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HomeMy WebLinkAbout11832 CITY OF DIAMON�BAR ������ �xA/ --- DEPARTMENT�F COMMUNITY&DEVELOPMENT SERVICES AED F . ,� 21660 E.Copley Drive S�te 190 ��j p 3 Z�,�� PRESS ����� suag.u�nvcs F�r��r��i�ATiar� FIRMl.Y� � JOBSITE �p� APPLICATION PERMIT P/C � ADDRESS R-C7�S �UT�-�f l.t�A�'/ DATE �"I�e� 9tr NUMBER��,�- , � ISSUE TYPE OCC APN LOT TRACT DATE CONST. GROUP � g OWNER " ADDRESS Z��� �.�-s�t`-f �+AY ZONINC, SEfBACKS w FRONT RW ❑ CITY A�u.,.rs E3r►n.ZIP TEL. � APPtICANT l,en.�.a ,�ScJone TEI.-i�b��zi-�v• q�A ❑ SIDEJSlaESTREET RW ❑ � CONTRACTOR LeR�u ,-E.�r O� Ca wat7 SIDE ❑ g ADDRESS �f s3 cr�Qeo sC»- PROPOSED USE o CITY rl�IS�-en►� ZIP�'�2Q TEL.�Lo 7�t-tV'! wo ARCWENG/ . � DESIGNER NO.DWEL. NO. NO. ADDRESS UNITS STORIES BEDROOMS � CITY ZIP TEL. N DESCRIPTION SQ.Fi: FACTOR PSF ADJ.AflEANAIUATtON N � OWNER-BUILDER DECLARATION �R7ADD/REM O 8 1 HER�Y AFFlIM IRAER PB�NLTY OF CE0.A/RY TH�T 1�M EXEMPT FfiOIA TME CONTaACTORS Li. GdtflQB(CB�OR � CENSEUWFORTNEFOLL�YJIN(1NEilSl1N(SEC.T031.SBU54NESSANDPROFESSKKiSCODE:N7YCITVOA (n OOUM�WFfpIRE0UWE5�PEPNt7TOCqNSTAUCT,AITEi�IMPqOVE.DEMOlISN,OflREP,11qM1Y5T9UG W P�l�ro� lUqE,Pq10p TO RS ISSVAlkCE,AL50 REOU�NES THE MPIICIUJT FOR SUCFi PERAIIT TO FILE A SIGNEO w 6TA�,1/ENT TFi�T HE OR SHE 511C5KSED PUqSUANT TOlHE PROVKtONS OF TF1E CONfPAC��lS LL � CBl$E tAW(CH/�PTER Y(COyMENCINO 1MT1i SEC710N 7am)OF DIVISION 3 OF TME BUSMESS AHD PRP � P��$D8 FE8.5pN5C�E�OqilNTMEORSNE19E7fEMPTTMEREFROMM'DTHEBASISFORhIENAEOEDEXEMP• (� TICN.M{YVIOLASIONOFSECTIDN7W7.58YANYAPP�ICANTFORAPEAMITSUFz7ECT5THEMPLICANTTO � pe-q�� � � �GYII PENAIiY OF NDT MORE TiAPI FlVE HUNDRED DOLURS(i�D�.I: � ❑I,ASqM1EROFTHEPPOP6RT',OqMYEMPLOYEES�NITHWAGESA5iHE1H50LEOJMPEN5AT10Ai, 0 L`pmmBfC19I Wqi p0 h1E WOim(,ANO THE STfRKTURE IS NOT INTENOEU ON OFFERED PoF SALE(SEC.)PM,BU51� J � 11ffS5 MA�FlOFESSIONS WUE:7HE CON7MCTORS LIGE145E UW�OES NOT APPLY TO AN OYIMER OF = PIqG@MY W/q BU0.D9 OR AIPROYFS TIIEREON.IIND WHO DOES SUCH WORK HIILSFLFOR NERSELF OR } (� 7rpp�/OH HIS pR HEA OWN E►IPLOVEES,PROViDED THAT SUCH M17ROVEAIENTS ARE NOT INTEN�ED Oq m � W^ p{FEpEpFppyy,E�F.HCIWEVER7MEBUNtMN60HIMvpDVEMEM455qDWI7MINIXJEVEAROFCOYPLE � MYI,Tl1E pWNEq�BUILOEA WILL NAVE TME BUNDEN OF PROVINO TF7�T/1E OR SHE D�D NOT 8UIL0 OR �IPNOVE POA iF1E WRPOSE OF ShLEI. w ❑4A3MYNEROFTIEPRDPERfV,AAIE%G.USNELVCOMPACTINO'M11�LICENSEDCONiMCTORS � Ttl Cqi87WlCT7HE PROJECT{SEC.laM.BUSiNESS 11ND PROFESSIqJS CODE THE CONTR�CTORS L4 V01U91iIX1 ADJ.AREA CEM6E lAW DOES NOTAPPLV TO M!OWNER OF 11 PROPERTY NT1D BULDS OP IMPROVES THEREON,AtYD YptlpONTp�CT3FORSUp1VRQIECT3WITHACONTRACTOR�S)LICENSEDPURSUANTTOTHECONiMG QUANTITY DESCRIPTION FEE � 70N5 LIGEN9E LNY.1. J O�AM E7(EMPT UTAER SEC. B.8 PC.FOR TMIS REASON � � � LL D/'TE �R U � W LICENSED CONTRACTORS DECLARATION W � IHEREBYAFFlRMUNOERPENALTI'OFPERpJRVTUT1AMUCENSEDUNDERPROVISKKJSOGCHAP7EH � � y(l��I6NGp10NATH5fCTIJN7000)OFDMSION30FTHE9USINES3ANOPROFESSKKJSGOOEAND � X MY UCENSE IS N!fllll FORCE Id�EFFECT. 4LI � ucEr+se cuss� uc.aa. 2 V Z� � v on�.,(yi—/6--9 8 _ corarwncT . _ a y � WOP.KERS'COMPENSATION DECLAFlATION � —� t ¢ N U � � I MEREBYAFFIRM UN�ER PENAIT'OF PEHAIFIY OWE Of THE FOLLOWING DECLARATIDNS: Z � C �_IHAVEMAVl�itMA1NTAINACESIfIFlCA7EOFCONSENTTOSEIF��wSUAEFORMIOHKERS' 2 � Q CpMENSATION.AS PROVIpED 6V SECTION 910�OF 7NE LAPOR CWE FOR THE PEFFORMANCE W �7ME WOFK FOR NMICFI 1F1�5 PFP41T�5 ISSUE�. � 0 �I HAVE AND N'ILL 1A�RJrAM WOPoSERS'WMPENSATIpi INSUFUNCE,AS HEWIRED BV SECTION � Q 37000FTHELRBORCODE,fORiNEPEflPDHMANCEOFTMEWORKFORMrtRGHt}115PERMRI3 ISSUE�.MV WORKERS'COYPENS�TION IN5URANCE GIRPoER AND POLICY NUMBERARE: CONSTRUCTION � CAfiq1ER PLANREVIEW ._ �,TJ..]C` �f�'L � PoLICY NUMBER ELECTRIC � � (iFl43EC110NNEIDNOTBEapLpLEfEppFT�fpENMfISFOqpdEµX.DqEppq.wi5(Stm)OqlESS�. PIUMBING � �( �CEp7�FVTWITMTIEPEFFOWMNCEOFTNEWORKFORVMICHIM5PEP41TISI55UED,l MECHANICAL � SHII��NDTEMPLOY/WYPEPSONINMIYMMINERSOASTOBECOMESU&IECTTOTHE INSPECTIONFEE ��� � WORKERS'COMPFNSATIDN UWS OF C1ILIFORN10.AND .. AT If i SHOULOBECOME S SUBJECTT07NE WONKENS'Cd1AEN5RTbN PHOYI S OF SE ION 3700 OF THE LABOR ISSUANCE ( cwe.i s�uu romwmn�car.�a�v isaNs. Q �� AP� SMIP � ( Q ��: � � � WAiWN10:fM11flET08EWAEWORKERSCOMPEN3AT10N GEISUNUWFUI.Ah�SHALLBE ENERGYPIC J � SUBJEC�ANEMPIOYERTOGN�Pll1LPENALT�ESANDqVILFIPlESUPTOONEHUNDREDTFiIX/SAND ENERGYPERMIT OOlLANS(5700.000�,Ml ADDITON TO THE C�STOF COMPENSATKKi.OPMAGES AS PROVIDEtl fOR IN J SECT�DN 3'IDB Of THE L�BOR WDE.�NIERESi.MD�TTORIVENS FEES. RETENTION FEE: S � CONSTRUCTION LENDING AGENCY PRE•ALT FEE: � IHEpEBYAFFlPYUN�ERPENALTYOFPERJUR/THRTTHEREI9ACOM5THUCT10NlENDINGACENCY 4 FOq7HEPERFOFMANCEOFTHEWORKWRWHICHTH�SPEWdITISISSUE0�5EC.309T,CIY.CJ. � w , � LENDERS NAME !_g— IENDERSADDAESS `i ICERTIFYTMI1tIWNEREADTM�SAPPLICAT10NhND5TATE1HAT7HEA80VE�NFORMJ1TqNISCORRECL TOTAL FEES • � � I/WREETOCOMPLVWITHN.IGTYANDCOUNTVORDININCESANOSTATElJ.WSPELATIN6TO8U1LUiN0 � CONSTRUCTION,ANDHERFBVAUTHORiZENECHESENTATIVE50FTM5LOUNTYTOEMEflUPON1HE ApOVE-YEMIONE�Vii�VEHTY FOR INSPE�TION PURPOSES. COMMENTS � �...� _� J �,,�c� _ m p � -4 N � DA RECPT.MO. PAID BY VALIQATION � WHITE--DePertment Copy,YELLOW—Fina�ce Copy,PINK—bsuea C�y,GQL.CiENRO�?—Fiae Copy.GREEN—Appliceni's Cap�y '`'��'� ���e�C���� I�IAfVIC)NL� BAR I s4t�,a�� tr'• i tN�P'�GTt�2N R�CC1R�► 1 ,, • * � a t *.■ '! � .�. M y s i r S�T BACK ��,� FLOOR J0157 , , � , '.� FTCaSIFOR�SfSTEEI� { � FHA RE{�NfTS �LECTRIC GROUNC} UNDER FLC30R DUCT , � GRC3UND PLU1�1EiING � UNDER FLDOR CCkt�DU1T , � _ _ SLA�GRA�E FIREP�ACE FOUNDATIC7N � , .. ,..� , , ; TEtv3P FOV1tER FIREPL�CE�C)NQ�i�AM • ' _ , � WA7EA SE�iVIGE MiD HT.BOND BEAtvf •' .° ,` � �"' ', f FiOQ�SHEATHi�t`^a - $FT,.�F�Q�D.$EA�v9. '. r,.;�•. t lr: , �. � i FRAP�lNGNENTlLIATION FINAL 8C1�1D SEAM F�OOi�G�VER ' � P�fiE-GRADiNG RC3UGN HE:4TING BENCHIRIG RC?UGH ELEC'fRiC ROUGH GRADiNG RGUGH PLU��BING FINlSH GRADING SHC}WERtCUB TE�T � PC�S�L E��CTFilG = — ; �x-r.��rt��sEc��t�� Pooi FEr�ci�� 4 V`JAI.L 1d�SULAT6CIN PC)C7L FiNAI. G�ILE�l�Bt�SULI,T60N QFF SITE 1�9PS. � - afiYWAI.L Nr1iLE�� DEDICAT603VS i � S�WEF� FINAL ENCa. i --._�_ ; SEF�i'9�TAIvK LAPJCiSCAPFJIRRiG. � _ � SE�{'PiT11..L. - � Ot°d SITE Ifiv1PS. � '• GAS�+1�T�iT F6P°�AL Zta�9ENG � FlN�a��C7�S�1'. , FIRE L7E1��!'. FIIVAL !� F1NAL hiEAT1NC; HEF�LTN bEPT. 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