Loading...
HomeMy WebLinkAbout13878 � �t CITY OF DIAMOND BAx � ' DEPARTMENT OF COMMUNITY dt DEYELOPMENT SERVJCES 21660 E.Copley Drive Surte]90 (909}860-3195 Fax(909)661-3117 PRESS , BUILDING PERMIT AppLICATION FIRMlY a D R�ESS ��� j DATECATION � � NUMB R �l � S�'° g-3 -� � � � APN �LOT TRACT pATEE NPE p�C p OWNE� �+� COMST. GROUP p ADORESS ZONING SETBACKS Z CITY J���t-t ZIP l737) TEL. I^ FRONT Ryy � g APPUCANT TEL. REAR Q € � CONTRACTOR "" SIDE SIDE STREET RW ❑ � � ADDRE ` � o Cm C/ ZIP l �' TEL. � PAOPOSED USE / / � t� ARCHIENG/ �(�� s�� � DEStGNER NO.DWEL. NO. Np, 3 7 �$ �� AD�RESS STORIES BEDROOMS Cm' ZIP TEL. UNITS � DESCRIPTION SQ.Ff. FACTOR PSF ADJ.AREANALUATION � OWNER-BUILDER DECLARATIOM SFR/ADDlREM Q �MEREBY AFRRM lRlDER PEWLLTY OF VER0.IRY TI1AT i AM EXEMPT FROM TME GOHTMCTORS LI- Ga�egB/CBfpOR {J,) CENSEUwFpqT11EWLLpWpyJREASpry(SEC.7037.68USMESSANOVROFES510NSCODE:ANYCITYOR (n �� COUMfYYNBCMREGUIRESAVERMRTOCONg7pUCT,ALTER,IYP{IOVE,DEMOIISH,ORREMIRANYSfAUC. pBt�Q(DB�k W Tl1RE.PNIOR TO ITS 188U�NCE,lILSq{IEC�U�qES TME APP�ICANr FOR SUCH PERMR TO FlLE A SIGNED w � STA1E11iM THAT HE OR SHE IS LICAJSED PURSUu(T TD 7HE PROVISIONS OF T4E CONiRACTORS LI� � CEM9E UW(pMP{ER Y(COMNENCWf3 YATH SECTION 7W0)pF DMSION e OF THE BUSwESS AND DRO- �'�' Pool/Spa fE55qN5C9DE)ORTNATMEORSMEISEXEYPTTHEREFIiONANDTMEBA515FOR7HEAlLEOEOE%6YP� (� ` PON.FNYVpUTqNOFSECTIfM7a91.5BYANYAPPLH:ANTFORAPERYITSUBJECTSTHEAPPLICANTiO Z �jg.Rpp} � A CMl PENAITY OF NOT MORE THAN FNE HIMDRED DOI.LARS(f5oo).): � OI.ASONMEROFlT1EPROPERi'/,ORNYEM�IOYEESWITNWpGE3ASTHEIR30lECOMPENSATqN, O Commerclal MIXA 00 h1E MKMUC A61f)THE STRUCTUFE IS NOT IMENOEO OR OFFERED FOR SALE(SEC.7oN,BUSb J � lIES4 A!q PqOFESS10N5 COOE 7ME CONTiUCTOHS UCEN9E UW DOES NOT AGVLV TO/Jl OWNER OF � PHOPEFTY Mnq BULL➢30N M�PROYES TNERFON,AND W110 DOES S�CH WOHI(H�NSELF OR NERSELF Oq 2 TNNOU�HWSORHEROWNEMPLOYEES,PRONOEOTHATSUCHWPqOVEMFNTSANENOTiNTENOEDOq � Gl OFFk71ED PDRBALE IF,FIOWEVEi�7HE gtNl,pWG Oq IMPR0�1AENf ISSOID WITNIN ONE VEAROF COMPIE- Z TI01'�.T1�OWNEfl�BU1tDEfl M'ILL NAVE TFIE BUHUEN OF ipOYING THAT HE OR SHE DID NOT BUItD Oq � 61PND�E FORTHE PUf#POSE OF SALE�. O 4���A OF THE PROPEiRY,AM�J(CLUSNELV CANTR4CTIN0 WIT�LICENSED CONiMCTORS � TD CONbTAUCT ME AROJECT(SEC.7oM,PUSINE55 AND P(iOFE5S10N6 COUk:''HE CONTRACTORS LI- VBI�a2iOn 2�_ADJ.AREA LLI CEl45EUWDOESNOTMPLYTONIOYMEROFAPROPEqTY1NNOBU1LO50fip�MROVESTHEREON,ANO � YM�DCOItfRACT4FdiSUCHPqNECT5VnT11ACONTPACTOq(S)LICENSEOWRSUANTTOTHECON7RAG QUAMTITY DESCRtPTI a � mas ucErase uw.l. ,"� FEE O I MI IXEN07 UNDER SEC. a B.6 P.C.FOR TH!S R_ASON 3 � LL DATE ONPlFfl � � U UCENSED CANTRAC70RS DECLARATION w � � IMERE8YI1FFIflYU�MJERPENALTYOFPEMJMT/ATIAML�DE4EE�UNDE4Pf�VIc�GO�CNADTER � � •�COYYENCINO WRM SECTION 7000)OFDMSION 30F THE BUSINESS AND PFOFESSq45 CODE.AN� � MY LICENSE 13 W FULL WaCE�ND EFFECL Z LL! ��/ TTT��� CCCJJJ m � LICENSE �LIC.NO. S � � � �j �ATE � CONTMCTO a ' W � Qj '��� WOiiKERS'COMAENSATIONOECIARRTION v � � � � � � ._ '_--- y Y/tFRM1UNDERPENALTYOFRERIURYONEOF?HEFOLLOWINGOECLAAA710P(5: Z � 7 �IHAVEANDWILLMAINT/JNACERT�ICATEOFCONSEMTOSELF-iNSUAEFORriORKEHS' a 2 � y� OLWPENSATION.AS PROVIDEO BV SECTION 37000FTME V�BOH CODE,FOR TNE GENFORIAANCE U � W OF T1iE WOHK FOR NM1IICH TNiS VERMIT IS ISSUED. � � � �, `t` .� i�., yyy _I NAVE ANp WILLMhINT11P�7 WORKERS'COMPENSATION INSURANCE,AS REQUIflED BV SECTION I ,s, I� ' � � � Q 37000GTMELRBOqCOOE,FDRTNEVERFORMANCEOFTHEWORKFORWHICHTHISPERMITIS �_T`� '/�7'/� .�(j i� y_�<- � ISNEO.NY NSATqN INSU CE CARRIE AND AIX.ICY NUMBEfl ARE: CONSTRUCTION OF LJII""il��-v 1`J L �t T � G���;;;qN���1E,,,R �p�'����"_ PIANREVIEW --�r,.�._•i;�:` . . --".�'. '- -� -,.. - � Z '"��Y'ry�R�y--y�' /4 ELECTFIC ¢ t 0 \���fa��ra?eeoor.RErIDoci�pEt�+rtacuAon�turnnEnoatia5g�ro�oatFsSx PLUMBING w 1"' Z 1 ��afF1'THATMTMEPERPORMANCEOFTHEWORKFORWHICHTHISPERMITISISSUE0,1 MECHANICAL CS /�✓ SFW.LNOTEAIPLOYANYPERSONINMlYMANNERSOASTOBECOMESUBJFCTTOTHE � NbRKERS'C04PENSATIONLAWSOFCALIFOFNIqANDl1GflEETh:A71FI5Hcri1CDBEWME INSPECTIONFEE S SU9,IECT TOTHE N'OFKERS'COMOENSATqN PRpVIS10N50F SECT � F 1HE LABOR � CODE.ISHALLFOffMWITHCOMVLYWI ROV15lONS� ISSUANCE � 1 0 4 � p DAlE:¢��APPLIC . � SMIP ��� W ENERGY P/C J WARNIHO:FNLURE TO SEWRE WORKERS'WMPENSATpN COVEPAGE IS UNLAWFl.IL,AN�5'.1ALL BE �y SUBIECTANEMPIOYENTOCRIMINALFENALTIESIVlOCIVILFINESUPTOONENUNDREDTHOUSAND ENERGYPERMIT � DOILARS(flao,000),IN ADDITION TO h1E COST OF CGMPENSATION,OAMAGES�5 PFOViDF.O FOfl IN SECTIDN37olOFTHEUBOflCOOE,INTEAEST,/�NOATTORNEY'$FEES. RETENTIONFEE: OCONSTRUCTION LENDING AGENCY PRE-ALT FEE: � � I HEREBYAFFIRM UNDER PENNN OF PEfWRY iHAT THFRE IS A CONSTRUCTION IENDING AGENCV FOR THE PERFORMMICE OF 7HE WORK FOfl WH�CH TMIS PEHMIT IS ISSUED(SEC.30g7,CIV.C.). Z W � LFNDEq'SNAME H LEN�ERSADDRESS_ � IAOREE COMPLYN7THALLCIRYIWD�CIXINTYORD?NAN ESANDST�ELAWSREUTTINGTOBUIL�NG TOTAL FEES .`.7.+// . , � �I ./ CJ � CONSTRUCTqN.M'DHEREBVAVTNORIZEREPRESEN7ATIVESOFTHISCDUN7y?OENTFRUDONTHE . . Z ABOYE-NFNTIONEOPROPERT'FORIrySPECTKKIPURPO5E5. o COMMENTS J � � NAME(PfllNfl. �� l� � � TUREOFpERMITTEE OAT� � RECPT.NO. PAID BY VALIDATION i N?11TE--0epartment Copy,YELLOW�inflnce Capy,pINK—Aasessor Copy,GOLDENROD--File Copy,GREEN—Applicanfs Copy } �1�'� C?F �t�i�t��� ��� �������.��� �����:� . <�56'� V:"d 0.� '.A... .9 �" J 8 R. ' � .. y .s , e �:,.;, O��GtYitr�4. . ::. '. . I � i I f L��CS�IiJ��� . . : . . ... ._ . "_�..' ."-_...__.........._._{___.. —:-._._ �._....�_.—_-_'�_ —...—.__ _'_._ ._...._...�_.._ .._..."_"._ . _....._ ._. FT:S1FC?i;+��S,S���L i ; ; � FH�F��Q"J�TS , ' _ __�_ -- -- ---- - _._. _ _ EL�CTF?E�C�RC`Urd� ; �� --j_r ll(VCa�.F� FI.C}c�€�t3UC� � ._ _ i -- ---- ___ . __. .___ ___.,. ��_.__ � _ __._ __._...__ _. • ��iC3UNC�F'L.��w��?��1� i �_,___ UP�s�f?R FLC7t7R CC+h��U1 i ' � � --- ----_. _.. T __.__._____ : ___ _ . -. . • SLAF�CRA�� __ �__.__ � --- ' �IF?�t'LACE i=i�i.tSd�r^,TI�7i't � ' � __ _ - ---_ .__.._ _ -- . T��v1P Pt�J�,`�s-� � � ��� �3nFPLe�CF BiJ�"J�3 E3�.�?�i _.__s � �. _.._.___.. ` ----- -- V��'aTER:;Et�-VIC�'_� .T� _ _ j �� ",1i�'�-�T. !3C}!�lC7 f3�t1�t`. � � _._ _._... .. _ _...___ � __ RJs�F SI w�:l',i'N!8^�;.� � '{T !� R � Fi BCJ°�Il�E3�ta"M� i .�_.�.______..� _ _ _ _.__ __._ _ w .__ _._ __ _. .._._.. 1=R�'t�IP3�t�Ei'v i 1�1�1i"(C3�1 i I F�l1'JFSL�3C3ND B�A�i i __.__ ___��._. - -- _..__ _ __.___.__ -- --- -_. .. _.. F?C1CJt-�C3i��R _ ? � _�_; PRr�-GRAC�IN{� _____._ _ __�_______._ ___ _ _ RC)uC�3-�6i�/�.Tl�VC, � i � E6EI4CNIPvC`a � -- •----�-- -�------ _.---- - � s ._ _ . . RC`U.C`.�r����CTt�IC i i � � RQUGFi G�?A[71�l.C'.-� 1 i ! ; _�— - � __ , _- __ _._ R�JtS�;#1 �'�LJ�l�}Nu i � i ��NISr(�€�1tGiPdc; ° �_ ' � N _ . _.-�__.__ __._ _._. ____�._...._�._____.._._--- -. ._ _ ._..... _.. �P-iUa1�`��-�1s��€�'i ES�T ( � i � t�C7t�L�L��l'RIC � � � � _____�_�_._ _ � ___ _____ _�._ _ _...m.. ��7. I_ia"i i�;`�iC}[t�i{� I _ ( PCt�L�=EPJCiRt{� ____�_�_ `_ _ . _.___._.' __ � 1',rr��L livSULF1Tl�'Jh3 � --�.��-----.--,_,_�-•.� �'�C}��=I��1�t� i � _�_ ___ �.__� _______ ._�_�r.�__.�.__�_ , __.._�_.._ _._ ( ,r".�Iws���Isu ?y'LA1`IC�i� : I � C�.F6=Sii�:f�J1�'°� � ' � .__ __ __.____�____�_____._�_.__� �. __ ----__ _. . _�._. ; � �'Fi"�'�`�'t �t t�'"�It(�'�'t� j � � �7�;.rrC�TiOi'v5 i' _ - ; .. .._. _i . .......,,.'......_ _ _ . . � JnC""..�YL��� ; � � t'�'s�ah�...""IY�..7. ' .... ._ ._ _" ...._ ..._'..__.._...._._.._.... ..........k .... ..._.. .........._ j ._ _..�,__.__m...__�y _� �. ; � ,��r�t�. ;Fa vii ( ; [� LA��;�,��'�fi6�r„C. ' _._. ��_ ___—____ __�...._______ __.__. ._.._._ . _ f �;^L �- � x ,G � ., t"' ��3-�. � _ . I �f'. f .. iidi9:..� _ � � � p . ._—.__... __�._.m.i._________�--:-�_. ��__....}....�. .._..�_ _...._.._.__---'--' , ,__........_...._'_ ..._._......__ .___.___._ __ .. „„,iE�rit ;��i E � � � ".�kh° �.✓tel�"�C:: � s ._._ _—___t_ . _�. _ _ �_._ _ _ _ .._.. �.. _ � � .� � �''"i. (1 i � � . �� � i ;�? I.i.'��i. 7"a k �.. i . '' ._.... .m..�._._�:__�.._,_..__._...........m_-. ._ .._..._..._._ _._. _...., � � ._..... . . _�. � _._.._ i i " t,� 3 . .:y.'.. 1�iK��i'�u � � . � i'��./�...,i L,�:. �. r't.V�`f... - . i.__._— .-----�_..___._._..��...__ .._ .__ ..__..... ___ ...__ .,� _ ,___-- ._.. . th �.7 . _-_ _. .. .._._. � V- � z_L.`�S�t 7 f'!!-� i v-t� f�, .�. `' j � .___ _�..____ ___.__ _ .. __ � .� ...� _?.� ____ __._..__.. ... �t��.!�:stiipv,; � �:.w�� �.`;` , ; ,..�_.:. __....�_... �.��---._;____�_.._�_�..___.__._..�_._.___._..__..v.__._._... __�......._ ' , __...__ __ _. __ _ _.. ( � �, , _..._._._ _._..__..._..--�----+--...._-----�,.__ _� � � � . . _ _. _. ; ��ti. � _-- �, , 3____ _ � �__� � � ..,..�:„ .�� -� __� . ....__ ... ._ _ _. _.... � � �-<� ,,��;���:�;-� ��`l, �,J(�' ,y(�.�� ' ; t -�:.,✓�.,�s-�dSSus...S� �...:i--:_.--�---__.+'�_._.�"�* '�. � _._.. .... . ._ � i , - - _. �_..__�._._._._._..____.._.__�._..___��.._._._._.�_____--__ � _ !. ____..._ _...--------__.._....._._...- -------_..____�_...---.___ ._.__--- - - g .. _ ...___._..---�-'-_ .._......_...... @ , }. ______..._.__._..��_ ._._._._._--__�.�____.......___.�_..........__ ... .. . � ..._._._ __ __.�.... ....... .__...._... � ,._. __�__._...._._._.._....__.._._ —.�...-----_. ....__...._.._...__..._._......�...__._._..._......_....._ ____.__ . �.. .t ..._. .......__.... , ,�> a ` �___,...,...._.____._....__..,........ _..__._ _.._._-_._ .-. .__..... �...�,...._._._...._._ . . __..... . ..._ . .... .. ....._... ._... .._.... :��. ��__ . ._._____ ..__._.._._. _......_..�. . . .___.......__.____._ .. ... _ ........ � ��F'?iC` �F"�!`�!!a��� _�_� .___..._._._.____---.__._.._._ _. _.__�_.�_ -._ .__.. �. _ ....��.. _.. .___.... � � a��P 1���9 it.���G.'= _, _ � �� P . � , ..,��.. � � � II � �,_.__.. ..,�.............�... .... . .. _._ � �..._._... _._.�.._..__",_..d..__...._ ,......_...._._ __._ Y .._.... .._ ..>. ............._.._.,...._. ._ . , t � �� __'__..._...___......,.._.___.._ —__.__._._..._.._.__—._._......._...__—_.�._._........._ . ... . .._ : [ .�_..'__'_ '__.__`__—___._....__�.._m.. .....—._ ..._ __.._ ...... � . f ,�sx�,:' : .._,..._. _....... _...._.e.._: � .._—.�.._...�._.......___ —_._...___._.,.._......__._.....,_ . , � ..� ........._..,.�_..._........_._.._. .__..............._ . ......_. ..._.._......._ .; .