Loading...
HomeMy WebLinkAbout15601 (20) e. _� CITY OF DIAMOND BAbt � DEPARTMENT OF COMMUNITY dt DEVELOPMENT SERVICES 21660 E.Copley Drive Suiu 190 � ` PRESS � (5109)8bQ3195 Fax(909)841-3117 »� $UII.DING PERMIT APPLICATION FIRMLY o D RESS��Y� I J�L�T �l�� V �/� pA�CATIOIy���'��),�U+ /)NUMB R "'D #� ! � V c� ISSUE TYPE OCC APN LOT TRACT DATE CONST. GROUP � OWNER H�,�c u d " ADDRESS �' ZONING SETBACKS � CITY ZIP TEL. �� REART RW O APPLICANT l TEL SIDE/SIDE STREET RW ❑ � CONTRACTOR ��N� �, t_ SIDE O � C�ESS��/��(Q Z'P q rTE��'►/� I� ppOPOSEDUSE 4 D L/`�'�' � � ARCWENG/ DESIGNER MO.DWEL. O. NO. ADDRESS UNITS STORIES BE�ROOMS � CITY ZIP TEL. � DESCRlPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION � Q OWNER-BUILDER�ECLAHATION SFR/ADDlREM O p i rg�r��u�mEa oEr+.u.�v oF pEwum nur i�rn�vr cnou n�e coNraAcroas u- Garage/Carport � CENSELAWfOR7FVEFOLLOWWGRFA.90M(SEC.TOJ7.58USINESSANOPROFESSIONSCODE:ANYGYiVOR (n COIMR'lYNAqIPEOUIRE3APEIWtT7000N87AUCr,MTEF,MPROVE.DEMOL15n,ORREMIRM1vSTAvc- W PetiO/DBCk NRE,PRIDfi TD ITS 159UM10E A150 AEQUIqES h1E APPLICANT FOR SUCH PEflYIT TO FILE A SiONED W ST�tEMEM THAT HE OR 9HE IS LICENSEO PURSUANT TO TME PROVISIONS OF THE CONiRACTORB LI- � C@ISE�AWW(p41PTEq y(COMYENCINO WITH SECTION 7000J OF DIVISION 3 OF 1NE BUSINE55 ANO PRO- � POOVSPB PESSIQNSCODE)ON7FUTHEOASHEISE7(EIAPTTNEREFROMANOiHEBASISFORTHFALLEGEOEYEHP- (� TqN.N1YVKILATIONOF36CTIOR17�it.5BYMfYAPPLICAMFORAPERMITSUBJECTSTHEAPPLICANTTO � (j@-RO01 r ACMLPBIALTI'OFNOTMORE7HFNFIVEHUNOREOOOLLARS�f500).): � ❑tASONMENOFTHEPROPER7Y,ORIAYENPLOYEESWITHWAGESASTHEIRSOLECOYPEN3AT10N, 0 CommerCie) WILL DO TiE WON�C AND 7ME STRUCNRE IS NOT INTENDED OR OFFERED WR S/�LE(SEC.70U,BUSI- J � ���ESSqNB�E:�VECONTRRCON.ANDIMAIOOOESSUGYIEWORKHIIISELFORHER�SELF R � Q iMppUW11q50q11ERO1MIEYPLOVEE3,PROViDED7HATSUCHNAPROVEMENTSARENOTINTENDEODR m W OiFEAEDiY7PBKEIF,HOWEMER,7HEBNLD�N(:OFWPPOWfiMENT19SOLDWITHMIONEVEAROFCONPLE� � i7oN,7HE OWNER�l11tDEN WILL MAVE TNE BUflDEN OF VRO�iNO 7MAT NE OH SHE D1�NOT PUIL�Oq MIAROUE FDA iFiE PURPOSE Of SALFI. ❑I,AS OYNiER OFTHE PROPERfY,AM E%CLUSIVELY CONTMCTING NTRi LICENSED CONfMCTORB � TO CONSTRUCT THE GROJECT(SEC.70M,BUSINE55 AND PROFESSIONS CODE:1tiE CONiMCTORS LI- VdI1J8I1011 OO ADJ.AREA W CENSEUWOOESNOT�PPLYTOANOWNEROFAPimPERTYWHO8UflD50HIYPROVESTHEREON,AN� � yd1000NTMCT3FOR8Up1PROJECTSWITHACONTMCTOR(S)LIC[NSEDPUPSUANTTOMEWNTMG pUANTITY DESCRIPTION FEE � 70RS lJCE1/5E LAW.). J O 1 AM E%EMPT UN�EH SEC. 8.8 P.C.FOR THIS REASON e( 3 � � w� ormiEa V � J 6 LICENSED CONTRACTORS DECIARATION W 2 I HEf#EBYAFFIF�1 UNDER PEN�LTY OF PERIUNY iFV1T I AM LICENSED UNDEfl PRDVISIONS OF CHAPTER � f(CPWENCMlON1THSECTqN70o0�OFDIVI510N30FTHE8U51NE5S�N07ROfE5SION5(bDE,ANO z MY LICENSE I5 IN FULL FORCE ANO EFFECT. m o C.�j� q a � � LICENSE CUSS LIC.NO. � � o�� 9f?.7 I o� corrrancroA 7 A-[.,_1 1�,L� a L WORKERS'COMPENSATION DECLARATION Q � U N IMEREBYAFFIRMUNDEflPENPLtYOFPE0.tt/RYONEOFTNEWLLOWINOOECURATIONS: Z Q G _INAYEANDIVILLRNINTAINACERTIlICATEOFCONSENiTOSELF-INSUREFOR4VORKEHS' _ q COAIPENSATION,ASPROViDEDBYSECTiON37000F7HElABORCODE,FOH7HEPERF-0RMANCE �U OF THE WOPo(FOR YMHA1 TF��S PERMR IS ISSUED. Q L W _�IHAVEMIOWiLLMNNT/UNWORKERS'COMPENSATKKJINSl1RMlCE,ASREQl1IREDBYSECTION O 37000FTHELA90RCOOE,FORTMEPERWRMANCEOFTMEWOPKiORWN�CNTHISPERMRIS ISSUED.MY WONCERS'COMPENSATION INSURANCE CARRIEH AND POUCY NUMBER ARE: CONSTRUCTION �� } �q�ER PtAN AEVIEW � POLICYM/MBER ELECTRIC � o �n�Ss�crnr�n�Hpre�ppuREi�poFn�p�+rsa�or��pa�nr+sry7m�aa�Ess} PLUM9ING z I CEHi{FY THAT W THE PERFORMMlCE Of THE WORK FOR WHICH Ti15 PEPMIT IS ISSUEO,I MECNANICAL - , � �J SW4INOTEMPLOYANYPERSONINANYYMAJERSOAST08ECOMESUBJECTTOTHE . . - - : � NqPKER3'COMPENSATKKIU`h'SOFCALIFORNIAµD�GPEEiHAT1FI511WlDeECOME INSPECTIONFEE _ S SUBJECT TO THE WORKERS'COMPENSATION PfiOVISIONS OF 3ECTiON 37000f THE LAeDf1 �$SUANCE CODE,ISHALLFORhIWfTHCONPLVWiTH OVISIONS. L � ^J� �}� ' _''_' _ _ '__ _ p DATE:��.v��t/APPLICANT: _ SM1P _,., ' - ; ,. J ENERGYP/C c'-:--! ° J WAIUJNNi:FA2URE TO SECURE WOFKERS'COMP ION MOE IS UNUWFUL.AND SHALL BE LL SUBAECTANEMPLOYERTOCRIMINALPENALTIES .Ocrvil ESUPTOONEHUNDHEDTHOUSAN� ENERGYPERMIT '- _ _- — OOLUNS(i10o.oa07.IN ADDIT70N TO THE CAST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN .. � � SECTIDN970lOFTHEUBORWDE,plTEREST,IINOATTORNEYSFEES pE7ENTIONFEE: ,_j.� a '' �,�` - � CONSTRUCTION LENDING AGENCY PRE-ALT FEE: $r . O � I HERE9V AFFIRM UNOER PENALTY Of PERJURY THATTHERE 1511CONSTRUCTION LENDING AGENCY FORTHE FERFORMANCE OF iHE WORK WR WHiCH TM�S PERMIT IS ISSVED(SEC.1097,CIY.C.). Z W � LENDER'4NM1E H �ENDERSAD�RESS ` WICERTIFYTHATIMAVEREADTWSAPPLICAT�ONN705TATETHATTHEABOVEINWRMATpNISCORRECi TOTAL FEES 1 � ' t 4 � I AOREE TO COMPLY NTiH PLl CI1Y MIO LWNTY ORUINANCES AND STATE UWS REIATING TO BUIWINO A ��w � � � CONSTRUCTION.ANOHENE9VAl1TFK)fiIZENEPRESENTATIVESOFTHI5CIX1N1YlOENTERUPONTHE ��� �� I180VE�MEHfIDNED PROFERT/FOH INSPECTION PURCDSES. COMMENTS � I � � b9z� _ � PEflIMTTEE NAYE(PRI � � * � SIGNA7l1REOFPE OATE , s RECP7.N0. PAID BY VALIDATION � F WHITE—Department Copy,YELLOW—Fineroa Copy.PINK—AssesgwCopy,GOLDENROD—File Copy,GREEN—ApplicanPs Copy �ITY C�F ����t}f�� ��� �PE��`��3;� ������ � .� ' � A .� � ~ '� .. d.. . . � � � _ _ _ .ry�� p 5ET BF�C9< � ' I ( FLC�C'R.�vIST � � g _.._.�... —._.__'___'..�..�._.__�.�_�-Yr..._.._.._._ _...�... ._...�...__�._— ____._.�.._._. . . .. ...__. ........ _._d F7GS/t=��h1St�TEE� ; FF'A RcG�y�i S � � ; __ _ -- — —___- --- �--- - --_ -------- �LECTRIC C�C�Ui�D UiV�}Er��LOC)�C�UCT -+—_ _______._ _ _.__.___3 �.�._ � � I ___ _.._..�..___.��.�. _.�.._ _ � _____ ,_ .____ . ____.;.__._�_____�__.......... .. . : GF�OUN[�PLUiv?�9iVG 1 I i UtV€��6�-?FLOOR CGi°.��UET ' € _____._ _._..._.._ _ . ___�_________... ,__....______.� ;___..__�____ _ : ____�..____: SLA(3 GRRDE �____; _;_FIRFPLA,CE FOUi![Jr�.T6C}i� _.i...�... ._..._._.`___.__.. � _. .. _ . e TEMP PC}�rVER _____� � I F[REF�LA�E��Pd(�b�r�P.�t E � ', G�'t�;i'ER SEf�V#G� i 1 . PvlIC3 h1T. E3Oi�(2.��c�AbE � t _ ___- _ E , _.. , : _..__ z__ --... _ __ _�__._ ; FiC}C3�Si-i�,�.Tti3i�G _�-Z,tl- � �FI`. E30NC)�EA�<", , k -- ____ —.._� _ J..._. __ . __ _ -- --._... _______ _____. FRAt�iNG!'JENTfLI�;�'EOtJ I -- - � �I�a�,L B��ID E3EA�,� i ' , .�.._.........._t.....�_ _--.;__r._.._ - . - : d -r�+ _ .�___.........."_'__.._. __...__.......__._____..._................._...__..__....._. — �__M._.._. .. ��{�l�t-li�'1�}��i i ( �""�it-G�f��f�G I s Y � �.__ ---_t_.__�......�.....e_...;..p_ _._�._ ...� .,_.�...�. ��%��..7� �i�t����:�a �C�4.���'�.{�'.7 �� ; e _ ._._-----�—...______�_...1--._..._......_.__.._._�._._..__._....�..__......__� ROUt�H EL�CTF�1C I ! RQtlCaH GRAC,'It�IG __. � � ; _� �_---_�,_.�_... �_—�_.__ . I RC�UGI-� PLU�r1�l�JG ' ! � F�fiJP�N C�RAI�it�G j � � �..�_ ___._____. _ ; _ _ � __.. ,..___ � � �i-9�W�Ht`CIJB TEST 1 1 r C)t�L ELECTFtEC � _ _____ __ __.. . --_ _ ____ ._...� ___ i �XT.L�+TH?SIDiC�G ' � PC��L FENCl�iG r __._._�._�� —__— _._m_. .__ _. .__ .._._.__. ._.__�__..._ ,__..__ ,--_ _ _.�_.____. ._ Wt�LL 1(VSUE..ftTltJCV ' POsJ�.t=iR:t�L ( i .._� ' .— _ �_._._.__..._._ __...____._...�._�___...______... GEI!I�iG 1���ULATiOiJ ° � t�h�F SiT�1[v9P�. i � - .____..___ .___. �._ ..w C3RY'JJ�tLL�!{�1�1�1G I ' D��}�uA1��vtdS .___ ; --____. ______,_ -.-;- ;..______. __ — __ _ , __..__. ; � riil��'h���"� i !� � ���'ta L:�tii.:.. i ... .__._� _ y�.._i ..... � _.y. �._..�.�...�_.. .. ._._. . �._.__.._ ... '.._.�_....____.... ........._._.�._._.�.._._....__.' "'�..�.� , � .__.__._...._...,_._ __ � ���`��+ dr���� � } } ��'ti�.��.�.��r��t�i�. � � � _ _-_ ; �J��€``�jlrl�.�... � � �� �%�`'i Ji�",.,`,�$v'�-'�, .. . � � �� (__p___)���± q@.[�} .._}..._.�"g'.v.. - i {_'-..�.. yy....._{ (`_�._._-"---- :....__......m......_____.....�......._..__.._....�._....._..__.._..._. ' i ! L.S'±NJ f"If�i�L:�! j t � ( �{`dY1� ' '.s'ilit�YV i . .. . _.. ._� I �. __._ �. . '_ _..._..v._._.__,� . .�_,..»...... ........_.._.._.. '�.,..._._�...._.........,...._ ..__........_......_...__.......,.. : . C f"3"�d?:L C�`�i�T. _ I � I F':Ft�C7t�Fi. Fltti.�°iz ; ; � __.__.�_- ; �_.__..._ ______�___�____,_�____Y_ ..___._ __.__.... _ _�.._._�. ___. , �=l;d�,�€i�ATli�G ; ; ' ; �tEr��`1§i ��€��'. ��i"�.�,L. ? � ; : � � , _ __.. _. .. _. ; ; � <�'�.��.t=L�C�'�ti� � ; ; �c_`� ��:�;��� s _ _ ` i ._ __ �.�—______..___; _. _--- -_. __._.__ ___.__ _.___. _. . _ �!,'' F'�.U���k(vC:� ! '� �ii��t�.e�`r' _.._ _. _. _____ ._�.._—� .;____ ...._. ___. _.__...__ �__.__ _�._ ____._.. � , ; __ _ � i ..., _._.______ i�� � ______�_� ; �. _ _.. .__ � � j f .. �' �; � I �,..__ ,����_..__... __._ _ ____ _.___.____ __. � � � .E , �:�..�a��`la����w�,3 ' _ __._ ..._._w_.___.___.._..__..�__.__.._...__._� ' _,.._..... _._ _�._.. ____._.._ ._---- .... _ � �._...._.� .. ..._,....,__..___.__.____. _.._�_�______..—______._.....--- t _._._.— _._.__._____ .__ �_ _.___ ... �: � ' � � .. . .._._._ 4 ' _._....�.,___... ...____._--� F — --- ._.____.......�.._........_..._._.........._._., i .._...._..._... �..�. � ._._..._._._..____. ____._ ...._..__...... _.._.____._. ......._..._.... ......___._. _._ .� } � __._""'- �.._'_.____._.�........�..._._.....m.........._..�.�.""_'..._._.......... ....____ ..........._....,_,.._...3 � i ���.��. ._..._.�__ _..._.... ......_ ,,,. ...._"'____ "'........._____�____ __ ......__. _ .........____._.._�.�_...__._... . ............. . 3 _- : ! _..,....._. �...._.�._....--,....-•--�.�.��.._.�._. . .. __..._. : ._ .................. ......_._.....�__.._.��__.. _....__._ .. SE�'7�lC T'i���Js� Sl�t� _ ...., SE�F'PIi/t.l SIZ� _�____._.___._____.____. _._____ . _._._..____._._ e._ �_. ._ _[ � ______. _____ __ __.._.._ ._._.____._ ___.___ _.._... __._ __.__. .., � 6 ................._.�..�.�..�_ �_... .._.........�. .._......_.....,.._._._.._____....._........._.._...._ .__..._..._...__ .....__.__.____.._....._..............([ {F { f __._._._. _�.....,. _.»....._.............._....._.._...,...__....._...._....._.....,.._.._a.._...____�_• _�__._....�.___._._.....,..... f � � ....»...�. _ .. . . A a,�. a . �.�_........_.._- .._' ___' ___.__ � ___..__ ...._...._._.....__.......... ., ....:.»....�v...n.,_m«...._....n..m................�............m-.»,........k