HomeMy WebLinkAbout265 SAN JACINTO RD_ 95-00000617City of Lake Elsinore]
PERMIT
130 South Main Street
PERMIT NO: 95- 00000617
JOB ADDRESS . . . . . : 265 SAN JACINTO RD
TENANT NBR, NAME . . : UNIT 103,201,202,203
DESCRIPTION OF WORK . : OCCUPANCY PERMIT
OWNER CONTRACTOR
OWNERHSIEHSAM
HSIEH HSING SUI
A.P.# . . . . . . 363- 140- -069 8
OCCUPANCY . . . .
CONSTRUCTION . . .
VALUATION . . . . 1,000
BUILDING PERMIT
QTY UNIT CHG
BASE FEE
5.00 X 2.7500 VALUATION
DATE: 7/05/95
SQUARE FOOTAGE 0
GARAGE SQ FT 0
FIRE SPRNKLR .
ZONE . . . . . . NA
ITEM CHARGE
45.00
13.75
FEE SUMMARY CHARGES PAID DUE
PERMIT FEES
BUILDING PERMIT 58.75 .00 58.75
TOTAL 58.75 .00 58.75
SPECIAL NOTES & CONDITIONS
OCCUPANCY PERMIT FOR 1ST TIME OCCUPANCY
OF EXISTING BUILDING. B -2 OCCUPANCY
SCHOOL DISTRICT WILL BE OCCUPANT
City of Lake Elsinore
Building Safety Division
Past in aunspicuous place
on the job
You must furnish PERMIT NUMBER
and the JOB ADDRESS for each
respective inspection:
Approved plans must be on jab
at all times:
V.
Please Read and Initial:
1. 1 am Licensed under the provisions of Business and Professional
Code Section 7000 et seq. and my license Is In full force.
2- 1, as owner of the property. or my employees w /wages as their sole
compensation will do the, work and the structure is not Intended or
offered for sale..
3. 1, as owner of the property, am exclusively contracting with licensed
contractors to construct the project.
4. 1 have a certificate of consent to selfinsure or a certificate of Workers
Compensation Insurance or a certified copy thereof.
5. 1 shall not employ any person in any manner so as to become subject
to Workers Coompensatfon Laws in the perfonnance of the work for
which this permit is issued.
Note: If you should. become subject to Workers Compensation after
making this certification, you must forthwith comply with such pro-
visions or this permit shall be deemed revoked.
Code Approvals Date Inspector
EL01 Tamp Else Services
P00l
r
PL01 Soil Pipe Underground
Pool Pool Plumbing/Press- Test
r" . - ..
EL02 Elec Conduit Underground
Pre - Gunite
BP01 Footings
BP02 Steel Reinforcement
P004 Pool Fend /Access
BP03 Grout
P005 Pre- Plaster
BP04 Slab Grade
Fine, POOVSPR
PL01 Underground Water Pipe
SS01 Rough Septic System
SW01 On Site Sewer
EL04 Rough Electric-Wiring
EL05 Rou h Electric -T -Bar
ME01 Rough Mechanical
ME02 Ducts, ventilating
PL04 Rough Gas R -Test
BP12 Insulation
BP13 Drywall Nailing
BPll Lathing & Siding
PL99 Final Plumbin
EL99 Final Electrical
ME99 Final Mechanical
BP99 Final Building
Code Pool & Spa Approvals Date Inspector
lnspactqr
P00l Pool Steel Rein. /Forms
Pool Pool Plumbing/Press- Test
P003 Pre - Gunite
ELOG Rough Pool Electric
Sub List Approval
P004 Pool Fend /Access
P005 Pre- Plaster
P009 Fine, POOVSPR
DEPARTME
Department Approval required prior to the
wilding being released by the City
neeri
APPLICATION FOR
BUILDING PERMIT
VALUATION CALCULATIONS
1st FLOOR
2nd FLOOR
3rd FLOOR
GARAGE
STORAGE
DECK & BALCONIES
PATIO
OTHER:
VALUATION:
City of Lake Elsinore
130 South Main Street
APPLICATION NO.
APPLICATION RECEIVED
DATE
F
F
F
F
F
SF
F
r
SF
FEES
BUILDING PERMIT
BUILDING PLAN CHECK
PLANNING REVIEW FEE
MISCELLANEOUS
TOTAL
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 inspec-
tion purposes.
75
ignature of Applicant -o ,gent Date
AGENT FOR CONTRACTOR OWNER
AGENT'S NAME LAKE r~r,sivae Llrarp da
P4 /ir7'1Q \ G'i
AGENT'S ADDRESS 545 GiAur<.ysr, L, r tLf -WOW, C4
STREET CITY STATE ZIP
ctos30
AP # By
BUILDING ADDRESS
TRACT BLOCK /PAGE LOT /PARCEL
NAME
L+rs -rte
OZ
MAILING / /
CITY STATE /ZIP
LA'Pe 4Zr30
Z
I hereby affirm thot 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 #
0 NAME
I
MAILING
ADDRESS
CITY STATE /ZIP PHONE
CONTRACTOR'S SIGNATURE DATE
Z
NAME LICENSE #
Z
U
MAILING
ADDRESS
Q CITY STATE /ZIP PHONE
NEW 11 REPAIR
OCCGRP./ CONST.
DIVISION: TYPE:
ADDITION CI MOVE NUMBER OF NUMBER OF
STORIES: BEDROOMS:
ALTERATION DEMOLISH
ZONE: OTHER
SINGLE FAMILY units
HAZARD AREA? YES NO
APARTMENTS units
SPRINKLERS REQUIRED? YES NOCONDOMINIUMSunits
TOWNHOMES units PROPOSED USE OF BUILDING:
PRESENT USE OF BUILDING:
COMMERCIAL []INDUSTRIAL
JOB DESCRIPTION
v PF -iz1 lT
le- 0V,L
REV- DATE 6 -1 -92
um
City of Lake Elsinore]
PERMIT NO: 95- 00000596
PERMIT 130 South Main Street
DATE: 7/12/95
JOB ADDRESS . . . . . : 265 SAN JACINTO RD
TENANT NBR, NAME . . : UNITS 101 THRU 106 - LEUSD
DESCRIPTION OF WORK . : ADD OR ALTER NON RESIDENTIAL
OWNER CONTRACTOR
HSIEH SAM MANSUR SERVICES, INC.
HSIEH HSING SUI 39627 KNOLL RIDGE
909 -677- -8564
LIC EXP 0 /00 /00
A.P.# 363 -140 -069 8 SQUARE FOOTAGE 7200
OCCUPANCY• . . . . RETAIL,RESTAURANTS,OFFICE GARAGE SQ FT . 0
CONSTRUCTION . . . TYPE V-- NON RATED FIRE SPRNKLR . .
VALUATION . . . . 25,000 ZONE . . . . . . NA
BUILDING PERMIT
QTY UNIT CHG ITEM CHARGE
BASE FEE 63.00
23.00 X 12.5000 VALUATION 287.50
ELECTRICAL PERMIT
QTY UNIT CHG ITEM CHARGE
BASE FEE 30.00
4.00 X 1.0000 SWITCHES / 1ST 20 4.00
8.00 X 1.0000 RECPT,OUTLET / 1ST 20 8.00
PLUMBING PERMITS
QTY UNIT CHG ITEM CHARGE
BASE FEE 30.00
8.00 X 8.7500 FIXTURE OR TRAP 70.00
FEE SUMMARY CHARGES PAID DUE
PERMIT FEES
BUILDING PERMIT 350.50 .00 350.50
ELECTRICAL PERMIT 42.00 .00 42.00
PLUMBING PERMITS 100.00 .00 100.00
OTHER FEES
PLAN RETENTION FEE 6.00 .00 6.00
SEISMIC OTHER 5.25 .00 5.25
PLAN CHECK FEE 262.88 262.88 .00..
TOTAL 766.63 262.88 503.75
CONTINUED ON NEXT PAGE * **
City of Lake Elsinore
Please Read and Initial.
Building Safety Division I. I am Licensed under the provisions of Business and Profs
Pry 1I1 OCiI ]1
Code Section 7000 et seq_ and my license is In full force.
place 2. I, as owner of the property, or my employees w /wage. as their sole
compensation will. do the work and the structure is not intended or
of ] the icb offered for sale.
You must furnish PERMIT NUMBER. 3. 1, as owner of the property, am exclusively contracting with licensed
contractors to construct the project.
and the JOB ADDRESS for each 4. 1 have a certificate of consent toselflnsureora certificate ofWorkers
respective inspection: Compensation insurance or a certified copy thereof
Approved plans must be on job S_ I shall not employ any person in any manner so as to become subject
t all times: toto Workers Coompensation Laws in the performance of the work for
this permit is issued_
Note: If you should become subject to Workers Compensation after
making this certification, you must forthwith comply with such pro-
visions or this permit shall be deemed revoked.
Code Approvals Date Ins tar
EL01 Tern Elec Services
PL01 Soil Pipe Underground
EL02 Elec Conduit Under round
BP01 Footings
BP02 Steel Reinforcement
13P03 Grout
BP04 Slab Grade
PL01 I Underground Water Pipe
SS01 I Rou h tic astern
SW01 On Site Sewer
3r Sheathing
Roof Sheathing
EL04 Rough Electric -Win
EL05 Rough Electric -T -Bar
ME01 Rou h Mechanical
ME02 Ducts Ventilatin
PL04
PL02
h Gas Pi -Te t
DrainsRoof
7
BP12 Insulation
13P13 Drywall Nailing
BP11 Lathing & Siding
PL99 Final Plumbin
EL99 Final Electrical
ME99 Final Mechanical
BP99 Final Building
OTHER DEPARTMENT RELEASES
Department Approval required prior to the
Code Pool & Spa Approvals Date Inspector
De p. Ins for
P001 Pool Steel Rein. /Forms building being released by the City
P001 Pool Plumbing/Press. Test
Date Inspector
Planning
P003 Pre - Gunite
EL06 Rough Pool Electric
Sub List Approval
Landscape
Finance
P004 Pool Fencing/Access
P005 Pre_ Plaster
En ineerin
P009 Final Pool/S
a City of Lake Elsinore
PERMIT 130 South Main Street
PERMIT NO: 95-00000596
JOB ADDRESS . . . . . : 265 SAN JACINTO RD
TENANT NBR, NAME . . : UNITS 101 THRU 106 - LEUSD
DESCRIPTION OF WORK . : ADD OR ALTER NON RESIDENTIAL
SPECIAL NOTES & CONDITIONS
SPECIAL NOTES & CONDITIONS (CONTINUED)
T.I. SIX UNITS FOR SCHOOL DISTRICT.
PLANCHECKED AS A B -2 OCCUPANCY
DATE: 7/12/95
PAGE 2
City of Lake Elsinore
Building Safety Division
Post in compicuous pL3ce
on the j b
You must furnish PERMIT NUMBER
and the JOB ADDRESS for each
respective Inspection:
Approved laps must be on jobppp
at all times:
Please Read and Initial:
1. 1 am Licensed under the provisions of Business and Profe b'
Cade Section 7000 et seq. and my license is in full force.
2.1. as owner of the property, or my employees:w /wages as their sole
compensation will do the work and the structure is not intended or
offered for sale.
3. 1, as owner of the property, am exclusively contracting with licensed
J contractors to construct the project.
4. 1 have a certificate of consent to selfinsure or a certificate of Workers
Compensation Insurance or a certified copy thereof.
5. 1 shall not employ any person In any manner so as to become subject
to Workers Coompcnsation 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, you must forthwith comply with such pro-
visions or this permit shall be deemed revoked.
Code Appr oyals Date Inspector
EL01 Temp Elac Services s ICbtA&,H G o . f W )cf -F d
PLOT Soil Pipe Underground o~ S E Q 1
EL02 Elec Conduit Underground F -r L1,
BP01 Footings T412
BP02 Steel Reinforcement
BP03 Grout C /
BPG4 Slab Grade
PL01 Underground Water Pipe
SSol Rough tic System
7 p r p
11 (
s CX . -FC) 7_V LEAS( 2 C K
SW01 On Site Sewer LAP—/ —' Lr 041FL—F-57Urm-
RP05 S 1 13-2- o cCu hC_ a
RPM Floor Sheathing
7-2-)- D 1 •"fib K IL
O O S
L . -Z
L c.
7 -Zb c-
EL04 Rough Electric-Wiring 7 G q-Z r Q . K 0 L— GF_
EL05 Rough Electric -T -Bar A J3—L (_'Cfi( C f ® L L_
ME01 Rou h Mechanical
ME02 Ducts, Ventilating
AA 7 , ! A V Q Q( !f 7[1
PL04 Rough Qas Pipe-Test
o p ,
dli L / • . //Z~ K.
PI 09 Roof Drains
P1 nWjgfiQn
BP13 Drywall Nailing L
BP11 Lathing & Siding
PL99 Final Plumbing
EL99 Final Electrical
ME99 Final Mechanical
BP99 Final Buildin
Code Pool 8 Spa Approvals Date Inspector
OTHER DEPARTMENT RELEASES
Inspector Department Approval required prior to the
building being released by the CityPOOLPoolSteelRein_ /Forms
Pool Pool Plumbing/Press— Test
P003 Pre - Gunite
Date Inspector
EL06 Rough Pool Electric
Planning
Sub List Approval
Landscape
P004 Pool Fencing/Access
Finance
P005 Pre - Plaster kEMm-wing
P009 Final PooVSpa
r
Cityoflak
130 South Main Street
APPLICATION FOR 7`f- 3" 2-(
BUILDING PERMIT X
VALUATION CALCULATIONS \/
1st FLOOR SF 1
2nd FLOOR SF
3rd FLOOR
GARAGE
STORAGE
r
SF >
SF
F
PATIO SF
OTHER:
SF
VALUATION:
FEES
BUILDING PERMIT $
BUILDING PLAN CHECK
PLANNING REVIEW FEE
MISCELLANEOUS
TOTAL
C.I 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 h eby authorize representatives of this
city to enter upon t`above- mentioned property for inspec-
tion purposes. 11
Signaturelof Applicant or Agent Date
AGENT FOR `` CONTRACTOR OWNER
AGENT'S NAME
AGENT'S ADDRESS
STREET CITY STATE ZIP
e Elsinore
I CID
4y[L; Rq ;444TE6 -1 -92
HOpr
E
y
City of Lake Elsinore-
PERMIT
PERMIT NO: 96- 00000860
130 South Main Street
JOB ADDRESS . . . . . : 265 SAN JACINTO RD
TENANT NBR, NAME . . . SAN JACINTO COLLEGE
DESCRIPTION OF WORK . : SIGN
OWNER
I-TSIEH SAM
HSIEH HSING SUI_
A.P.# . . . . . . 363 --140 -069 8
OCCUPANCY . . .
CONS'T''RUCTION . .
VALUATION . . . 3,000
BUILDING PERMIT
CONTRACTOR
DATE: 10/21/96
STEVE'S SIGNS /ELSINORE VALLEY
SIGN SERVICE
31556 RAILROAD CYN RD
CANYON LAKE CA 92587
909 - 244 --5911
LTC EXP 0 /00 /00
QTY UNIT CHG
BASE FEE
1.00 X 12.5000 VALUATION
1.00 X 5.0000 PROFESSIONAL DEV FEE
ELEC'T.'RICAL PERMIT
QTY UNIT CHG
BASE FEE
1.00 X 21.0000 SIGNS
1.00 X 5.0000 PROFESSIONAL DEV FEE
FEE SUMMARY
PE ;RMIT TEES
BUILDING PERMIT
ELECTRICAL PERMIT
OTHER FEES
PLAN CHECK FEE
TOTAL
CHARGES
80.50
56.00
56.63
193.13
SQUARE FOOTAGE 0
GARAGE SQ FT 0
FIRE SPRNKLR .
ZONE . . . . . . NA
I'T'EM CHARGE
63.00
12.50
5.00
ITEM CHARGE
30.00
21.00
5.00
PAID DUE
00 80.50
00 56.00
00 56.63
00 193.13
e inr•; G':)IE.N11 ±t
l
City of Lake Elsinore
Buildlig Safety Division
Past in con-- p1C1o15 plaoe
b"
on the job
You must furnish PERMIT NUMBER
and the JOB ADDRESS for each
respective inspection:
Approved plans must be on fob
at all tidies:
Please Read and Initial:
1. I am Licensed under the provisions of Business and Professional
Code Section 7000 et seq. and my license is in full force.
2. 1. as owner of the property, or my employees w /wages as their sole
compensation will do the work and the structure is not intended or
offered for sale.
3. 1, as owner of the property, am exclusively contracting with licensed
contractors to construct the project.
4. 1 have a certificate ofconsenttoselRnsureora certificate- ofWorkcrs
Compensation insurance or a certified copy thereof.
5. 1 shall not employ any person in any manner so as to become subject
to Workers Coompensation Taws 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, you must forthwith comply with such pro-
visions or this permit shall be deemed revoked.
Code Approvals Date Inspector
EL01 Temp Elec Services
PL01 Soil Pipe Underground
EL02 Else Conduit Underground
BP01 Footings
SP02 Steel Reinforcement
BP03 Grout
BP04 Slab Grade
PL01 Underground Water Pipe
SS01 Rough Septic System
SWO1 IOn Site Sewer
BPO6 Floor Sheathing
RP07 Roof Framing
D,DNL Roof Sheathing
PI 03 Rough Plumbing
FI 0.3 Rough Elegtric-Conduit-
EL04 Rough Electric -Wiring
EL05 Rou h Electric -T -Bar
ME01 Rough Mechanical
ME02 Ducts, Ventilating
PL04 Rough Gas Pipe-Test
PI 09 Roof Drains
FlashincL
BP12 Insulation
BP13 Drywall Nailing
BPl l La thin & Siding
PL99 Final Plumbin
EL99 Final Electrical
ME99 Final Mechanical
BP99 Final Building
Code Pool & Spa Approvals Date Inspector
OTHER DEPARTMENT RELEASES
De p. Inspector
Department Approval required prior to the
building being released by the CityPo01PoolSteelRein, /Forms
Pool Pool Plumbing/Press. Test
P003 Pre - Gunite
Date Inspector
EL06 Rough Pool Electric
Planning
Sub List Approval
Landsca
POD4 Pool Fencing/Access
Finance
P005 Pre - Plaster
Engineering
P009 Final Pool/Spa
City of Lake Elsinor
PERMIT 130 South Main Street
PERMIT NO: 02- 00002293 DATE: 11/25/02
JOB ADDRESS _ . . . . 265 SAN JACINTO RD
DESCRIPTION OF WORK : FIRE SPRINKLER SYSTEM
OWNER CONTRACTOR
CALIF. REO MNGMT CORP. PACIFIC FIRE PROTECTION
TEMECULA CA 92589
909 -694 -6900
LIC EXP 0 /00 /00
A.P.# . . . . . 363 -140 -069 8 SQUARE FOOTAGE 0
OCCUPANCY . . . GARAGE SQ FT 0
CONSTRUCTION . _ FIRE SPRNKLR
VALUATION _ _ . ZONE . . . . . . C -0
FIRE SPRINKLERS
QTY UNIT CHG ITEM CHARGE
BASE FEE 30.00
1.00 X 15.0000 FIRE SPRINKLERS PER BUILD 15.00
FEE SUMMARY
PERMIT FEES
FIRE SPRINKLERS
TOTAL
SPECIAL NOTES & CONDITIONS
fire sprinklers
CHARGES PAID DUE
45.00 00 45.00
45.00 00 45.00
City Of Lake Elsinore
Building Safety Division
Post in conspicuous place
on the job
You must furnish PERMIT NUMBER and the
JOB ADDRESS for each respective inspection:
Approved plans must be on job
at all times:
Please Read and Initial:
1. I am Licensed under the provisions of Business and Professional...
Code Section 7000 et seq. and my license is In full force.
2. 1. as owner of the property, or my employees w /wages as their sole -
compensation will do the work and the structure is not intended or `
offered for sale.
3. 1, as owner of the property, am exclusively contracting with licensed
contractors to construct the project.
4. 1 have a certificate ofconsenttoselfinsureora certificate ofWorkers
Compensation insurance or a certified copy thereof.
5. 1 shall not employ any person in any manner so as to become subject
to Workers Coompensation 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. you must forthwith comply with such pro-
visions or this permit shall be deemed revoked.
Code A rovals Date Inspector
EL01 Temp Elec Services
PI-01 Soil Pipe Underground
EL02 Elec Conduit Underground
BP01 Footings
BP02 Steel Reinforcement
BP03 Grout
BP04 Slab Grade
PL01 Underground Water Pipe
SS01 Rough Septic System
SW01 On Site Sewer
BEQ_ Floor Sheathing
P1 Qq Rouab Plumbing
Liectric-Condult
Rou h Electric -Wiri
EL05 Rough Electric -T -Bar
ME01 Rough Mechanical
ME02 Ducts, Ventilating
PL04
PLDZ_
Rou h Gas P -Test
Roof Drains
BP12
BP13
BP11
PL99
EL99
ME99
BP99
Flashing-
Insulation
Q wall Nailin
Lathino & Siding
Final Plumbing
Final Electrical
Final Mechanical
Final Building
C-
OTHER DEPARTMENT RELEASES
Department Approval required prior to the
building being released by the City
Date Inspector
Planni
Landscape
Finance
Engineering
Code Pool & Spa Approvals Date Inspector
De p- Inspector
Pool Pool Steel Rein-/Forms
Pool Pool Plumbing/Press— Test
P003 Pre- Gunite
EL06 Rough Pool Electric
Sub List A oval
P004 Pool Fenci /Access
E005 Pre - Plaster
P009 I Final Pool/Spa
VF
ycac
1 D
S
3d
APPLICATION FOR
BUILDING PERMIT
VALUATION CALCULATIONS
1 st FLOOR SF
2nd FLOOR SF
3rd FLOOR SF
GARAGE SF
STORAGE SF
DECK & BALCONIES SF
OTHER:
PHONE
SF
VALUATION:
FEES
BUILDING PERMIT $
PLAN CHECK
ADDITIONAL PLAN CHECK
MICROFILM
COPIES
IMPRO FEES SCHOOL FEES
City of Lake Elsinore
130 South Main Street
PAID
DATE
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 inspec-
tion purposes.
Signature of Applicant or Agent Date
AGENT FOR CONTRACTOR OWNER
AGENT'S NAME
AGENT'S ADDRESS
STREET CITY STATE ZIP REV. DATE 11 -1 -9U
APPLICATION NO.
t ? --2 Zq 2D
APPLICATION RECEIVED
DATE _z p j—
AP l#
Y
j •, a BY
BUILDING ADDRESS
TRACT BLOCK /PAGE LOT /PARCEL
NAME
Z
30
MAILING
ADDRESS
PHONE
CITY STATE /ZIP
Z
1 hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
70W) of Division 3 of the Business and Professions Code, and my license is in full Force
and effect.
AN CLASS ! TAX p
USINESS
NAME
MAI ING
ADDRESS — [ q,C~ tjyjrf)
I"C/
CITY STATE /ZIP PHONE
CONTRACTOR'S SIGNATURE DATE
0
LICENSE p
w
V
MAILING
ADDRESS
Q CITY STATE /ZIP PHONE
NEW EiREPAIR
OCCGRP -/
DIVISION:
CONST-
TYPE:
ADDITION C,.IMOVE NUMBER OF
STORIES=
NUMBER OF
BEDROOMS:
ALTERATION !..IDEMOLISH
ZONE: OTHER
CISINGLE FAMILY units
HAZARD AREA? YES NO
APARTMENTS units
SPRINKLERS REQUIRED? YES NOCONDOMINIUMSunits
L.JTOWNHOMES units PROPOSED USE OF BUILDING:
PRESENT USE OF BUILDING:
ix!COMMERCIAL INDUSTRIAL
JOB DESCRIPTION
REV. DATE 11 -1 -9U
G3"\p-
N
DEC -12 -02 THU
Tone i +sdale
Fire Gtliot
plpu!]V ,=v1n..g thu
U,rI1.T1cj% -por3 c_d
NCO-, Of RiVeTsida.,
County am-t the
ciucs of
j}3unu,H
i3cnument
Culim: >"t
Gw\yan I.:a:a
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CaecJI4'.lu
Ucscat 1lti,a 5prm.ti
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9 : 1 3 All R I V CO FIRE F &E FA', NJ1. 9099554885 F. I
K I V MK piuG %.vuIN JL 1
FIRE DEPARTMENT
In cooperation with the
California Department of Forestry and Fire protection
Fire Protection Planning and Engineering Services
4080 Leman Street. 2n° Floor - Riverside. California 92501 • (9W) 955 -4777 • Fax (909) 9EC g
SURVEYOR'S OFFICE
LDING AND SAFFTY
TRACTiTARCFI, MAP NUMI3FR:
PERMIT' NiJMAI- PLOT #: _ LE
OB SITE ADDRESS:.
FINAL FOR RECORDATION
RELEASE FOR BUILDING PERMITS
SHELL FINAL ONLY (NO TENANT)
FINAL FOR OCCUPANCY
FINAL. OCCUR, TEMP. EXPIRATION DATE
BUILD PLAN CHECK FEES PAID
MITIGATION FEES PAID
MITIGATION FEES NOT PAID
io
FEES NOT REQUIRED
fF You SHOULD HAVE ANY QUESTIONS, PLEASE CALL THE RIVERSIDE. COUNTY
FIRF. DLPARTMENT, PLANNING SECTION A.I. THE ABOVE NUMBER.
I l- 1,1- (lliemm
FRANK KAWASAKI. BATTALION CHILF
RELEASED BY: _ _. - -- —
DEC 12 '02 09 :05 9099554886 PAGE.01
Cily of Lake Elsinore
PERMIT
130 South Main Street
PERMIT NO: 02- 00002025
JOB ADDRESS . . . . .
TENANT NBR, NAME _ .
DESCRIPTION OF WORK
OWNER
265 SAN JACINTO RD
REO MANAGEMENT
MECHANICAL PERMIT
CONTRACTOR
DATE: 10/10/02
CALIF. REO MNGMT CORP. OWNER
A.P.# . . . . _ 363140 -069 8 SQUARE FOOTAGE 0
OCCUPANCY . . . GARAGE SQ FT 0
CONSTRUCTION FIRE SPRNKLR
VALUATION . . . ZONE _ . . . . . . C -O
MECHANICAL PERMIT
QTY UNIT CHG
9.00 X 12.2500
1.00 X 5.0000
BASE FEE
REPAIR. /ALTER MISC
PROFESSIONAL DEV
HVAC
FEE
ITEM CHARGE
30.00
110.25
5.00
PLUMBING PERMITS
QTY UNIT CHG ITEM CHARGE
BASE FEE 30.00
1.00 X 5.0000 PROFESSIONAL DEV FEE 5.00
1.00 X 8.7500 FIXTURE OR TRAP. 8.75
FEE SUMMARY CHARGES PAID DUE
PERMIT FEES
MECHANICAL PERMIT 145.25 00 145.25
PLUMBING PERMITS 43.75 00 43.75
OTHER FEES
PLAN RETENTION FEE 1.00 00 1.00
TOTAL 190.00 00 190.00
SPECIAL NOTES & CONDITIONS
relocate heat pumps add sink and
condensate lines
Open COUNTER
Date: 19119/82 18 Receipt no: 1974
der 519Totaltened $
199 -
H
Total parent
City Of Lake Elsinore
Building Safety Division
Post in conspicuous place
on the job
You must furnish PERMIT NUMBER and the
JOB ADDRESS for each respective inspection:
Approved plans must be on job
at all times:
Please Read and Initial! w'
I. 1 am Licensed under the provisions of Business and Professional
Code Section 7000 et seq. and my license is in full force.
2. 1. as owner of the property, or my employees w /wages as their sole
compensation will do the work and the structure Is not intended or
offered for sale.
3. 1, as owner of the property, am exclusively contracting with licensed
contractors to construct the project_
4. I have a certificate of consent to selfinsure or a certificate of Workers
Compensation insurance or a certified copy thereof
5. 1 shall not employ any person in any manner so as to become subject
to Workers Commpensation Laws in the performance of the work for
which this permit is issued.
Note: Ifyou should became subject to Workers Compensation after
making this certification, you must forthwith comply with such pro-
visions or this permit shall be deemed revoked.
Code Approvals Date Inspector
EL01 Temp Elec Services
PLOT Soil Pipe Underground
EL02 Floc Conduit Underground
BP01 Footings
BP02 Steel Reinforcement
BP03 Grout
BP04 Slab Grade
PL01 Underground Water Pipe
SS01 Rough Septic System
SW01 On Site Sewer
BIM5_ Floor Joists
JaP08 Roof Sheathing
PI 01 Flauah Plumb no
EL03 Rough EleQtric-Conduit
EL04 Rough Electric-Wiring
EL05 Rou h Electric -T -Bar
ME01 Rough Mechanical
ME02 Ducts, Ventilating
PLO4 Rough Gas R -Test
Flashina
BP12 Insulation
BP13 DrYwall Nailing
BPI I Lathing & Siding
PL99 Final Plumbing
EL99 Final Electrical
ME99 Final Mechanical
BP99 Final Buildin ) i3
OTHER DEPARTMENT RELEASES
Department Approval required prior to the
building being released by the City
Date Inspector
Planning
LEngineering
ndsca
ance
Code Pool & Spa Approvals Date Inspector
De .Ins c
PD01 Pool Steel Rein./Formsn. /Forms
P001 Pool Plumbin /Press. Test
P003 Pre - Gunite
EL06 Rough Pool Electric
Sub List A oval
P004 Pool Fencing/Access
P005 Pre - Plaster
P009 Final Pool/Spa
4
C City of Lake Elsinore
130 South Main Street
V APPLICATION NO_
APPLICATION FOR m -2a
EI ECTRICAI APPLICATION RECEIVED,,
DATE tJ`
PI,UMIIJING PERMIT
MECHANICAL AP a ' By
J I certify that I have read this application and state that the BUILDING ADDRE55
above information is correct_ I agree to comply with all city
and county ordinances and state laws relating to building TRACT BLOCK /PAGE LOT /PARCEL
construction, and hereby authorize representatives of this
city to enter upon the above- mentioned property for inspec- J NAME
n If -tTrt
tionpurpose U r-1.1i 1pt
MAILING
Z: ADDRESS ' JO
ON EPHONE
EC _711 `7 ' :. •` ^-
J ,(J 00 CITY
L -E Cf _
STATE /ZIP
Nf
Si natur f Applicant or Agent Ode
I here4y affirm that I am licensed under provisions of Chapter 9 (commencing with Section
10001) of Division 3 of the Business and Professions Code, and my license is in full force
AGENT FOR El CONTRACTOR OWNER en
LICENSE
pd
effect.
CITY BUSINESS
AND CLASS TAX N
0 NAME
AGENT'S NAME
MAILING
ADDRESS
AGENT'S ADDRESS
STREET CITY STATE
I Y
ZIP
STATE /ZIP PHONE
CONTRACTOR'S SIGNATURE DATE
BUILDING PERMIT NO.
ELECTRICAL Quart PLUMBING Quart MECHANICAL Quart
New Residential Multi Family Fixture or Trap Furnace up to 100,000 BTU's
New Residential Single Family Building Sewer Furnace Over 100,000 BTU's
Private Swimming Pools Rain Water Sys per Drain Floor Furnace / Vent
Switches / 1st 20 Private Septic System Unit Heater / Wall Heater
Switches / Over 20 Water Heater / Vent Install / Relocate / Replace Vent
Recpt. Outlet / 1st 20 Gas Piping System 1 -4 Outlets Ventilating Fan
Recpt. Outlet / Over 20 Gas Piping 5 or More Outlets Exhaust Hood
Lighting Fixtures / 1st 20 Dishwasher Fireplace
Res. Fixed Appliance / Outlet Solar Tank Commercial Incinerator
Non -Res. Appliance / Outlet Solar Collector per Panel Air Handler 10,000 CFM
100 -200 Amp Service 600V Grease Trap / (Interceptor) Air Handier -4 10,000CFM
200 -1000 Amp Service -4 600V Install, Alter or Repair System Fire Dampers
Service Over 1000 Amp or 600V Lawn Sprinkler System Registers
Misc Apparatus, Conduits, ETC Backflow Device Smaller than 2" Boiler / Compressor to 3 H.P.
Signs Backflow Device Larger than 2" Boiler / Compressor 3 -15 H.P.
Sign Branch Circuit Floor Drain Boiler / Compressor 15 -30 H_P.
Busways / EA 100 ft Floor Sink Boiler / Compressor 30 -50 H_P_
Temporary Power Service Water Service Boiler / Compressor 11 50 H.P.
Temp, Power Distribution Sys. Alter or Repair Drain or Vent Repair / Alter Misc_ HVAC Equip.
MOTORS / TRANSFORMERS Fire Sprinklers per Building
Motors up to 1 H.P. SWIMMING POOL
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
REV, DATE 11 -1 -90
l
rW City of Lake Elsinore
PERMIT
130 South Main Street
PERMIT NO: 02- 00001572 DATE: 9/11/02
JOB ADDRESS . . . . . 265 SAN JACINTO RD
TENANT NBR, NAME . _ CALIF. REO MGMT., CORP.
DESCRIPTION OF WORK ADD OR ALTER NON RESIDENTIAL
OWNER CONTRACTOR
CALIF. REO MNGMT CORP. OWNER
A.P.# 363 140 -069 8 SQUARE FOOTAGE 7591
OCCUPANCY _ _ . OFFICE, RESTAURANTS, MISC GARAGE SQ FT 0
CONSTRUCTION . . TYPE V- NON RATED FIRE SPRNKLR
VALUATION . _ _ 113,865 ZONE C -0
BUILDING PERMIT
QTY UNIT CHG ITEM CHARGE
BASE FEE 895.00
14.00 X 5.0000 VALUATION 70.00
1.00 X 5.0000 PROFESSIONAL DEV FEE 5.00
ELECTRICAL PERMIT
QTY UNIT CHG ITEM CHARGE
BASE FEE 30.00
20.00 X 1.0000 SWITCHES / 1ST 20 20.00
5.00 X .6500 SWITCHES / OVER 20 3.25
20.00 X 1.0000 RECPT,OUTLET / 1ST 20 20.00
75.00 X .4500 RECPT,OUTLET / OVER 20 33.75
20.00 X 1.0000 LIGHTING FIXTURES /1ST 20 20.00
63.00 X .6500 LIGHTING FIXTURES /OVER 20 40.95
1.00 X 5.0000 PROFESSIONAL DEV FEE 5..00
MECHANICAL PERMIT
QTY UNIT CHG ITEM CHARGE
BASE FEE 30.00
5.00 X 6.5000 REGISTERS 32.50
1.00 X 5.0000 PROFESSIONAL DEV FEE 5.00
FEE SUMMARY CHARGES PAID DUE
PERMIT FEES
BUILDING PERMIT 970.00 .00 970.00
ELECTRICAL PERMIT 172.95 .00 dpr2 (iifm
MECHANICAL PERMIT 67.50 . 0 0 Da&0 .541/02 11 Receipt no. 1518
OTHER FEES
Total tendered
Tot nt
81239.87
1239.87
PLAN RETENTION FEE 5.50 0 0 Tl
CONTINUED ON NEXT PAGE
City Of Lake Elsinore
Building Safety Division
Post in conspicuous place
on the job
You must furnish PERMIT NUMBER and the
JOB ADDRESS for each respective inspection:
Approved plans must be on job
at all times:
Please Read and Initial:
1. I am Licensed under the provisions of F3usiness and Professionaf`'
Code Section 7000 et seq. and my license Is in full farce:
2. I, as owner of the property, or my employees w /wages as their sole
compensation will do the work and the structure is not intended or
offered for sale.
3. 1, as owner of the property, am exclusively contracting with licensed
contractors to construct the project.
4. I have a certificate of consent toselfinsure ora certificate ofWorkers
Compensation insurance or a certified copy thereof.
5. f shall not employ any person in any manner so as to become subject
to Workers Coompensation 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, you must forthwith comply with such pro-
visions or this permit shall be deemed revoked.
Code Approvals Date Inspector
EL01 Temp Else Services
PI-01 Soil Pipe Underground
EL02 Elec Conduit Underground
BPol f Footings
BP02 I Steel Reinforcement
BP03 Grout
BP04 Slab Grade
PL01 Underground Water Pipe
SSol Rough Septic System
SW01 On Site Sewer
BF105 Floor Joists
RPOR Roof Sheathing
BP09 Shear Wall & Pre-Lath
PI 03 Rough Plumbing
fj,Qa_ Rough Electric-Conduit
EL04 Rough Electric-Wirina
EL05 Rough Electric -T -Bar
ME01 Rough Mechanical
ME02 Ducts, Ventilating
PI-04 Rou h Gas Pipe-Tq, 5t
FLQ2 Roof Drains
I
BP12 Insulation
BP13 Drywall Nailing
BPl l Lathing & Siding
PL99 Final Plumbing
EL99 Final Electrical
ME99 Final Mechanical
BP99 Final Building
Code Pool & Spa Approvals Date Inspector
OTHER DEPARTMENT RELEASES
De . Inspector
Departawt Approval required prior to the
building being released by the City
P001 Pool Steel Rein-/Forms
Pool Pool Plumbing/Press. Test
P003 Pre- Gunite
Date Inspector
EL06 Rough Pool Electric
Planning
Sub List Approval
Landscape
P004 Pool Fencing/Access
Finance
P005 Pre - Plaster
Engineering
P009 Final Pocl/S
City of Lake Elsinore
PERMIT 130 South Main Street
PERMIT NO: 02-- 00001572 DATE: 9/11/02
PAGE 2
JOB ADDRESS . . 265 SAN JACINTO RD
TENANT NBR, NAME CALIF. REO MGMT_, CORP.
DESCRIPTION OF WORK ADD OR ALTER NON RESIDENTIAL
FEES:
SEISMIC OTHER
PLAN CHECK FEE
TOTAL
SPECIAL NOTES & CONDITIONS
CONTINUED)
23.92 .00
723.75 723.75
1963.62 723.75
tenant improvement with suspended cei.lin
9
23.92
00
1239-87
City Of Lake Elsinore
Building Safety Division
Post in conspicuous place
on the job
You must furnish PERMIT NUMBER and the
JOB ADDRESS for each respective inspection:
Approved plans must be on job
at all tidies:
Please Read and Initial:
1. 1 am Licensed under the provisions of Business and Professional .
Code Section 7000 et seq. and my license is In full forcc.-
2- 1, as owner of the property, or my employees w /wages as their "sole
compensation will do the work and the structure is not intended orOofferedforsale.
3. 1, as owner of the property, am exclusively contracting with licensed
contractors to construct the project.
4. I have a certificate of consent to selfinsure ar a certificate of Workers
Compensation insurance or a certified copy thereof.
5. 1 shall not employ any person in any manner so as to become subject
to Workers Coompensation 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, you must forthwith comply with such pro-
visions or this permit shall be deemed revoked.
Code Approvals Date Inspector
ELo1 Temp Elec Services 2 S A/LA-
PL01 Soil Pipe Underground
7-
J rg L iT 51 + 1 5--
EL02 Elec Conduit Underground ii] N ST LA, P0 b y
BP01 Footi2ps
BP02 Steel Reinforcement
BP03 Grout
BP04 Slab Grade
PL01 Underground Water Pipe
Rou h tic S stem
01 On Site SewerkRoofFram'na
AP08 Roof Sheathing
PI 01 P[Quah Plumbho__ A/
EL03 Rough r'
EL04 Rough Electric-Wiring
EL05 Rough Electric -T -Bar 14 r • \ l e w +
ME01 Rough Mechanical
ME02 Ducts, Ventilatin
PL04 Rough Gas Pi -Test
Bgol Drains
BP12 Insulation
BP13 Drywall Nailing
BPI Lathin a Siding
PL99 Final Plumbing
EL99 Final Electrical
ME99 Final Mechanical 1z G
BP99 Final Building IZ49
6 Y
Code Pool & Spa Approvals Date Inspector
OTHER DEPARTMENT RELEASES
De p- Inspector Department Approval required prior to the
building being released by the CitypoolPoolSteelRein. /Forms
Pool Pool Plumbing/Press. Test
P003 Pre - Gunite
Date Inspector
EL06 Rough Pool Electric
Planni
Sub List Approval
Landscape
P004 Pool Fencing/Access
Finance
P005 Pre - Plaster
En 'Hearin
P009 Final Pool/Spa
i
x za
lFj .4i
City of Lake Elsinore
110 Cniith Main Ctraat
REV- DATE 11 -1 -90
APPLICATION NO.
APPLICATION FOR 17
ELECTRICAL
APPLICATION ECEIVED
DATE
PLUMBING PERMIT
MECHANICAL AP a By
I 1 certify that I have read this application and state that the BUILDING ADDRESS
above information is correct. I agree to comply with all city .
and county ordinances and state laws relating to building TRACT BLOCK /PAGE LOT /PARCEL
construction, and hereby authorize representatives of this
city to enter upon the above - mentioned property for inspec- NAME ,
Lion purposes -
Z MAILING
O ADDRESS•'"
Signature of Applicant or Agent Date
I hereby affirm that I am lie nsed underer provisions of Chapter 9 (commencing with Section
J 71330) of Division 3 of the Business and Professions Code, and my license is in full force
AGENT FOR CONTRACTOR I OWNER LICENSE #
d
effecter-tt/I N.
CITY BUSINESS
U /
y
Z AND CLASS V W TAX R
O NAME
AGENT'S NAME
MAILING
ADDRESS
AGENT'S ADDRESS
STREET CITY
CITY
STATE ZIP
STATE!ZIP PHONE
CON R ACTOR' IGNATURE DATE
BUILDING PERMIT NO-
ELECTRICAL Quan PLUMBING Quan MECHANICAL Quan
New Residential Multi Family Fixture or Trap Furnace up to 100,000 BTU's
New Residential Single Family Building Sewer Furnace Over 100,000 BTU's
Private Swimming Pools Rain Water Sys per Drain Floor Furnace / Vent
Switches / 1 st 20 Private Septic System Unit Heater /Wall Heater
Switches / Over 20 J Water Heater / Vent Install / Relocate / Replace Vent
Recpt. Outlet / 1st 20 Gas Piping System 1 -4 Outlets Ventilating Fan
Recpt. Outlet / Over 20 G-f Gas Piping 5 or More Outlets Exhaust Mood
Lighting Fixtures / 1st 20 Dishwasher Fireplace
Res. Fixed Appliance / Outlet Solar Tank Commercial Incinerator
Non -Res. Appliance / Outlet Solar Collector per Panel Air Hondler 10,000 CFM
100 -200 Amp Service -4 600V Grease Trap / (Interceptor) Air Handler -4 10,000CFM
200 -1000 Amp Service 600V Install, Alter or Repair System Fire Dampers
Service Over 1000 Amp or 600V Lawn Sprinkler System Registers 2
Misc Apparatus, Conduits, ETC Backflow Device Smaller than 2" Boiler / Compressor to 3 H -P-
Signs Backflow Device Larger than 2" Boiler / Compressor 3 -15 H -P-
Sign Branch Circuit Floor Drain Boiler / Compressor 15 -30 H -P-
Busways / EA 100 ft Floor Sink Boiler / Compressor 30 -50 H.P.
Temporary Power Service Water Service Boiler / Compressor la 50 H.P.
Temp. Power Distribution Sys. Alter or Repair Drain or Vent Repair / Alter Misc- HVAC Equip.
MOTORS / TRANSFORMERS Fire Sprinklers per Building
Motors up to 1 H -P. SWIMMING POOL
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
REV- DATE 11 -1 -90
V
Ci tV of Lake Elsinore
PERMIT
130 South Main Street
PERMIT NO: 02- 00001807
JOB ADDRESS . . . . . : 265 SAN JACINTO RD
TENANT NBR, NAME . . . REO MGMT
DESCRIPTION OF WORK . : DEMOLISH ALL OTHERS
OWNER CONTRACTOR
HSIEH SAM OWNER
HSIEH HSING SUI
A.P.# . . . . . 363 --140 -069 8
OCCUPANCY . . _
CONSTRUCTION . .
VALUATION 1,000
DEMOLITION PERMIT
QTY UNIT CHG
1.00 X 30.0000 DEMO PERMIT PER UNIT
FEE SUMMARY CHARGES
PERMIT FEES
DEMOLITION PERMIT 30.00
TOTAL 30.00
SPECIAL NOTES & CONDITIONS
demo upstairs office space
DATE: 9/09/02
SQUARE FOOTAGE 0
GARAGE SQ FT 0
FIRE SPRNKLR
ZONE . . . . . . C -O
ITEM CHARGE
30.00
PAID DUE
00 30.00
00 30.00
Oper: COUNTER
Date: 9/09102 09 Receipt no: 1466
Total tendered 930.00
Total papnent 830.00
City Of Lake Elsinore
Building Safety Division
Post in conspicuous place
on the job
You must furnish PERMIT NUMBER and the
JOB ADDRESS for each respective inspection:
Approved plans must be on job
at all tithes:
Please Read and Initial- r
1. I am Licensed under the provisions of F3usiness and Professional
Code Section 7000 et seq. and 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 and the structure is not intended or
offered for sale.
3. 1, as owner of the property, am exclusively contracting with licensed
contractors to construct the project.
4. I have a certificate ofconsent to selfinsure ora certificate of Workers
Compensation insurance or a certified copy thereof.
5. 1 shall not employ any person in any manner so as to become subject
to Workers Coompensation Laws in the performance of the work for
which this permit is Issued -
Note: Ifyou should become subject to Workers Compensation after
making this certification, you must forthwith comply with such pro-
visions or this permit shall be deemed revoked.
Code Approvals Date In ctor
EL01 Temp Elec Services
PLOT Soil Pipe Underground
EL02 Elec Conduit Underground
BPo1 Footings
BP02 Steel Reinforcement
BP03 Grout
BP04 Slab Grade
PL01 Underground Water Pipe
SS01 Rough Septic System
SW01 On Site Sewer
PI 03 Rough Plumbing
Rough ri -
EL04 Rou h Electric -Wiri
EL05 Rough Electric -T -Bar
ME01 Rou h Mechanical
ME02 Ducts, Ventilating
PL04 Rou h Gas Pi -Test
Framing & Flashing
BP12
BP13
BP11
PL99
EL99
ME99
BP99
Insulation
Drywall Nailing
Lathing & Siding
Final Plumbing
Final Electrical
Final Mechanical
Final Buildin
OTHER DEPARTMENT RELEASES
Deparirnent Approval required prior to the
building being released by the City
Date Ins ctor
Planning
LandscaDe
Finance
En ineerin
Code Pool & Spa Approvals Date Inspector
De R_ Ins ctor
Pool Pool Steel Rein. /Forms
Pool Pool Plumbing/Press. Test
P003 Pre - Gunite
EL06 Rough Pool Electric
Sub List Apffoval
P004 Pool Fencing/Access
P005 Pre - Plaster
P009 Final Pool/Spe
ycpr
1 City of Lake Elsinore
130 South Main Street
APPLICATION FOR
BUILDING PERMIT
VALUATION CALCULATIONS
1st FLOOR SF
2nd FLOOR SF
3rd FLOOR SF
GARAGE SF
STORAGE SF
DECK & BALCONIES SF
OTHER.
PRESENT USE OF BUILDING:
SF
GRADING CUT CY
FILL CY
VALUATION:
FEES
BUILDING PERMIT $
PLAN CHECK
ADDITIONAL PLAN CHECK
GRADING PLAN CHECK
MICROFILM
COPIES ---
IMPRO FEES SCHOOL FEES
PAID
DATE
1 certify that I hove read this application and state that the
above information is correct. I agree to comply with all city
and county ordinances and state lows relating to building
construction. and hereby authorize representatives of this
city to enter upon the above - mentioned property for inspec-
tion
Si ature Applicant or Agent Date
AGENT FOR CONTRACTOR OWNER
AGENT'S NAME
AGENT'S ADDRESS
STREET CITY STATE Zip
APPLICATION NO.
iE-6
APPLICATION RECEIVED
DATE
AP# By
BUILDING ADDRESS , - 1 --/ /
y,
I A {/ F•
TRACT BLOCK'PAGE
hl.•
LOT/PARCEL
r` NAME ^..n/
IV._ - 'll "•
l 1..U9/P
I
CITY
I here6v eflirm Char 1 am licp +se urdRr provisions of Chopler V (cornrnencinq with iect:on
70W) of Division 3 of IM Bvslnest and Professions Cede. and fnr lice it In fv11 fOtce
and eff.cl.
CITY BUSINESS
R
LICENSE 0
TAX I
y AND CLASS
IIONAME •,
jhj
MAILING
v
r
I `
ADDRESS
ITr STATE ZIP r VNL
rAHTRACTOR'S SIGNAlf7Ri.,-
DATE
NAME
LICENSE e
vi
MAILING `
I ADDRESS
u
STATEZIP PHONE
t CITY
JNEW L REPAIR
OCC GRP./ CONST.
DIVISION: TYPE:
ADDITION MOVE NUMBER OF NUMBER OF
STORIES: BEDROOMS:
ALTERATION I .DEMOLISH
OTHER
ZONE:
SINGLE FAMILY units HAZARD AREA? YES NO
APARTMENTS units
CONDOMINIUMS units SPRINKLERS REQUIRED? YES NO
TOWNHOMES units PROPOSED USE OF BUILDING-
COMMERCIAL i :INDUSTRIAL PRESENT USE OF BUILDING:
JOB DESCRIPTION D lV o IA) V I a
REV. DATE 11-1•90
A-"