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Home My WebLink About12527 (4) .I - �� CITYOFDIAMONDBAx � ��E� DEPARTr�ENT OF COMMUNITY&DEVELOPMENT SERVICES � 21660 E.Copley Drive Suite 190 S E P 1 O ZOO� (909)860-3195 F�(909)861-3117 PRE$$ �� BUII.DING PERMIT APPLICATION ' �IRMLY � JOBSITE />� APPLICATIONG ��/ PERMIT P/C ,�t o ADDRESS v ATE /��`` �S NUMBER �� # ��/ I � � ISSUE TYPE OCC APN LOT TRACT O � � ,� DATE CONST. GROUP p OWNER /��Dc�-��z,_y ti� - p ADDRESS��GD/ W/�-SM/h'C B�V�-� �.� �^�� ZONING SETBACKS Z CITY G ziP�a�z-rTE�i�b-YL6� '�60e FRONT RW ❑ g APPUCANT FRt/J /��aOr2 TEL7�a REAR ❑ SIDE/SIDE STREET RW ❑ � CONTRACTOR T rCyq�'on/ EY�Gv SIDE ❑ � ADDRESS - R t- PROPOSED USE •� . � cirrCJY2.a.�� ziP 6 TEL.71� �17:�9 o ARCH/ENG/ - � DESIGNER NO.DWEL. NO. NO. a ADDRESS UNITS STORIES BEDROOMS � CITY ZIP TEL. N DESCRIPTION SQ.Ff: FACTOR PSF ADJ.AREANALUATION Q OWNER-BUILDER DECLARATION SFR/ADD/REM O p 1 HEREBY AFFlRM UNDEH PENALTV OF PERNRV THAT 1 AM EXEMPT FROM THE CONTRACTORS LI- G8f8QB/COfPOft W CENSEUWFORTHEFOILOWINOREASON(SEC.7071.SBUSINESSMlDPROFESSIONSCODE:ANYC�TVOR (n U COUMYNMIGfREOU1RE5APEFMRTOCONSTAUCT,ALTER,IMPROVE,DEMOLISH,ORREPAIRANVSTRUC- W Patio/Deck Z 7URE,PRIOR TO ITS ISSUANCE,AlSO REOUIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED w STATEMENT THAT HE OR SHE IS LJCENSED PUiiSUANT TO THE PROVISIONS OF THE CONTRACTORS LI� w � CENSE UW(CHAPTER Y(COMMENCINO WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PRO- � PooVSpa FESSIONS COOE)OR THAT HE OR SHE IS EXEMPT THEREFROM AND THE BASIS FOR hIE ALLEGED EXEMP- TION.ANYVIOLATIONOFSECTION7W7.6BYANVAPPLICAHTFORAPERMITSU&lECTSTHEAPPLICAHTTO Z Re-Roof � A CML PENKTY OF NOT MORE THAN FNE HUNDREO DOLURS(l5oo).j: � ❑lASON?IEROFTHEPROPERTY,ORMYEMPLAVEESWITHWAGESASTHEIRSOLECOMPENSATION, � Commercial . ^' - WILL DO TME WORI(AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE(SEC.7ou,BUSI- J N NESS AND PROFESSIONS CODE:THE CONTRAC70RS LICENSE UW DOES NOT APPLV TO AN OWNER OF � /1 � VROPERfI'WFiOBUILDSORIMPROVESTHEREON,ANDNR1000ESSUCHVlOHKHIMSELFORMERSELFOR m V Q THRODUM HIS OR HER OWN EMPLOYEES,GROVIDED THAT SUCH IMPROVEMENTS ARE NOT INTENDED OR w OFFEREDPDRSALEIF,HOWEVER7HEBUILDINGORIMPROVEMFMISSOLDWfTHINONEYEAROFCOMPLE- Z �TION,THE OWNERSUILDER WILL HAVE THE BURDEN OF PROVINO THAT NE OR SHE DID NOT BUILD OR � � UAPROVE FOH THE PURPOSE OF SALE). O I,AS OMMER OF 7HE PROPEHfY,AM EXCLUSIVELY CONfRACTINO VrtTH UCENSED COMRACTORS � TO CONSTRUCT THE PRQIECT(SEC.70N,BUSINE55 AND PROFESSIONS CODE:THE CONTMCTORS LI• V81UellOfl ADJ.AREA CJ W CENSEUWDOESNOTMPLYTOANOWNEROFAPROPERTYNM1iOBU1LD50RIMPROVESTHEREON,AND � NM1pCONTRACTSFORSUCNPRQIECTSWITHACONTRACTOR�S)LICENSEDPURSUMlTTOTHECONTRAG QUANTITY DESCRIPTION FEE � TORS 110ENSE UW J. � ❑I AM IXEMPT UNDER SEC. B.6 P.C.FOR THIS HEASON Q �G P.- s , O � " 2 Ovy-�ts' 2, �O � � DATE OWNEF U /� ��o C � O Z W b c- � LICENSED CONTFiACTORS DECLARATION W 1 HEREBY AFFIRM UNOER PENALTY OF PERIUHY 7MAT 1 AM LICENSED UNDER PROVISIONS OF CHAPTER � p. Y(COA/MENCINO WITH SECTION 700D)Of DIVISION 30F THE BUSINESS AND PROFESSIONS CODE,AND Z X MY 110ENSE IS IN NLL f-0RCE ANO EFFECT. m L1J Q � UCENSE Cf�LASS p LIC.NO. 1 j i V DATE I V� 1�� l CONTRACTOR � d W a� WORKERS'COMPENSATION DE RATION Q � U � I HEREBV AFFIRM UNDER PEN�LTY OF PEiL1URY ONE OFTHE FOLLAWING DECURATIONS: ' I � Z � �,IHAVEANDWILLMAINTAINACEIifIFIGTEOFCONSENT70SELF-INSUREFORWORKERS' 2 COMPENSATION,AS PROVIDED BY SECTION 37000F 7NE LA80R CODE.FOR THE PERFORMANCE U Q OF THE WOHN FOR NM1/ICH THIS PERMIT IS ISSUED. � � _I HAVE AND WILL MAINfAIN WORKERS'COMPENSATION�NSUMNCE,AS PEOUIRED BV SECTION Q 97000F THE LABOR CODE,FOR THE PERFORAIANCE OF THE WORK FOR WHICH THIS PERMIT IS • O h /1 ISSUED.MY WORKERS'COG:PENCSATION INSURANCE CARRIER M1D POLICV NUMBER ME: CONSTRUCTION s�[/ jCARRIER STATG �l'�� PLANREVIEW Sd OU/� 0 POLICYNUTABER l 1 DS 3 1 �I. ELECTRIC D O V � �niss[[,'rorlr�Ho7sEoo�.w�E7fnoFnfra�war�sraaorlEr+urna�uoauas�siro)ora�ss� PLUMBING OP w MECHANICAL IOO�OO Z I CERTIFY THAT IN THE PERFORMANCE OF T1E WORK FOR WHICH THIS PERMIT IS�SSUED,I �} SHALL NOT EMPLOV ANV PER"NI IN ANV MANNER SO AS TO BECAME SU&IECT TO THE y WORKERS'CAMPENSATION LAWS OF CALIFORNIA, AGREE THAT IF I SHOULD BECAME INSPECTION FEE SUBJECTTO TME WORKERS'COMPENSA710 RO NS OF 5 710N 37000F THE IABOR � . S p pR CODE,ISHALLFORTHWITHCOMPLVWITI S OV ISSUANCE I /� p DATE:IO�I l�lv APPLICANT: � SMIP Q . w ENERGY P/C •G J WARNINO:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNIAWFUL,AND SHALL BE � SU&IEC7 AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND ENERGY PERMIT � O� DOLLARS(f1o0,o0D),IN ADDITION TOTHE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN j H /�f � SEC710N 370E OF 7HE LABOR CODE,�NTERE57,AND ATTORNEY'S FEES. � RETENTION FEE: ` v�✓ O d CONSTRUCTION LENDING AGENCY PRE-ALT FEE: � I HEREBV AFFIfiM UNDER PENALTV OF PERIURV THAT THERE IS A OONSTRUC710N LENDING AGENCY n r T � � �a oQ FOR THE PERFORMANCE OF THE WORK FOR N?iICH hilS FERMIT IS ISSUED(SEC.3097,CIV.C.). Z W � LENDER'S NAME H LENDER'SADDRESS � I CERTIFY THAT I HAVE READ THIS MPLICATION AND S7ATE THATTHE ABOVE INFOPMATpN IS CORRECL TOTAL F � � I+�� W I AGFEE TO COMPLV WfTH PLL CfTV AND COUMY ORDINANCES AND STATE LAWS REUTING TO BU�LDING � CONSTRUCTION,AND HEHEBY AU7}IORIZE REPRESENTATIVES OF THIS 5pUN7V TQENTER UPON 1HE �! �g ZIBOVE-MEHiIONED PROPERTY FOR INSPECTION PURPOSES. �� / COMMENTS � ��eEo S w a�'L— �� m a PERMITT PRI � /_ � � y SIONATUP OF PERA1fTTEE DATE � � RECPT.NO. PAID BY VALIDATION WHITE—Depertment Capy,YELLOW�inance Copy,PINK—Assessor Copy,GOLDENRO�File Copy,GREE�Applicant's Copy . . .. , .. . . . � �. . . . , . _ "1.. . i..� r i.. � � .. . .'I:, . .. , .. � CITY OF D1�1iVIOND BAR . , ',y � . �. ' ` B�S��CTION RECOt�� ' , q, �4�� ,. �D �£ � �..1 �. ,D p.� D � � � , • � . �,�� .;.� �4.�.� #" :+� _ '� 'SET BAG1� �; :', FLC30f�JOlST ,�`�� ,� � ` � �FT'GS/FORMS/STEEL • � • FHA"�REC�MTS � ` ELECTRIC GROUND ' � UNDER FLOOR DUCT '• � GROUND PLUMBING • UNDEfi FLO(�R`CC1�IDUIT�`_� ' , . :�,. SIAB GRADE FIREPLdCE FI�UNDATiON� " ' ' TEMP POWER � FIREPLACE BON�D BEAM. ' WATER SERVICE •,..;. _ ' � .._ MID HT. BOND BE,AM:'�.,' ..' ::z�""•.•-: . . . ! .. , - , ROOF SHEAT}i�N� .-�� 't .;` .'.;. . . . 8 FT.-B.QND•BEAM:. � '�_" .. . _ �,�,;�- . '' FRAMINGNEI�TILIATION �� . "'` �'� FINAL BOND BEAM • • ROOF C�VER � � PRE-GRADING :' ; � ROUGH HEATING ' BENCHING ROUGH EI.ECTRIC ROUGH GRADING ROUGH PLUIVIBING FINISH GRADING SHOWER/TUB TEST • PdOL ELECTRIC. � - EXT. LATH/SIDING � POOL FENCING. WALL INSULATION � POOL FINAL CEILING INSULATION ��- ��{�` '•,� `�` OFF SITE IMPS. , � DRYWALL NAILING � DEDICATIONS SEWER . ' . _.. . FINAL ENG. .. •. - SEPTIC TANK_ _ _ _ . ,i�,_:_ �..-,�� . LANDSCAPE/IRRIG. SEEP PIT/L.L.� . . �" `; =:'' � �-. .. . ON SITE IMPS. ' GAS AIR TEST FINAL ZONING � FINA�CONST. �� - • .. ' ' FIRE DEPT. FINAL �� FINAI HEATING ' - - � HERLTH DEPT. FINAL FINAL ELECTRIC � � ' � DEV.FEES RAIp .. FINAL`PLUMBING ' � • •� ' � . ENERGY ' . .. _ r. -- 01 0 .'o o-,' ,� ��:'�� , .... ..__. , � � � , � . , `. COMMENTS „ . !�. . . �, .... _. ., . . . _ .�_, : _ ��' �:~'�`=� ti - . . . � ; ' ___.----�� - — � `�.. .. .�:,,r. . ` • ti 1 . . .. • .�• :y- i' '1 � : , . . __ ._. . . _ ' _ • .. . _ .. �. , � .. •-- \.. .� - .. " — - „ ,' _ , � t,;' _., _ . . . � _ . ` , . SEPTIC TNNK SIZE = � - �� '' ' , _—>- : : � - - __ .._ . _... . . . SEEP PIT/U SIZE ; � - �-- � ,� ,�"—� .��,� r�L;�� `� ... �_��-. _.. ....._.. .,... .. . . . � , , h � a ;� � '�Yr� a .y� ,eak ��t q,�„�tt i ��/� . . � ) '.��i,� .. . �- -. . . T � .lai:��.'. � 5 �.:r,_l�}1� r�..i.� ..i�Y�1�7�� f"�� . ._.. _ . . . ._ .. . _ :ki i i : � � y� �'^�'Sry'y�<. - • t \ �`\ ._. � . . . - . t ��. � �� 4.�� `. � C. � 1 k3•y 11 r� • . � � i [* #� � � � � �. a ,� t,��. .� � � � � "�t � , . � . , . � ^ x . -. X � °� � � � " �� ;�� . ;� . ' ' i - , . .