HomeMy WebLinkAbout10215 �
��� f � ���
C1TY OF DIAMOI3U BAR
COMMUNITY DEVELOPMEN'I'DEPARTMENT
.:.� 21660 E.Copley Drive Suite 190 PRESS
(909}86a3195 Fax(909)861-3117
�"'"'� BUILDING PERMIT APPLICAT[ON FIRMLY
y JOBSITE y ` r, � APPLICATION -�j PERMR �5 � P/C i
d ADDRESS `- DATE � NUMBER V #
� ISSUE TYPE OCC
� APN LaT AC� ' DATE CONST. GROUP
� OWNER ���
o ADDRESS ZONING SETBACKS
z Cm, � -- L FRONT RW ❑
g APPLICANT � . REAR p
� SIDFJ3IDE STREET RW O
CONTRACTOR SIDE ❑
� ADDRESS
0 CITY ZIP� TEL PROPOSED USE
8 ARCWENG/
W DESIGNER NO.DWEL NO. NO,
� ADDRESS UNITS STORIES BEDROOMS
� CITY ZIP TEL
y DESCRIPTION SQ.FT. FACTOR PSF AW.AREANALUATION
� OWNER-BI:ILDEH�ECURATION SFA/ADOIREM
O
p 1 HEREBY AFFlRM UbER PENK7Y OF PERIURY TH�T 1 MI EXEMPT fpOM THE CONTRAClOp9 L4 6e��
W CENSEUWFOR7NEWLLOWMOFEASONf9EC.7o37.6BU5NES9l�NDPiqfES310N9CODE:ANYCrtYOq (n
U COUNTYNMId/REOUIRE3APEHMRTOCONSTRUCf.ALTER#�FROYE.�IOU9H2ORpEPNHANVSTRUG- W patb/Dack
TUNE,MIOR 10 tT5 IS&UNCE.N.SO REd11RE3 THE APPLICAMf WX$VCH PEflMR 70 FllE A SN3NED
W STATENEMT tHl1T HE OR SHE IS UCENSED PUASUMIT T01Nf PHOVISICNS DF TNE OON7MCfOH9 LI- W
� CH/SE LAW(�TEp o(COMNENCMO WfiF19ECT10N 7aao)OF OMSION�OF THE BUSINE99 ANO PNG LL PooUSpa
FESSIONS COOE)OR 7HhTHE OR SHE IS E%EMPTTMEIiEfROM AND THE B�SIS fOR iNE ALLEOED E%ENR
� TqN.W7'/VIOLAT',ONOFSECTIOF77W1.6BYIWYAPPLICANffORAPER/IITSUBJECTSTHEAPPLICANTTO z Ro-Roof
� A[NLVENKTYOFNOTMdiETHANFNElfiJNDREDDOLLAR5if50D1.1:
� O4��NEROFTIEPROVEH7Y,OflYYEMPIOYEE3VfI7XWlUiESlS1MEW30lFCONPEN5AT10N, 0 C�m���
N7LL DO TIiE WOPo(Mq TNE STRUC7Ilf1E IS NDT IMENDED OR OFFERED FOH S/LE(SEC.70N.&!54 J
NE59 ANO PROFESSION9 G170E:THE CONfAAGiOR3 LICENSE LAW OOES NOTAPPLY N AN OY/pEP OF
� PFIOPEIRYWNO�Ji1D5WtYAPFpVEBTHER£ON.hM7YApODES5l1CY1NbNKHILL4ELFORMERSELFOR =
� � 7HHOUC.fIMISORNENOWNEYPIOVEES.PipVIDEOiNAT5l1C11MPFOVEMENTSIIRENOTMRElIDEOdI m
I Q OFFEREOFURSALE.IF,MOWEVER.MEBUILfMNOONYPROVEMBITI55alDWRMMONEYEAR�00NPLE
Z TION.TME OYMEPEU1lDER WILI.lUVE Tlff BURDEN OF PROVMk3 hUT NE OR SIiE DID ND'f BUILO OR
� MIPROVEFORTIIEPUPPOSEOFSALkj.
❑4�S OMNEN Of 711E VMPERII;M1 E7[CLUSrvELY COMAACTNG VrtM LICENsm O�NiMCTORs
� 10 OON87RUCt THE PRUIECT(SEC toN,&/51NE58 AND PRO�SSIONS CODE iME CONTMCTOFS lL 1/81UafI0R A0.I,AREJ1
'�.. W CEN3EUWDOE9NOTAPPLYTOMldWNER�AFROVEXTYWIp&1ND90RNIPRpVE31HERC-0N,ANp
� wNoca+rwcrsronsixa+�c�swinuooKrar�cro�s�i�vsEownsu�rron+econrta�o WANTITY �ESCFIPTION FEE
, � rorre ucENSE uw.�.
O ❑t uA EXEMVi UiDER SEC. &l V.G FOR 711IS NEI130N
�
LL OATE OV/NER
Z
� UCENSED CON7HACTORS DECLAHATION W j
1lIERE9Y AFfNiY IRqER 4£NAL7Y OF PEiWRY TNAT 1 MA LICB/SED 1dAER PRUVISIONS OF CNMTER
(xy� f(OOAM�NCMIO W11H SECTIONlljMJDoa)OF DMS�ON 9 OF 7HE BUSINE55 Nq PIiOFES510NS CODE,MA Z !
W LICENSECIA$S���t+�0- I V �� ! � �
O �
�— -
� o�rE coNrru �
w
� WOFlKERS COMPENSATION DECIARATION �
� INEA�VAFFiMUWDERPEN+LL7YOFPEIiIURVONEOF7HEFOLIOWIN00EQAMT10N3: � .
�
O _INAVEM�OlW1WINSAWACEAT�FICATEOFCONeEMPo54F�MSt7i�PoRM'ORKERS'
� OpAPEN9AilON.l16 PROVIDEA 8Y SEC710N 97ao OF 1F7E L�OR CODE FORTHE PERFOHAiMICE
OF 7NE V/(]pl(PoR MMNY17HI5 PEtUi1T 44 iS3Um. �
fl
w �I NAVEMA WILL A/MlTAM YNDpKENB COMPENSATION MSUiM�E,AS REUU�PED 9Y SECTION
Q 97000FTHElIBOROO�E.PoRiF1EPERFOiMAANC£OFTHEWOPo(PoRYRMUli}#BPERMITIS
ISSUE0.MYNtlRKEl�COLM 19�ONINS ANCECARR�E DPOLIGYPAlF ERAt�: CONS7AUCTION
j GnRiEP PU1N REVIEW
2 vaicrran,�eeR � E
� fnass�cnorar�wor�m�nEr�oFnfren�rsr+oad+e�r+ormOalJasM�7pitEssl PLU '
w 1 CERTIF1'THAT N 7NE PEPFORMANCE OF THE NOPoC FOX vMidl i1NS PEAMrt is 6�ED,1 MECHANICAL
� c> . ".. ____
SFW{L HOT EMP�pYANy PERSpI M M!Y MANNER SOAS TO BECOME R�JEC7 TOTHE 1
� WORKERSCOMPErySAT10NlAW60FCALIFOPoJIA,}NDAGREETMATIi15MI0UL�8EC01.�E INSPECTIONFEE � F; '• Fj�'�m:$y I _►�+l
� �lEC170 TIE VpRKERS COMPB7SRTION PROVISiONS OF SECTpN 37ao OF 7NE LA60R
CODE.I SW�LL FOHtMMITM COMPIY WIiN T110SE PRDV{SIONS. �SSU�'7CE �
� SMIP
� DATE: .. APPLMMANT: ,f
w ENEHGY P/C � '�,
� WAIp7Mf3:FAILURETO�CUNENbRNERS'COMPEN8ATIONCOVEHAfiE18UMAMFtA.1WDSNN.LBE
�y SUBIECTM1EMPlOYERTOCPIAIlULPEMULTIESMqCMLf71E4UPTOONEMAIDREDTIWS+UA ENERGVPERMIT
DOLL�q3(it00,00C),INAODI710N TO THE COST OFCO►IPENSA110N.OAMAOES AS PROVIDEO WH IN
� SECtqN77oeOF7iELABORCODE.WTERESi.ANDATfOPNEY5FEE3. REiENTIDMFEE:
d CONSTRUCTION LENDINCa AGENCY PAE-ALT FEE:
O
� 1 NERE6Y AFfAM tMDER PENALTY OF PERMIR+'T/UT THERE�S ACON8iqUCTqN IENDMO AGENCV
FOp 7HE PEqfONMMlCE OG THE N9RK FOR MTIICN THIS PEiWIT IS ISSUED(SEC.�7.CIV.C.1.
�
� 1E10EP'B NAME
� IENDEitSAODRESS
¢ ICERlIFVTM4TIHAVEREADiVi��PPLIGTI0NMA5TATFiV1ATTNEIIBOVENJFOFMA7MJNI3OORRECT. TOTAL FEES r
W IAOREETOCOMPLYWfTHALICITYMDCOINfIYWiDN1MICESANOSTATElAMISHEtATAJG709lRD�NG
� CONS7RUCf10N,MDHEREBYAUMOH12fFEPRESEMAiNE40F'fHISCOl1MYTOENTERUPONiHE
� ED PHOPEHTY ,NS ECTION PURPOSES. C,QM�NENTS
� � � ��a
� v G
a -- !�
m
N 8%IN�iNREOFPEiW1T1'EE O�7E �
� RECPC N6. PAID BY VALIDA
WHITE--pgpertment Copy,YELLAW--Fe+eroe Copy,PINK—Aateeea Copy,GOI.pENqOD--R�Copy,aREEN--ApplkxnCa Copy
CII�Y 4F C71��+l�NiD �3A►�R
., If�i�PECTIOhJ REC4l�t'�.7
. � � . , ,� - � �, .
SET BACi� ' FLOOR JOIST �
FTGS/FORMS/STEEL FHA REQ1v1T15- '
ELEC7RIC CROUND UNDER FLOOR DUGT
GROUriiD PLU1vIBiNG UNDER.FLt7rC}R CU(�I�11`f1- -' _ •
SLAf3 GRADE � FIREPLAC�"Ft]UNDATNON --
TEMP POUWER FIfiEPLA �1ND f��tal -' � - '
Wf►TER SERVICE MID HT. BOND BEAM �
AOOF SHEATHING 8 FT.E30ND BEAM
FRHMINGNENTIUATION FINAL BOND BEAM
ROOF COVER PRE-GRADtNG ..
ROUQH HEATFNG BENCHING
ROUGH ELECTRIC - ROUGH GRADING
ROUGH PLUMBING FINISH GFiA•DiNG "
SH01NERffUB TEST POOL ELEGTf ilC
EXI:LATH/SIDING P�OL FENCli�9G
WALL INSULATION POOL FI(�tF�L
CEILING INSULATION OFF SITE Ih4PS. �
ORYWALL NAILING DEDICATIOt�S '
S�WER � FINAL ENG. �
S�ePTtC TAtJK LANDSCAP�/i'R'RiG. �
SEEP PIUI..L.. �, _ - , ON SITE IMPS.
L'iAS�iIR TEST __ `ti `•, ,.. ;- ` -` - ' .. � FFNAL Z0IVING
FINAL CONST. - i Ftf�E DEPT. FiNAL
FINAL HEATING _ - HEALTH OEPT. FINAI -
FI(�AL ELEC7R - . : t' • . - - + � DEV. FEES PriID �
FINAL PCUMBIN� `�` —1TENERGY < �
_ _ _ � --t-�—___�;-; _
,
� : ��, � . -
::, ,,�,� , ;.
�r � � i _,_�.__ I '
_ _-._-�---,; , � _
__ _ _. .
CO'rv1�fENTS
. ,� , ._ .
�s _
SEPTIC TANK SIZE _ - -
SEEP PIT/U SIZE