HomeMy WebLinkAboutCENTRAL STREET 511_04-00000826 '4 C-A
i of Lake Elsinore
�vPERMIT 130 South Main Stre��r
PERMIT NO: 04-000008:26 DATE : 4/05/04
JOB ADDRESS . . . . . 511 CENTRAL AVE B-C
DESCRIPTION OF WORK OCCUPANCY PERMIT
OWNER CONTRACTOR
PASADENA STREET INDUSTRIAL OWNER
512 CHANEY ST
LAKE ELSINORE CA 92530
A. P. # . . . . . 377-130-028 1 SQUARE FOOTAGE 0
OCCUPANCY . . . GARAGE SQ FT 0
CONSTRUCTION . . FIRE SPRNKLR
VALUATION . . . 1 , 000 ZONE . . . . . . M-1
BUILDING PERMIT
QTY UNIT CHG ITEM CHARGE
BASE FEE 45 . 00
1 . 00 X 5 . 0000 PROFESSIONAL DEV FEE 5 . 00
FEE SUMMARY CHARGES PAID DUE
PERMIT FEES
BUILDING PERMIT 50 . 00 . 00 50 . 00
TOTAL 50 . 00 . 00 50 . 00
SPECIAL NOTES & CONDITIONS
occ . permit for miibec powdercoating
inc
Date: 4/05/64 85 Receipt no: 4789
Total tendered 958.88
Total pageent 950.M
Please Wad and Initial
I I ani I urnscd unde r the provisions of Buslne ss and ProlctistonaF
L,odc Si non 7(ill I ci seq .and im he e•nse is in full ion c
��I)st II) lull s!)Il'lll)ll� �)�.11'l' _' 1 as owner of the property or m% eniplovvv%w/wages as their soly
t enm}x nsdnnn w-111 do the work and the sirue tun is not mle reded or
I11) t ll l',1111) oil,red for ,!,
d 1 asowmerof the prup•rtN anitvlushehevnlracting with h<e•nsed
c onirae tors to construct the projtx i
I��'I i \I \lfit �` -I 4 Iha%r e(cnifireteof(onG,nttoulflnsure oracerulicale of Workers
Compensation Insurance or a certified corA thereof
5 I shall" '
hall r,ni',MPIOi dn,I)ereon in ar»'manne r uias tobee nrne•subject
i• - - - to lkurners C'wmpnsation Laws in the Ix•rfor ranee of the work for
whie-h this p,rmn is issued
Note II sou should beconu• subl,t to Workers Comlx nsaliun afler
making this crrWla anon you must forthwith cornph with sue h pro-
visions or this Ix rmii shall he deemed n•eoke d
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` OTHER DEPARTMENT RELEASES
C._:-oar-,ru'nt Qaproval required prior to the
S _-
Du11CIne:,e'Inc released by fhe City
-- C- -- - -
Da e nsnec'or
-J_
aa- -�
Finance
Encineerma
- � City of Lake Elsinore
130 South Main Street
APPLICATION FOR APPLICATION O.
BUILDING PERMIT
APPLICATION RECEIV D
DATE
VALUATION CALCULATIONS AP s By
1 st FLOOR _SF BUILDING ADDRESS
� Oki 7W AL AV if 8-C
2nd FLOOR _SF TRACT BLOCK/PAGE LOT/PARCEL
3rd FLOOR _SF
NAME
GARAGE _SF
STORAGE _SF Z MAILING In
ADDRESS I S rJOcl T
DECK&BALCONIES _SF o
CITY STATE/ZIP
OTHER:
_SF I hereby affirm that I am licensed under provisions of Chapter 9(co menciny with Section
1
000)of Division 0 of the Business and Professions Code and my license is in full force
and effect
0/0O z LICE TAX BUSINESS
Z AND CIA TAX
VALUATION: g NAME
FEES MAILING
ADDRESS
BUILDING PERMIT $ _ CITY STA 'ZIP PH
CONTRACTOR S SIGNATURE DATE
PLAN CHECK
ADDITIONAL PLAN CHECK NAME LIC EN
u
Z MAILING
= ADDRESS
V
K
Q CITY STATE'ZIP PHONE
❑NEW ❑REPAIR OCC GRP i CONST
DIVISION TYPE
MICROFILM OADDITION ❑MOVE NUMBER OF NUMBER OF
❑ALTERATION G'DEMOLISH STORIES BEDROOMS
COPIES ❑OTHER ZONE
❑SINGLE FAMILY units HAZARD AREA? YES NO
IMPRO FEES ❑ SCHOOL FEES ❑ ❑APARTMENTS units
❑CONDOMINIUMS units SPRINKLERS REQUIRED? YES NO
❑TOWNHOMES units PROPOSED USE OF BUILDING
❑COMMERCIAL ❑INDUSTRIAL
PAID PRESENT USE OF BUILDING
DATE
JOB DESCRIPTION
❑ 1 certify that 1 have read this application and state that the
above information Is correct I agree to comply with all city r
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
live
Signotuor Agent to
AGENT ZRI110
ONTRACTOR ❑ OWNER
AGENT'S NAME
AGENT'S ADDRESS
......
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