HomeMy WebLinkAbout11921 ' CITY OF DIAMOND BAB
-- " DEPARTMENT OF COMMIJHITY�DEVELOPMENT SERVICES
� 21660 E.Copley Drive Suite 190 �� ����
(909)860-3195 Fax(909)861-3117 PRESS
��'�� B�TILUING PLRMiT APPLICATIQN FIRMLY
� �OBS�TE +i � � ff APPIICAT�ON ,� PERMIT � P/C
� � ADORESS `� �G-' DATE "� NUMBER #
� ISSUE TYPE OCC
� APN LOT TRACT DA7E CONST. GAOt1P
p OWNER
" ADDRESS ZONING SEfSACKS
� Z CITY i ZI EL. FRONT RW ❑
a APPLICANT E TEL S OFJSIDE STREET pW p
� CONTRACTOR J SIDE ❑
¢ ADDRESS .�-
� CITY ��B• ZIP TEL. -/ PflOPOSED USE
oARCFVENG/
� DESIGNER NO.DWEL. NO. NO.
ADDRESS UNITS STORIES BEDROOMS
� ClTY ZIP TEl.
rn DESCRIPTlON SQ.FL FACTOR PSF ADJ.AREANALUATlON
Q OWNER-BUILDER DECIARATION SFRlADDRiEM
OQ 1 NEREBY AFRR4 UN�FA PENALTY OF DE0.AIRY THAT 1 AM E%EMPT FROM THE CANTMCTOAS lb ������h
(y (�NSELAWFOR7HEFOLLOWIlX3REASON(SEC.70.31.SBUSlNESSANDPFiOFES510N5CODEANYG7Y0A (n
C.� COIWT�'Nptl(�IqEalYiE9APER4RTOCONSTHUCT.AITERMPAO�E.DE110LI5H2ORAERaIRANVSTRUC• �
Z 7URE,Pqq11}O RS ISBUANCE,�LSO HEQU�RES THE MPPIICAHf FOR SUp1 PERMIT TO FILE A SIGNED P����
�3J STATEIABAT THAT HE Op SHE lS LICENSEO VURSUANT TO THE DHOVISIONS OF TiE CONTRACTORS LI- w
� CENSE LAW(GiAPTER 9{COMMENCINO VATH SECTION 7000)OF DIVISION 3 OF TIIE BUSlNE55 AND PRP � PoollSpa
FESSION,4CODE)Oq7HATHEOFSliE15E%EMPTTHEREFPOMANOTHEBA31SFOtiTHE�LIEOEDEXEMP- (�
TION.ANVVIQUTIONOF9EC710N7091.68YMIYAPPLIGWTFORIIPERMITSUBJECTSTHEAPPLICAMTO Z qgRpp�
� �cna vEruLn oc Nor na�nuw FtvE�aEo oouu+s tssoo�.k
O ❑4��N�EROFTHEPROPERTY,ORMVEMPLOVEFSWITNWAGESASiHEIR50lECOMPEN5AT10N, � COIt1M6fCIdI -'
Z MALL�O TNE Npi1K,AND THE STRUCRIRE IS NO7 IMEND6D OH OFFERE�FOR S/�LE(SEC,7a1,BUS�- J
NE83 ND MlOFESIilOqS CODE:THE CONlMCT00.4 UCENSE UW DOES NOT APPLV TO AN OWNEP� _
� PIqPEN7YW1108UIlUSORI4PRDNESTHEREON.ANONh10DOESSUCHWORKFp/RSE�FOqHEti6ELFOR
(L TKqW11W50RHEXOMMBIVLOYEE3,Pfi�ViDEDTHATSIR]iIIAPROVF]IENiSAflENOTNTENUEDOR m
L�J OFFER[DiaR3lILE�F,NOWEVER7HEBUK0INGORHIDROVFYENfISSIXDWITHINONEYEAROFCOMPLE-
L TION,i?i�OWNER&LLDER YYILL NFVE 7HE&/RDEN OF DROVIN6 TMAT FiE OR SHE DID NOT BUILD OR
= YPi1PYE FOR il1E PUNpOSE OF SALE?
W ❑I.�SOMIl�NOFTHEPNC1PERfY,AYEXCll1SNELYCONTR+ICTUlaWITHLICENSEOCONTpACTOIiS
� TO CONSTpUCT 7HE PMJECT(SEG 7ou,BU51NE55 NN PRDFESSIONS CO�E:7HE CONTRACTORS U- Valuetlon ADJ.AREA
. � (�N6EIAWDOESND'fAP%.VTOANOWNEROFIIPHQPERTYNM1IOPU�.USORlAPROVESTHEPEON.MID
WFqOONTRACTBPDRSUCHPRQIECTSWITHACONTR,�CTOR�8�LICENSEDWRSUANTTOiMEWMTMG QUANTITY DESCRIPTION FEE
� TORSt1CFNSELYV.�.
❑I W 6%fiYPilX1DEH SEC. B S P.C.WR THIS REASON �
U
u. �
DATE OWNER U
� W
F LICENSEO CONTRACTORS DECLARATION W
� INEREBYAFFIR1AlR�ERPENALTVOFPERJURVTHATIFMLICEHSEDUrAERPROVISiWiSOFCHAPTER �
� •(WWIENCWOW(TNSECTqN7000)OFDMSION30fTMEBt151NESSAN�PROFE5510NSCO0E,Ml� Z `
X MY LICENSE IS M FIRl iORCE AND�FEC7: n
IJJ m
� UCENSE CIASS LIC.NO.� �_ �
~ DATE "� M CONTRAC70R � d
� WORKERS'COMPENSATION�ECLAFiA7ION � 3�� 1 �
�'� a r a
� IHERFBYAFFIRMUNDEHPENAL7YOFPERJUMONEOFTNEWLLANI�NGDEf%AMTIONS: V �
� ^IFUVEMAWILLMAINTAINACERTIFlCATEOFCONSENTTOSELF-INSUREFORWORKERS =
COYPENS�TION,ASPROYiOEDBVBECTION370DOFT1EU80RCODE,FORTIEPERFORMANCE U
� OFTHEINOHI(WRWHICHTHISVERMITISISSUm. �
0
W IHAVEMIDWILLMAIMIIMWOAKERSCOAtPENS�TIONMSUiW�CE,ASREWIREOBYSECTION
Q37ooOFTHElA80HCODE,FORTMEPERFORMI,NCEOF7HEWORKWRwHIdi7HISVERMITIS
ISSUED.MVWORNERS'C�01y1PEN,S/AT�IDNIN�3llMN�CECl.W.yF�iE�HN1U�PO�LRIC-Y--NUMBEflAflE: CONSTRUCTION
yc.�wa!eq ��,G�y �"Kl��[e� 1.� PVtN REVIEW
� PoLlCVNUAfBER �, 1 � � ��( Z l'�"�l�f�T�—�^� ELECTRIC
5 � (IHIssECfnNNE�No7BE00hFLETEDacitEaEaMisroaalEH�[�EDOOLu�0.5�y�m�ontEssl PLUMBING 1 1 �
i
- Z ICEqTIFYTHl1TIN1HEPERfORMMICEOFIH&WOPoCFORWFiICHTHISPEfiMRI5155UED,l MECHANICAL
(f SHALLNOTEIIPLOYANYFEHSONINANYMANNERSOASTOBECOMESUB/ECTTOTHE
� (�y WOHKERS'COAIPEM4ATIONUWSOfCALIFORN�qANDAGREETFNTIFISIIWLOBECAME INSPECT�ONFEE �
SUBJECTTO TNE WORKERS'COFIPENSATIdJ PROVISIONS OF SECTKKd 3700 OF 7ME LABOR �
s c-o�oe�i s�ruu,F,onn+win+can+r�r ann+nrose rrrov�srows. ��// � � ISSUANCE
� p DA7E:��± APPIICANT: �. ] V SMIP
� ENERGY P/C
WARNINp:F�LUFE TO SEW RE WORKERS'COMPENS�TION COVERAOE IS UNLAWFVI.AN�SHALL BE
�y SU6IECTANEMPLOVERTOCRIMINALPENkT1ESANOGIVILFlNESUPTOONEMUI'AREOTMOUSANO ENERGYPERMIT
DOLUFiS(5100.00a).IN AODtTION TOl}IE COST OF COAIPENSATION.DAMAGES AS PROVIOED WR IN
� SECTqN 3�08 OF iHE LABOH CODE,MTEREST,ANO ATTORNEI"5 FEES. RETENTION FEE:
a CONSTRUCTION LENDING AGENCY PNE-ALT FEE: � �
� IHEREBYAFFlRMUNDERPEN/LTYOFPEWUFYTHATTHEFEISAOONSTRUCTIONLENDINGAGENCY `... '�-+ � 1
� FOR TME PERFORMANCE OFTHE WONK WR WHICH THIS PENMIT IS ISSUED(SEC.9097,C�V.C.�.
i
Z
W
� LENDER'S W�ME
1=- LENDER'SADDRESS
� TOTAL FEES � ?J' �
¢ ICEHTIFYiHATIfUVEREADiHIS�PPLICATqNANDSTATETMATTHEABOVEINFORMAT10NI5CORRECT.
� IACREETOCOMPLYVATHALLCITYN1DCOl1MYORDiNANCESIWOSTATELAWSRELATINGT00ULDINO
� CONSTRUCTION,ANDNEREBVAUi}�OitlZEREPRESENTATIVESOFTNISCOUNTYTOENTERUPONTXE
ABOVE-IAENTIONED PflOPERTY WR INSPECTqN PUfl E5.
COMMENTS
� '�T-� ��� 7 6 9s'
� OEtW� wrrt� ���� /�
� ✓A
y SIONANREOFPE IT�EE � `� OATE
� RECP7.NO. � PAID BY YAUDA
( WHITE--Depnrtmen�Copy,YELLOW—Finwnce Copy,PINK—Asseesa Copy,GOLDENR00.-File Copy,GREEN—ApplkanYS Copy
i
C17Y t)� C)1,�►i�t71�i� �/1►F� s i
3PE�1��C7R1 1�ECC��C� �
�
Ip . � ` R M 1! - ' �. , 1 •' � R
!I
SET BACK . _ FLOOR JC�'ST � , �
FTGS,'Ft7F�P�1SfSTEEL � FHA REQMTS ' '�
ELECI'F�1C G�tQllND ; UNDER FLOCIR DUCT
taFiOUNi� PlUNi81NG � � UNDER FLOL}R CCYi4FD!111T- - ,;,-- _- - .
SLFa�GRADE FIAEPLACE KOl1Ni��TICIN '- } ' . .
T��r9P POWEF7 ^i FIREPLAC��ON��BEAN]-- -� I
lNATER SERViCE MID HT.$t3ND.E3EAM . _:�—' I
R{�t}F SHEATHihlC� I 8 Ff.B0�lD BEA� ' - . �
FRAIvi1�SCalV�R1TiLI�TIC?N ' FINAL 60ND BEAM (
ROOF CQVER � PRE-GRADING
ROUC.-�H NEATIN�a BENCHING
ROtJGH ELECTRIC ROUGM GRADING
�t3UGH PLUPRBIIVG � FINISH GRADING
SHQ4�dERt�U�TEST PC10L E�EGTRIC
EXl'.LA�f"i31S1[3CtiCa PC}OL FENCING
WALL INSULAT(Otd PC70L FINAL
CElLING I�JSi.1L.t9Tit}N C3FF SiTE IMPS.
t�RYV�AI.�.PdA1LitUG DEDlCATIONS
SEI1VEFd FINAL ENta. ,
�EF'�€"!C�'t+�:�C ( LANDSCAPEtfFtRl�. � 's
�i�F'F'6T/L.�. T i �C�hi SiTE ICv�PS, __..�_.__�._ �
�
Gr�S r'�(�i TEST FINAL ZOt�1P3G � i
FIi�J��.COt�IST. f FlF3E�?EPT. FINAL �
. _ ......_._.__..__._.. _ _ _— - -__.—__._..
�
FlN.+�L HE�TIt'dG � HEA.I.TH C1E4'T. FiNAL i
�E�1Ai�ELEGTi�1� � j DEV. FEES PAID � �
��*��t���U��3€taG ` ' . --- �` � EPJ�RC�Y
� ----
i �' � � '
�e�}i4r"i i`��N��
` _.�_.._
SEP`►IC Ti-iNK SIZc
SE�P PiT1�! S1ZE
I . .._