HomeMy WebLinkAbout15120 GRAND AVE_ (2) I
CITY OF LAKE ELSINORE CONSTRUC i iON PERMIT w; h
_(�_�,Z� Applicant to fill in all s+aces except those within heavy border lines and sign all appropriate declarations 1,3i'
Project Address f�? f—
PERMIT NO. TRACT NO_ LOT NO. UNIT ht).
Assessor's Pareet N].----- ,. - - �
none �
Owners � ALTERATION REPAIR zr.. Zone
Addreu - D ) TYPEOFCONSTRUCf1DN -- NEW ; ADD �] r )O� A.P. #
9-�� s& Lrcerse'�'a. _ CONVERSION _ OEMOLISF' OTHFP. -� '
S r---• Access Building: Z
Arch En ��_ ` f -__ DESCRIPTION Of WORIll OF PLD' - E Mom Building: --
Addreu _ �--� -" O
rvG[J� _Phone��'- T Front N
Contractor' •i�me �r�+�-� TYPE OF PERMrr 7 GRADING FOUNDATION TRUC1URAl e{ Rear --
Add ess tafa'nn9)tea'"- — - _ TENANT = ELECTR:Cn _ PLUMBING 1 MECHANICAL - -- N
No. -�/Z�r+-- OTHi: __ C�Right G
city License Occupancy _----------- K --
LICENSEO CONTRACTOR DECLARATION PROJECT CISCRIPTiON a0 t - Atrls S Left H
nu•by atf,rm that I am licensed under previsions or Charter 9(come enc+nq •f:� Zoae �� Parkin Req./Provided -
Z7 Ping. Ref.# O
with y_ct•nn :000) of Division 3 of thy` Buzrne'•z and Professions Cot If And CotKVo[t'M � Dra _I____�S --
't h_ense n ; 0 force a effect. p valuation
d .a. L,cenu`ryt— Planning Note:
L,cenu lass ppGL=- dd- — Remarks T
to.� 1(1A Signature --
ell! _ - S
Rit R5'COMPENSATION DECLP11. r: _ -�-
,tbv affirm that I have a Certifir_ite of consent to selt•insu to-roof r a e(Sec,aon '
o Vil kert' COmtv_nSdtiCn ,n1a]rdnC0. Or a CerG1,ld COPY
3800, Lab. C�.s
Policy No. JRf• - Company
II Certit.id copy is hereby furnished. fz,on. -
Certif, tl cpciy.!s tiled with:Pe n, sup
r - - '
Date ���_p'.1f„aP"!._- AERS'Ct - -_
' -XEMPTION FROM WORKERS'COMPS ATION JECLA hundred
( _ - FEES �T 9 GRRDING FEES
ITrtrs sec i,cn need nc•be completed ri the Derm,;,s for one hundred(5100)or FEES ELECTRICAL . FFES MECHANICAL
{ esst. PLUMBING — _-- -- — " r, cu.rards
{ ctrAty :hLt ,n the berto•mance of the AO'll' fc' "Co•!•.;rr, subject
is t to t,1 l )1.
employ any PCr;on ,n any r,in-,•.f so as:o beco":e sublCct to the Alter, Repair Generator r'0.5K�5Kw; — 1 Boiler - cu.�ards
lVors.eri' Compensation Wws nt Cat,'orn'a-- --`- ---____-_- - -- -}--- - Durt_Undet Ground ftli. _ -
Oa.e _ --s,gnatlae t-� , Construction Pale Sub.
5r,,o ,d Deco�+e sub,eu to tre Auto Wash '- i Duct Structural 33(iD•3370 Plan Check Fee S
NO'ICE:t',alter mal"ng tors dec'arat,,•. r''= Cookie Unit ' -- _
tvorlo-v Compensation crowsicns or tr.e �acr,r Cude. -:^-u must torthkecj. •t--'--- 3�COd312 Permit fee
S - --
Backflaw Preventer g -
_ comply wrrn Burn prov,s,ons ,,, to s cerm,t snap o•: deemed revoked. Pole Light
--1-- �`-- -
CONSTRUCTIOp LENDING AGENCY BaCkfIOW if_r10aU0n -�..----g---- �Exhaust System - ;
ye c, 1z,;he perrcrmarcc Dryers GGas ]Eleetrit 1 Total fees
t ncreD,r an,rm that there,s a cons:,uct -n:rr.]r..a a Lr _----�---t _
3097 •C,v. _.) Clarifiers Evaporative CoOter
of ttie work for 'Alperr',rt rs ,Slued-iS_ci _ ---� Dishwasher Fan --.. -
Lenders Name - , F.A U. ? _ Heating Syr(em&Ducting ;
! r'ixture Traps ea. t i 00.100 000 BTU 100,000 BTi' ' 3300.3311 Scmmary of PersllilFea
OWNER LVILDE►t UEr-ARATION F,'lOr D21ns _ , I-IxtUfeS --J-!-- 7^,
I herCbti ai him !till I am CxCmPt in-m cf C t.hDtp cssr s Canso Law".ne' LGAC:Any c,rY ne - =i- -- -_ FHO.0,�or Canopy _j C/f,,I,owin7 reason (So.:.on 7031.` Bus.^^_ss a^d - L.r)r'-.nks - Outlets _ Budding '_ /c,uinty .vn,en reau„es a permit tr,Ccnst'uc;,alle?, aopi.ra tefor lsuclfpermitr - t Swi[Ches _ l_i= II - -- -_
any structure,Prior to ,t.issuance.aisc•r:cv,fcs {Gas yCrnCe Qul!etS Refrigeration System V vl,mbmR 3
urs�an'to the prov,s,oas f s
hie a signal statement that ha sec ,� 1;Cel,sed p n section 7000 dt - _ Meter Ci up to 2i)0 amps_ A`jC5
•Contractor's L-ccnsc L.,w(Chapter (coin-,e�r c, �r that re�sne ,s exempt Inter,epior�-_ - - �0.100go 3TU r 100.000 BTU Electncal $
v,smn 3 of the Business an] P,ofess.�ns Co C1_ r. ��urat,on et SL•rt,on ! Meter L, over 200 amps
ororrom ano the basis for it anocFr,Cxi�o ccts ne'applicant to a civil F.Trap - Sub Q2nel I _ Fire lil':.t!•�!(.ICBO Mzchamc:l $
_--------
)e o f by ]nY aPPl,Cdnt fhr P .-.1'.1-- _
penalty of not n,o•c than five honored editors(S>�oi. _Roof D'ains __,- - --�- System Rapair/Alteration Olher $ ----
rtv „r my emc'rrycet :.th wages .is the+r Soto - ❑ 15.5OKW — -
as owner of the firono Trailer S,wer -_ Transformer G 50+KW _ _ Fire Dampers - - S ----
�rde. The _ontractor's ---- _ { 110231 SMIPR:S
coin Densalion, will I:, the wort,and tr.r: struCluro ,z ^�' ntene s or root' �_
Pr^iC SSional �i
for sate (seci,on 7044, Business .i^c v M.o Duties or improves SeyYef Ca{. -___- -}-- ; r-. , ReOlsters _ _
l-,ctnSC law does not apply r,an •f nrer,�N,nprt rettr:rr:u9n his t,r hor own Sewer Fort,action•P;dg. Motors CI 0.1 rfP.J 1�i•S -- _1�.3 --- -�- 1lu-232 syip Corn S ��-:._•-
:•,c,Con, and who dons such hor. rr• rtcrced-or_otlMc,s for Inc. Solar L�9-15 HP 016.15T' �'tClnete_t0_1 —
empioveeS,umvrded th,; such ,mp,r-vemer:a a*! �_ Solar Cai!ee,^rs - - �" 33f,0.3310 Summary atFitai Check Fen
sate. If,However,the nu-ldrnq or,n w-emen,is sr, : :. thin oro roar ni r IM. Sing/Fam. Res. Mlsc. _-_- - 7
pt,t,on,the owner will h,wC the Uu,Ce'O!mhvinq hC :•^-n,d not bu,ltl or h:,• --+--r Piping .� - - ----j' T•• -! i - /3
prove icy the purpose of sale). t,�r..;.q with licensed COO _solo_ Multi•Fam. Res. �'�---
r .:xc.,,:,.,;.�y c - I Solar Tank ---i--- -
5 owner of the property.a Swimming Poo{/Spa --
uano,to a,nst,r,ct trio orol'ct (Sec:ior.1 TJ�:,El`s,�'^Ss,vnCr of uropofly who -. -- - y_---- T-r--- Plumbing ----
Ton Contractor's L,ecnsr. La,-, dues "'' 0 r n o ects with a con• Swimming Pe.,;:.pe.-____. Issue - -+
bu,utt n, unp,nves thereon,a.,d wn�CUnlrafSt if,f Svc p, 1 Water Heart' -• - I tllfhl[81 .- __- --
tractn,(s' license Pursuant to Ire Contractor's 1Jcecse Law). I am aware that
t,not s, their w,rve,'s Cnrnpm)sahon rnsuraneo SnC�d Ile p,nvitlee to me. _.�-- Ivule
.� I am e xempt undnf Section ._. _. -� B.L f'.C.for this reason Water SerVtCe_-_._
- - _--- __ _� .__ -_-_.-----•------ Se tit�ystom — DEVELOPMENTSERVICff;lEnN ) Otheronto _ swt - ,s'' _ , Date 3Ya03315 PlanningIneraby cwt,ly that I have rrae chi: apptrcat(on and state that the abovo �ttiati i'af1I11gApptaadll �,_wDaU .1" -mionn.it,on ,s coned. I agree. to .ornpvwith art my and cntlntY drd,nances - BaadngApArowdEY - .— -_ ..-Date/�1-f�f--
and state laws relat,nq I(, bu,lcing constr i�abovedj7lc�lCnnCOUIof,)pefty core,
- Applitaffon Issaed By f So41 f!aOff $ -- -
Sentat,ves of in'$ city to n for upon flj1� luue
ms-ect,on poi Unto --
LDriverS'License of S M
While-luill Green-Temporary file Copy.Canary ssa.
. rod•Attounting
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