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HomeMy WebLinkAbout31733 RIVERSIDE DR_ (3)f r.D CITY OF LAKE ELSINORE CONSTRUCTION PERMIT Project Address 31 LJ _ _ -•t- -- Applicant to fill in all spaces except those within heavy border lines and sigr, all appropriate declaration Assossor's Parcel No _ - - ^ - % sc'- PhoheC2 PERMIT hti. TRACT 140. LOT H0. IYUNIT t I parn'IName _ - P sddress TYPE OFCDNSTRK`110, NEW ADD ALT ; itiT)ON - 0 REPAIR Arch Foig. 1 CONVERSI(N " I1tMOLISH L] OTHER t• A-P. # Address Contracn7r's Name Fhorte DE- RIPTIOY OF WORKJUSE DF BLDir - l i L - - - - - -- S G Mara Front i -- " "- Adjr f -M, 'q) r' TY XTIENIA111PERIIIT :' GRADINC 1 FOUNOVION ELECTRICAL ' . PLUMBING STRUCTUL.% MEOUNICAL T a Rear City License No. _ _. -- 1 THEk A C Ipi1 -iR' LICENSEa CONTRACTOR DECLARATION PROJECT DESCRi?T10N Sq Ft .__---- Occu'San'Y _...- -- - K I nt•ety affirm that i am Ii: ensed under plaq.,!ons O' c,a to- 9 (commencing; t -e se.:t Ion 7000) of Divns.on 3 cI the Eiusi - ass and vrcfessions Code, and Cansttuct,00 type lane .,_ r _ -_ - 5 T ti Accessory my hccnsa It in furl face anQ `elect, _ _ ,— _- i' ef- - - 11- -- L'atuatr;n S_ Q -^'^- PC4 _ Pill . Ref. # I t lcce L lass _- o,t :?g1 Sr9natu = _ y Remarks Planning Notes — WORK RS' OM ENSATION GEC7: T:ON I neroby all rm shat I have a cer Gt`catc of c.li sent to itli -In a or a cUtiflCJte Of Wily leers' Compensation insurance, or a certitre ropy thereof ( Section - 3800. lab. C -- -- - - - -- Pticy Na.. Company ------ E - -- . . v - F 4etlilied. :opYI reCy furnish e d Co,tiod pY i ed witn the 4?; 6 I 9 U+ si Z O N t G R E Q IM T Dar Tn ADPra C n t ' S N _ ECLijA ATI- O NyKERlS' e camplCled if the p n e widrrd (S - l ) or isse.X -1 rl not O __- _ -- -- - - - - -• _ r•, ^- I cercertify that i.) Inc crtnrmance of v.•', s IA.:r t s r ued, f _ It CT.L' GRADING FEES sna t npi h) r person in a nano r )s : t cnmr si, cc :o file PLJMBING FEES ELECTi31GAl FEES MELFfAMICAI FEES vl;r6 A Las nl Ca f3 ' _- Sig•)atura _ ______ Alter, Rlrpair - -- -- i_Generator E05KW 5.15K'il - Boiler Cur _ - _._. -cu yards It, aR ar•. n, this deuara, on, v r, snea a b :crlif s to the Auto W 1sFI - Construction Pale Sub. Ij_ Duct -Under Gro±and Fill: _cu.gards f r arnr C.3ce sou n si fhrth «ith - - - - -1 war,!r . Com/inuUpf prior -. or d t re L Duct-Structural-__ a : with sl ch prOwt,on: wile this : etn,it shalt 'se reen)ed ,cr okea. Bac, flo nr Prerenter - ; Cooking Unit _, 33603370 Pian Check Fee S 41 CONSTRUCTION LENDING ZENCV BaCkfloN Irrh atlOn Pile Light Fan - Vectilatinri- t rereby alhrm Thal act :s a constrs.rtmr. tendvig 34e•rcy for tr.e perfnf.nance -- 3----- -r - - -- _ 3300.3312 Permit F ^e s of the work ICr which this Permit is issued ,Se :l:-n 1007 rev. C.) Clarifie s Dryers _:Gas EICCIfIC -• -_- ExFi3iKI System f -_ -- Total fees $ Lerar•r•s Name _ - -_ r^ - -- J - - Dishwasher +fan 4 - Evaporative footer tamer's Address __ w - {- -_ - OWNER BUILDER DECLARATIO V -/ Fixtur< T_rsps ea. F.A.d. Heating System & Owaing I hereby . +.(firm that t am exempt wum file Cnntfaclor's urcrsc L0.1 fOr •`-p Floyr tlra ns_- -. -__- i Fixtures _ _ JO•!, 00,(1ii0 BTL' O 100.000 BTU - 611nNmg reason (Section 7031.5 Business and P,nfrtvnn,li Cote. Any r•v n• __T_` -_-.__ _ 330iY3312 summary of Permit Fees J co ntY which requi•es a permit to :0.1struct, attar. imaroee, dent nsn W rePa r 0lr'i n (s _ ___ _ _ - Outlets ___ - -_ Hood or iancpy r- 00 any - ,tructura, Prior to its rsuance, assn renurres the aPPh ant 'or such penmt _ _- Type I TYDell 0 tD h e a signal staterr:cnt that nc /silo is liur,sea pursuant to 1! c )roy lions of -iias Ser 'cr. OUilets $WitCheS -_ -_ BmWln( $ s the Contractor's L,Ctn;e I.)w (Chaoter 9 (c ,mmencinn wiU Sechun 7000) 51 - t- - - - - -- Drwsrtn 3 of the B•-isiness and Professions Corte) or Ina' tic,sri is cxernpt -- _Inr;rci, for ;i __ _- Mr-,'Br t U f0 200 Lrg Refriretatior System Plumoint $ inernfton and :he basis for the alleged exemption, Any v- ulati, n of SCcnnn -- - Meter i_. over 200 amps 00-100,000 BTU 0100,000 BTU 1 _ 7031.: by any applicant for ,) Permit suDiccis t a applictnt (o a avir T•',ra; -, - - amity of not more than five hundred dollars (S500). I R_CO aiainS SUO pansI Fir& /Fact. Bit. ICBO # 1, as owner of the Properly or my CmPl"VeCs v rtn vaq!s 3s nrei, sure - - -_ Mechanical $ G 15.50KW System Repair /A'teration U..rnconsation, wor do the woes, and IhC structure +; hilt iolCn9CJ n m. ^red _ frl,le _ewer I Translorrrler - Other $ -__- o, tale (Section 704.1, Business ant, Professrd.al Cede: Tile Gnn +rat :or's -- - - - --- - - Liccr.sc Law hdus not apply to ao owner of a n,nietty who twiids or nnpic'w's Se+ver_Cap _ C 5G +KW Fire Dampers - - nerion, and wnu (toes s•r n ntl• r.rrrtulfinerscit if tnrour,h is x ter o,vn Sewer Cornectian Oldg. MOtCfS 01 HP C71'/: B Registers 110271 SMIPRrs $ qq_ emP oyees, provided the, suN, nnprnven:enis are nut. intenn Aa n, ,)ffo,ej In, _ -_ -_ -- -_- 110.232 SMIP Cm T .L,/. sate. if, however, toe bt,.te,ng or rmpro amen; is meet yntn„ c, (. Year r,f cc,,,I- -SOIar CtI :I;' - - ~- - l Inc. Solar 09.15 NP 016.15+ Incinerator _ Ctors peel on, the owner will I ave the uuruan of proAng neis'1C Clid t'Ot build Or .m• •; .____- -• -•,_ _ p ^d ,e for the UrPnse Of : :ale). ; Snitl Pi,,i ig -_•. - Sing /Fam. Res. Misc. _ 3360.3310 Summary of PNn Check Fee% U as owner of tire pir.per,y am exciusrvety cnn:rachna w,th'ICCrl' ,] n- _.._.*____--- ___- . --. —_ actors to Construct [ne clmi''ct (Sect!bn 7oa•1,'3 +isrr,ess and D, of •seam cane: Colar Tank__ _ Multi ham. Res. __ Tr: Contractor's License law does not am)l to an owner of nore,r «ho s,rrin min Pool!$oa - Building T' •__ -L . nw ns or improves ulCro,,n, and who contracts in: such prolar, s .Pith .I con. ) - _— , - _ 1 Swimn)ing Pool S,)a t,a: :or {s1 Ice so pursuant :h the Contractor's L.Icense Law). I im a.are that ,. Jate' Beater - Issue „^ -- Plumbing Pr or'! o their Vlorker's C,.,npeosation intufarici, should be 'o fie• fl to m6, _ __- ,___- ___,_ -- -- - -.— - - Electrical I air. exempt under SectOi n -- _. B. b P. G. ff;r this reason Watf:f ;LfirviCP`__ -_, _ Dz:e .-- _-- _____. __ D'vrtor _ ._.. -. ___ - -- -_ -- - - - -•,. ___ -._ D(YEEOIMENT SERVICES REQUIREMENTS: -- _ I testy certify trial I nano rraa tilts PI ;Catihn and state tr)t the above idISL- -. -_- - Other S n amation is rnrract. I agra( to top with an ci:y and cc. ,ofy nteinan as - iAllhl {Ipyraedfy- Dad Z-+ Pla nm 1 / , t ar y state uws totatinp t 'd q a tt•ucnnn, anq narab) . id1) o Ize ro a --- - - -^- -- 8tl)idiag A(Iprl>yt/B) -- 3360d3T5 6 l-- r~ --- - sor.tativot u19 G1 p n !no above-mentinnvl cr petty - a it spfcoon p r.. A IiWon Issuild BY Dail _ Datn l _3 ... issue _ Total Fees Due 1 [, .ves' Llconse or SS M :" Wtile Budding. G::: Temporary File Copy• Caney A;:essN. Pink Apahcanl, iroldeerr,: Accounhni c Q o d J m J j CLN R> w E 1 CF i a MCi0CL L C 1 0r t f c i C ) h W W fro O n m J Of cal CI,LL O LL i a W m a !X W LL a! g clo U vicc f)Io' b' S, cnl c i 7 co U w c 0 d i 1 w I I I O o C7 - a I pl I I wt O yi 1 v, I W 0 la J j Z i W W w U 00 uj c Q O! J O. 4 r 2 4 77 3C c I dlz Iz CL° z 0 L) c s• z V LIML . lei c i C ) h W W fro O n m J Of cal CI,LL O LL i a W m a !X W LL a! g clo U vicc f)Io' b' S, cnl c i 7 co U w c 0 d i 1 w I I I O o C7 - a I pl I I wt O yi 1 v, I W 0 la J j Z i W W w U 00 uj c Q O! J O. 4 r 2 4 77 3C c f II rji II''I I II 1 i f 1 I I I iI i W I z f + fff 111 WF m i c 3 f m I _0 izc go I- f a i IB oZi C- 2^ 7 _C C C CI o + r r c c LL C dI 3 rn o c LL W u I 0 c cLL o c- Im r ! I IC x G: O C Ii IL LL c ,O y 1 M I j- 1f I 1 + ! O m II11 W ii g J Q Q U Z I s% E a 't' a O 3: ' O.! m QO t/1 LL a cO OW 0 y+ d U 0 U C m 7 0 e Hti d 7C ! 3+ I i III I 1 m i I c I i c J WW go t m tt QQ O to O I LL JJ' c, i U. o f = l f II rji II''I I II 1 i f 1 I I I iI i W I z f + fff 111 WF m i c 3 f m I _0 izc go I- f a i IB oZi C- 2^ 7 _C C C CI o + r r c c LL C dI 3 rn o c LL W u I 0 c cLL o c- Im r ! I IC x G: O C Ii IL LL c ,O y 1 M I j- 1f I 1 + ! O m II11 W ii g J Q Q U Z I s% E a 't' a O 3: ' O.! m QO t/1 LL a cO OW 0 y+ d U 0 U C m 7 0 e Hti d 7C ! 3+ I i III I 1 m i I c I i cO OW 0 y+ d U 0 U C m 7 0 e Hti d 7C ! 3+ I i III I 1 m i I c I i fcocl Addross Asssesor's Force, No. n t phone - owntif'S Name p j A"` Lrrense No. Address ` hone ir's CITY OF LAKE ELSMORE CONS-FRUCTiON PERMIT bdfdtr lines and sign all appropriate declarer :trip Apyti^+ant to fill in all spaces except rhos' within her/vtf UNIT .10- 1 LOT NO. 1 TRAP , Aa. — RMt nu. 2 -' LJ REfAtR ALTERATtOM1u A.P. # TTFE W115iNCT n MFM 1, « — S. Msin Building: DEMOLISH C OTHER COi(YERSiON r " t E VESLRIPi1011OFWOR[;USEofBLDG.- -. 7 Front cFRUCTURAL Rear GRADING C FOUN() rnEOFFERMIT A'IOM i - t3 r PLUMBihG MECH16"I" C Right C ftMKT ^ EEC-IRICAL X Left OTHER rSca9arzt S address i mgr _- f - - IPi108: Sq. FL Aries PROJECT DESCR tote _- Pin . Ref. City L'cenS8 Et:J RATION tsar 9 (eornmenon , (OUSifueW tF7• —_— RACTOR C Planning Note? ICENSED CO under rpvi:ionsa ^a pro,essions Code. Ana affiipNENSATI m t 1 am t,ceseti nt the Business Yilaatlt f j— _ , tJ 1 hereby in 3 it section effect. _ UCense No. My t:.trn:e is Rem License Clasture Date — DECIARA'TI0" r cer tificate 1 fiUte of con_snt to self.Insu thereof ( SectienWORKERS' COti a certif,ed COPYHerebyallifn, that i nave a ce net of workers' compensation Ins / — Lab. C -13800, m r v policy No. - - -— h tl. i,- ncrebl f :artq Orvis,on. Ce:lrf,ed Copy is til a with the ;,tY BCelt" "t' copy APDI,eant — ` AL RATION FROM WORKERS' OMPEN TION DEC nun Si90) or C: e t ,s tnr one '•u EXEMPT I ^`to .:ot be cpmDtetetl if iha Pe' - rm•r •`- asued, i Th,sscction • r the ,y rk f0 w7,cn this Pa act to the less). In the Perfornynce O fk So to become S.:bl CarUly 1113 any PefSpn ,n ar,V ma•. _ Snd.1 not employCompensation L"s of Calif Orri,a• e' ; no Workers' C Signat.,re —you should eco,ne soot f rtr n Date ` his declara:t. n, y ou ns::st Oav:.,,ad. 11, alter making t boo C. dame I NOTICE: enI t, .r, prOv'Vons of lht la hall b Worker S' T.nmP rOVtS,Oris Or this Per miT s f }r•,rrri ante c°,^PIY with such 0 AGENCY a 6ncY for a De CONSTRUCTION :. ENDING ! S<.ctlortanUnsthatthereisaconstructinn,lenssued 4 n7 C,v. C. 1 nere0v that yyh,th t,,s Permit s ' Of the Wor k Lender's r the La noel's Address - _ T pN tense Law Professional Code'. Any city o! OWNER Bf' son tm 111 UECLARA rove. demolish or rt^P, it1 .ttrcby atlrm U,S ctio 7031 5 Bust, ss antl ntractor's V requr res the apPl'canl tpf rOV•s s o1 in:towmg rc cq Sect a Par "t't T° construct, alter• im cn •nty prior to Its issuance. also with Section 7pt)c) r,t any stru.aure. P Is exempt to file a :,gnaw stalamtnl that he/she ,S licensed e) or athat011e /. ne ct,OnwChProfesionCoo jin9 v,otat,on o• ; the C„nt•actor's License La ( tlon. Any t cant to a civil 13 -'s,on 3 of the Business and alleged sub;ects the aP0' i,cant for a t e priors (S500)- therelrom ens tit, PP i cant trio a pelf exam . as as snail ;olC 7031.5 PY untlre6 ' employees w,tn wag t;enaltY °t n °t mole the • The Cnritr +.liter'sroOCrP/ • + r my 1. as owner P1 profesSsonal C^nnel pu,1Ci 'I P` Proves cp,npensatlon, wit! "the0 C:k,s ;n the strucItIre Vy 101 ie Th c n ° ere 10r Shca (Section R h. or Qted foil I to an owner of a P mendedLicensellwaOCSduopsuhworkh,mseN jherStlf Or tttt OUg ` car OIMOm- thefecin. and Who TONG rt`.Cn:s at C not ' td f0: bu, demPloYeeS• Pf O.•.rC° that such ImD nt Is he /ShC sale. It, e - at" the butid,n9 Or rmo" not r i SOtd ,Nitro^ on 1 urPOSe of sales- Ontracirnq with I, cenfed con, 1 'a Ia. In, the r.wne, will have the bu,den n P .th es erase Guile, rove for Tnc 0 ro ally, J'rt excess, 4d Business anG rt woo Sec UOn 70 1 to an r,NI"I" Ot %, .,. Y 1, as Ownar OI lhC p P tcTS wPh a concCASCLawdoesnotaPPyIi••• aware thattractorstoconstructthe pt Olecl , tense h I'T Tho CO l rC oyes theraOo' an° wn0 contracts ice sec^ P' rl rov,dad to me. buitaS OF Ocsnse Pursuant tp the Cn— tractOr s r' B b P f r his reason props p trye1f Worker's ComPenSait °^ , nsurancc should oe D I] t am exempt on'a Jof T— tDJU t,U on and Statta that t0in7nCls car Y nave rend orf GIYPwit all dtY .no County1h ultrialtre. t ,and Hereby Autnorize rapfor 1 herebyy rltlm9 construct f0party mformatlon is correct. ti0 t'' tle - mtlnTi°neA P and state laws u o SentJt IVJS !__ Y$ignJl urc -- pr SS ' IpnlOrr.ers' tic.nf+ Gddenrad•MD' in.,e..Ru11Sm4 Mfs•itmp9gfl Flk Co01• _ — — fan tisttwasher --- -- F.A.U. Fixture Tra s ea. Fixtures nterce tors --t - -- Meter o+rer ?mpS P -Trams- Sub ane`- , Roos Drains [7 l5•a0K Transformer 50 +KWTrailer) Sew_ ---; , Sewer Cap Motors G 0 -1 NP L 1 h B Seller Connectinn Bldg. Inc. Soar 9 -15 ell' X1615+ c..Inr Collectors c:nniFam. Res. Fan •Ventt+attn;_--- Exhaust SM stem D He9a system & utt g o-ioo 00o BTU t ov Hood nr Cartopy r C V a ffRetrigeratlin System 30.1g0pooBTUC FirsFitt. B t. IC80 SVsteln Repair /Alm °_f FireDamper_ = Rc I Incinerator Accessory pMLOF11iW SERyILES QWREMENTS:— tlg _ __ -- o•u _ atiolt zl0 N 1 N R' E Q M IS ACtt.s j GIADIMG FEES cu Ya as Ut -- cv.lads FIR: _ice 3401 Platt Check Fee S 3225 Permit Fr° S Jost( Few S -- - Samaurf of fe'Mit Fees 3220 8dildir -1 $ 3221 Plumbirt $ 3122 Electrical 3213 Mecnanrl ja( - 3224 Rete ^bat $ 1301 SNIP Res 2307 Sul? Com 3225 - ISaRlltlJfjofPionCRxltFoes 3401 Bu'dinl $ - - -- 7iumbifq Electrical j - -- — =_ Mtr6aarwl S _._- - -• - -- 3403 Other — 3412 PltnvIlt $ -- --" - -- - ao Cr r aS c = E FEES ELEC1q 4iter R — CConstructlun' Pluto ash_ -- - J CCookin Unit B?ckflow Prevel'ter _ Li ht rrBackilow / e I -Pole L C)rif nterce tors --t - -- Meter o+rer ?mpS P -Trams- Sub ane`- , Roos Drains [7 l5•a0K Transformer 50 +KWTrailer) Sew_ ---; , Sewer Cap Motors G 0 -1 NP L 1 h B Seller Connectinn Bldg. Inc. Soar 9 -15 ell' X1615+ c..Inr Collectors c:nniFam. Res. Fan •Ventt+attn;_--- Exhaust SM stem D He9a system & utt g o-ioo 00o BTU t ov Hood nr Cartopy r C V a ffRetrigeratlin System 30.1g0pooBTUC FirsFitt. B t. IC80 SVsteln Repair /Alm °_f Fire Damper_ = Rc I Incinerator Accessory pMLOF11iW SERyILES QWREMENTS:— tlg _ __ -- o•u _ atiolt zl0 N 1 N R' E Q M IS ACtt.s j GIADIMG FEES cu Ya as Ut -- cv.lads FIR: _ice 3401 Platt Check Fee S 3225 Permit Fr° S Jost( Few S -- - Samaurf of fe'Mit Fees 3220 8dildir -1 $ 3221 Plumbirt $ 3122 Electrical 3213 Mecnanrl ja( - 3224 Rete ^bat $ 1301 SNIP Res 2307 Sul? Com 3225 - ISaRlltlJfjofPionCRxltFoes 3401 Bu'dinl $ - - -- 7iumbifq Electrical j - -- — =_ Mtr6aarwl S _._- - -• - -- 3403 Other — 3412 PltnvIlt $ -- --" - -- - ao Fan •Ventt+attn;_--- Exhaust SM stem D He9a system & utt g o-ioo 00o BTU t ov Hood nr Cartopy r C V a ffRetrigeratlin System 30.1g0pooBTUC FirsFitt. B t. IC80 SVsteln Repair /Alm °_f FireDamper_ = Rc I Incinerator Accessory pMLOF11iW SERyILES QWREMENTS:— tlg _ __ -- o•u _ atiolt zl0 N 1 N R' E Q M IS ACtt.s j GIADIMG FEES cu Ya as Ut -- cv.lads FIR: _ice 3401 Platt Check Fee S 3225 Permit Fr° S Jost( Few S -- - Samaurf of fe'Mit Fees 3220 8dildir -1 $ 3221 Plumbirt $ 3122 Electrical 3213 Mecnanrl ja( - 3224 Rete ^bat $ 1301 SNIP Res 2307 Sul? Com 3225 - ISaRlltlJfjofPionCRxltFoes 3401 Bu'dinl $ - - -- 7iumbifq Electrical j - -- — =_ Mtr6aarwl S _._- - -• - -- 3403 Other — 3412 PltnvIlt $ -- --" - -- - ao f Q a O N O a aa Q MI _ yu a I f Iz z J a. z z 0 D Q H oHU pz p CL V Q rI Q{ L•JE (j mI Ilfl I o 1 pI u Z I IoIa N n' C I '• I Lj o cLrm E - 0. E °__ 1 c f- a d o of tr -7, J- 1, 21 zf c f• - ~i f >I 1 Q, I zl O I OH W I w j O I s W I Ja c _ « • j .c r•• • y N Z O O 1rI 41 -I - c of y ix- 0 w E (nn l LL. I Iy Q Ja Q L Of W ofw CL2 Q 1 E 1 i Of .0 I ` j 1 I ofIc ImIU c I o i oiJ c° w 1 uIE 7 > OI v CC, cc rl I p Q z u yjt WIF y co Q Ol JE 0 z W C, W x Na W 11 W cc 1L o T1 3:1 a Pc C v a I I i0. ` I iTi zI oIL v al 1 ; i U' I F- I I s I I f 01 a y Ji W gL aE } Q E ) 4I J( cn i v IL J if[ n J j i• 1 = ; J 1 s j I I I f I 1I `' W I z tI I s i i I E t I 1 J F E i ! E J I 3 I i I f 1 s i f I f f J= I e i I , 1 Tl I mi c ; OC r• ( I r ! 7 _C [ LI C I C O, I LI J W S ( I Ic C I a•J [ Nt RSI f-1 p. I - LL I p J 0 ,Q OQC R LL 3_ i s u' rn LL r ' 'Q _ . z O I E I I $'! LL ` z _V= H ' t FL N 'J cc 0,0 F' nl I yt- C7 LL a E m ! a ^ ..' Q fij( G m '° 'a n`' •_ N .1 - z •v y I IF= U-! . p O w j tL ii u X. lL c, n 1 Q II ! , cm 1 ro`a_,N HI I I co I y LL a w I j i I i J f t; I IE -j al l i [ I 01 O , I c ; OC r• ( I r ! 7 _C [ LI C I C O, I LI J W S ( I Ic C I a•J [ Nt RSI f-1 p. I - LL I p J 0 ,Q OQC R LL 3_ i s u' rn LL r ' 'Q _ . z O I E I I $'! LL ` z _V= H ' t FL N 'J cc 0,0 F' nl I yt- C7 LL a E m ! a ^ ..' Q fij( G m '° 'a n`' •_ N .1 - z •v y I IF= U-! . p O w j tL ii u X. lL c, n 1 Q II ! , cm 1 ro`a_,N HI I I co I y LL a w I j i I i J f C1'_'Y Or LAztE EISINORE BTjILDING DIVISION C) X NE L *?_L VERI F I CA-T, 1 ON A city or count;, wh`.cn is required tc giv© notice pursuant to Section 1* ty shall attach to such notice, and, as a condition precedent Section a building permit, requite the completion and require the return of an owner - builder verification. Attention Property Owner: An "owner- builder" building permit has been applied for ark. bearing your si.ature. huildina e'=m't l "sued v_ eri sicatior. i-s LMce }ved. I personally plan to provide the major labor ane materials for construction of the proposed property iaprovemen:.. Yes No s (have/have not) - signed &a application for a building permit for the proposed work. J in your nare s t th_s 1. 2. 2. I hove contracted with the following person provide the pz "posed construction: Name 6111-kPz"LLL Address Phone ( ) Contractors Lic. t 4. 1 plan, to provide portions Of the work, but I have hired the following person to coordi.n -te, supervise, and provide the major work: Name Address Phone (714) Con ^ -actor F s Lic. 5. i will provide some of the work but I have contracted hired) the tollowing persons to provide the work indicated: Name Lddress one Type -0-: — If additional space is required attach subcontractors list.) I hereby affirm that I have received a copy of the information set' f California health and Safety Code forth iz Section 19830 of tkie State o personal and bave complete the above info_ a -ion to the best o.. my p knowledge, in .... Name: Prin:.e=; or U!ypea) Sec. Drivers Lic. 1 or Soc:. o PER14IT NO: 91- 00000723 City of Lake Elsinore PERMIT JOB ADDRESS . . . . _ : 31733 RIVERSIDE DR DESCRIPTION OF WORX . : ADD OR ALTER NON RESIDEUITIAL OWNER BROOKSA'ONE INV 5000 BIRCH ST STE 10100 NEWPORT BEACH, CA 92660 130 Sor:th Main Street DATE: 7/08/91 CONTRACTOR OWNER — - - — °`_ — A.P.# . 375- 171 -085 SQUARE FOOTAGE 0OCCUPANCY . RFTAIL,RESTAURANTS,OFFICE GARAGE :Q FT 0CONSTRUCTIOIZ . TYPE V- JON RATED FIRE SPF -NKLRYALUATION ?_,000 ZONE . . . . . . YdA CHANICAL PEP.14IT — -- QTY UNIT CHG ITEM CHAFGE BASE FEE 15.002.00 X 4.5000 VENTILATING FAN 9.00 UMBING PERMITS QTY UNIT CHG ITEM CHARGE BASE FEE 4.504.00 X 6.0000 FIXTURF OR TRAP 24.0r 3 . U0 X 3.0000 INSTALUALTER OR REPAIR 9.003.00 X 3.0000 ALTER OR REP. DRAIN, VENT 9.01) FEE SUMMARY CHARGES PAID DUE -^ PERMIT FEES___ MECHANICAL PERM1' __ 24.00 .00 21, 00PLUMBINGPERMITS46.50 .00 46.50 / OTHER FEES PLAN CHECK FEE 16.25 .00 16.25 TOTAL 86.75 . CO 86.75 CPT#:02- REV. DATE 11 7 40 r City Qf Lakc FlFinore Puiiding Safety Division post in conspicuous pilace i on tile i Xb Y7,j must furnish PEFWT NUMBER and the J09 ACDRESS for etch respective inspection: Approved p'cns must be on job of C11 times: t _ Code Appre-.015 Date Inspector C-L01 Temp Elec Fvriices 1 Final Poot /Spa PLOT Soil Pipe Underg round M I Suit list Approval EL02 Elec C-induit Underground BPOI Footin is BP02 Steel Rt inforcement BPC3 Grout SP04 S!ob Grade PLO1 Underground Water Pipe SWI Rough Septic System SW01 On Site Sewer P103 Rough Plumbir.g EL03 EL04 Rough Electric- Coaduit Rough Electric - Wiring ELOS Rough Electric -T -Bor MEW. Rough Mechanical ME02 Ducts. Ventilating PLW Rough Gas Pipr. -Test PLO2 Roof Drains SP05 Floor Joists SP06 Floor Sheathing SP07 Roof Framing BPOR Roof Sheathing BPO° Shear Wr,:l & Pre -Loth BPIO Framing 8 Flashing BPI] t,3thing 8 Siding BP12 Insulation BP13 Drywoll Nailing PL99 1 Final Plumbing EL" Final Electrical ME99 Final Mechanical Mechanical---- SP99 Final Building s Code Pooi 8 Spa Approvals Date Inspector P001 Pool Steel Reef. Forms ^ P002 Pool Plumbing, Press. Test P003 Pre- Guoito POW Pool Foncing,Access Please Recd and In:•ial. ir am l- aitsed under the provisions of Bustness ord Prglessional Cade Section•. 70:10 et seq. and my license is in full forces S ri 2. i. as owner of the properly. or " emplatees w wages as J their sole compensation will do the work and ho atrucfure is not intended or offered for sate. 3 1, as owner of the property. am excfusave!y controlling with 1 licensed contractors to construct the protect. A. I have a cem.ficoie of corsen! to self,ns.:re or a certificate f ' of Workers Compensation. insurance or o certified copy theraoi_ y 5 1 sooll not employ any person In any m =nnar so as to become sub;ect to Workers Compensation to" in :he performance of the ark r which !h,s permit .s issued. Note: rou should become subject to Workers Compensation offer making this certdic_'.or you must forthwith comply with starh provisions or this permit shall be deemed revoked. P005 Pro - Ploster ELO6 Rough Pool Electric P079 Final Poot /Spa SL99 Final So!or M I Suit list Approval Please Recd and In:•ial. ir am l- aitsed under the provisions of Bustness ord Prglessional Cade Section•. 70:10 et seq. and my license is in full forces S ri 2. i. as owner of the properly. or " emplatees w wages as J their sole compensation will do the work and ho atrucfure is not intended or offered for sate. 3 1, as owner of the property. am excfusave!y controlling with 1 licensed contractors to construct the protect. A. I have a cem.ficoie of corsen! to self,ns.:re or a certificate f ' of Workers Compensation. insurance or o certified copy theraoi_ y 5 1 sooll not employ any person In any m =nnar so as to become sub;ect to Workers Compensation to" in :he performance of the ark r which !h,s permit .s issued. Note: rou should become subject to Workers Compensation offer making this certdic_'.or you must forthwith comply with starh provisions or this permit shall be deemed revoked. City e Elsinoi. 01'La r 130 Surat % INa n Street pF l 1 7/05/91 PERMIT NO: 91- Ofl000723 1JNASSIGNED 7013 ADDRESS - -WORK ADD OR ALTF'R 1,10F RESIDENTIAL D - ESCRIPTION BROOKsTONE ZNV STE5000BIRCHST 010000 92660 NEWPORT BEACH, A.P•# . • ' • • OCCUPANCY • • ' CONSTRUCTION • VALUATION • • ' CONTRACTORSt. ciwNER i 7 3 SQUARE FOOTAGE 379 -171 -085 S OFFICE GARAGE SQ FT RETAIL, RESTAURANT FIRE SPRNKLR • NA TYPE V- NON RATED ZONE 1,000 BUNG FEU IT CHG QTY BASE FEE 5.00 X 2.0000 VALUATION FEE SUMMARY PE_ - FEES BU ILDING FERMI'!' O -- FEES PLAN CHECK FEE TOTAL CHARGES 25.00 16.25 41.25 ITEM CHARGE 1.5.00 10.I)0 PAID DUE 0 25.00 911 00 16.25 00 41.25 - TME s ! S 1QUR RECEIPT - ME% MACHME VALIDATED 07 — Og- 1991iiu :r0 pMixe t. ACCT4 100-3220-4 RC H ; Li2b 1I1.0Im, I.MMlT 81 Zh7 RFV. ()ATE 11.1.00 City of Lake Elsinore B01ding Safety Division Post in conspicuous place on the fob You must furnish PERMIT NUMBER and the .108 ADDRESS for each respective inspection: Approved pions must be on job at all times: C060 Approvals Dote Inspector r ELOI Temp Eloc Services PLO] Soil Pipe Lindergrc ind EL02 Etrc Conduit Underground BPOI Footings BP02 Steel Reinforcement BP03 Group BPn4 Slob Grade _ PLOI t]ndergr and Water Pipe SSO] Rough Septic system I s - I On Site Sewer r i_ PL03 Rough Plumbing I EL03 Rough Elecuic- Conduit ELW Rough Electric - Wiring FLOE Rr:uyh Electric -T -Bar ME01 Rauh Mechanical ME02 eructs. \rentiloting _- PLOJ rough Gas Pipe -Test PL02 Roof Drains BPOS Floe. Joists 8P06 Floor Sheathing BP07 Y.00f Framing _ -_- BPOS Roof Sheathing OP09 Shear Woli & Pre -,.nth VIC Framing 8 Flashing 13P11 lathing & S;d;ng BP12 insulation BP13 Drywall Noil'.ng -- PL99 Final Plumbing - -- EL99 Final Electrical ME99 Final Mechanical _ BP" Final9urldin3 - -- Please Read and tnitiol: 1. 1 am Licensed under the provisions of tlustnoss and Proltssloral Cccte Section 7000 of seq. and my 14- erso is In full force. t, as owner of the property, or my employees wfwages as their sole compensation wltl do the work and Ifte structure is P not intended or offered for solo 3, 1, as owner of the property, am excluslvoly coatrycttrg with licensed contractors to censirul.t the project. d. 1 have c. certificate o! corsertt to selfinsure or a certificate QI Workers Compensation insurance or a co; lified copy thereof. j`'Kn I shall not employ any person in any mo.iner so as to brrcme J subject to Workers Compensation Laws in the performance of rho work for which this permit is issued. Note: If you should become sublect to W.trkers Compensation afte• mak`ng this certification, ycu must forth..ith ramply with such provisions or this permit shall be deemed revoked. Prot R, Soo Approvals Steel 9crn. Forms Dote Inspectorool ool Plumbino %Press. test ro- Gunite ool Fencing %Accesskro•Ploster ough Pool Electric inal PooI,sPo inal Solar ub List Approval _-___ — .---- ----_ - ---- 4 by lw Yi c. 777 pity of Lake Elsinore PERMIT 130 South Main Street PERMIT NO: 91-(100001399 DATE: 9105/91 JOB ADDRESS . . . . . : 31733 RIVERSIDE DR A TENANT NBR, NAPE . . : EL PRESIDENTA DESCRIPTION OF WORK . : MECHANICAL PERMIT OWNER CONTRACTOR y BROOKSTONE INV OWNER: - A.P.# • 379- 171 -085 3 SQUARE FOOTAGE : 0 OCCUPANCY . . . . . GARAGE SQ FT . 0 CONSTEUCTION . . FIRE SPRNKIR . VALUATION ZONE . . . . . . NA MECHANICAL PERMIT QTY UNIT CHG ITEM CHARGE BASE FEE 15.00 1.00 X 6.5000 EXHAUST ROOD 6.50 FEE SIJI khRF CHARGES PAID T DUE PERMIT FETES MECHANICAL PER.MIT 21.50 .00 21.50 TOTAL 21.50 .00 21.50 THIS IS YWR RECEIPT WHEN MAMINE VAi,IaNED 03 -03 -1991 3:30 PK/M . A=4 s .CO- 3"220 -0 PTO:02- 1668340SE A. ORT PEWIT 091 -899 31 -9 NEV. [,.TE• 11-190 City- of Lakt Elsinore Building Safety Division Past in conspicuous place cry the j ®b You mus i furnish PERMIT NUMBER and the JOB ADDRESS for each respective inspection: Approved plans must be on joh at all tiM?S: Zado Approvals Date Inspector EL01 Trop Eiec Sorvices PL01 Soil Pips Underground LO2 Elec Conduit Underground BPo'• footings SP02 St*M Rein' orcernent BPW Grout 3PO4 Slab Grgde PLOI Underground Water Pipe SS01 Rough beptic System WO1 Ct t Site Sewer PLO3 Rough Plumbing EJO3 ELC-s Rough Electric- Ccnduil Rough Electric 414 "ing EL05 Rough Electric -T -Bor MEO: Rough Mechonical ME02 Ducts. Ventilating PLO4 Rough Gas Pipe -Test PLO2 Roof Drains BPQ5 Floor Joists SP06 Fleor Sheat EngJSP07RoofFraming BPOB goof Sheathing 9PO9 Shoot Wall & Pro -lath SP10 Framing & Flashing Bpi I Lashing a Sidinq_ BP12 Insulation 8913 PL99 Drywall Nailing Final Plumbing EL99 Final Electrical NE" Final Mechanical Wig Final Builning — Cotie Pool & Soo Apurovals Gate Inspector P..%I Pool Steel Rein. - Form Ail Pool Plumbing /Press. Test i'Oli3 Pre - lignite _ PQO4 Poet Fencing /Access — POCS Pro- Pinstor EL06 RcuOh roai Elea -- 9099 Fin :Pspa M- SLW Firol Safor - Sub list Approvo! PFA Meow Rand and Initial: 1. 1 arms i.icW -sod under tF.a Pt'tvislens of Susinees rtrA Prtiess1an01 Coda S+eUion 7000 et swl. ono my h; ease is In full tarcp. 2. 1. as owner of thi ptrfcrty, 01 my emaloyees w!wagec ns their sole companation vAll do tits work and the structure 11 not intended or altered for sole. 3. 1. as owner of the p>,.,perty. am ezciusively contracting with licen%.d cone, actors to ctnsituct the project. 4. 1 have v certificate of consent to selfinsura or o certificate of Workers Compensr.tian inturance or a certified copy thereof. 5. 1 st all not employ any person In any manner so as to become f rub %act to Workers Cempensatton Laws in tha performance of the work for which th "s pormll is 19sued. Note: If you should becoino subject to Wwkers Ccn+pensation after making this certification, you must forthwith comply with such provisions or his permit ehail be deemed revoked. t h - - City of Lake E PERMIT iv South Main Sheet PERMIT NO: 91- 00000900 JOB ADDRESS . . . . . : 31733 RIVERSIDE DR A TENANT NBR, NAME . . : £L PRESIDENTA DESCRIPTION OF WORK . : FIRE SUPPRESSION SYSTEM OWNER BROOKSTONE INV A.?.# . . . . . . 379- 17i —O85 3 OCCUPANCY . . . . CONSTRUCTION . . . VALUATION . . . . CONTRACTOR D sTE: 9/05/91 z OWLJER S.1'-JARE FOOTAGE 0 GARAGE SQ FT . . . 0 iFIRE SPRNKLR . . ZONE . . . . . . . NA PLUMBING PERMITS QTY UNIT tHG ' ITEM CHARGE BASE FEE 15.00 1.00 X 10.0'.100 ANSUL SYSTEM FOR HOOD 10.00 FEE SUMtiARY PERMIT FEES PLUMBING PERMITS TOTAL CHARGES PAID DUE 25.00 .00 15.00 25.OJ .00 25.00 THSS IS YNX RECEIPT WHE4 MACHINE VALIDATED Pr1i REV. GATE 11-1•90 e/y A"wo APPROVAL! f 1 I TITL PAT i I I - may i i i ' i, ' f- j p i 1 - - -- - -- r , i I t 1 I I 24?