1 SEISMIC H CITY PLAN RETENTION ❑NEW OCC GRP./ CONST ❑ADDITION DIVISION TYPE ❑ALTERATION NUMBER OF NUMBER OF ❑OTHER STORIES BEDROOMS ❑SINGLE FAMILY ZONE ❑APARTMENTS ❑1 certify that I have read this application and state that the ❑CONDOMINIUMS HAZARD YES above information is correct I agree to comply with all city ❑TOWN HOMES AREA? NO and county ordinances and state laws relating to budding ❑COMMERCIAL SPRINKLERS YES construction,and hereby authorize representatives of this ❑INDUSTRIAL REQUIRED? NO city to enter upon the above-mentioned property for insp- ❑REPAIR PROPOSED USE OF BLDG bon purposes ❑DEMOLISH PRESENT USE OF BLDG �Q/� JOB DESCRIPTION U/ l l 00 Agent for Zcontractor El owner Agents Name Agents dress Street City Stat Zip City of Lake Elsinore 130 South Main Street APPLICATION# APPLICATION FOR PERMIT APPLICATION DATE AN BY ELECTRICAL/PLUMBING /MECHANICAL BUILDING ADDRESS I hereby certify that I have read this application and state that the above information is correct I agree to comply with all city and county TRACT BLOCKNAGE LOT/PARCEL ordinances and state laws relating to budding construction,and hereby authorize representatives of this city to enter upon the above-mentioned O N property for inspection purposes L(( df WN MAILING ;IV','PH S$ E ADDRESS ( ONE 47"I?�R CITY S TE/ZIP Agent Date 1 hereby affirm that I am licensed under a provisions of Chapter 9(commencing C with Section 7000)of Division 3 of the Business and Professions Code,and my role one) O license is in full force and effect AGENT FOR NTRACTO OWNER N LICENSE# 1 CITY BUSINESS n T AND CLASS ✓ AGENT'S NAME UkkAkJ 1 QaW A N i lG 6 O 1 AGENT'S ADDRESS I v C MAILING �,� ` street city /) state( 1 yg T ADDRESS (� �tl.L�—/)fvl bQA O C1TY STA f PHO R L CONTRACTOR'S SIGNATURE ELECTRICAL Quan PLUMBING Quan MECHANICAL Quan New Res.Multi Family/SQ. FT. Fixture or Trap F.A.U./Furnace/Ducts/Vents New Res. Single Family/SQ.FT. Building Sewer F.A.U./Furnace/Misc./> 100000 Pool Electric System,Private Rain Water System per Drain Floor Furnace/Vent Switches/ 1 st 20 Private Septic System Unit Heater/Wall Heater Switches/Over 20 Water Heater/Vent Install/Relocate/Replace Vent Receptacle Outlet/ 1 st 20 Gas Piping System 1 -4 Outlets Ventilating Fan Receptacle Outlet/Over 20 Gas Piping 5 or More Outlets Evaporative Cooler Lighting Fixtures/ Ist 20 Dishwasher Ventilating System Lighting Fixtures/Over 20 Solar Tank Exaust Hood Residential Fixed Appliance/Outlet Solar Collector per Panel Fireplace Non-Residential Appliance/Outlet Grease Trap/(Interceptor) Commercial Incinerator 100-200 Amp Service<600V Install,Alter or Repair System Air Handler> 10000 CFM ' 200- 1000 Amp Service<600V Lawn Sprinkler System Air Handler< 10000 CFM Misc.Apparatus,Conduits,Etc. Backflow Device Smaller than 2" Fire Dampers Signs Backflow Device Larger than 2" Registers Sign Branch Circuit Floor Drain Compressor/Heatpump-3 H.P. Busways/EA 100 FT Floor Sink Compressor/Heatpump 3- 15 H.P. Temporary Power Service Water Service Compressor/Heatpump 15-30 H.P. Temporary Power Distribution System Alter or Repair Drain or Vent Compressor/Heatpump 30-50 H.P. Motors/Transformers Fire Sprinklers per Building Repair/Alter Misc.HVAC Motors up to 1 H.P. Swimming Pool Compressor/Heatpump Over 50 H.P. Motors/Transformers 1 - 10 H.P. Swimming Pool/Public Motors/Transformers 10-50 H.P. Swimming Pool/Private Motors/Transformers 50- 100 H.P. Water Heater/Vent Motors/Transformers> 100 H P. Replace Piping Replace Filter Misc.Replace Gas Piping TEST SPECIMEN AND COMPRESSIVE STRENGTH DATA SHEET PROJECT NAME Stafford INSPECTION FIRM Richard Lutz PROJECT ADDRESS 16511 KIWI Way INSPECTOR'S NAME Richard Luiz Lake Elsinore,CA INSPECTOR'S LICENSE NO On File PERMIT NUMBER 04-02073 SET IDENTIFICATION NUMBER N/A CAST DATA(ATTACH DATA SHEET OF OTHERS WHEN AVAILABLE) CAST DATE 10/12/04 DESCRIPTION Concrete Grout Mortar Shoicrete Masonry Prism Other GUNITE CONTRACTOR Pacific Pools+Ramos SPECIFIED F'c-PSI 2,000 CEMENT TYPE V SUBCONTRACTOR Woody CAST BY Pete ADMIXTURE N/A ENGINEER DM Pasol NO OF SAMPLES 1 WATER ADDED N/A CONC SUPPLIER N/A TOTAL YDS PLACED N/A SLUMP N/A PLANT N/A TICKET NUMBER N/A AIR CONTENT MIX DESIGN NO 4 5-1 CAST TIME N/A AIRICONC TEMP N/A LOCATION IN BLDG Bottom of The Swimming Pool NOTES NR=Not Reported Test specimens were 3-in x 3-in x 3-in cube samples cast using wire mesh(no mold used) Results relate only to the tested specimens COMPRESSIVE STRENGTH DATA DATE SPECIMENS RECVD 10/18/04 EQUIPMENT USED Forney DR2000 REPORT DATE 11/9/04 SN OF EQUIPMENT 99108 TECHNICIAN NAME C Herinquez-Supervisor CALIB I RECAL DATE 9-04/9-05 SPECIMEN AGE AT TEST TEST SPECIMEN DIMENSIONS-IN' AREA LOAD F'c BREAK IDENTIFICATION TEST DATE TIME I 2 ] 4 SO IN LBS PSI TYPE' NUMBER DAYS 5 6 7 a (hit) 2925 2911 2933 2918 854 ` 1 D012760A 28 11/9/04 4 31am 28,261 I 3,311 1 3 031 3 029 3 030 3 030 ua, Avg.F'c2B= #DIV/0I Specimen dimensions 1-4=width and length of each face at midheight,4 through 8=specimen height at midwidth 'Break type designation per ASTM C39 Figure 2 a=Cone,b=Cone and Split,c=Cone and Shear,d=Shear,e=Columnar 10-04 V2 10600 Pioneer Boulevard, Suite G • Santa Fe Springs, California 90670 • (562)903-0032 Fax (562)903-3534