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Home My WebLink About16758 LAKESHORE DR_ (3)ff -AiI qe! ia 130 South Main Street pERMIT DATE: 8/06!91 PERMIT NO: 91- !)0000814 JOB ADDRESS - - : 16'.58 LAKESHORE DR UNIT D CREATIVE HOME SEL;FRS TENANT ES DESCRIPTION OE" WORK : ADD OR ALTER NON RESIDENTIAL - CONTRACTOR „_ 0 r LTD C`'NEEt iT_RST RIVERSIDE ASS6C SQUARn FOOTAGE 0 378 -290 -016 2 0 A.F.ik RETAIL,RESTAURANTS,OFFICE GARAGE SQ FT • OCCUPANCY FIRE SPRNKLR • Nye CONSTRUCTICN TYPE V- NON RATED ZONE • • • VALUATION 500 BUILDING PERMIT ITEM CHARGE QTY UNIT CHC 15.00 BASE FEE CHARGES PAID DUE FEE SUki RY PERMIT FEES - 15.00 OU 15.00 BU IDLIBUIDIINGPERMIT OTHER FEES - PLANRE_'ENTION FEE r'00 00 00 20 50 SEISMIC GROUP R 9.75 00 5.75 PLAN CHECK FEE 25.45 TOTAL 25.45 00 SPECIAL NOTES & CONDITIONS_ HAND[CAl' STAIRS AND HANDRAIL THIS IS TOU R PECEIPT WHEN MACHINE VALIDATED RV. DATE 111.90 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 plo:es must be on job of all times: Dote I Inspector SP10 Framing R Flashing BPI, lathing 8 Siding SP12 Insulation BP13 Drywoll Nailing PL99 Final Plumbing EL97 Final Electrical ME991 Final Mechanical 78P9S' Final Building f Please Road anti initial: r 1 am licensed under 'ho provisions of Business and Vs.!"itiurvtlode54cCon7000ofseq. and my license is in fu`I force. j 1 OF owner of the proprrry. or nY emplotees wlwoges ushairsolecompensotirnwilldotheworkasathestructureisnot; it.!dii-d w oifered for sole 3. 1 e; owner of the property_ am exclusivell contracting withlicensee! c ,iniryctors to construtl eh, proiect. A. I have o certificate of conspni to selfinsure or a certificateC of Workem Compensation insurance or a certified ropy thereof. 5. t shall not employ any poison In any manner -o as to become subject tr Workers Compensation twos in the pe•formance of therarkforwhichthispermitisissued. Mote rl you should become subject to Workers Compensation offer .Woking this certificolicl. you must for hwith comply withsuchprovisionsorthispermitrhellbedeemedrevoked. Elec Services lae Undergr -,und onduit Undergroundrgs Reinforcement 8PW Slab Grode FLU: I Undz!,ground Water Pipe ough Septic Sys!rm n Site SarverKPLO3oughPlumbin g EL03 Rough Electric•Conduit ELOI Rough Electric- Wiring EL05 Rough Electric -T -Bor MF01 Rough Mechanical MEC2 Ducts. Vemiioting PLOP Rough Cos Pipe -Test PL02 Roof Drains BP05 Floo. Joists BP06 Floor Shoathing BP07 Roof Framing EPOS Roc! Sheathing BPO9 Shear Wall S Pre -lath SP10 Framing R Flashing BPI, lathing 8 Siding SP12 Insulation BP13 Drywoll Nailing PL99 Final Plumbing EL97 Final Electrical ME991 Final Mechanical 78P9S' Final Building f Please Road anti initial: r 1 am licensed under 'ho provisions of Business and Vs.!"itiurvtlode54cCon7000ofseq. and my license is in fu`I force. j 1 OF owner of the proprrry. or nY emplotees wlwoges ushairsolecompensotirnwilldotheworkasathestructureisnot; it.!dii-d w oifered for sole 3. 1 e; owner of the property_ am exclusivell contracting withlicensee! c ,iniryctors to construtl eh, proiect. A. I have o certificate of conspni to selfinsure or a certificateC of Workem Compensation insurance or a certified ropy thereof. 5. t shall not employ any poison In any manner -o as to become subject tr Workers Compensation twos in the pe•formance of therarkforwhichthispermitisissued. Mote rl you should become subject to Workers Compensation offer .Woking this certificolicl. you must for hwith comply withsuchprovisionsorthispermitrhellbedeemedrevoked. ell c i i c o rscr; E.x t-C t E - v s 7Su cE 5t R 1. ISI oe_ 44 -(+m t k A k L— VPrc,%k- lk VIP v-3 - Ll Li c' Tof KfA xry to e. VIP v-3 - Ll Li c' Tof KfA xry r City of Lake Elsinore 130 South Main Street APPLICATION FOR BUILDING PERMIT VALUATION CALCULATIONS 1 st FLOOR 2nd FLOOR 3 A FLOOR GARAGE STORAGE DECK & BALCONIES OTHER: SF GRADING _CUT CY FILL CY VALUATION: __. FEES BUILDING PERMIT SF SF SF SF SF SF PLAN CHECK ADDITIONAL PLAN CHECK GRADING PLAN CHECK MICROFILM COPIES IMPRO FEES C SCHOOL FEES L_j PAID DATE I certify that I hove read this opplicotion and state :hot the above information is correct. I agree to comply with all city and county ordinances and state laws reloting to building constrvCtion, and I.ereby authorize representatives of this city to enter upon the above.mentioned property for inspec- tion purposes. 1 Signotllre of Applicant or Agent Dote AGENT FOR 0 CONTRACTOR 0 OWNER AGENT'S NAME AGENT'S ADDRESS STREET CITY STATE 'LIP APP( (CATION NO. r ! - APPtICA T)Iq RfiCE1VED DATE 1'S . b l =T y AP t BY ITIrcDING ADTr Tt:ACT QOCR. PAGE tot smith NAME _ r c - , [ - v"` s` `,-- t -. • f F ' y PIiONfMea _ ADDRESSei f^ i-. _r- -t _ . 23 t' : «— + •1 I T -- — CITY ST RTE ZIP loll' _ 's• 1 hrobt, aIfil- I I I es*. IKO."d vndv r lor.s.a+s oI ChPP — 9 le w.1h sw!— 70DO', of Dr ;%I to 3 of th* liariness and Profestions Cad. a.'d mr tKSnM :s 1n full forts a.d .Hl t. LICENSE f CITY 6ui1NESS s A-40 S Twz • z MAKING ADDRESS CITY STATE -ZIP PNot f CONTRACTORS SIGNATURE DATE NAME LICENSE • MAKING ADDRESS CITY STATE'ZIP PNCNE CONSr NEW 7REPAIrt OCC GRP. ' 47 7 IT DIVISION: TYPE: ADD CMO% E NUMBER OF NUMBER OF STORIES: BEDROOMS: LTERATION : 'DEMOLISH ZONE: HAZARD AREA? yes 10 SPRINKLERS REQUIRED? YES 140 PROPOSED USE OF BUILDING: PRESENT USE OF BUILDING: OTHER SINGLE FAMILY units APARTMENTS units CONDOMINIUMS units TOWNHOMES units COMMERCIRL : aNDUSTRIAL JOBDESCF;IPTION fl . REV. DATE 11•1.90 C CFA City of Lake Elsinor --e PERMIT 130 South Main Street PERMIT NO: 91- 00000846 JOB ADDRESS . . . . . : 167`.8 LAKESHORE DR DESCRIPTION OF WORK . : ADD OR ALTER - RESIDENTIAL OWNER CONTRACTOR FIRST RIVERSIDE ASSOC LTD OWNER P O BOX 150 GRAND TERRACE, CA 92324 DATE: 8/19/91 A.P.# . . . . . . 378 -290 -016 2 SQUARE FOOTAGE 1400OCCUPANCY . . . . RETAIL,RESTAURANTS,OFFICE GARAGE SQ FT 0CONSTRUCTIONTYPEV- NON RATED FIRE SPRNKLR . VALUATION . . . . 500 ZONE . . . . . . NA BUILDING PERMIT QTY UNIT CHG ITEM CHARGE BASE FEE 15.00 FEE SUMMARY CHARGES PAID DUE PERMIT FEES BUILDING PERMIT 15.01) .00 15.00 OTHER FEES PLAN CHECK FEE 9.75 .00 9.75 TOTAL 24.75 .00 24.75 THIS IS YOUR RECEIPT MEN MACHINE VALIDATED Q$ -19 -1931/ 3=10 PMi:i24. ACCTC 100- 3220 -0 RCPTN: R02- 16396 /RO ;R PER PERMT X191 -8 REV. DATE 11.1-40 r- -- Please- Rood and Initial: I I am Licensed under the provisions of Business and Professional I Cjty of Lake Elsinore I ` Code Section 7000 et soy. and my license is in full force. Building Safety Division 2. I, as owner of the property, or my arnpfoyees wlwogos as their %cle rornpensation will do the work and the structure is Post in conspicuous Place no, inten :edor offered for sole. 3. 1. as owner of the property, ens jxclusively contracting with the stoc structtheproject- liceedcontractor nnson 4' 1 have o certii• cote of consent to selfinsure or a certificate You nst furnish PERMIT NUMBERw of Workers Comrensotion.nswance or a certified copy thereof. the JOB ADDRESS for each 5. 1 shrill not er.,ploy any person in any manner so as to become and subi +ct to .704-ers Compensation Laws at the performance of the respecfjve inspection: wort for which this permit is issued. Approved plans must be on lob Note. If you should become subject to WorP.ers Compensation at all times: after makit•.g this certification you must forthwith comply with such provisions or this permit shall be deemed revoked. Cod^ Approvals Date Inspector iL01 lcmp Elec Services PLOI Soil Pipe Underground l - - --- ELM Eloc Conduit Underground BPO: Footings _ BP02 Steel Reinforcement SP03 Grout OPO4 Siab Grade PLOT Underground Water Pipe SS01 Rough Sep'ic System SWOT On Site Sewer FLO3 Rough Plumbing - -- Ei03 RougnElectric - Conduit EL04 ctric•W.ring ELOS Rough Electnc•T-Bor ME-01 Rough Mechanical ME02 Ducts. ventilating PLO4 Rough Gas Pipe -Test PL02 Roof Drains EPOS Floor Joist: BPO6 Noor Sheathing SP07 SPOS Roof Framing Roc! Sheathing OP09 Shear 'Wall & Pre•Lo!h BP'O Framing & Flashing Spitt Lathing & Siding BP12 Insulotinn BP13 Drywall Nailing P199 Final Plumbing EL99 Final Electrical ME99 Final Mechanical SP99 Final Building Code Pool & Spa Approvals Dote Inspector Po01 Pool Steel Rain. Forms 1002 Pool PlumbingiPress Test P003 Pre•Gunite P004 Pool Fencing /Access P005 Pre Plaster ELOd Rough Pool tlecirit P099 Final Pool /Spa _ r - - - -- - - - - -- -- -""-- SL99 Final Snlor Sub Lisl twr- City of Lake Elsinore J Type of Signs SIGN PERMIT XiElectric Non -electric Protect Address rte/ i ( `-' -' L 1L • 7- --- Applirant's Mailin/r A dd r e ss _ S }Y' (; 3 "I ?honed - - Ov,ner's Name - - - ,0 Ad dress r Arch!Eng. -_— — License No. -- Address Phone ) ` Contractor's Name `T_ 7 7 7 r • " , r Address !nJa,hng) . G;v License No. -- LICENSED CONTRACTOR DECLARATIONI :,ereny allirm rule( I Jm licensed under provisions of Charter 9 (commencingwansccfian7000) Of Division 3 01 the Business and Profess 3s /Cde, and my license ism full fgrcr a Y cllett_— , ; ' 3 _- r /tense No._ License Class DJte "p.n rZ - Signature - 0RKCRS' COMPENSATION DECLAI ATIONInerenyaffirmthatIhaveacertificateofcorisen: it) self- ilSO /e or a certificateofWorkers' Cniepensation Insurance, Or a certrfled CCoppy thereof (Section Bno, Lab, C.) CC,mPJny -) I )11-&-r 7 & Policy Nu. -- -- furnished. -, Certlf:ed Copy is hereby 1 Certified Co Dy IS filed with the city Bu,lai'lg Div 5inn - - - -_- Ga;e____--- - - -- -_ APPthcrnt FA FROM WORKERS' COMPENSATION DECLARATION j(Tnis 5eehn'e need not be COMDleled If the permit is or one hundred (5100) or 5). • -• a .qh this Pernh't r5 Ssced, i Ce,t'tV Ihtlt in the performance of the v :O +•,/ I1eC_. a Subject :n the sr ail onl employ any Person in af'.y m n't,Y sp s f'• L sin•" C P aUOn Laws Of Californ 1 7yyy > '- -L - - -- f. rr 5,9r•at urc _"1 - -- rU to the NOTICE: I:. Ift cnsat On gp, this vi 9, OnSi rof r the Lai)— CCde, CYOUl n11 icd forthwith evninr:.cr5• Cnrr-1sly w,In SJCr' pr o-n 5,nn5 or this perms: shill( be deemed revoke i CO NSTRVCI ION LENDING AGENCY lnirm th n agency for tilt Perfoperformance ' cUV • at there ,s a construcUOn Ientl. 9 ag itinn 3091 C,v. C.1 work Inr •.Vh,tn this penml r55u<`d (Se - -. Lo ntler'S Name L,. nner'S Address - - - - - - - - - - -- OWNER BUILDER DECLARATION ncrcUy affirm that CI ate exernoeBus,ncss,,nd Ptoless,onaliCode: Any City 01f _ilOwiny reaar:n (Sc .t only which requiresoies hl5perw;, to Cdlso 'Ca:. feS the inprove APDI Can demolish or Such(Pef -It env str,.clurc. liu: .7 Sign Cd st JtCnlCnl that hC lShc is !'tensed Du +SUant to lt1C provisions u Protess'on' Code) tit that he /she ,s exemptcefn I %,geed .1 ri Law (Chapter 9 (C'lnhtnencin.] with SCCl,nll 7000) n C• " In. 3 r,, 1hr B is,ne55 and nC.lnl for a Wont sun•CCIS llhC dPPliCanl to a Civil 7n3l by Inur „fin::' Jed the UdLS for IhC tIICq Cd fxC nhptinn, Any v, olal,on of Section penalty of ,lit mint ? n Itvr hundrCtl dollar, (5`.00)• r5 JS thCir Sale I, as nv: ncr nl ;hC M' %r•rlY nr my Cn-n'''. CCS vain' i i,,'nPens.lUnn, 04-11 tl:• Ihr, wnrx, Ana '``h1,' tCss,o JI Code! lThrCConl offered ctor s Sa!C (>r•r! inn 70.7.3• BUSmeh ' t who bU, ids of improve:• L h Sc Law dirt•. nor JDply ti, .111 'iY /n._r Pf a Pr at+' Y rnvctncnb: not intrndcO ur ollcrcd fort,•ienih, .Ind wh', O•,•:'. ;nCh wnrL h,rr,se: ''?C: SCIf hr lm i, U'llh h1S Of Ile' 1• r npin VCCS, Prnvul rr: Trhal "ILI' nip e : i,n• S.1, . If, hr, Waver, the '•hudn,nh nr mhp +uv :n,t'OI n tlC hrn tn one VCa. a ,r ihi,•: uri,, Ihr, i,•04 nCr rail' have iha blpden r.I pr. i `T • . nrnvC fur Illy our prise of •.alt). •.nnlraClu,q with IiCCnSCd Con• uwnr, nl ,he Jn. Del! V. 1m e><CIU 01.1: ct ec L,on 743 1, s ness and Prf property t Cwh tiarlurstn trine(ni'.I the pine'. 1 11 r, an owner le W -tit aJrt „+'s License l..lw dues not apt V : t. uiin•, nr nnpn,vrs thrrCnn, and wnu contract, ice se L prj. I ar with a tint t,.Ir In.ense Pursuant :r: the r'nntracinr'S LiCCnSC Lawe 1 provided to me. pr not of the r HOrLCr's Compensation insurance Sh F3ulad, pCCpfor this reason Da .. Owner belCUy cnrt'fv Ilhdt I 11aV4 Cdr, tills 'cappintion and stale th,ll the above minnnat u,n ,t r4n eCt.,I agic In Comply will' all U1/ and County, oJCi'n CA Ps and Slate W."% Will n r' b ^ nlaf upon construction, a ab Ove menieOYCd property ur insprcti u, pi is i //Jr' _ DatC [ -- - Urrvm s• t_,Cen o nr SS A'/ r- -- -----"'- White -Building; Coneq- Applicant: Pink-Assessor: Go(dencod•Accounling Description Canopy traction Board Ad.-rtis,ng Statuary Other Trac. Sit,! ISecurity & Right of Entry Agreement rl Special Event !Request form submitted) rl Change of Copy (amortization) Ground Wall _ Roof Projecting COnStruct :On Convenience Super Graphic ELECTRICAL Fixtures Device Boxes Outlets Switches S'gn -- Standing Sections Issuc Fee FEES INSPECTION APPROVALS Sign Date - Underground Conduit Properfp A. P. No. programs Shopping Center /Integrated dev. J By Owner /or by City Sign Disc. - -- Date letter sent: __ - -- Variance - - -- Planned Signing C.U.P.': --- Front:. - -- illumination t-t Non - Illuminated Ft. Stfcmt: Interior Illumination Exterior Illumination FEES INSPECTION APPROVALS Sign Date - Underground Conduit Properfp A. P. No. Zoning_ -- , sq.ft. sq.ft. Rough Wiring Dete sq. f.. -- 21 — — (a) — Sign Disc. - -- Received by Street frontage: Front:. - -- Ft. Stied _ - Right: Ft. Stfcmt: Left: Ft. Rear- Ft. Street.-•--.--= --^-- Building set bac'x from ultimate right-0-11Y ft. Sign Location l Right - ._------ Left Front ---- sign Description Area ' Letter Height Sign Dimensions Foundations x- 2) x sq.ft. sq.ft. Rough Wiring 11) Itemt.of Inform ? ation ._-- sq. f.. -- 21 — — (a) — Prattling sXl Valuation S s3300.331a pF3aiiin Fee $ _i_( Building Fee S Electrical S - 0300.3312 SuhTotal S plan Cl:cck S - / -- p SubTotai 5 4110-232- SMIP Total FCC., 5 DEVELOPMENTSERVI Planning Approved SY: - Building Approved BY: - nnntimtion issued BY: Final Electric Final Planning Final Sign REMENTS: Date / 2 G Date Total for Activity - opy Verbtige -_”" —_ -- - Ground Sign: Overall Height -- Planter Alva — Ground Clearance - -- T'hisactivitY -- Notes: Total Sq. Ft. of All Sisk TotalSite_ -_--. -- I THIS DESIGN IS THE EXCLUSIVE PROPERTY OF ELSINORE VALLEY SIGNS AND CANNOT BE REPRODUCED IN V.HOLE OR IN PART WITHOUT PERMISSION OR WRITTEN CONSENT. l S City of L7k o f3ui irq Dept. FIT, RT 0 lk SjiJ rICE 1 EnwAu'` ILt'vwl rim LY3 PL C i ? NW , ACS C,Qv u{U 1+( il t e7•.t.l t'M'GS 1.i!'1 aJ.IV oe STEVE'S SIGNS ELSINORE VALLEY SIGN SERVICE 31556 Railroad Canyon Rd. Canyon Lake, CA 92380 714/244 -5911 52- M THIS DESIGN IS THE EXCLUSIVE PROPERTY OF ELSINORE VALLEY SIGNS AND CANNOT BE REPRODUCED IN WHOLE 06 IN PART WITHOUT PERMISSION OR WRITTEN CONSENT. I u 0t 01- 1 jv-ciI C1 r f- 1 iii A-f TLrnAA /%I.. , t -,LSn„ STEVE'S SIGNS ELSINORE VALLEY SIGN SERVICE 31556 Railroad Canyon Rd. Canyon Lake, CA 92380 714/244 -5911 Ii TAirY- u 0 - 41 W Loud It 3 L t tiESH ORE SIR Lri1 ALA Lr KOhoet OR. I" frolect Address Assessor's Parcel No. - _ ll si- j_ Owner's Name Phone Ari&dss Li,anse No. ---- -- ch /Eng. a ress __--- —.— Phone - Con ctcr s Nantp - Addres marling! — -- I CITY OF LAKE ELSINORE CONSTRUCTION PE3g*IT J IPP f cant to fill in all spaces except those within hea•ry border lines and sign all appropriate declarations TRACT N0. :C-NO. UNfT N. PERRU NO— _ r I City LicenNNO' -- - -- LICENSIr_D C NTRACTOR DECLARATION 1 hereby affirm vt i am I•cen d on rep Busnessand profess ones Code. and with sertion 700 of Divis n 3 o t MY ncenso is In full ct — License No. —_--- Licer.se Class Dat a -. -- - ----- O N WORKERS'COMPENSC R t hetCby affirm that I h e O CO Kent 1 ed ICopy thefeOI (Section o1 Workers' Compenae,/ 3800, Lab. C.) parry — - -- Polity No. --- - -- bCCftilietlcopyIsHereby C n CCfliticd COPY lS filed with the my Bus in9 Division. rate ___ -- Applicant __------ ----'- EXEMPTION FROM WORKERS' CO the PO ATJON D one hundred (5100) oror This Section need not be COrn Peeled'f the pCrrnt less)_ lic.ertily trat In the per'Or n ran an;•IlnlJnnrer so asltb becon n Subject to rile shall not employ any' Pe +•'w4 Of Calls Oroia. _ Workers' Coin Pensatian Signa: Date to the NOTICE: It, alter making th4 dons rof ithe L bOT Code. YO'J Must i forthwith vdorkers' CompensatiOn Pcomplywithsuchprovisions Or -his permit shall be deeh7ed revoxe . CONSTRUCTION LENDING AGENCYlHerebyaffirmthatthereISaCOnstrucUnn lenoiny agercv far the Performance0fthewcrk10, which ttis permit it— issued (Sect.on 3097 Ci'. - -C•1 Lender's Name Add OWNER BUILDER DECLARATIONIherebyaffifmthat1amexemptfrom the orllraClnr't LJ[C/1ie Law for the wnlch requires a permit to construct, alto+• Im Dr ove, damr Suc Or repairhere ISreason (Section .031.5 Business and ProtassiOnal Code: Any , re of County licant for such permit any ty w Uf C, Prior to its Issuance• alto reQ uUed the app thefContractor'S Li rinse Law ( ChaPteri9l( conlmenc lig with Section /000) off pivrsion 3 of the business and Pr o1CSSIOnt COtle) ur that hC /she it exempt therefrom and the basis for lttheallptCC^ exemption. SUietts iheYappl font Of o ccivii 7031.5 by any aPP penalty cif not more than Live hundred dollars employees . 1, as owner of the prooertY or Illy enrplOyCet with wages d their sued Compensation, .Darr do the wr.rk, anC fhprofCSSiOndlsC01 nThe eContractor's r 1 t to an owner of a prOpe•!y who builds or improvesforsale (section 7044, Business in L•ccn sC taw •toes not at%P Yinereon, and who does Such work linomont er are el} or into de his Or her ow eniplo tes, provided that Such `lnl rf IO entent is sold within Line Year nt cdmr• saleSale. I nov•ever, the will ha * lq I , the owner will ll r8 th.0 b("of 01 proving ha /She tlitl not b6rltl r ifn• Prove for "It Purpose of solo). nt 11 license con. I, as WATICI of %ne prnoerty, am CxGu 044 Business ac ing with ssIolletl con. 11111101 t to C)nslruct the prnlect (Seaton 704 I' Business and The COn1r..Ctor's License Law does not APPIY to an owner lo t weer la who buddS n improves thereon, and •.v llo contracts for ,Uth pr O1CCIi with a con- Th. tractor (t rcense Pursuant to I" Contractor's Lice Ise Law). 1 Ain, aware the! 1 prool O theil Wot kar'S Cninoensation rnSura, ::. should be WOVt(lit to an i _-_- P. C. for this teas, t am exempt under Section -- Date -- (f informal, in Is cOrract. tgI.te to comply with all city and cou,,tY '.rd,oancesherebyCreifythatIeYis owner read this dpplrcation and Staff that lhC above and state laws reldtln9 t o enter Qycgopn^trtthell obi vC nlenteibnedauthorize pr.) OoftreP' o snspectiet of this - . \ \1 6 = ata 2 Z nsDeCtlon P ( e Si9natura _ `, : Drivers' License Of SSS V • - -- Ride. ulldlag; CanaryTempwary Flk Imo. Prnk•AWSSOI: Goleenlaf•ADDilant C ADD UTERATIO Summary of Permit Fees 3220 TYPE OF COFF TR11CiH?N Cl NEW OTHER S "" r'- 11-0 A C CO!IVERSION DEMOLISH Main uilding: io_ DESCRIPTION OF YNRfl /USE OF BLDG ---- 7] CA FOUNDATION A L'CTURAL S - TYPE OF PERMR 1 GRADING C! FIECTRICAL D PLUMBING MECHRhICAI FA TENABT SMIP Res SMIP Com. i OTHER OrcuDanty — PROJECT DESCRIPTION: Sq.Ft Acres Construction lone _.__ --- -- type — Psrkin PCa valuation S-_-lt -C - — Notes Remarks PLUMBING I F AItE, Repair Auto Wash Backflow Preventer Backflow Irig?a.ion Clarifiers Dishwasher _ _ Fixture Traps e_ a. Floor Drains Fleur Sinks Gas Service _ tlutlPt: Interceptors gRoofns wer p r...... Rldn ls;ue FEES M 15 Fan Heating System & Ducting F.A.U. p.100 -,000 BTU Cliqu FixtLres { Hood or Canopy Outlets T Be 1 Type H Refri eration Systemn • 5R _ emnc I I 9 0O N N G a ed E a RJI T r-- 77 _ c°_ rtes, Meter U over zuu amps t ' ire Fact. BlI W60 # __ — Subpanel System RepairlP.lteraticn 0 15 5 IKW Transformer r-t cn utu Fire Dampers - Motors 0.1 HP 61'% - 8 nayl rc, . Inc. Solar 09.15 HP 016-16+1 Incinerator SiH m. Res. Misc. Fa Aaulti•Fam. Res. — —E -- Issue - DEVELOPMENT SENVKEs REQUIREMENTS: Date Imiag Appfoad N _ _Date r—_ -- BuildiingAypinwdBY - __•Data Application land By t AOCT.0 GRADING FEES cue -- ^.._.cu. Yards Fill -- - - -cu. yams 3101 Plan Checli Fee S - - - -- 3225 Permit See $ — -- Total Fees $ Summary of Permit Fees 3220 Buidink S "" r'- 11-0 3221 Plumbing I _ -- 3122 Electrical 3223 Mechanical S - 3224 Wenuor. 2301 2302 SMIP Res SMIP Com. 3225 Other 3401 summary of Plan Chcck Fees Idmg $ Plumbing Electrical S r - - - -- Mechanical 3403 3411 DWI Planning Total Few Due $ 0 w I `o t , w i I O l I I -- 12 ! dl j z i of CL ! u' ci c ir0 z a a a. U Q I E =! 1 001 I ! I 51 ! ! Q ? FW rn1 l n aOv a f O mil ® .L 11 I , lQg I wj a°ci Ri `' al j , j L71 ml QI I , U IQ co C' oiS LL E O III a l OdQa1 7i N it W j CL Q l o dt E c I ti I I CL I ! ii l I `o t , w i I O l I I -- 12 ! dl j z i of CL ! u' ci c ir0 z a a a. U Q I E =! 1 001 I ! I 51 ! ! Q ? FW rn1 l n aOv a f O mil ® .L 11 I , lQg I wj a°ci Ri `' al j , j L71 ml QI I , j fi- rL Q' y w m o+ p} y1 III LL! 1` J! i I TT III I I I i I II I I i lIIillyI i rn w > I + N c yt0Z11 II 3:1 1 ' f 2 ! l1Q u Qt (51O( a > ? O X w ,; O C31 na! uz I I I I Ill f± ol I Ij I ji;i I!l li I 1 ! w i ( i I I I i I 10 I cz7' I ! I l r oI mj i + 1 ! I I I I ! I ! I l j =+ i j I I ! a I I I I i zj I I --31 rol U' 1I c UO I i l °I Cj i a c w ° ) I m i= a rn• i _ w ` I I c a ¢ I ° O; O . . ci m ' ml I rn! I a1 a' j c i l IC. Vy l U i '- i J I N N .: - -1 ° t c - I I- v c j# ciS , al rn i u a, Q ~ I I i I H _I E UI t I i , (il f„I I Li LL l _ Qil I I -Idc 3l ' I1 ml a. C i ro ! - (n JI O' 1 cl I LL «. _ U u t- dI E' R a a a. i 5, N w O r Ix, EI I a QI °i OI a IuI r! ro t c Z u! . w N EILccIIyrI1DLn .o - I- ! a' n, m ! 3uzc` Z j c c, aI rnl _ m. CocofofnOofcl03 - ° L, a , . ; } m ro ; wi 2j L7 e, al m m C: ,ol o H Jj n! w I t o o b o! 20 mlU' ! LL (7 i' Il I ! 2 O OI _ C C O Nl Yj I LC CC 1- I lb I c q 0 I i ,y u i ii Z u.l <( l7 vi m! m y U. II! f-aU N C7 l m c I UI oc J w t+ c 1 IJ m m d Z zl •yi Q ul J m' a l UJI I 1 1 1 LL CI LL' i c N c j w dfI E cal ti I 2 d c cm2; ni wI I j fi- rL Q' y w m o+ p} y1 III LL! 1` J! i I TT III I I I i I II I I i lIIillyIi rn w > I + N c yt0Z11 II 3:1 1 ' f 2 ! l1Q u Qt (51O( a > ? O X w ,; O C31 na! uz I I I I Ill f± ol I Ij I ji;i I!l li I 1 ! w i ( i I I I i I 10 I cz7' I ! I l r oI mj i + 1 ! I I I I ! I ! I l j =+ i j I I ! a I I I I i zj I I --31 rol U' 1I c UO I i l °I Cj i a c w ° ) I m i= a rn• i _ w ` I I c a ¢ I ° O; O . . ci m ' ml I rn! I a1 a' j c i l IC. Vy l U i '- i J I N N .: - -1 ° t c - I I- v c j# ciS , al rn i u a, Q ~ I I i I H _I E UI t I i , (il f„I I Li LL l _ Qil I I -Idc 3l ' I1 ml a. C i ro ! - (n JI O' 1 cl I LL «. _ U u t- dI E' R a a a. i 5, N w O r Ix, EI I a QI °i OI a IuI r! ro t c Z u! . w N EILccIIyrI1DLn .o - I- ! a' n, m ! 3uzc` Z j c c, aI rnl _ m. CocofofnOofcl03 - ° L, a , . ; } m ro ; wi 2j L7 e, al m m C: ,ol o H Jj n! w I t o o b o! 20 mlU' ! LL (7 i' Il I ! 2 O OI _ C C O Nl Yj I LC CC 1- I lb I c q 0 I i ,y u i ii Z u.l <( l7 vi m! m y U. II! f-aU N C7 l m c I UI oc J w t+ c 1 IJ m m d Z zl •yi Q ul J m' a l UJI I 1 1 1 CITY OF LAKE ELSINORE BUILDING DIVISION O W N E R- B U I L D E R V E R I F I C A a I O N A city or county', which is required t-) give notice pursuant to Section 19830, shall attach to such notice, and, as a condition precedent to issuing a building permit, require the completion and require the return of an. owner- builder'•verification. Attention Property owner: An "owner- •builder." huilding permit has been applied for in your name and bearing your signature. No building permit will be issued unil this Nrerification is received. 1. I personally plan to provide the major labor and materials fob construction of the proposed property improvement. 4; Yes No 2. I (have /have not) \ signed an application for a building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction: Name Address Phone ( Contractors Lic. # 4. I plan _o provide portions of the work, but I have hired the following person to coordinate, supervise, and provide the major work: k Jdame Address _ Phone (714) _ Contractor's Lic. # 5. I will provide some of the work but I have contracted hired) the following persons to provide the work indicated: Name r '' nnnn Address Phone Type of Work If additional space is required attach :subcontractors list.) N'A A I hereby affirm that I have received a copy of the information set forth in Section 19830 of the State of California Health and Safety Code and have complete the above information to the best of my personal knowledge, in compliance with this State Law. 1 0 Date: I cSigned: Name: . 1 ? 1'rl \N e — Printed or Typed) q Drivers Lic. # or Soc. Sec. f v( 'J E7 2 L) 1