Loading...
HomeMy WebLinkAbout13883 1� CITY OF DIAMOND BAB � DEPARTMBNT OF COMMUNI'FY&DEVELOPMENT SERVICES _ 21660 E.Copley Drive Suite 140 PRESS ' -��"W BUQ.DING PERMIT APPL�CATION FIRMLY o AD RIESS �ZZ� "' y�� � DATECATION �_/G /'L NUMB R ����� #`___[�� � ISSUE TYPE OCC APN LOT TRACT DATE CONST. GROUP p OWNE� `'` ADDR SS �y�' M N ZONING SETBACKS � CITY �/MNUN.� � ZIP EL. r REART RW o APPiICANT TEL. SIDE/SIOE STREET RW ❑ � CONTAACTOR /?/�1 � iL. " �� SIDE ❑ Q ADDRESS PROPOSED USE � � CIIY ZIP TEI. Fii ARCFUENG! � DESIGNER U` ADDRESS NO.DWEL. NO. NO. UNITS STORIES BEDROOMS � CITY ZIP TEL. N N DESCRIPTION SQ.Ff. FACTOR PSF ADJ.AREANALUATION � OWNER-BUIIDER DECLARATION SFR/ADD/REM O � I HEREBY AFFIiM IA�DER OEldALTY OF PERJURV TNAT I AM EXEMPT fROAI TNE CONf(UCTORS LI- (�j8fd96/CeIpOf1 ti,l CENSEUWFORiHEFOILOMONGHEA50N(SEC.7o31.3BU3NE34ANDPROFE551oN5CD0E:ANYCITYop (f� C7 COUHTYWWIC�IPEOUIRESAPERMRTOWWSTRUCLALTER�PROVE.DEMOLASH,ORREMIRIINYSTRUG �/� NqE,PRIOH TO RS ISSUANCE,ALSO REWIRES iHE APPUCANT FOR SUCH PERMIT TO FlLE A SIldNED W Pet10/D@CIc �� � 3TATENENf THAT ME Oti SME IS UCENSED%1RSUANf TO THE PROVISIONS OF TNE COMiRACTORS lb CENSELAW�CHAPTER Y(COA1MENqNO WITH SECTION 70P0)OF DIVISION 3 oFTHE BUSINESS 0.N0 PRO- � PoOVSpa FESSqNSCODE)ORTHATHEORSHEI3E%EMPThIEREFROMMJDTHEBA515FORTHEAItF.GEDEXELAP- (� TION.ANYVIOlAT10NOF5ECTION70.71.68YANYAPPLICANTFORAPERM�TSUBJECTSTHEMPLICANTTO z Re-Roof r ACMLOENALNOFNOTMORETFUWFNEFA1t�REDDOlUfi5�;5aD).): ^ ❑I,ASOYMEROFTIEOROPERTY.Oq4YEMPLOYEESWI7HWAGESA5THEIRSOLECOM7ENSATION, � Commercial � WILL DO THE WORK,M70 iHE STRUCTURE IS NOT INTENDE�OR OFFEF7ED FOR SALE{SEC.)OM,BUSI- J L NE55 AlID PROFESS�ONS COOE:7HE CONiMCTOPS LICENSE UW�OES NOiAPPLV TO AN OWNER OP A � � PADVEfiTYWHO8UILOSORN1PqOVESTHEREON.AN�VMO00ESSUCHWORKHIMSEIFORHEASELFOR = '� , Y " (,L i}AROUtiHN150liNEROVMEMPLOYEES,PROYIDEDTHAT5UCHIMPROVEIAENTSARENOTINTENDEDOF m � OFFEAEDiORSALEIG,lpWEYEIlT/1EBU1tDINGORNAPPpVEMENTI550lDWITHiNONEYFAROFCOYPIE TION,7HE ONMIEH-BUILDER WILL NAVE TNE BUROEN OF PROV�NG THAT HE OR SNE DID NOT�UILD OR = NPHCVE FOA TME PURCO..E OF&LLE7. w ❑I,RSOWNERO�TNEPROPERTY,AMEXCLUSNEIYCO�MCT'NaN^�TNVC[NSEDCONTMCTORS � TO CQNSTpUCT THE PRDJECT(SEC.70t1 BUSINESS AND PROFESSIONS COUE.THE CUNTRRGiDRS L6 V0IU3SIOI1 _ _ ADJ.AREA � CEtiSEUWDOESNOTMP�ViOAHOVMEROFAPROPERT'NM1IOBUMDSORILiPitOVES7HEflEON,AN� wNocarrw,crsFonsucnvRaecrswini�corrrrucmA�s�ucEr+sEoeunauu+rroniEcorrtrua pUANTITY OESCRIPTION FEE � m\��///n'''s���ucEnse uw.). /� b 1/J1 EXEMPTUN7EH SEG B.L P.C.FOqTHIS Re'ASdV Q � \ U a �=- o�_ owraeA — U � w UCENS5D CONTRACTORS DECLARATICN J � w I HEREBY AFFIP4lRJ�ER PENILLTY Of PERIURY THAT I AM LICeNS`eD UN6ER PtiG'J�SIvNS OF LiiAPTEfl � s y(CpYMENCINO WITH SECTION 7000)OF DNi510N]OFTNE BUSINESS A40 FROFESSIONS COCE,MD Z X w1yLICENSE151NFVLlFOiiCEFNDEFPECT. � 4J � 0 UCENSE CLASS LIG.NO. J 1 V DATE CONTR4CTCR a . � � WORKEFS'COMPENSATION DECIARATICN � : Q " � U ( � I HEREBY AFFlRM UNDER PENALTY OF PENUFf1 ONEOF THE FOLLOWING CECURM1TKK.S: Z Q � Q _�W1yEMVpWI��MA1NTAtHACERTIFICATEOFWNSEMTO£ELHNSUqEfORWORNF.AS' _ } � CONCENSATION,ASPROVIDEDBYSECTION37oaOFTHEL49CRCWE,FORTNEPERFORMANCE W i OFTIE WORK FOR WHICFi 7HI5 PERMIT IS ISEUED. � � ���.../// ��{,�yE dryp W!LL MA�NT�!N WORKFRS'COMVENSATiON INSURANCE,AS R'cIX11RED 9Y SECT�ON O � ¢ 37W6f7HElMORC6)C,WHT�EPERFORMMlCEOFTMEWOPKFOriWii;CHTlIISPERMITIS t �,�� � ISSUED./AYWOFKEPS'COfA^ENSATIONINSURANCECARR:EFANOPOLICYNUM9EFAFP CONSTRUCTION � � c�q�� PLAN PEVIEW � _J / s--f) zaaart+uueEA ELECTRIC � `7� •��/ s� �-�� o ����rAEm.at�o��vEr�swHcr�Mau�ooa.wasm��ar�Esst PLUMBiNG � f'�S� w 10ERTIFYTU7INTHEPERFORMRNCECFTHEWORKFORwHICHTNISPERMITIS�SSUED,1 MECHANICAL z (} SHAIL NOT[MPIOV ANV PERSON N1 M1V MANNER SO AS TO PECAME SUBJECT TO THE � WOWSERS'COMVENSATIONUWSOFCALIFOHNIA,ANDAGREETHATIFISNOUL�BECOME INSPECTIONFEE � SU6JECiTO THE WORKERS'COMPENSATION VROVISIONS OF SECTpN 970o Of THE UBOF7 �SSUANCE � �� �' � CODE,I SHALL FOR�IIW�TH COA�PU'N�TN T�VOSE PROVI5KKJ5. O SM�P CITY C1F T�T^ i�rr''[��S i:. ,�. �� p DATE: APPLICANT. ._ 7� ..r4�.� . J ENERGYP/C �+JI_iT.T�T?�71: �yt°� [`��FT�'• J WMNIN(7�fAILUFE TOSECURE WORKERS'COMPENSATION CAYERAGE I5 UNUWFUL,AN�SHALL BE -� - �y 9UBJECTANEMPLOYERTOCRIGIINN.PENALTIESAN�CMLFMFSt1PTOONEHUNOREDTHOUSAN� ENERGYPERMIT [%1l.URS(i100.000).IN ADDITION TO THE COS7 OF COMPENSATION,Dl1MAGE5 AS 7ROVIDED LOR IN J SECTION370BOF7NELABORCODE.INTEREST,AN�11TfORNEY'SFEES. RETENTIONFEE: � W CONSTRUCTION IENDING AGENCY PRE-ALT FEE: d � O • � IHEREBYAFFIRMUNOERPENALTVOFPERIURYTHATTHEREISACONSTHUCTIONLEN�INGAGENCV FOR THE PEflFORMANCE OF7HE WORK FON WMIGM THIS PERMIT IS ISSUEO(SEC.309�,CIV.C.). Z W � LENDER'S N.�E � LENDEfl9ADDRE55 w W �CEp7�Fy 7ryqT�HpVE REAO TH5 APPLICA?pN AND STATE TNAT TME A90VE INFORAIATION IS CORRECT. TOTML F E ES d I AGREE TO COMPLY N7iH ALL CITY AND CWNTY ORDIN�NCES M7D STATE LAWS RELATING TO BUILDIN(3 ^j (^ � pONgTqUC710N,M1D HEREBV AUTHORIZE REPflESENTATIVES OF THIS COVNTY TO ENTER UPON THE ///J�{,� J f� C/�p }1 �� y��� Z ABOVE�A/EMpNEDPROPERTVFORINSPECTIONPUHPO�ES, j �i►r1Z.�G '�'e-�-���.(i(T � j� 4"'i��'1 � � • �, COMMENTS � 1�,,-��''""���� �v t�R-� cf� m PE�tCN RINT) C� J a ` � � Cn (A SIONANREDFPERMITfEE DA7E � RECPT.NO. "' PIUD BY ' L � VALIDATION -� � I � WHITE-0epartment Copy,YELLOW—Finance Copy,PINK—Assessa Copy, ENROo-file Copy,GREEN—Applicant's Copy 1 �:I���° �� �������:�� ��=��� ����t�`��a°i��� ��^��3�� I ° � . R�ur ,��,m ��.;. � e �-�.m.� �' � �m'� ' ,� �:�� � �°`_� � , , , � �� Sr��%�"i � i C-���}�i���i��' i E C...._........ . ...._ ;... ...._..__.___ ___...—�.,..._____ ._______. _i. q.-.._. .._ . ..___._.._.... _. ._._. _......y..__. ._._... . ._..___--__._...-- '��J`"J ¢ �ii���&t� ±a?��� j ' i t:� �� �s�', iJ I _..._� _ .-�. .._._._. .__....._. �__ .. .._._ ._..._._. . ' � __ ..__ .._ ..._.._.._.�.....__ �LE,�".1 F�li+C i3�"+.34�d.t i � t.li�"�LI t 't._t��a€�� �J`_f°t i ! � — - •� - --- _. t ._ .__� # _____ . .. __�.� _.__.___.�.._._ � G�sC�+��G>'r'p �. s�C� ' � ; ui°#�L(� FLC��F�C�� : :�� ° _._ _._.. ,.Y.� ._. ...__ ; _ __ i ��.�Y.��;��*?'��... .. ...._.;. .. � � �"���'. � r�� t"�. e - ��;+"g.s ; ., _. .._... .. _�__w_....._—__—_ . : ' � � '� .. , _.._ _.._... � - _._.�. ..._... "'� � . � .__._._. _ . . ' ' ; ; f _" . ___ ........ ..__._... ._._..._..._.._.....__ , � �°@'a� �.�'dC�� I ' _�". "' �...�p,a� ' _ �'iri _�^' f�'�i.3��.��3L � _� �_ i __ —_ _ r ; . _ h � '»br"ia�rs ��t�ea ,: � tFi-� r� �3�.<i�t.r€.��,s i � � _ ._ . ----- __.. __ »..___. , � -----�-__.._.._ : _______..._.. ._ _..._..._ F'.::t��-� -��,. �F,'a s. I cs t-i ��'�i a c����'�i I ._.._ ..�_ ..__. --_�._.__ — - — �i,� EiaCaT'�+�"�v x i!_f�TlJt�; �—___ _ r ji'tiF�,� i� d�'�J Eztiil'�� _ t � _ — ;_ -- _. ; — _ ____._ _.._._..._... .____.. ��,��3F�. )r' � ' E ; N�;�-C:i`sr1Cl�� __.__ ��..___._--- � - __ '_ __ --» , ; — _. � . _.._ �. ,__...�._._.., �f:�'`..�. ��. r�{'�. �.��i�via ' � ____--�-�---____._......_...__ _ � ,-' : „ ` ` ! E �,< ; ��::;`�:1k�S�G ; : ¢ _ ...� _ ....�.d.�.n _....,.�.._,......._._............_......_.�,�..._. _ ...._..`. _.... b . ......... �._.._._.....__ �. � �'`�'.a �"�., 'S�"il� ; � I � t�'iv`vG'+!Ca�-'ir1"�.11PJ+."a p ,_ _--_. _-- —- � p.^� _ ..___ �___. f �"4 J: r. a_ 3>�.3f���:3 � . �� � (s`v�3i i t'�P\iJi��z .. � . _�.� � ...-.- ..... ....�._......_.__._. ___...��... :........__.._..��_....._.,............._.�. ........._.._. .___..._.,.�..�......_....._ ._<..,._.... ...�� .__.�� . -�•- -»- ( ` �'i.�L�C,!�'iiu __�_ _----____�__._���; � �� � � 3�1:3 'r_�t , � � i ' fi� : _.�. _...._.... r�'f� i . � -- _ _______ _P, ,. _ - --.___ ._.__.......__._____ _ .i ... �E _`_���Jls�,% � � , w'(:r»L �=E:sa�s9�a:a � _ __ ,__—_� —_.._. _ .�_ ______ __.__ . _3 1 r �C� �.�?p HI�V�v � ' I � , �tr%eJ�..i�l��rll_ r i _ �_.__.__._._—i-____._._____�._.__._._ .._. ._.°_._._ �..._.� !_._ .._.._____ , , 4 : t Et, S t,,y ; ' � � �.,6e� €��i ;.� C�y € _....� .._.._�__._.._....._ � � _. _ �. ___-------� _._ _�V._ ____.� _ . __... . ; € "' e �f� E .e:� ; � � C3c ��r`r�4r`�a� i 3 � ._ _,_, .__ ,.._._...__ __... _..______� _ .___. ____ _._ fi—_. ' __.____._..._ __.__._.... ____ ... .. ,ry �__.__....—_� '. � �PA � ': ;. a II'a�i(..��.G, - ! . ... . ...._.......... .. ..........._.__.__._ ` ...._...._......_.... � .�..... .___..... _._ �.� ! � .. _ ,. , �____,....._._.._.__....__"___. Q t. .. __._.. .___ ..__._-____..__.._._._......�......... ; ..., . . ,.�4':�e"k r i ( i �;'iiY�>:C.rv.�'7�.jl�.t�!i7._........_,.��. „ � ... .. ....._...,�_.,,-..._.�:-._...._.m....�....� _ _. �: .�.� .. n ' � ., .__ .._..__ _ ._.__.._. ._ . ..__.._.....,. ___..._................... . .._....__ _ - �_. ...._i-..._. $ ; ��_. ;,.__L,, i �i � ! �..�I�t�.. _..:�a,4;""i I � i - . .. ...... ._ ......_._ ___ __.__...... . � # _ . '� -Y,.9{ � � ( j � i�'�{ ...J'�i d . .�.._. � � . .___._ ...._ _..; . ... _ �„ �._....._ _.......... _,..,....m... _ _....r _ ._._.... � ......... .___. .._ ,.._...._...._..�_........_ .... .,g ' ` lC0 �� t ��ed �r��� rI,' �� _ _ . .__. _ ___ _���,�_n�.�__._������--_� ._ __ _ ______._ __. _.____.�_ .______----- -�i,�� __ ,. g : ,. _..._. ;-.;, e � m.�- ; 3 a.. 1 9 1 i�;r,'� ° , i . ___. _ _.,�__._...._�._._. __...._._______ _._..__...._ ___.._ .. ____.—_._ � �_ _ .__...._.__.. __. ........._ _....__.. . ------ ° ; ��'"�"' E ; �E= ,��C-. � __. _.._�_.. �._-__...._ __.._.� _ � �:�r�,�, ` _ _ ------... ..----- -- _ __..___._____�.. ______.._ ._......__._; i.��:; . . � z , .'� ,� � �.� , r_ . m m. __--__� ._>— ---....- ---- -___ ---___ __`----- -_ _.. __.._.___.__... ;_ � . __.._..._. : � i _ --.._. __- _ ---__.�___.� � ; ; ; ; __. _ _ — _�. _... _� _�. _..__.___._�� _._.._... _.___._.._.. ` i ._ .__ .: ! ' � P �; ,� .r. _ � ; �. ___..�.__..._____._. __.�.... ...._____.._a._.___ _ �.._____.___._�..__ � '`� �w , ; _.._......__�__.____ ___ , • ..._.._._._....__.__. ..._. ._- � E ..� ,.�;,� , ; i ,.. �a»�.� �� � � _.... ._�..�_..__. .._.._. _.._.._�.____._. __.___...__.___.______..__.....____.._.__._____...___.._._._.____.__m.._._.._.. � ..__.........____�_. _ __--..� �_... .._. __.....e_._._........_._� ____.�_..._ �.._._._.�_.__..__ � , ..._--- _._-- ' ! , _..... _......._.._-- _...__._ .__,. ____..._..._.__..______...__ .__...._ . , � _...._..�.. ; � ' �_ --. __.._.�.________._._...._.._ _....�..._.__:_._..._..._.._....____...___ __..._.__._ � � ; ° g__�...� � ___._ ____m__�_..._.._._._�_._�._.. _ _._.._.... , _. _____—_----- ----_..___.�. _.........________.._.. i � Y___._..��. ......_..._........_ ..............__'-- ._._.._'_' .__._ ._..._.__.�_..._..d...__.__._. ............._,_......__._..._.........._._...._�._.....___..___._..__......._...._......,�.� ...___..........._.._._.�_ . .. . _................._...__.: 4 � !_�....._._._..r__�...__.._,__.__._,_______ __�.__ ._.____...___ ._ __._...______.__ ._.�_._._....._.__.__ ____ _..._.____.�.�_. .._..... , I �__ _____.___._______.__._.__.._ __. --------- -- –---__�._.__...._.__ _ __.. __, s__.._.______..____._.._....____._.___......__. ___._._ _ --__.__.____.._—� _. ________.___ _..___ ___ ___.. � � �_._ _ _ ___ ._____.�..___ _._.........__ _____ ---_. , .___._.._ _._____ ____...__ _..... ...,.._________�_ ___ , I � ��.�'[ � �-�� �� ����� _ r � � � _.__ __ � ___---- - _�� i v L�.'� §_..�z I �. z� ......�......._.._._.....,........._,_..,,,...W._.__.._..__ ( + i 7 ___ ,..................._..�...._........_..........__.__...._..__._.__....__. . ....__._._. ., a ' .. ... ; � a = � :� .�� ....._....._....�_ ...___-,--....e__._..._.._.._.__. _.._.._.._..,_......_._.____.._.......___..__�_.__..___.....__.____._..__-..._.._._... ___....,..__....._.._._. .._._.._.__.. ' :: . . - - . .. ......._......__. ......z F � z � �_.._.__........__ ____. ..__..___.�._.___.. ...____._ ....... ___ _..� I --.._. .---------__.__._ __.__._ __.____-- : � � I � , 6 _........____ ___._________ ._._... _._ ________. ___...�_____.. _ ..__ _... . ...... _ _.__�_._�___.__ ____.__._ _, # C.� ` I ,. � . � � .�. � � ___.____.__�_�_ ____ � �. _ _____ ._, . __ m m,__ _ — --- —_ . _. . � � � � . � _ ___ _._ _._.____ _ _.___ ______.._.� , _____...� __ .._. __ _.___.___ ____, ; ti __.___..____� _ . _._ . _ .___..__. .__ _._ . .__. : � n , _ _—_ __. . .__ k � _. H . . . :. , , a a � a , , _ .. .:���.. _..______�.____ .. __ ..___ _W_____�_._ _. _ +._�..._....� .�..�.. _ _� �