HomeMy WebLinkAbout12714 (37) �`_ CITY OF DIAMOND BA�
DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES
� � 21660 E.Copley Drive Suitc 190 '
(909)86Q-3195 Fax(909)861-3117 PRESS
��'�? BUII.DING APPLICATION FIRMLY
� ADDRIESS I �O U � � � DA��ATION '?O NVMB R ��� #� �`/✓
� ISSUE TYPE OCC
APN LOT TRACT pATE CONST. GROUP
°C OWNER
S AODRESS ZONING SETBACKS
� CITY ZIP TEL. FRONT RW ❑
� APPLICANT TEL. REAR ❑
SIDE/SIDE STREET RW ❑
CONTRACTOR R�G�QM' S�'n �i`�'K 51DE O
p� ADDRESS � � � pROPOSED USE
� CITY �/'Yc.Ar�_ ZIP TEL �,�0
� ARCHIENGI �
DESIGNER � ��'"''��� NO.DWEL. NO. NO.
AODRESS UNITS STORIES BEDROOMS
� CITY � ZIP TEL Z � O
� DESCRIPTION SQ.Ff. FACTOR PSF ADJ.AREANALUATION
�
� OWNER-BUILDER DECLARATION SFRlADD/REM �
I HERE6Y AFFIRM UNDER PENALTV OF PEiWRY THAT I AM E%EMPT FF10M TF7E CONTMCRIRS U� G9lSQB/C8IPOSI
8 CdISEIAWPDRTlIEPoLLONANOREASON(9EC.70.9t.6BU5MESSANOPflOFESSIONSCODE:ANYClT1'Oq (f�
COUNTYMMICHiiEdUIRESAPERMffTOCONSTRUCT,ALTE0.�NPFOVE.OEMOLISH.OflHEMIRANYSTRUG w patlo/Deck
TURE,PRqq TO RB ISSUNiCE,ALSO RE�UN�ES THE APPI.MJNIi FOR 6UCH PERMIT TO FlLE A 91GNE0
STATERIENT 7H�T HE OR BHE IS LICENSEO PURS WNT TO TNE PImVIS10N6 OF TME OONTMC?ORS LI�
C�MSE�M'/ICH0IPTERYfCOMMBJqNOWITFIEECTIONlOoO)OFpIYI5WN90FhIEBU51NES5ANDPRO V' Pool/Spa
FE69qNS COOE)OR hNT HE OR SIiE�S EXEMPTTHEREFFqM AND 7HE BASIS FOR iFIEALLE0E0 EXENP�
TqN.ANY VqIATION OF SECTION 70.71.6 DY M1Y MPLICMIT FOR A PERMIT 9UBIECTS 7NE MPLICANT T0 Z Re-Roof
� �CML PENALTY OF NOT MORE iNAN FNE NUNDRED DO�UHS 1=6001.1' —
� ❑t�ba�MNEROFIHEPROFERTY.ORMYENPIAYEE5WI7MWAf3ESASMEIRSOLECOMPENSATqN, COrtImBICl01 Z t�
YMLL 00 iHE WORK IWO THE 87RUCNRE IS NOT MENDED OR OFFEHEO FOFl BALE(SEC.)DI�.BUS6
� NESS AND VFOFES&ONS CODE:TME CONTIUCiORS UCENSE LAW DOES NOT APGLY TO AN OWMER OF =
PROPEFRYri/W BULDSOH NAPRDVESTHEREON,AND WHOOOE9 SUCH WORKHIMSELFORHERSEIFOq
Q i1f10UGHXISOR/¢HOWNEMPLOYEES,PROVIOE�lHAT6Upi1MPROVEMENT'SARENOTRiI'ENDEDOR m
� pFFEpFpFOR3N.EIF,/10WEVERTMEBUILOMGqiMPHOVEMENTW80lDWITHINWJEYEAROFCOMPIE�
TpN,TME OWNER�Bl1qDER YVILL IU�YE THE BUHOEN OF PAOVINO TH�T HE OR SHE OID NDT Bl11LD OR
NIPFIOVE FOR THE PURPOSE OF 9ALE).
W OI,ASONMEROFTHEPROPENiY,AME%CLUSIVELYCONiMCTM6WIiHLICENSEDCONTFACTORS ��►r�
� TO CONSTqUCT 7HE VFiOJECf(SEC.7oN,BU61NE5S AN�OROFESSIONS CODE:THE CONTMCTdIS lb V0111@f10� y.�- ADJ.AREA
CBISE UW OOES NOTAPPLY TOAN OVMER OFA PROPER7`/WMO BUILDS OR IMPFlWES TNEREON.M7D
W/pOONTRAGT6�ORBUCHPROJECTSWIhlAOONTMCiGP�S)LICFN6E�PUR6UIMTdiHECOMMG Q�fA�N pESCHIPTION FEE
� TOHS UCENSE Uw.}
O 1 A1A IXEMp7 UNDER SEC. B.6 P.G.FON TMIS iiEA50N �
Q
� MTE ONMER �
� � 3
LICENSEDCONTRACTORS DECLAAATION
� I IiEREBYAFFIPY UNDEP PENALTT OF PEFlM1R'�TlIAT I AM LICENSEO UPAER PROVISIONS OF CNAPTEN �
� •(OOMMENCWOWITh18ECTpN7�)OFDiV1910N90FTHE0USINE55ANOPPOFESSIONBCODE,AN� Z
X W IICENSE IS N FUI.L FORCE AND EFFECT. �
Llt L q
� UCENSE 5 c LIC.NO. �C� • �
� p/�7E � O r CONTHACTOR �r d
�
� WORKERS'COMPENSATION DECLARATION U G �N�,�' d p
� 1 MEREBYAFFIRM UNDEP PENALTV OF PE0.NIRV ONEOFTME FOLLOWING DECLAMTIONS:
� Z
Q
Q �_I/IAVEANDMALLMMNTNNACEIITIFIGTEOFCONSENTTOfELF•INSUREFORWOAKERS' _
Z �pp�$,qTpN,/15 PqpYIDED BY 9EC71dJ�700 OF TIiE U60fl COpE.FOH THE PENFORMMICE U
Q OF TME WORK FOR WMipi TNIS PERMIT IS ISSUED. �
� �IHAVEANDWILLIMINTAINWORKERS'COMPENSATqNINSUMNCE,M5RE0U1REDBY8ECT10N �
Q 97000FTXE UBOR OODE,FOR THE PEHFOflMM10E OFTHE WORK fOR WHICHTHIS PERMIT IS O �D
� ISSIIED.MYWORKER'COLIPEN3AT SURANCECARRIERAN�POLICYNl1M6ER�RE� CONSTRUCTION
� CMRIER S�lt�''C ��f rC¢ PUW REVIEW Z 2
� POLICYNUMBER I d'S9�G=9 ELECTRIC
Q �nnss[cnwr��noreEooux�moFn#aEa�rr�sFa+ouEK�000u�asR+�)a+�1 PLUMBING
a I CERTIFV THAT IN THE PERFORIAANCE OF TME WORN FOR WN�CH THIS PERMIT IS ISSUE�,1 MECHANICAL [_O O
(� SH�LLNOTEMPLOYANYiERSONMANYMMNENSOA570BECAMESU&IECTTO7HE INSPECTIONFEE
� WORKERS'COMPENSATIONlAWSOFGLL�FORNIA,AND110REETHATIFISHOULDBECOME
S SUBJECTTOTMEWOAKERS'CNA7ENSATqNPi10V1510N50F5ECiON77000FiMElA90R � �
coo isHaicorxrHnnmoon�w.rwini vNrnnsari ISSUANCE �q e+,..
0 on�: ��3" 9j' npauc�wr: .. SMIP �� Lr7IJ '
� WARNINO:FNLURETOSEWREWORKERS'COMPENSATION VERAG ISUNU1NFU�AND6HALLBE ENERGYP/G
BUBJECTlWEMPIOYERTOCRqIWALVENALTIE5MIDCIYIIFINE5UP700NEHUNDREDT1i0USMID ENERGYPEFIMIT , �0,-�
� OOlLMS(i100.000),Ml ADDITION TO iHE COST OF COMPENSATON,DANAGES AS VNOYIDEO FOR iN
�J 9ECTIDN87DlOFhIELABONCODE.RlTEREST.ANUATTORNE�"SFEES. RETENTIONFEE:
Q
qW„ CONSTRUCTION LEN�ING AGENCY pqE-ALT FEE:
�
I HEREBY AFFIRM UI�OER PENKTY OF PE0.IUAY THATTHERE IS A CONS7RUCTION LENDtNO A(1ENCV
FOR TME PENFONMANCE OF TNE YYORK FON WHICN 7HI5 PEPMIT IS ISSUED(SEC.30Y�,qV.C�.
�
� LENDERSNMIE
� LEND6R9A�DNE55
� ICERT�FYTMATIHAVEREMT713AVPLICpTqNAND9TATETHATTHE�BOYEINFOAMATpNISCORRECT. TOTAL FEES � ( J� ��
� IA6REET00041PlVN7TXALlCRVANDCIXINTYORDINANCE3AN�STATEUW5RELATWOTOBUILDING �
OONSTRUCTION.M10 NEREBv MJiHOFlIZE FlEPRESEN7�71VES OF TNIS C011N7Y TO ENfER uPON 7HE /
S�. /iBOVEJAEHTqNWPiIOVERTI N�N5PECfIONPURPQ4E5. C,QMMENTS /
9 t�h /��N
�
m PERIARTEE (P � II�/
Q
N
y lIOtUTUREOFPE E ' D�T �
� RECPT:NO. PAIO BY VALIDATION
WHnE—Uepanment Gopy,vELLOW—Flne�s Copy,PINK--Aessasa Copy,CiOLDENROD—File Copy,OREEN—ApplicenYe Copy
�� ..._..---- ----
� . , . . . ., . . . . � . . � . .. . . ,
CITY OF DIAIilfOND B/!►R �
If�lSPECTION RECORD
- � E � � - a � � � E -
SET,�ACK • � ,'�' FLOOR J0�5T`� �', ; . , , l 1 ,. ..
:�
FTGS/FORMS/STEEL ' FHA REQMTS ^
ELECTRIC GROUND � ' UNDER FLOOR DUCT
GROUND PLUMSlNG tJNDER FLOOR CU�IDUIT
SLAB GRADE FIAEPLACE FOUNDATI�N ^
TEMP POWER FIREPLACE BOND BEAM
+ •.�,. - ,.: s.•:.... rr,r�
WATER SERVICE MID HT. BOND BEAN��'' '
. .. •. . .
ROOF SHEATHING ' � � 8 FT.B07V�;{3EAM i'�. � � * � � �� 3>,.�; ;•;
FRAMINGNENTILIATION � � W FINAL BOND BEAM �
,.. ' . .
ROOF COVER ' PRE-GRADING . :,�)"'k� ,��� ��:
ROUGHHEAT1NCi BENCI�II�iC-1�"�� �' '� 1' � . :%"3 ;.:s1,
ROUGH ELECTRIC � �� ROUGH GRADING
ROUGH PLUMBiNG FINISH GRADING �
SHOWER!TUB TEST j PDOL ELECTRIC •
EXT. LATH/SIDING ` � POOL FENCING u
WALL INSULATION POQL FINAL �
CEILING INSULATlON � pFF SiTE IMPS.
DRYWALL NAILING Z � - i DEDICATIONS
SEWER ; `v I FINAL ENG.
SEPTIC 7ANK ; —• LANDSCAPE/IRRIG. i
SEEP P�T/L..L. � ' ON SITE IMPS.
GAS AIR TEST ; ': FINAL ZONING i
FlNAL-CaNST. Z ' --- ' FIFiE DEPT.FINAL � �---�-j-�—
FINAL'HEATING � , f'� � '`" ' � ; HEALTH DEPT. FINAL �__ -} J __;
FINAL ELECTRIC "' ' ' " ' - '� ! '; DEV. FEES PAIQ � : �
FfPJAL PLUMBING i ' ENERGY � �
I
i ; �.� . j �
! I !t !� —'---;--r�--- w�
- �, � , , >. ... .. . ---s-`,,-,�•�-`
Ci������s - .'` s_4.. � l:,
� '�
, F � ,. .. . , --
__--�` . . -_-=�' •' '` ��
�` ;�
_ r-
. �t�.t'�." _� �,`,4�: `�t�` '4 ,,.1��- \'r' -
SEPTIC TANK StZE �
SEEP PIT/l) SlZE � �i, '•' �;�l�r►'`: ---- -
4� " �I .�,;�, .. .. , - ; ____ ---
�, . � .�.
��',, �� � . (�1 r� p . ,
ii I�.. � i.r.iYl•1 •�V;iri y i TS'.
\�.1__ t . � .
,�� �-. t� .
't�
.�
. .
, ,, \ . . .�, 4 . � , � .+� Z