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HomeMy WebLinkAbout14858 (19) ' CITY OF DIAMOND BAA -- " DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES _ � 21660 E.Caplcy Drive Suite 190 (909)86b-3195 Faz(909)861-3117 PRESS $Ug.DING PERMIT APPI.ICATIAN FIRMLY .����E �.��s� .� r APPLICATION PERMR P!C � AODRESS ��� DATE �NUMBER�# g ISSUE TYPE OCC APN LOT T_ TRAGT DATE CONST. GROUP p OWNER �Q� fl AODRES ZONING SETBACKS � CITY ZIP TEL. R�RT RW p� APPLICANT TEL SIOE/SIDE STREET RW O � CONTRAC q SIOE ❑ ADDRE � CRY P�7� TEL� 6'�E S�S' PROPOSED USE � 8 DESIGNER P�� ,�� ADDRESS NO.OWEL. ~ NO. ` NO. , UNITS STORIES BEORQOMS � CITY ZIP TEL � tn DESCRIPTlON SQ.Ff. FACTOR PSF ADJ.AREANALUATION Q OWNER-BUILDER DECLARATION 0 SFR/AODJHEM � I NFBEOY AFFlqIJ UMDEq PENILL7Y OF PEA.AIHY 7HAT 1 MI E7(FFAPT FqOM THE CONTRACT00.S ll- ��Q���n CEt6ELAWF(1qlYEFOLLOWINOREA50N(SEC.7W1.581I51NE55ANOPF�FE551(M'SCOOEMIYCRYDQ (f� COUNT'fMhllqiRFOU1PE8APEHAiR7000N5TRUCT,NSERNPROVE.DE40L15M.OHREP#IRAMYSTNIG W pell0/D901( 7WIf.PRGIi 70 ffe 138UANCE.AL90 PEW11NEg THE FPPLICANi Wq SUCN PENWi TO FllE A S�GI�D � ST�TEiIENT THAT HE OR SHE IS LICENSED PUqSUiV1i TD 7HE PROVISIONS OF THE ODNfAACTOi7S U• � � C�UW(CHMTEB,9(CON4ENCINQ YAT51 SECTqN 7000)OF DIV15qM 3 OF TIE BUSINE55 ANU PI� PooUSpa FESSqNSCOOE�OphU7HEOHSHEISEXEMP7THEREFROM/W�711E8ASI3fORTHEALLEOEDEXEIIP- (�J T�MI.ANVVIOLATIWOFSECItd17W1.69YANYAPPLK:MfrFOHAPERMITSUBJECTSTHEAPPLICAMTTp z �{jppf F,,, ACNLVENlLLT'OFftlTMDRETXIWFNEMItmf1ED00LW7.4li�l)= � O4ASOYM6ROFTMEPROPERTY,OPMYENPLOYEESWITHWAGES�STMEpi50LECOMP6NSATiON, � CpmTBfCidl � �MML P�P1E Wd1YC AtA 7HE STRUCiURE IS AIOT IMENOED OR OFfEREO WR SALE�SEC,70N.W51• J NES&AM PRDFESSION.4 CODE THE CONTMCiONS LICEN6E lAW DOES NOT APPLY i0 AN QWNER OF � � PNOPFfRYVAfC8131AD80RNAPROVESTHFREON.NIDMR100fffiSSUCHWDRKHIIASEIFORHERSELFOq � [r 1MROlIp1 iMS OR HFR OwN EYGLOYEES.P1iOY1DFD TNAT SUCH q,IPPOVEUEMS ME NOT IN7ENOEU 0q m l�l piF�EpWpg�(E�G,II�WEVER7ME91MIINNRORMAPfiOVFl1glTISSOIDVIITHINONEVEAROFCOMPIE- � 7qN.7i£ONAJEAdl1UDER MIILL HI1VE TME BUFmEN OF PAO�nN6�}iAT NE Oq SHE DIU NO7 BUILD Oq � = MPf10uE FOq 7HE Pilfii'OSE OF SaL�. ❑I.AS qM1Ep OF TFfE PROPERfY,AN E%p.U51VELYCOMTENCTiNO NTf}i LICENS6D CONTMCTORS � TO CONBTHUCT 1t1E Pi10.lECT(SEC.7oN,&JStNESS AND MdFSSIONS COOE:TNE COHTP.ACtoSiS th Vafuation ADJ.AREA � 11J CEM$EUWDOESNDTAPPLVTOANOWNEROFAPROPERTYW/qBU!IDSORIMaflOV€STH6R€011,ADA - � MlIDWNrfUCTSFONc�ppp,)ECTSw17HACONTRI�CtOR�S)LICENSEDPURSUANTTOTHEC9NfR,14 QU,4�ITY DESCRIPTION FEE � lOHBU�ENfiELAW.). ❑IAMEJ(E4PTtMDERSEG B.6P.C.FORTMISREASON Q U LL ¢ DATE OWNER U � W �ICENSED CONTRACT�RS DECLARATION W gI NEIiEBYAFFliW UJDER PENAL7Y OF PEitIUM TN�T 1 AM L�ENSED UNDER PFIOVISIONS Oi CHAPTER � � i(OOIYIENGI6 4RTH S6CTqN ioao)OF OMSKx1�OF SHE BUS1NE55 AND PROFESSIONS COOE,AN� g � W UCENSE IS M FUl FONCE IND EFFECT. m 0 IICEtLSE CU65�LIC.NO. �`� � j v a,� G� 3Q C'�O � conrrancr a � WORKERS'CW/PENSATION DECLARATION Q NiHEHEBY�FF1PMtMDERPENALT/OFPERJURYONEOFTHEWLL0ININCDECLAMTIONS: Z � O _IHAVEMIOW!LLAMHJTANACERTIFlCAIEOFCONSENTTOSELF-INSUREFORWOPo(ERS' _ Q CONPEN8ATION,i15PROVtOWBY8ECT�ONaTooOF4HELABONCODE,FORTHEPERFOP.MANCE 'U OF THE WOPK fOR 1VHIp1 T115 PEfMIR 181S6UED. � � _I tiAVEMA WILLMAR1�ARi Vqf{KEflS'flOMPENSATiON INSUR�NCE,AS AEOUiAED HY SEClION ` QQ 97WOFiHE FOR7HEP5R�ORAIANCEOFTHEWORKFoqNM1ilqiTHISPER411TIS //]r' /-�'►\ �ssuEo.Mrwn �Nsu RCARRIER �POIICYNUMOERAflE: CONSTRUCTION �nL(J `��.� � CAAH�EN PLAN REVIEW � POLICYNUN86R ELECTRiC i (fYKs[c�td+rt�NQreEmY�IETIDOFTHEPERNfI3roRONEFA�EDOC/iMSM�IORtEss� PLUMRING �, � ICERTILYhUTM7TiEPEPFOPMANCEOFTNEWORKFORWHICHTHISPERMITtSISSUE�,I MECHANICAL j c, SMALLNOT EMPLOYANY PERSON M7 ANY MANNEfl SOAS TO BECOME SU&IECT TO THE —������ � WOHKERffiCOYPENS�TIONUN50FCAL�PoHN�A.NNDAOREETHATiFISHOVLDBECOME INSPECTIONFEE SUBJECTTO T!�WONKERS'CO�APENS�TION PRONSION40F SECTIO!!37000'r TNE LABOA CODE,I SHALL FORTHWITH COMPLY WI7N 74105E PROVISiOIiS. ISSUANCE _� s �� „(� � 8 DATE: APPLICANT. SMIP '-iS� E� n �3 I;`i e . � WAFMJWCi:FNLURE TO SECURE N9RKERS'COMPENSATpN CpyERAGE IS UNUWFU4 AND SHALL BE ENERGY P� E� SU&IECTIWE4PLOYERTOCRWWALVENALTIESIWOCIVILFk1ESlIPTOONENUNOfiE�TMOIIS�N� - k� =.i.�1�`.'::..',:_j„��� � DOLU1RS�floo,000).1NAUOITIONTOTNEC0.STOFCOMPENSATION.DIIM�OESRSPROVIDEDFORIN ENERGYPERMIT� �� ¢ SECTqN atae OF 7HE IABOti CODE,NTEREST.AND ATTORNEI"5 FEES. (j�ENT1ON FEE: �, ��P�"�q "t�"��1� w CONSTFUCTION LEND�NG AGENCY � PRE-ALT FEE: gIHERE6YAFFlR4Ut�ERPENKTYOFPEPJl1RY7HATiHEHEISA(ANSTRUCiIONLENDINO�OENCY FOIiSNE PERFOAMMrGE OF 157E WORK FOR WHlqi THIS PERM17 5155UED ISEC.3uB�,CIV.C.). � LENDERSNAME � F�- IFNDERB ADDRESS � ICEiMiY7MATIHAVEREADTHISMPUCATIONANDSTATE7HAT7HERBOVENJWRMATqNISCORPECT. TOTAL FEES I AGREE TO COMVLV WITH AL�CITY MIO OOUNT�ORDINl1NCE5 0 STAiE UWS NEUTtJ�TO BUILDING l CONSTRUCTION.MIDHEREBYI1UiHOX�ZEREVRE NTATIV THISCOIMTYtOE ERUPONiHE `� � _ J/j(J j�_ � � � � S� IOHED VAOPfRTI fMi 1NSPECTION F �i `� Y�•••ti1 f.Q'f( � / ..,� g �_ COMMENTS � m PERY (Pfl11ln � Q � � �� � BIOfNTURE OF RNITTEE TE � RECPT.NO. PAID 8Y VqIJ4AllpN NRiITE-0apaRment Copy,YELLOW—Finance Copy,PINK—Assessa Copy,GOLDENRO�File Copy,GREEN—Appl' 's Cnpy C1�Y �� C71�+►i�C)�f�3 E3AR .. , !6'���'��1`1�t� ����I�L� r ` � � �► �r � � � s���Ac�� � E F�oo�.�a�s-r � F-r�sr�o�r��s,s-r�E�. � � Fr�a��r�r�-rs � I ELFCTR,C;C>f�OUND �� � UNdER FLOOR�UGT' i Gi-�UUC3i?PLUP,��1NG ^ UIti1DER FLOOR G�I�IDUIT ��T i SL,�E3 G�6aDE i � FlREPLACE FC7UNDATION I T�s`�.�F'�'04VER FI�iEPLAC�BQi�D 8EAh9 - ( 4"Vt;-�TE�i�E�iV1C� i P�fiD HT.BOND BEAM RC.K�F';HEr�TI-�ING - S FT. 60ND BEAM - Ft'�-,'�Nii'Pd�;V��i I�L6f�1.([;�a . F}NAL 6OND BEAt�3 F�OOF GQVEI� PRE-GRADIR7G ROtJGH N�t�i�ifVt"a gENCHItVG ----�—� FtOUGN ELECTRiC ROiJGH GRADlNG ; �� F�UGN PLU��9i�:C� FINISH GRADIiVG �_ � � S}-lC711�11�rJTUF3 TEST ���� t PC3�L�LECTRtC�� --- � ��T.LAT'N156pi�.G � ` PQ�L�=ENC3tvG ��P:�LL INSCSL�iTIt7N s � POt�L FINA� � GEILi�JG 3�SU�A?IQti C3FF S)3E lt�iPS. � €�����L�.ra�a���� a���ca�roorvs — � ~� �s--�-���-�-:�- � �ir��,t�N�. �_ .._.__._. si�� -PTlCir�rs�;�� �� � _ , L�,N[7sckP�J�R�i��. t � � Sc���=°i7/L.L. d � � � C?�7 5i7E livtPS. -`~� �" s,�AS t;IF3 i'z�ST f�1PJr��ZQ�'�il�iG �- -- i �i��,� ���s�. j � U ������P-r. �2r��� � - - _a. _ _ ._ �__.___ __ f=ltV,�L HE��T("!C; , i�EAL.TH C7EPl". FiNAL � Fli�a�L EL.�CTRiG i i ��V.F��S F'��ID �--�------- � � .�___. .�. _�: ;. _ = r - '- _.___.�_ , ��i;V,�a� P'�U.�t�iB`S£',�' � t � Eitii�RaY j i t--.- ----- � �I� -mm--��-��� � _s ! �� I w , f - .. �_._.i�_....._ _..._________�._ ` _. � �>(Jiit`itV9�1�iT� _..^.._ . � � �, . _.____ _ _.�_.. _� � �� --- - - --�. �.__ ._.. � ��... . _. .. _ � -____ �.._.._..____. _. 9} ' $ ��PT6C T°�f��SIZ� .�______ j � �s'".—.�F'�'l�i"i`t,3 �IG� ,y i I - � ___ � � -------- � __ I � IiALNUT VAILEY UNIFIEQ SCNOOL DISTRICT 880 50UTN LElqt� AVENUE � MAf.NUT, CA 91789 � � CERTIFICATE OF COlG'LIANCE MITH FEE PROYISIONS�OF 60YERNl�NT CODE SECTI0�1 65996 . � DEVELOPER .���T/u���O �� �✓� _• Signature of App icant ADDRESS ff�.s t��uf,� /�'f'' The person signing represents that ��Qm��l.,��� ���Q`�L f� he/she is authorized to sign on � behalf of the owner/developer and TELEPHONE ( ���� ) �% ���' that the information provided is true and accurate to the best of his/her knowledge_______ ------------------------------------------------------------ --------- --------------� FEE SCHEDULE: THE DEVELOPt�NT FEES LEYIED BY TNE YALNUT YALLEY UNIFIED SGFIOOL DISTRICT � UNQER PROYISION OF SECTIO�t 65995 OF TNE 60VERNNENT CODE ARE: Residential Development 51.501sq. ft. Commercial/Industrial Developrt�ent 0.25/sq. ft. --------------------------------------------------------------------------------------------------- TRACT/PROJECT ADDRESS /G�J 1��,'.r�r,/' �� �/�iY�i���`�.'•,r NUMBER OF BUILDING(S). IN PROJ�CT ,����i��oi'? BUILOING PERMIT APPLICATION NO(S) LOT/AQDRES5 USE OF BUILDING AREA (SQ. FT.) �� 1. Il.-c S .�.�n'/J 7^-� ��`��IC�J���/� � 5�'U SO i 2. .?7�.�,k I� 3.27 3. SI6NATURE INFORMATION BELOW LINE Tp BE COMPLETED BY SCHOOL DISTRICT SUSTOTAL (ATTACHEO SHEETS) TOTAL FEES DUE RECEIPT N0. �'av This is to certlfy that all fees due to the Walnut Valley Unified School District under provision of Gavernment Cade Section 65995 as a prerequi- site to the issuance of a Building Permit by the Department of Public Works have been received. Based upon the information presented, this Certlfication of Coapletion is hereby executed. Th1s to certify that the above described development has been determined to be exempt from the development fees of Government Code Section 65995 � and 8u11ding Permits may be issued therefore. • . M. H. Grimshaw, Ed.D. Assistant Superintendent Fiscal and Facilities Management 1/87