Loading...
HomeMy WebLinkAbout13962 (1084) CITY OF DIA I� � �� MOND BAR DEPARTMENT OF COMMUNITY dt DEVELOPMENT SERVICES > Zi�oE.c�i�y���swc�i90 (909)660-3195 Fax(909)861-3117 PRESS '��'� BUILDING PERMTI'APPLICATION FIRMLY � JOBSRE �I� ^^, /� lJ �y�, Q ADDRESS �5� `7. Va�L�-Y�/tyT� APPLICATI � PERMIT �o�P�c`��_ o DATE �F�I NUMBER N � APN LOT.�Z TRACT 39�0 7 9 OA EE � NPE OCC CONST. GROUP � OWNER ' o ADDRESS ZONING SEfBACKS W CITY ZIP TEL. ' FRONT pyy p � APPUCANT TEL. ��R � � SIDE/SIDE STREET RW ❑ CONTRACTOR NG• SIDE p ADDRESS n f W• ��TF1ER A�E-- g CITY n���iE� GA ZIP Z-�� TEL�1'I•91�-f377o PROPOSEDUSE �T�EP-��E� FI(Z� �P(�INK�-E"� — ARCH/ENG/ , 1-It: L M►l� 4ofL� - �Loo��' � DESIGNER_ d(�+SS 1� O ' NO.DWEL. NO. NO. ADDRESS UNITS STORIES BEDROOMS � CITY ZIP TEL � �n DESCRIPTION SO.FT. FACTOR PSF AW.AREANALUATION � OWNER-BUILDER DECLARATION I SFR/ADD/REM O I HEREeY AFFlRM UNDER PENAIN OF PERIUM'THAT I AM ExEMPT FRCM iHE CONTMCTOqS U- Garage/Cerport � C£NSEUWFOfITHEiOILOWINOREA50N(SEC.70.71.6BUSINESSANOFROFE5510NSCOOE:AHYqTYOR (n Y COIMiYNF11p1RE0UNiE5APEAMrtTOCONSTRUGLALTER�PROVE,0Eu0U`M,ORRE7AiRM1Y5TRUC• W patb/Deck 6 TURE,PRqR TO RS ISSUIVJCE.AL50 REWIRES 7ME APVUCNlT FOR SUCM PERWT TO FlLE A SIGNED w w� ETATEMENT THAT HE OR SHE IS LICENSED iUiiSUANT TO THE PROVISIONS OF THE COHTMCTOR3 LI• � � CFISE UW(CFUFTER 0(COMMENCIN(3 VlITH SECTqN 7000)OF DMSqN]OF TME BUSINESS A4D VRO� PooVSpa FESSqNSCOD�ONl/UTHEORSHEISEXEYPT11/EREFROIAANOTHEBASISFDR1HElLL1EGEDEXEUP• (� TtlN.ANVVIOIATIDNOFSECT10N70]1.68YA4VA7PLIGWTFONAVERMITSU2JECTSTNE/WPLMJV�TTO Z Re-Roo1 �,�, ACIVIL VENA�7Y OF NOT MOiiE T11AN FNE NUJDRED DOIURS�fSOC).): '� � OlA30YMEROFTHEVROPERTY.ORMYEAIPLOYEE5WI7HWAGE5A5THEIF50lECOMPENSATqN, CpmmBfCldl - YIKl DO TME WOIY(M1D THE STRUCiURE IS NOT INTENDEO OR OFFERCD iOR SALE(SEG 7a�,BU51• � � NESS M0 iROFES510N3 COOE TME CON7MCTORS UGENSE Uw DOES NOT A77LV TO AN OWNER OF ? PROPEHTT YMO BVILOS OR MPROVES THERFON.IWD WMO DOES SUGi WOFiK HIMS[LF OR HERSEIF OR � TIYi0U0HM50RHEROWNEMPLOYEES,PROVIDEDTNAT5Ud/WPROVEAlEN7SARENOTMENOEDOR m OfFEiIED GORSALE 6,HOM/EVER��1dD�N��R Y.fPkOVFYFM 6 SOLD WiTNM ONE YE�R OFCOA/V�E• TIDN,T11E 01MNER-BUIIDER VALL/UYE h1E BUf10EN OF PROViNO TNAT NE OR SME DiD NOT BUILD Oq MOpOVEFORTHEPURPOSEOFSALEI � O�ASOVMEROFTHCPROPERT`/.MIEXCLUSNELYCONTMCTINOYVIhILtCENSEDCONiMCTOH3 TO CONSiRUCTTHE PROJECT(SEG 70u,BVSINE59 ANO PROFESSIONS CDCE:7ME LONTMCTORS LI- Va1118t100 �r7�000 ADJ.AREA C@15E UW DOES NOT APttY TO M!ONNER OF A VFOPERT/Yh10 BlIRDS OR IMFROYES TM[REON,MID � 1M�OCONTMCTSiOR5UQIFRQIECTSWITHACONTMCTOR(S�UCENSEDPUFlSUANTTOTHECANTRA4 pUANTITY DESCRIPTION 70HS LICENS£LAW�. � FEE � OIAME7(EWTUNDEFSEC. ' � B.1V.C.F00.THISREASON J Q U � ¢ DATE OHTIER V � LtCENSED CON7RACTORS DECLARATION � w � IHEF�BVAFFIRYUNOERPENQTYOFiER1URYhUTI/JAIICEN5E0lIN�EFPPOV1510N50FCHAPTER V, s �(COUWENCNOVnTHSECT�ON7000)OFDMSqN70FTHEBUSiNE551✓+DPROFESSiON1fACE,AND Z u� W IICENSE tS N F'UlL FOFCE IND FFEtt � a a�� 5 � LICENSE LIC.NO. V DATE CONTMCTOR � W �,,� � � WORKERS'COMPENSATION DEC ATI N i�i� � N I HEREBV AFFIRM UNOER PEIUITY OF iERA1M ONE OF 7ME FOLl01MN6 DECUMT N O _IHAVEMAWILLI.WMAINACERTIFlCATEOFCONSEMTOSELF�NSUR[F�FiWORKERS' � COAIPENSATqN,ASVROVI0ED8YSECTIpJJfOOOFTMfU�BORCOCE,FO �IIEVERFORMANC�_ O TNEM/ORNFORWHICMTHISPERMITISISSVED. C i 1 HAYE ANU WILL I.WNTA7H WOPo(ERS'COMPENSATIOH INSURANCE,AS REOUIRED BY SECTION ��/� _ Q97000FTHElABORCOOE.FORTHEFERFORNANCEOFTHEWORKiOqNMICHTH15PER1A1T15 ��/I] � ISSVEO.MV WORKERS'COMPENSATpN INSUNNGE CMRIER APA POIICY NUM�ENME: STRUCTION _ C/ [l ] CAARIER 'f"Q�-�GGC�1J�"�IJi:I�! �- �Illra� �Q PLM (iEVIEW C — Z voucr r+uuaEa�O�a 7`�`��T RIC ��� p (if�65[cI�aNNE�NOtBE2^I.riFiIDOcitE s a. �D (S m� � PL BING Z 1 CERTIFYTHAT NT1E PERFORMANCE OF THE WORK FOR WHIC}I THIS CEAMR IS ISSUED,I ME HANICAL () SN�LLL NOi EMPLOV ANY PERSON IN ANY MANN[R SOAS TO BELOM[SU&1ECTT0 TNE (n WOPo(ERS'GOMPENSATIONlAW50FGLIFORNIA,AN�AGREETMATIF15HOl1L�BECOME SPECT�ONFEE � �'*'1. SU&IECT TO THE WORKERS'COM?ENSA710N GiiON510N5 OF SECTION]70o OF THE UIBOR -�y�' rj COOE,151V1LiOfiT1AMTHCOMPLYWIiH'��Jap_SE{Rt HOVi IONS. I ISSUANCE � 7�f.�( ��� '� SMIP 6-�.� p WiE: ��I APPLICANT: _�__ � WM1NIINO:FAILURETOSEWHEWOFiKERS'COIAPENSATIONCOYERAGEISUNLAWFUL,�NDSHALLBE ENERGYPIC _�F•.Il� � �, �;nnn � SUBJECTANEMPLOYERTOCRIIAINALVENALTIESANDCNILFWESUPTOONENUNCREOiHOUSAND ENERGYPERMIT � DOIURS(5100.000),W AODITION TO iHE COST Df COMPENSATION,DAIAAGES AS PROVIDED FOR IN � SECTIDN77DeOFTHELA80RCO0E,INTEREST,AN�ATiOHNEV5FEE5. ' RETENTIONFEE: 11 Y !'l.J;!'�,>J�,�;���Ijf•i�� o CONSTRUCTIONLENDINGAGENCY i P �ALT,�� �/ 1' 1LJ:iVtit�'.r^?D;;�;F�.i i� n � INERE9VAGFIRMUNOERDENAINOF�E0.NRYTMATiHERELSAODNSTRt1CTIONLfN01NGAGENCY � � / Z FOF THE VERFORMANCE OF iME WORK FOR WHipi iF1IS 7ERIAIT IS ISSU[D ISEC.9�a1,CIV.G). � W � LENDER'SNAIIE �S LENDER'SADOR[55 n "- ICERTIGYTUTIHAVEREADTNISAi%.iCAT10NANDSTATETXATTIEPBOVEItiiORtAATqNISCORFECT. TOTAL FEES�2�g� ��/� •�O W IA6REETOCOMPLVN7THKlCRVANDCOUNTVORDiNANCESM105TATEUwSRFLATWGTOBULDIN6 V � � CONSTflUCT10N,ANDH[REUVAUTl10RREflE7RESENT�TIVE50Fh11SCOUNTYTOfNTERUPONTHE Z ABOVE�A�ENTIONEDiitoPERNFORINSPELTIONGURPOSES. ', COMMENTS � �/'�T �1 SF-(EfL J � QGERMITTEENNIE(VRIIfT) �� �Q J r � �� N y� ��i�_�:.�� � � SICNATUREOFVER1.11TfEE � DATE �, � ', RECPT.NO. PA1D BY VALIDATION WHITE—Depenment Copy,YELLOW—Finance Capy,PINK—Assossor Copy.GOLDENROD--File Copy,GREEN--AppticaM's Copy , , CITY �F DIAf�nOt�D El�,R � I��SPEG i 10���! F�ECOF?�? �-.-- --- ._ _,�� _. � _ ___ _�.. _.__ _ ----- _�, ------ _.._._._,.. � 9��F ,C�.sc f [s�i��f tii'��F 'I►'�'y.a=�c; �C��g�!►�E`9� '',t�l►�,A��i ��F;. �I►�1y`�.•.I_r Ir�:1�� � _ _ ._ -- -- __ . ._. �. _.. ..__... . . . _. .. ._. . . ... SET BqCt; ' . I I FLOOR J015T � I _ . .._ i-1 GS`FORiAS;P,i EEL j ' � � i � FHA REQ�J!T5 ^-------���— f�LECTRIC CROUND , UtdDER FLOOR DUCT ; G�=,OUirO PLLIi,1�ING I �' UNDER FLOOR GUf�IDUIT � ____ S�AB GRr1DE i FIREPLACE FOUIIDATION 1 � __ , TEi^P POV'J�R FIREPLACE BdNd BEAh1 � I WAi ER SERVICE M1D HT. BOPdD BEAt�1 � � , � ROOF Si-1-ATHING • �FT.80'VD BEAP.9 � (�---- _FR��"IiJG!VENTfLI/\TIOPd � FIPJAL BOND BEF1��1 � t�UOr COVFR � � PRE-GRAbiNG , ROtJ:f{ H�!1TIfJG 6E�JCHRJG R`�UG`a E�ECTR!C � RQUGH GRADING f;OUGI-I PLUtJ;BING j ! FINISH GRADING ~ � � c�1pi�"JER�'TU3 TEST � � POOL ELECTRIC � I E};1. L�'�TH,'SIDING � POOL FETJCING ' ---,-^---- I '`,^.'P�LL 1'�dSULATiON POOL FIfJAL i _____ �` C�ILt�:G IiJSULATION � OFF SITE IP.1PS. ; ! D:7Y1iJ�!L NC�!LING � D�DICATI�P�S i ' � _` ---- � 5��"J�i? � ; FINAL ENG. I I _. � SE?TIC TAt�r: L11r`�DSLr7PE/IP,RlG. --� -- �----- � 5���� PIT/L.L. � OP�SITE IrfPS. —j � -- --- �_3�,_�,"_IrsTEST � FIfJ�,L7.ONI�dG r — ; Fi"1,L C�'��ST. FIRE D�PT. FRJIiL � f—� — - - _ ��,2-� �9�`��1�'ltit,�'7__� { Fi;:�.L HGF�TI;•d�, � HEALTH DEPT. FI��IAL � ! � '=i 1�,1 :LEC i R1C DEV. FEES P,41D --�T_�� �— �— --- i----- - -- � ._.,., -- � . � ,` f'LU:"E!�;G � , � E�d�RGY ' i . I _ , .;•... , — ----- -- --- -�--_�..-- I � I I , -- ---- ,. - - _ , s _ _ � � � � i :;� � . _ .. —�— ----- --- . . . , . �_ ��-�-- ----- �- -- f ,.��i�Jii:�;��ui`S j -- ---- � f---- — ---------------------- �- ------- I '. , ' ' ' • • — �--- , , -- --- . -- -- — � . • i __— — — -- — ------------ � i- -- -- - _._.--__ �------ -------- — _.—`.--- � - '- ---------------- — - -------------------- :=�P i IC TAt�1K SiL� � S�EP f'IT,�J SIZE --- -- _. _ - -----_ . ..�r�. ._... . __._ - . --- —- -------I ( , • — -- ------ ; t�4t _ --- - ' - -- -- -- I. .. o. . . . . .... ... . -- ------- . � --T�