HomeMy WebLinkAbout15-1757 � CITY OF DL4MOND BA ` + �
I DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES
� �` 21810 Copley Dnve,D�amond Ber,CA 91765 �,r�.��RE�
„� (909)839-7020 Fax:(909)861-3117 Building Inspect�on Hothne(9119)839-7027 FIRMLY
'�� BUILDING PERMIT APPLICATION
i JOBSITEADDRESS / APPLICATION DATE � P/Cq PR IS—I TS�' I
� �SSUE DATE PERMITit��� I/J /
z APN LOT 7RAC7
yOWNER NPECONST OCCGROUP I
n AD�RESS
� _ . ZONING SETBACKS
� CIN ZIP TEL _ FROM FiW ❑
s APPLICANT TEL I� REqq ❑
n � SIDE/SIDE STREET RW ❑
? CONTRACTOR SIDE ❑ �
a AD�RE/S�S
x CIN J ZIP OZ TEL � —�D PROPOSED USE TL'm
�+ S
� ARCH/ENG/DESIGNER J��E � i� ^�' �e(f
ADDRESS p DW EL UNITS C S70RIES 2 C BEDROOMS
z CIN ZIP TEL
a ����o��� DESCRIPTiON S� Ff FACTORPSF ADJ AREA/VALUATION I
� I IrereW�firm uMx Parelh al Pe�lurY tlra�I em emnpl rtom Ae foiNecmfe Stale lleroe!ew la ma rea9m(9) SF WFDD/REM I
� InElrateE belaw by tAe checkmark�e�,I hare plereA ne�t ro iha eppl�able Nem�e)�Sectlm 10.T15,Bwinep enE perege/Carport
Vrahsflau Cotle Nry elty or caml�Viet rapulras e permX b cauEucl,elter,Impmn Eemolleh,or rapalr,vry
2 ihYCOvB�D„OrEGIbIOYe�IG�0180RWhOEM90DIk2M10�06V�mnEGllbBilpllMBdO011iY11tl191M0lihB rq Palla/Dsk I
� blkw�tlWouxMEGEMV�aWolO6Cwtracbr'BSbblkmmla��QmV�01Cum�e�GnYM1�5eetlan W
t2 0l OMcbn 7 ol0e&d�ea enE Rol�lao Gob]ar ihal ne or she b eiempt hom Ikensure ana Ne Gaels lor LL P°°�� �
nihealleB�eKempibnMyndatlonal5e�tan70315tyanyeppli�ntMapertnllsubl��eeppli�ntroeclvllpenalry = Ra�Rool
s af not more Nan Me huntlretl tlollan R5W) �
� U�6lowneroltlreprOpeR/ormremplqeaewlNwdpp2NNalrWlemmpe�u#Ion,MIICoU��otorUWroona � Commercial I
� OI I�1B WD1�t�dIY��110 6b11G�IR�9 IIO�III�IY�CQ 0!OflCICd IU 6dIB�$0.�117�,01191169 BIM PIOfP�bl19�B ThB m
� �OII�&.10R$m��C0119B�dWd09d110�3V�rymdllOWlIBf01pf0pBl�'Kfi0id11W0�0lIIQIpyBfl9'ClQBRAId�B�fOhbY���9
� or Imprmea the pmpeM�Vrwltlotl that ihe Imprwamanb are nN IntenGetl ar aflereE br eale tt hawerar,Ne buIIEInA or
� imprwameM is sdtl xiNln wre year ol wmoktlon iM1e Oxner Bulltler x111�ave Ne EUNen ol prwlnB��n was irol bultl I
j almprweOMihePurp�ol�le) I
� U�%9 owner ol me propMy am e¢luanety wMrectlnp wlih Ilcenseu CoiNacbrs m wnaW ct ihe pm�ect(Sectlon yaluatlon • Adf Area �
Z ]04C Business anJ Prolexsions COCa The fqntrecbrs'Stab Llcanse law tices nol apply m an onnar of prppaM1y wAo
a slmprwmtlrertonaMwhowntrac6Mtl�aprqecbxiNallmnsetlCpitrar,mrpureuanttotliefmPectae'S01e pUAtJTIT' DESCRIPTION FEE �
Y lsamla.r) I
3 U�em e[emptham IlcmwR unEer tlie CantrectaYe Sdte lkenm lew b�NB b110MnB���I9} � I
i By my slBreNre Celon I ack�wMeEpe tlrat evicept 1a my Derorel rewAene In vrtilcA I must heve rtalCeG lor et least ane � I
j �ear0�mmnpleOmultl�eimpueme�mvertEb�tlnspemil�IrauqllagWryMlaaGutlure0ullnave0ulliman � I
WMb bIl�Gbnll11d9110f bEG110.'1191NC18E Ill lb BIItlIB�Y�'I�CBIISB�MIRdLiCl6 I Y�Bliidlld�IId�B�Y0IIIIB BOpI�B
� Iaw,SectlonlONNNaBuynexsen7PMesslonaCotlelsarallableuponrequeslwhenihlsappllcationlseuUmltteAaret I
� theMlonlnAWebslte�t¢/xxwleA�n/ocapavlWaw�Ml �
z I
�
OPiE SIGN m
LICElLSED GONINRCfOP'S OFCIAMTION � �
� I AereEy elflrm unEer penalry N OeQury tAet I am IlcenseE unEar 0ia�leions N CAapter 9(commannnA wIN SecUan 7000) �i
� plpWNm]olNeBu9lne�JPmI�09CAtl9 BIIOmyIILYn98191pNllb¢9ffiI�� � I
n � C i
= uc�s� � cournncrae �D�fI1�C1
�a won�ms coa+rasanoN oecwunox� � I
y ixmeeruawauxor�rErwro�aEn.amroNeoFTMerouavnNeoEewwnoxs Q
,¢> I have enE wlll malman e CeNA��e af Canseril ro Sell-Insure br Nbiker§CanDenatlon es D�OW by CONSTRUCTION � Z 4 L� . .�i
� Sec�m]700aliheleharCaCebrMeOeRormanceolMewoMbrwMchihlspeimltlelssueE p�,p,NREVIEW ��iJ�
a J�IAaveenEwlllmal�InWaM1ehCwnpeimtlmliau2nwazrequlreObySectlm]700NNeleborCotlela
� mepanarmancedmawarkJ«wmNmbpeimrtbL�uoaMyYbM§Canpensatbnireurencefanlvena ELECTRIC •S5
�d PoliryNumharare PLUMBING
y rppq�Eq L be rf� MECHANICAL
� PoUCYMIMeEn � S 2 INSPECTIONFEE
(M65ECIpNr�rATffCOnfIF�FD6n�Er9MR6�aN01FHfARmD0.1N5R��N��1 ISSUANCE �'� • I
� ImrtllyOmtlniheperlmranmolNexuklavrtilchihhpemMhlgSueAlsAallMempbyairypamonlnanymannarmmb SMIP /.�0 i
Lerome subpst b ihe Mbhele Cwnpen9atlon laxe ol CelNanm ME eArea Nat�I slwulE bacome sub�ect m tIw Wwker§
� Conp���/n NSatlon3]OONtleIah/� �I��ry/mi�/�'�np/ry� Mmeqwhbns ENERGYP/C
2 ��-V��� �/��"j ^�'� ENERGYPERMIT I
� WPANING Falure m[ecurs Nbhere Campenatlon cwerepe le unlawful anA eAall suh�act en amployer to cnminal RETENTION FEE Z�O� I
penaltlav enE civll finae uP m one Auntlr¢tl Nousantl Eollars(St00000) In eEOitbn m Me aat ol ihe compensaban
� EartNpe489pNnOeOlarin9aYon3]OBOINalaborwOaln�e9enGalmmayblees PRE-ALTFEE
y COMSIRIlCTION 1FH01NG R(SILY BSAF • �'0
y I A¢re�y elflrm unJar Denalry af p¢�ury thel ihlrt 19 e Cmistructlon lanCinA ABonry br Ma parlarmanca N ihe work br
3 whlth�Al9permi11915eueE(Sec3C9�CHC)
�o�n�sruu.�
i �no�nsnoopGtt
� I ceNry ihat I hara reaO tAls eppllatlan anG smte Mat iha above Inbrmatlan Is mrract I epree ro mmply with ell clfy entl TOTAL FEES /�jf� L�0 2. 4 Z I
wurM1y oNlnancq antl amb Iaxe relatlnp N buliOlnp wnstruNon,antl hereby eNhMxe n0�enta��vas N Mls counry m COMMENTS ��•
e�rupm be aGws men0wce00�GaM�I�pedbn pury�s�� i
a
� PEflMITTEENAME1PflIN� !
7 �+
s SIGNAiUNEOFPFAMRiFF M7E RECOPf tl U PAIO BY�VAIIDATON_� �
2s6}o V�}919y �F I
WHRE—Oepertment Copy YELLOW—Flnance Copy PINK—Avsessu Copy GOLDENFOO—Flle Copy,GREEN—Appllcent'e Copy
CITY OF DIAIMOi�D BAR
INSPECTION RECORD
• . • s - a . • • -
SETBACK/LETTER TRACTAND LEDGER
FDOTINGS FORMS SWITCH GEAR
SLAB COMMERCIAL HOOD
UG PWM8ING T-BAR
OG ELECTRICAL INTERCEPTER
UFER GROUND HOT MOP/SHOWERPAN
SEWER LATERAL SEPTIC/CESSPOOL
MAIN WATER LINE HEHS REPORT RECEIVED
SEWER CLEANOUT DEMOLITION
ROOF SNEATHING ROQF DRAINS
FLOOR SHEATHING ROUGH CONDUIT
SHEAR WALLS IXTERIOR POOL/SPA
SHEAR WALLS INTERIOR ROUGH PLUMBING
FRAMING/VENTING ROUGH ELECTRICAL
ROUGH MECHANICd�L ROUGH MECHANICAL
ROUGH ELECTRICAL W( �C( 1 GAS TEST
ROUGH PLUMBING PRE GUNITE
INSULATION WALL POOL PRE OECK BONOING
INSULATION CEILING P-TRAP
DRYWALL FENCE/GATE/ALARM
LATH(PRE) FINAL POOL
LATH EXTERIOR WALLS
LATHINTERIOR WALL FOOTING/STEEL
GAS TEST WALL STEEL 7�'( )2M°( )LIFT
SCRATCH COAT WALL BOND BEAM
ELECTRIC METER RELEASE WALL DRAIN/SEAL
GAS METER RELEASE WALL FINAL
SPECIAL INSPECTION RO FRAMWGPLAIJNINGAPPROVAL
FIPIAL BUILDING S ROUGH FIRE APPHOVAL
FIkAL MECHANICAL FINAL FIFlE DEPp11TMENT
FINAL ELELTflICAL FINAL PLANNING
FINAL PLUMBING FINAL ENGINEENING/PNI
7C ofOCCUPANCY FINALCOMMUNIiYSEHVICES
CERL ot OCCIIPANCY FINAL HEALTH DEPT
FINALINDUSTRIAL WASTE
COMMENTS