HomeMy WebLinkAbout15295 CITY OF DIAMOND AAR
- DEPARTMENT OF COMMi3NFTY�DEVEL�PMENT SERVICES
� 21660 E.Coplcy Dtive Suite 190
(909)860-3195 Fax(909)861-3117 PRESS
'M"�,� BUII,DJNG PERMIT A�PI.i�ATION FIRMLY
� ADDRIESS � I�� OATE CATIO� `� (� NUMSE �/'—^ �` #�
i-•
� ISSUE TYPE OCC
APN LOT RACT DATE CONST. GROUP
p OWNER
LL ADDRES ZONING SE'fBACKS
� CITY ZIP L. FRONT RW ❑
APPiICANT TEL. REAR ❑
� SIDE/S1QE STREET RW ❑
CON CTOR SIDE ❑
AOD ES
p C r 2 _ PROPOSED USE
o ARCWENG/
DESIGNER
�i'7 NO.DWEL. NO. NO.
p� C�DRESS ZIP T� UNITS STORIES BEDROOMS
cn
v� DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANAIUATiON
Q OWNER•BUILDER DECLARATION SFR/AD0/REM
O
� 1 MERfBY AFFlH4 UNDER PENALTY OF VFRA1qY THAT I AM EXEMPT FROM 7HE CONTRACTORS U- Gef8�C8�OR - �
CENSEIAWFOR7HEFOLLOWINGREASON�SEC.lN1.58U5RJESSANOVfiOFE5510N5CODE:ANVdTYOq (J�
COUMYNRIICIIREIXIINES�PEqMRTOCONSTRIlCT,ALTERIMPROVE,DEMOLISIi,ORFEPqIRnNYS�fRUC• �y,� Pa���
TUN�PRiOfl TO ITS ISSUANCE,AL9Q FIEW IRES R1E APPlICM1T FOR SUCH PERMST t0 FILE A SYGHED W
. � STATE�IENT THAT HE OR SHE IS LICENSED WRSUANf TO THE PROVISIONS OF THE CONTRACTORS L1-
CENSE UW(GUPTER O(COMMENCINO WITH SECiION 70DO)OF DIW510N 9 0F TME Bt1SME55 AND PH0- �'u' POOUSPB r.. '
fE5SI0N300�)OflTUTHEORSHEISEXEMPfTNEREFROMANOTHEBA5ISFORTHEALLEGEDE%EMP- (�
TION.MIYVIDL�TIONOfSECT1ON7031.b9YANYAFVLIC�NTWRR�ERMIT5U8JECT5THEAPPLICANTTO Z R�RQO� '� -'
� ACMLPENALiYOFND'TMOREiHANFIVEMl1NORED�OLUP51Ssou).r
� 04�301N1EqOF1HEPHOPEFTY,ORMYEMPLOYEESriITHWAGESASTHEIR50LECOMPEPLSATiDN, '. ❑ �m���) .
NALL 00 THE WORK ANO TNE STRUCNRE IS NOT iNTENDED OP OFFERED WR 9ALE(SEC.7W6,BU51- -. J
� NESB MD PROFESSIONS CODE:THE CONfMCTORS IICENSE UW DOES NOT APPLY 70/Ji OWNER OF � ,
PNOPERiY WFp BUND30{i 1MOROVESTHEREON,AND VMOOOES SUCH WORK HIMSELF OR HE0.4ELF OR
L= 1NR011(aHHI50RHEqOWNBdPLOYEES,PROVIDEDTHATSUClIIA1GROVEMENTSAHENOTINTENOWOR m
GOFF8IEDFORSKEIF.HDWEYERTMEBUILDINOOR9AVROVEMEMISSOL�WfIWNCNEYEAROFWMVIE-
Z TION.hIE OWNEp-0UILDER WiLL MAVE iHE&/flDEN OF PROVINO iHAT HE OR SHE OID NOT BUIID oR
= MPiIOVE FOH THE PURFOSE OF SALE} t
w ❑4��ROFTHEPROPERfY,NAEXCLUSNELVCONTqACT1NOWR}iLICENSEDCONTRACTORS
� TO CMJSTRUCi 1HE PROJECT(SEC.7041,BUSINESS AND PROFESSKKJS CODE:THE COMRACTORS LI- VBIIIStlOf1 A�J.AREA
W CENSEUWDDESNDTMVLVTOAN01N�EqOFAVqOPERTYWHOBUIL�SORIMPROVESTHEREON,AMD
� wwco'rtw�ciswnsua+vrro�EcrsvnTM�cor�rrucroa(s�i�wsEoauasuavrroTMeco�'�Eua QUANIITY DESCRIPTION PEE
� TORSUCENSEUW.).
O ❑I AM EXEYPf UNDER SEC. B.�P.c.FOq THIS REASON Q
3 �
� o�
OATE oWNER U , .
� UCENSED CONTRACTORS OECLARATION W .
� IHERE9Y�FFlHEtUNDERPRU�LTYOFPERAfAYTHATIAMLICENSEDUNDERPROVI6IONSOFCHAPTFR �
p� Y(Cdi/ENCRqWfiNSECTION7000)OFqN&qN30FTHEBUSMESSANDPHOFESSIONSWpE,AND Z
X MY IK;ENSE IS M CE MID-E�FfECT.
� UCENSE CLASS F�V LIC.NO. ��✓ `r �� �
V DATE �CONTRACTOR d
W
� WORKER3'COMPENSATION DECLARATION 4 r
� IHEREBYAFFlRMUNOENPENdLTYOFVEfU1RYONEOFTHEFOLLOWiNGQECLARRTIONS: - . Z 1 � �]'�} '��.`,
f v V w
� _IWIVEMON7LLAU�NTAMIACENT7FlCA7F�C�NSENTTOSEIF.INSUREFONYlORKERS' _
COMPENSATION,ASPiqVIO�BYSECTON3700OFTHELABORa1�E.FCRiHEPERPoP.AIANCE U
�� OFTHE WOFK WR NMldi 7HIS PEAMIT IS ISSUEU. �
�
w _�HAVEANDWiLLEUIMAMWOPo(EAS'C�M7ENSATIONINSURANCE,ASREOUIREDBYSECTION
Q 31a00F7HE CODE,WP7HEPERWRMtNCEOFTHEWORKFOqWHICH7HISPERMITIS
� ISSUfD.AIY R ,H5WMP 3A71ONIN NC'� �NUMBERARE: CONSTRUCTION
y c�nen ' � PLAN REVIEW
� roucYnnn+eER � �^^� ���'S O ELECTRIC _ f
� (IMssEcrtoNN�NoiBEWAPLEtEooFnfaa8Rr5fOnd�EtA1�oREDoat.CRsls�ro)oalEss} PLUMBING
Z ICERTIfYTNATM7HEGERWHMMICEOFiH RNFORWHICNTHISPERMITISISSUED,1 �� ���� �
V' SWLLLNOT EMROYNNY VERSON INANY M EF A9�TO BECOME SUBJECTTO TNE
(/� NORKERS'COMPENSATION lAWS OF CALIF NIA 0 NGPEE TNAT IF I S/KKILD 6ECOME INSPECTION FEE
S SUBJECTTO TliE WORKERS COMPENSA PRO�IONS SECTiON 3700 0F TME LABOq
ccqE�s��utFo nrncx�+virNnn� bv rori_. ISSUANCE
� SMIP
p OlRE: � RPPLIGAM:
� ENERGY P!C
WMNINO:FAM1URE TO SEWRE WORKERS'G�APENSATION GOVEHAGE IS UNUWFUL,AND SHALLBE
� SU9JECTANEMPLOVERTOCRRAMAIPENN.TIE6ANDCNILfINESUPTOONEHUNDREDTtiWSAHD �pGYPERMIT
p0{,LAR9(�f ao,0o0),N ADOITION TO THE COST OF COMPENSATION.DAMPGES AS PRONpED FOR IN
J SECTION970lOF7HELABORCODE,NTEREST,ANDATTORNEY'SFEES. RETENTIONFEE:
�
�a CONSTRUCTION LEND�NO AGENCY pRE-ALT FEE:
O
� IHEi�BVAiF�flMU�ERPENALTYOFPEFiJURYTNATTHEREISACONS7RUCTIONlEN01NGA0ENCV
z FOR THE PERFORMPNCE OF THE WORK FOR WHfq{MIS FERMIT IS ISSUED(SEC.]09�,CIV.C.).
W
� IENDER'S NMIE
1— LENDER'SAODilE55 t
¢ ICER71FYT1AT1l1�VEflEADTMISAPPIILAiqNMIDSTATETHRT7HEA80VEINFORMATIONISCORRECT. TOTAL FE�S (,'
� I I10REE TO COMPLY VATM ILL1 CT'M10 001R1TV OflDINANCES RNO STATE LAWS HEU7ING TO BUILOtNG r
CONSTHUCTION,AND HEREBV ALlI)iORRE pEPRESENTATNES OF THIS CIXINiV TO EMER UPON THE
S'� �eovE-r�p�rtroN raonEarr wa u+saEcma�vuarosEs. COMMENTS
� L
�
�
m VEF�AiTEE
H � �� r (� C/ )., ,. /� \ �
� SN3H�TUREOfPEiMAfTTEE �ATE
� RECPT.NO. � PAID B ._ VAIIDATON
WNITE—Uepahment Copy,YELLOW—Flnance Copy,PINK—Aasassa Copy,GOLDENRO�File Copy,OREEN—ApplicanPs Copy
CfTY OF CtIANlC?ND BAR
iNSPEC"TIC?N RECC}�tD
• � l o - � � � . � .
5ET BACK FLOOR JOIST
F'i'GS/FORMS/STEEL FHA REQM7S
ELECTRIC GROUND UNDER FLOOR DUCT
{:sROt1ND Pl.UMBlNG UNDER FLOOR GUNDUIT
SLAB GRADE FIREPLACE FOUNDATION '
TEMP POWER FIREPLACE BOND BEAM
VYATEFi SERViCE - MID HT.6C}ND BEAM ' � '
ROi3�SHEATHING 8 F?.BOND BEAM •
FRAMINGNENTILIA`fION FINA�HOND BEAM
R�OF GOVER PRE-GRADING
ROUGH HEATING BENCHfNG
RC)UGH ELECTRIC - ROUGH GRADtNG
ROt1GH FLUtv16tNG FINISH GRADING
SHC}WEFUTUB TEST � PQC7�EI.ECTFIIC
�XT.LATN/SIDiNG POO�FENCWG
WALL iNSULATiOt� PQOL FINAL
CEILING INSULl�TfC3N OFF SITE IMPS.
RRYWALL NAILING DEDiCATiONS
SEWER FINAL ENG.
SEPTiC.7ANK LANDSCAPE/IRRlG.
SEEP PITILL. ON SITE IMPS.
GAS AiR TEST . , FINAL Z(7NING
FiNkl'COhiST. ' , , . '. FlAE DEPT.FlNAL
F1NAL HEATING —(� . HEALTN DEPT.�INAL
FWAL E�ECTRIC DEV. FEES PAlD
FINAL PLUMBING ENERGY
• •
GC)14i1ENT5 '
I`��
.�°
SE�'TlG7ANKS12�` �: � :" :i..� � `.�,
SEEP PlTJU SlZE �