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Home My WebLink AboutBROMLEY AVE 17480 CITY OF LAKE LsirlO E BUILDING & SAFETY DREAM EXTbLEME TM 130 South Main Street PERMIT PERMIT NO : 08-00001394 DATE : 12/04/08 JOB ADDRESS . . . . . 17480 BROMLEY AVE DESCRIPTION OF WORK DEMOLISH ALL OTHERS OWNER CONTRACTOR A. P . # . . . . . 378-132- 001 9 SQUARE FOOTAGE 0 OCCUPANCY . . . GARAGE SQ FT 0 CONSTRUCTION . . FIRE SPRNKLR VALUATION . . . 500 ZONE . . . . . . R-3 ------- _---------------------------------------- --- DEMOLITION PERMIT QTY UNIT CHG ITEM CHARGE 1 . 00 X 30 . 0000 DEMO PERMIT PER UNIT 30 . 00 1 . 00 X 5 . 0000 PROFESSIONAL DEV FEE 5 . 00 ------------------- -------------------,�� -------------------- --- FEE SUMMARY CHARGES PAID DUE PERMIT FEES ------------------------ DEMOLITION PERMIT 35 . 00 . 00 35 . 00 OTHER FEES ------------------------ PLAN RETENTION FEE . 52 . 00 . 52 TOTAL 35 . 52 . 00 35 . 52 SPECIAL_NOTES &_CONDITIONS - --DEMO—OF FIRE DAMAGED PLASTER IN HOUSE NO ASBESTOS Oper: i-(UNTER2 Type: DF Drawer: 1 Dare: 12/04OEs 04 Receipt no: 3353 20 02 1394 Pip BUILDIN6 PERM 1 $35.52 Traynn number: 129134 CX EHECk 565 798.52 Trans date: 12/04/0B Time: 10:51:23 City of Lake Elsinore Please read and initial Building Safety Division 1.1 am Licensed under the provisions of Business and professional Code Section 7000 et segr and my license is in full force. Post in conspicuous place -0. 2.I,as owner of the property,or my employees w/wages as their sole compensation will do the work on the job 1l// and the structure is not intended or offered for sale. 3.l,as owner of the property,am exclusively contracting with licensed contractors to construct the You must furnish PERMIT NUMBER and the project. JOB ADDRESS for each respective inspection: 4.1 have a certificate of consent to selfinsure or a certificate of Workers Compensation Insurance Approved plans must be on job k ora certified copy thereof. at all times: S.1 shall not employ any person in any manner so as to become subject to Workers Compensation 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, Code Approvals Date Inspector you must forthwith comply with such provisions or this permit shall be deemed revoked. EL01 Temporary Electric Service PLO1 Soil Pipe Underground EL02 Electric Conduit Underground BPOI IFootings BP02 Steel Reinforcement BP03 Grout BP04 Slab Grade PLO I Underground Water Pipe SSOI Rough Septic System SWO1 On Site Sewer BP05 Floor Joists BP06 Floor Sheathing BP07 I Roof Framing BPQ8 Roof Sheathing BP09 Shear Wall&Pre-Lath PL03 Rough Plumbing EL03 Rough Electric Conduit EL04 Rough Electric Wiring EL05 Rough Electric/ T-Bar ME01 Rough Mechanical ME02 Ducts,Ventilating PL04 Rough Gas Pipe/Test PL02 Roof Drains BPI 1 Framing&Flashing BP 12 linsulation BP13 Drywall Nailing BPI l Lathing&Siding PL99 Final Plumbing EL99 Final Electrical ME99 I Final Mechanical BP99 IFinai Building Code Pool&Spa Approvals Date Inspector OTHER DIVISION RELEASES Deputy Inspector Department Approval required prior to the POOI Pool Steel Rein./Forms building being released by the City POO 1 Pool Plumbing/Pressure Test P003 Pre-Gunite Approval Date Inspector EL06 Rough Pool Electric Planning Sub List Approval Landscape P004 Pool Fencing/Gates/Alarv,s Finance P005 Pre-Plaster Approval I Engineering P009 Final Pool/Spa CITY OF LADE LSIN.0R E D R_FA M EXT IZF M F ,h,. 130 South Main Street APPLICATION FOR APPLICATION NO. BUILDING PERMIT APPLICATION RECEIVED l�l�'1 DATE AP# BY VALUATION CALCULATIONS 19UUILPING ADDRES r 1st FLOOR SF b N71� TRACT BLOCK/PAGE LOT/PARCEL 2nd FLOOR SF AA E 3rd FLOOR SF 0 \ W MAILING GARAGE SF N ADDRESS E CITY STATE!ZIP STORAGE SIF R I hereby affirm thlat I am licensed under provisions or c ap er commencing DECK&BALCONIES SF with section 7000)of division 3 of the business and professions code,and C my license is in full force and effect, OTHER: SF 0 LICENSE# CITY BUSINESS N AND CLASS TAX# T NAME VALUATION: R A MAILING C ADDRESS FEES T CITY STATE/ZIP PHONE 0 BUILDING PERMIT $ R CONTRACTOR'S SIGNA URE DATE PLAN CHECK NAME LICENSE# A PLAN REVIEW R MAILING C ADDRESS SEISMIC H CITY STATEIZIP PHONE PLAN RETENTION ❑ NEW OCC GRP./ CONST. ❑ADDITION DIVISION: TYPE: ❑ ALTERATION NUMBER OF NUMBER OF ❑ OTHER STORIES: BEDROOMS: ❑ SINGLE FAMILY ZONE: 0 APARTMENTS ❑ 1 certify that I have read this application and state that the ❑ CONDOMINIUMS HAZARD YES above information is correct. I agree to comply with all city ❑ TOWN HOMES AREA? NO and county ordinances and state laws relating to building ❑ COMMERCIAL SPRINKLERS YES construction,and hereby authorize representatives of this ❑ INDUSTRIAL REQUIRED? NO city to enter upon the above-mentioned property for insp- ❑ REPAIR PROPOSED USE OF BLDG: tion purposes, ❑ DEMOLISH PRESENT USE OF BLDG: JOB DESCRIPTION Signature of Applicant or Agent Date Agent for [J contractor I] owner Agents Name Agents Address Street City State Zip SAFECO Insurance 12/1/2008 1 : 23 PM PACE 1/005 Fax Server A- TM TO: Company: Fax: Phone: FROM: Safeco Claims Fax: 1-888-268-8840 Phone: 1 -800-332-3226 NOTES: 2rd asbestos report. Date and time of transmission: Monday, December 01, 2008 1:1 7:52 PM Number of pages Including this cover sheet: 05 The Information contained in this message Is confidential.If you are not the Intended recipient,or an employee or agent responsible for delivering this message to the intended recipient,do not distribute or copy this communication. If you have received this communication In error, please notify us immediately by replying to the sender.Thank you for your cooperation. SAFECO Insurance 12/1/2008 1 : 23 PM PAGE 2/005 Fax Server w rAl n r�RIO 1r� ENVIRONMENTAL LABORATORY SERVICES, INC, Polarized Light Microscopy Analysis SafeCo Insurance Report Number. 337927 Atm:Adrian Filip Project Number. 27894 PO Box 34700 Project Name: Seattle WA 98124 Pioject Location: 17480 Bromley Ave Lake Elsinore,CA 9z530 Claun Number. Date Received: ]I/142006 Number of Samples: 9 Date Analyzed- 1111412008 Pa Number. Date Reported: 11/17/2008 Leb/Client ID/Layer Location Material Description Color Composition(°A) 337927-001A Living Room Ceiling Plaster Beige 90%Carbonate 1 20%Mbxrals Total Asbestos None Detected 337927-00113 Living Room Ceiling Drywall White Brown 85%Stilfate 1 15%Cellulose Total Asbestos None Detected 337927-007.A Living Room Caiug Piaster Beige 90%Carbonate 2 20%Mi w als Total Asbestos None Detected 337927-OW Living Room Ceiling Drywall Wlilte Brown 10%Sulfate 2 15%Celhlose Total Asbestos None Detected 337927-003A Living Room Coll Ing Plaster Beige 80%Carbonate 3 20%Minerals Total Asbestos None Detected 337927-003B Living Room Ceiling Drywall White Brown 85%Sulfate 3 150/6 Cellulose Total Asbestos None Detected PW I of 3 7271 Garden Grove Blvet., Suite A • Garden Grove, CA 9Z841 • Tel: 714/899-8900 • Fax: 714/899-7098 www.l')atrtotlab.con) SAFECO Insurance 12/1/2008 1 :23 PM PAGE 3/005 Fax Server Polarized Light Microscopy Analysis SafeCo Insurance Report Number: 337927 Attn:Adrian Hip Project Number: 27894 PO Box 34700 Project Name: Seattle WA 99124 Project Location: I7480 Bromley Ave Lake Elsinore,CA 92530 Claim Number: 315240493015 Date Received: 11/142008 Number of Samples: 9 Dato Analyzed: 1111412008 PO Number. Date Reported: 1 1/1 712008 Lnb/Client 1D/Layer Location Material Desariptlon color Compositlna(%) 337927-OO4A Living Room Wall Plaster Beige 88%Carbonate 4 12%Minerals Total Asbestos None Detected 337927-004B Living Room Wall Chyavnll White Brown 83%Sulfate 4 15%Cellulose Total Asbestos None Detected 337927-005 Kitchen Ceiling P}nster Beige 80%Carbonate 5 20%Minerals Total Asbestos None Detected 0 Page 2 o f 3 7Z71 Garden Grove Blvd., Suite A • Garden Grove. CA 97$IIl • TP1: 714/B94-RQOO Fay, 71A1P99-709R wwet_na tri otla h.mm `AFECO Insurance 12/1/2008 1 : 23 PM PAGE 4/005 Fax Server Polarized Light Microscopy Analvsia SafeCo Insurance Report Number: 337927 Attn:Adcian Hip Project Number: 27894 PO Box 34700 Seattle WA 98124 Project Name; Project Location: 17480 Bromley Ave Lake F.Isir-ore,CA 92530 ClaenNutnber; 315240493015 Date Received: 11/14/2008 Number of Samples: 9 Date Analyzed: 11/14/2008 PO Number. Date Reported: 11/17/2008 Lab/Client ID/Le•er Location Material Descri tion Color Composition % Rosa Mendoza Cristina E.Tabatt Analyst Approved Signatory Bolt sample analrad per 40 QR 753.S*W F.Appeadix A;EPA40WR-WI is mid to<himUc m#erials;EPA-60Uf664-112ZU SMWIM as dyad ,..,.. _.....�.. ....e ;i c,.:dv i;iheiC iv r, runs,ts;r-1: n i1:3 t IOC SdrnRleS Ot iaN cunm±ration]evctS. This neQort a�Slies only to the items tested. ----:.___.- _ _ _ _,:.: _— a.� +c ropresenr ci:s��rinl Irom which ssnples urm cd1ected. This mpart was issued :20tr358-T)ac4zcdiied laborati-xv,end cney not be reproduced without*A atpressed written ca vmt orFstdol EnvlrwmenUd. 71, t.sxr nlukc nAl��r.=y'S ins: ..:.i:r:~.i :6.-wgiar, sTa�n mvai nr t €i�:.u.,,t' i 'F.kiVA �r �rrrwnv tp f�Aaro: -:-.r w�:�__:J�.�:::.�:�=::�`.'..:-_-_.�-"Y—•-•- -�--a.-�a�r.....i.�w.y........r�M�-_..r........ � ...... _.__.y.r____-`� f leee will;r��dlr.3�_.rrs m.�_.+�lvsrrt earl rosfrrF._erTari:r .saw,.lu im a lifHr Only rssun�:�"• tit�1 r'• .....� Bs:•^:.. Sui.e A Carc?e.. Grove. CA 92.R4I , Ta.!, 71Af.RQ4-ltQM Fax? 7t1:4OD-70+7R !"l[NW.nwFrinrlah�nm . SAFECO Insurance 12/1/2008 1 :23 PM PAGE 5/005 Fax Server PATRIOT FIELD BULK SAMPLE COC NMt!N FAIL REQUESTED(AS YIp LABORATORY Se#MCb - TAT PROJECT PROJECT I CITY: ��jp �+ y� NAME: ADDRESS: �TMI' I Ty�i '""s" ✓II IDYQj Z[/P�: PROJECT a"7 NUMBER: PS AIDle $amp[c Location Material Type F N Condition Notiee N. ILL ftlkAj- .� �l •�. ': ." .i `� �; 'I I i .• i .as f t EI • f �"' �- ii.�k,� - z• .1'il Y4.il. 'v'ie�'.'3 1.Jf."f,.a'- .",i _( __ .11 . i f rwnDil - i of n it 1 rr��e - a - ., .• ... TT _ -_ 1 1 1 ! SampieeceItetqulshed6V: - - ; Date/'Iims: • Samples received by.' 7271 Garden Grove Blvd,Suite A,'(( rdert Grove,CA 92341 Tel:8381743-0998 teI:7N/8y4!89QQ Fax:?;4/394 'CS8 ,�,