HomeMy WebLinkAboutRIVERSIDE DRIVE 31681_04-00001552 * 1 0, ",417
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City of Lake Elsinore '
PERMIT 130 South Main Stre
PERMIT NO: 04-00001552 DATE : 6/23/04
JOB ADDRESS . . . . . 31681 RIVERSIDE DR #I
DESCRIPTION OF WORK ADD OR ALTER NON RESIDENTIAL
OWNER CONTRACTOR
UNKNOWN OWNER
A. P . # . . . . . - - SQUARE FOOTAGE 560
OCCUPANCY . . . OFFICE, RESTAURANTS, MISC GARAGE SQ FT 0
CONSTRUCTION . . TYPE V- NON RATED FIRE SPRNKLR
VALUATION . . . 5, 600 ZONE . . . . . . C-1
BUILDING PERMIT
QTY UNIT CHG ITEM CHARGE
BASE FEE 63 . 00
4 . 00 X 12 . 5000 VALUATION 50 . 00
1 . 00 X 5 . 0000 PROFESSIONAL DEV FEE 5 . 00
ELECTRICAL PERMIT
QTY UNIT CHG ITEM CHARGE
BASE FEE 30 . 00
5 . 00 X 1 . 0000 SWITCHES / 1ST 20 5 . 00
10 . 00 X 1 . 0000 RECPT,OUTLET / 1ST 20 10 . 00
5 . 00 X 1 . 0000 LIGHTING FIXTURES/1ST 20 5 . 00
2 . 00 X 4 . 2500 NON RES . APPLIANCE 8 . 50
1 . 00 X 5 . 0000 PROFESSIONAL DEV FEE 5 . 00
' PLUMBING PERMITS
QTY UNIT CHG ITEM CHARGE
BASE FEE 30 . 00
1 . 00 X 5 . 0000 PROFESSIONAL DEV FEE 5 . 00
1 . 00 X 8 . 7500 FIXTURE OR TRAP 8 . 75
FEE SUMMARY CHARGES PAID DUE
PERMIT FEES
BUILDING PERMIT 118 . 00 . 00 118 . 00
ELECTRICAL PERMIT 63 . 50 . 00 63 . 50
PLUMBING PERMITS 43 . 75 . 00 43 . 75
OTHER FEES Date: 6/23/64 23 Receipt no: 6391
PLANNING REVIEW FEE 22 . 60 22 . 60 2084 1552
BP BUIMY('i PERMIT 1 4228.25
PLAN RETENTION FEE 2 . 50 . 00 TranfEnuWr: M67
SEISMIC OTHER . 50 . 00 CA CASH 50 $236•00
Tram date: 6/23/04 Time: 10.46:10
*** CONTINUED ON NEXT PAGE ***
\ I r I'Icdc{lead and Initial
= I I ant I-tct rist d under n
OW proc1sinns of 13usttusn and Professional
(_ale 4reiun 7000 el si q and my hr enst is in full force I
Post Ill ltlll"plcuoll` )lace 2 I asow•ntrofiheprolx•m ornn• employctsw/w.ygesasthetr%ole compensation will do the work and the strurture is not intended or?
on thu Joh offcmd for s0-
3 f as owner oI tht property am ex(Iust%eh•cxmtracu rig with licensed
contrarinrs to e one true i lht projtx t
4 Iha%eacenlliratrofronvnttose•It3nsun•ora certificate ofWorkirs
It i,I1Jf!;t �� „iir...':.ii` - „i ,,r •l Compensation insurance or accrlifiidC%A' thereof
i I shall not emplo%am pt rson In am manner so as to bet ornn subject
'le'� r �`�1 i• .' to�Aorkers(-oompcnsatiun laws in the pert-nnnancc of the work for
which this ptrmit is issued
%oic• It loci should Ix-conic subject to Workers Comfxnsitiun alter
mnl.in,this tt rtificaunn �e,u must torthw•rth oomph with sue h pro-
visions or this F••nnit shall he(let-me d n•%okt d
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- G'part-r><Yit Appra:al required poor to Tice
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bwiorri5 be,rx3 released oy the City
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Da'e Inspector
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City of Lake Elsinore
l ,� v PERMIT 130 South Main Street
PERMIT NO: 04-00001552 DATE : 6/23/04
** PAGE 2
JOB ADDRESS . . . . . 31681 RIVERSIDE DR #I
DESCRIPTION OF WORK ADD OR ALTER NON RESIDENTIAL
FEES : (CONTINUED)
PLAN CHECK FEE 84 . 75 84 . 75 . 00
TOTAL 335 . 60 107 . 35 228 . 25
SPECIAL NOTES & CONDITIONS
TENANT IMPROVEMENT FOR L.L.
ACUPUNCTURE CLINIC.
\ h PI, +st• ih•ad and Initial
I I arm Liccn—d under the pru�1stons of Business and Proll•ssmnal
(_cxie Stttion 7CXK1 el seq and rnv license is in full fon e
��tl�( 111 l'U11��)Il'111111� �)�.Ill' 2 l,asowneroliheprolxrty orrny empinve•esw/waXesasthetrsoir
compensation will do the unrk and the strur tun• is not Intended or '
tlrl the joh ollcrrd for sal•
3 1 asownt rot LhLpropert� aineaclushelycvniractinRwithhcrnsed
contractors to construct the project
f\\11 I M V R I R "Id i 1. 4 1 ha%c a re•riifie ate of t nnst nt to seifinsum or a certificate of Workers
ompensanon insurance or a certified tole,thereof
r o I shall not t mplov anN person In any manner so as to heir ome subject
to�Aorkrrs C coin prnsaIion Laws in the performance of the work for
which this permit is issued
Lott If%ou should become suhjet t to Workers Comix nsation after
mehtrig this crruficanon %ou must forthugth cornph•with sue h pro-
vi.ions or Ihr l••rnui shall he deemed revoked
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case p s Saz D z, a e rs:> OTHER DEPARTMENT RELEASES
D arv-nerit Approval required poor to the
Fc--s budding being released by the City
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Da;e Inspector
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City of Lake Elsinore
130 South Main Street
APPLICATION FOR APPLICATION NO.
BUILDING PERMIT C),�q - 15�2
DATE APPLICATION RECEIVED,
0 t
DATE /J—�/
VALUATION CALCULATIONS AP# By ^
t st FLOOR (0O SF BUILDING ADDRESS
V
2nd FLOOR SF TRACT BLOCK/PAGE LOT/PARCEL
3rd FLOOR SF
GARAGE SF NAME A C-v P
STORAGE SF i M
DECK&BALCONIES SF o A
u
OTHER:
SF , P e commencm.w ec,on
7DDO)of Division 3 of,he Business and Professions Code and my license,s,n fell force
and effect
✓CC��(�� � LICENSE M CITY BUSINESS
CIO Z AND CLASS TAX#
VALUATION: g NAME
FEES MAILING
ADDRESS 7VOtu�
BUILDING MI CITY STATErZIP PHONE
0 ' CONTRACTOR S SIGNATURE DATE
PLAN CHE Il(
ADDITIONAL PL NAME LICENSE#
u
uZ. MAILING
= ADDRESS
V
a
Q CITY STATE/ZIP PHONE
❑NEW ❑REPAIR OCC GRP / CONST
DIVISION. TYPE
MICROFILM 2 . ❑ADDITION ❑MOVE NUMBER OF NUMBER OF
LTERATION L.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 l S
❑ 1 certify that I have read this application and state that the
above Information is correct. I agree to comply with all city
and county ordinances and state laws relating to building
construction, and hereby authorize representatives of this ;, ��J
city to enter upon the above-mentioned property for inspec- •��
tion purposes
Date: 6/03/04 83 Receipt no: 6010
Signature of Applicant or Agent Date BP BUILDIIG PERMIT 1 $197.35
AGENT FOR ❑ CONTRACTOR KOWNER CA CASH 9128.88
Traits date: 6/03/04 Tim 15:41:23
AGENT'S NAME
AGENT'S ADDRESS