Loading...
HomeMy WebLinkAbout15214 (20) `_�'�� CITY OF DIAMOND BAx DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES , �w 21660 E.Copley Drive Suite 190 ''�"� (909)860-3195 Fax(909)861-3117 PRESS "�'� � BUII.DING PERMIT APPLICATIQN FIRMLY � JOBSITE �s APPLICATION b r�� PERMIT P!C Q ADDRESS��h�� UL�Z-�"�G A�s`�i� DATE , � - NUMBER I � �F g ISSUE TYPE OCC APN �OT TRACT DATE CONST. GROUP p OWNER�/� G/G�' o ADDRESS � ' ' � -s�/G ZONING SETBACKS Z CITY � � - ZIP TE -�, FRONT qW ❑ � APPLICANT TEL. ��-- Y REAR ❑ � SIDE/SIDE STREEf RW ❑ CONTRACTOR `���(�'-a7''�j�,f'�__T,��kZ SIDE ❑ � ADDRE /�� - CITY G Z�p�'1�TE� -, ..,`, PROPOSED WSE o ARCFUENG! � � DESIGNER NO.DWEL. NO. NO. ADDRESS UNITS STORIES BEDRQOMS � � CITY ZIP TEI. v> DESCRIPTION SQ.Ff. FACTOR PSF ADJ.AREANALUATION p� OWMER$UILDER DECLARATION �p�A�lREM � � 1 HEFEBY AFFiqM UNDER PEN.LLTY OF PEIW RY THAT 1 MI ExEMPT FPOM THE CONfMCTORS LI- GHfflgB/Carport yl CENBEUWfOR7HEFOlLQNWGHEA40N�5EC.7031.SBUSiME39MAPR6FE55lON5CODE:MlYCIttOP (f) � CdNTVWItlCNNEOl1WESAPEHNRTOCONSTRUCT,ALTEI3,14PppVE,QEY9U5H2ORREPMRANYSTRUG �j,J pazjproOCk 71N1E,PRqR TO ITS I$SUMWE,K80 REWIRES THE�Pp�ICANT FOR SVGM PERMIT TO FlLE A SICNIED � ST�7EAIEM iHAT HE OR SHE IS LICENSED WNSUANT TO THE PROVISIONS OF TME CONTRACTORS LI- � � CFNSE UW(Ck7TpTER Y(COMNENGNO WITH SECIION 70W)OF pIVISpN 3 OF THE BUSINE55 ANO PHO- � PooVSpa FESSIONS CODE)OR THATl1E OR SHE 18 EXEYPT TY,EREFRGV.1 Mb 7HE BASIS FOR THE ALLEGED EXE/1P- TION.MIYYqIATOMOFSECTION7031.6BYANYMPLICANTFORIIPENMITSU&IECTSTHE�PPLICANTTO Z Fj@-{ipp� � A CML PENIILTY OF NOT NORE THAN FIVE HUNDRED DOLURS(fboo).�: � ❑I,ASOMMEHOFTHEPNOPERTV,ORA/YENPLOVEESWITHWAQESASTHEqiSO�ECOYPEILSATION, � COf11RIBfGl81 WILL p0 THE WORK,N�THE STRUCTURE IS NOT INTENDED OR OFfERED FOR SALE(9EC.70M,BU51- J tES6 MA PRDLESSIONS CODE:THE CONT0.4CT�R5 LICEKSE UW DOES NOT APPLY TO AN OWNER OF I N PNOP'ERTYVMIO BU4D80R NAPiiDVES TNEREON.M�MR10 DDES SUCM WORK NNISELF OR HERSELF Ofl � � 1HROUaHMISORHEpoNMFIiPLOVEES,PROYIDEDTHATSUCHIAIPROVE4ENT5AqENO71N7EN0E00R m I Q .OFFEpEDF�iSKEIF.NOMfEVbRT1E8U�LDWGORMMiNYEMENTI550LDWITMINONEYEAROFCONPL& Z T�ON,THE OMMEN-BUILDER VALL HAVE T1E BURDEN OF VROVWO THAT HE OR SHE D1D NOT BUILD OR = WPROVE PoR T1E PURPOSE OF BALE� ❑4��NAiER OF TME PROPERTY,NI IXCIUSNELY CONTMCTM6 wITM LICENSED CONTMCTORS TO CONSTIiUCi 7HE P�.IEC((SEC.7041.BUSME55 AND PROFES5ION5 CODE:TME WNTRAC7oR5 LI- V81U8tiOf1 ADJ.AREA I � CENBEUY/DOESNOTMPIYTOANOWNEROFAPflOPFRTVWHO&1CDSORIMPROVE6THFAEON.AND � WFqCOHTR�CTSFOqSUdfPROJECT3WfiHACONTMCTOR�S)LICENSEDPURSII/W�TOTMECON�MG QUANTITY DESCRIPTION F�E � TOR9 UCENSE LAW.). ❑1 MI IXEMPT LNIDEfl SEC. 8.8 P,4 FOR THIS REASON J U 3 � LL DATE OMMER V � J LICENSED CONTRACTORS DECLARATION W � I MEREBYAFFIRM IXIDER PEWLL7YOF PERIURV 7HAT IAM UCENSEO UNOER PROVISIONS OF CMAPTER � p� 9(COYYENCINC�N'RFISEOTION70D0)OFDMSION30FTHEBUSMESSANDPROFESS�ONSCDDE,MID Z W LICENSE LS W F1AL GORCE ANO EFFECT. �i/ m 0 tJCENSE•C�U5�5 �� LIG.NO.��� j ~ UATE�C U'"C)n CONTRACTO����� d U W � WORKERS COMPENSATION DECLARATION ¢ � IHEREBVAFFlRMIMOERPENALiYOFPERJURYONEOFTHEFOLLOWING�ECLAMTqNS: U y 4 G _�I MAVE MD WILL MAIN?ANr A CERfIFlCATE Of CONSENT TO SELFINSUNE FOR WOHNERS' _ � C011PENSATKKJ,AS PFlOVIDED BY SECTION 3�ao Of THE UBOR CADE,FOR tHE PERFORMANCE `U OF ME WORK FOR NRtICH iH13 PEFiMiT IS ISSVED. � 0 IH�VEANOWILLMAIHTNNVIORKERS'CQMPENSATIONINSURANC�ASREOINREDBYSECTION - �� Q 3700 OF TME I.MOA COOE,iOR iHE PEflFORMANCE OF THE WOflN FOR WHICH THIS PERMIT IS ISSUED.MY WORKEPS'Oq/FE615ATION�NSUMNCE CAHRIER AND POLICY NUNBERARE: CONSTRUCTION uqqiER ` .y'�" 'd`r �y��— PLAN REVIEW > � � �. � / E� " � po��crriuusEa fiY� � - "� � .�� ELECTRIC � �ssFcrorau�Hor�mr�.�ooFn�rErwir�s�a�Erurt�..woounas�s�oo�oqtEss� PLUMBING -- z ICERTIFYTFI,�TMTFIEPERFOFlMANCEOLTNEWORKFORWHICHhI1SPERIAITISI55UED.1 MECHANICAL (j SHILLLNUTEMPLOYANYPERSOHNANYMRNNERSOASTOBEGOMESl1BJECTTOTFiE �j WORNERS'COYPENSAT10NlAWSOFC+�IIFORNiqANDAGREETHATIFISHWLOBECOME INSPECTIONFEE SUBJECTTOTMEWORKERS'ODNPENSATIONPF�VIS NSOFSECTION97000F ' UBOR �j GO�E,i3HNLFOHfHwiTIiCOMPLVWITh17Ho5E o i�Gua. ISSUANCE �}�� 'I �� A � � �� _�y „ • SMIP �+"— �wCflBt+� /�,� p DATE: I��[�.I�1>PIICANT ' w ENERGY P/C �� ` �TY J WARNING:F��UHE TO SECURE WORKERS'WMPENSATKKJ RAGE IS UNLpWFUL,AND SHALL BE � SUBIECrANEMPLOYERTOCRIMINALPENALTIE$ANDdVIlFNESUPTOONENUNORmh1W5MlD ENERGYPERMIT ��tTi'rl��C1 DOlLAAS(5100,000).IN ADOITION TO THE COST OF COMVENS�TpN,DIW�GES AS PROVIDED FOR IN �.a`,��yxT � SECTION97080F7HELA90RCODE.INTEPEST,ANDATTORNEYSFEES. RETENTIONFEE: a CONSTRUCTION LENDING AGENCY PRE-ALT FEE: O � IHEREBYAiFlPNUNOERPENALTYOFPEFJUNYTMATTHEREiSACON5TRUCTIONLENDINGAGENCV FOq THE PERFORMANCE OF THE WORK FOR WHICN 7NIS PERAIIT IS ISSVE�(SEC.3oal,CIV.G). � � IENDEfYSNM1E F= LEN�EH'SADDNE35 � ICEHTIFY7HATiHWEHEADTHISAPPLICATIDNANDSTATETHATTHEABOVEINFORM�TqNISCORRECT. TOTAL FEES � G W 1 A/iPEE TO COIAPIV WITX ALL CIN RNO CWNT/ORDINMICES PND ST�TE LAWS REUTING TO BUILDING � CONSTRUCTION,MlDHERE9YAUTl1URIZEREPRESENTATIVESOFTHISCOUNTYTOENTEHUPONTHE S� ABOVE-MENTIONED PiK]V TV WR MSPECTION PUFlPOSES. COMMENTS � �r"`�'Z��2� N Sc`�/- ' m v�, I ��d"`C�C� OF EE OI1TE - s RECPT.NO. PAID BY VAUDATION ~ WHITE-0epertmen(Copy,YELLOW--Finence Copy,PINK—Asaexsa Copy,GOLDENRO�File Copy,GREEN—ApplicanPs Copy 3 �,���'�° ��= �i a�:.�`�`��a��� ���a�s �������i��� ������� - - � _ �t ,.-�+---�..� i .e � n:: `�� .�. �<'.�. ��$g� t.�v;, 4:i�": r � �` ,� � , �e:. � ��� b3 t�� �._._....._ ..__....� . __i. �M__�_._. . �_�t. '�."�J'��"��Js��.........__ .......m��__- ; � �' .. ____.. . .� _ -______. .._.. _._... _.._�_ _._' � ���`'J � �.i�...-�",.>� � � � , f'�ir�Y �{,isut�il i � � I ..____...,. _ __ _...._ '___"t 7 ........... _�� _....._`.____ .__ �a tC.rta`��iU ; i j � U�4�L{�S!���v'r�t l�'��.J�'i� � ', ..3 � � �C?C�"i 9 2ei, f ___._._. _. �' ..___ � I _____ _.. . .... _t_. .__._ - _ ._ _ __._ _ G1��}V���oi-t� s;s;vCa � _,_T___ � uCJt'� F?rL�"v�'v�Ct�. '+ �g^�._.e_� __ _>__ __..__ f _ _ _,__ -- -- - d g w.��VriJ�.ah"t'��.e I, f € ( ��Y"� .t'p�._��u�� �i°} v�)r � ii�2 � .. ��4 i _._...___ ,_....�._...._____._....�.. . ...._ _....._.... __ _� � .._�__.._..A.__ i ` .....,...__— ._.._. . � T�c t r�C'`v;, ti _ � i lci�('i�C��C)ivil�%Vt�e,� � � � � �� �. _.. _.�___�_.._________ �_._ � _ , �,'�€;°,t'�-r� `°�i�� �°r ;= �� � � tE�`3 t3�. C3��tiL7 t�.�e:+�" -__ € ___ - _._._ .._—_...._ ___-�i ,�^� ` `//�,�J//j — �, - - _ ,,_ _.._ I,*��� _-- -- -� � �b4J � '�at �i l�t�r,:�:; "'�/ �' i /� � - V l�i gC.�g.�llLd L:L�.."��kl �. E_ _'__ ._. ._ .6�-L�_...__.i_.....�_ ����b�� ......� _____..._.____......... _.........._... ._----.._..__..._ ._._._�____....._' ... _.. _.___.._ � _ .. � ��1 �ild .e�,a �k��IFa ! =iv , � r�.','1'i� t�'�J's�C7 E3�;4fi�1 ` _ _._.... _ _____ .___.__ ..._ ___.._.________..___..._._��_____...___� ��, _ _�._._._� ._�___._.__._...a___.�_____._ a tg,�t �C..��mm� r�4 r__ . �� ---_i_._� _�� 'a �-r t r€Y Cac���C�It"u�.___ _._ �-_ _������__ ______.__ § I , , P , i � "�CY a �r I " a E ��: UHlI�aC'a I � � _ _...... � , , � �-i°�'�.3 L ..1�il� � � � ;�J 'G�i G��AD(�.li� � ( �� r P ...... ... . .,.. :.__a..._..._._._..._ .__...�._ ......._...,_...�_�_: ..._ ._ ._ :p. ...� . . . . ........_.__�_ _—_. E ? � I..t s �i5��,;e1 a � ��:��?1 �..��p�1�ii��_ ___ � _ ; ._�. ._, ._ . _j . _.._....____...,....;...__...._._..._........._..� _._T� .._.._.__.._.. ._...�..............�_� _._ } j .. j �y i r, /'� ..�._"....._._._....._ ____�.__.._..._.....____..�.____�_.....____�._._..._.._q 9 -�£z: �.'n F� Fi_e:}� � �i.✓�.?i...�.d...C��SI�V � .v _ ... ._ _;._.__��._.._ ;..._._.__T � _._ ._..........Y....— .._________._ —� t. ._..___W.._�_..__.� 3 . ��� - ..,.;^. . 1 ' � � ffa',� i ,�;��#v�� f � 1 � F�v L t �ivi.6tas�a _ _� r.._._. �_� _ � _�� _..._.� _.� x' _�_ �...__. � � s m�. t',i 4.��':; � �� � € ��1�. �i..rt° � � 1 __ ._ __ .,....._...�__n _.. _..._.-----'---'W.�`„"-- . ..._.__...,.. .._._ . � _ _.____ _..�_._ .,. _ 6 k. ;i r t d '� �..!-a�3�: F � � �i'� "� t� �'e i�`,3 .. ..._....�...............�a_�.�.......u.....,._...._.._._�.e. � 3 _ ....."�_____,..............__._..... '..�_�..._._..___—._ _.........._.__..._ ......_. ..�_......._... � ��'� . �i..i ,,. _„ ! �7,=.r3�;?T�vs�1:i � � � , a ;__.__._ .........._ ....��_._. ._._. ._...-.- -_,_ ---____..____ F ____._._ -- _.._--_ _._..----`____ F.___..__..__..__._._� �_ ' ,, .� i f ; e f L � I i _. ...._.__ __ . ;.....__�.__ _ _!... ._.�___-__�_.... _._ . _ ..._. �. � ...__-__...._ ._ .._._._ __.._.� __m.__ �. ...._ - _ �_____�� � � 3 s �' �-.i�:.,, � , � i r�C�tr� .r.�" 1����:�� � � _, i : ....�.. �= ......-� _ .� . _• . f ( �"•.�' t�€} �3i���e"� ..._... .. .......... . ........__ j ..._. _. _�_� ._.....__.__ -- . _ ....._._ 4._ _"_.'_....... ________., ......___ _.� .. .._._. ._ .»....__...__.__ �.—...�._._ _"_ _ ..__. �. ._..__ a .., . . . ...- (� i �� .. � �� � 1 ,; � -, , .. t 7 i'v}S..1» ���� 6��� ��i :� _ _...e. `y�_._}��.._,_......�. ._..- ..._..:... ...... ...... � ...... .. .._. __.._ .. .._ ......._..___. .._ ._ _...._ ; � �: `-� ;1 �'/� �(,� � [ .i� 3€_ --S �.'� JF�4 .. : ! i .... _ ._._.................___..._f.___.. m/�........... .._ �_}..,� 1._. . ,...__ .,....____.___'_...._ �...._..____`__._._.._._..... _ ! � . ..- ._ .....:�F9�Y'..: I I I � ��."`:E...f!W� L.l�_�d 9. !'l�YYSt.~ .. .�� . ...._ ..... .........__�....w._.�_ ..............__..___.._.............,......_.�..,_..�_.�. ....__. ..........._ ._..____ .....,.,,._._...... ........._...._. ....... __.___..� _.._....._�_._____... _I ! ' _Q -..� � ,.4. ..,. .. '',. � . � & ` -.�.. �.. 'v.. �ixt... � ''.. � ��.:.t I""t:.���'t��,U 1 ' ' � _ .._. ......._. . __. <'.........�.....a...___..__',....__.._......___..d.�._____..._____..._.__.. _... .. _. ...._.._.__.___ ._._..._._..__._._ ___..____.�__._...�...Y..�..........._.__...s.__ . .. ��„•i:;`��:kc . j , �.�.`t?�i"��.''r �--��... _� ? , [ . �.. :. ; : . . , , < . . _ .._....�....____._,....._____........... __...._..�_______...�._..r._..____.__�........._____.�._----.. ,_________..W...........__.__._-__....._.... . � , ........_..__.__ ..��-----__._.............. . ......... . . � ; .._.........__._.�...___................£ . � i , i � ; > i _. .. ._...,....__.._..� _._............Y..Y._._.._ . .�..�.........�_..._...__ y_. '__..__ _.._..._.._ �.._...,...._.�....-'-_,.._.- ---.__._.._..._� �: . � � ,' . � �� _�a�.. : + ; s � � � �___ ._ ..._.._.._.______._...�_.___._..._..___...�,. _......._.._,...�_�..,....._._..._. ___._._._...... ,_._.._...._. � , ._.....---__ ..........._._._.��...._....__..._.._.__........._"} 3 � � , . .. .. . .. - . . i � '� r `;�€'-- � ° �^' � , ,� <�...: m � ..'S I , u.Ym. � ___�___._____�... _..�_______�.. __ .._ �__�___..._� ... ..�___._.�_.__ _.___ _.___._..� ._-.......»_..__..._..,......_..._....._............��.._.._._.........._.. _......_._.._.�....u-.._...........__.........._. _..._........._.____�__..__._.__....,_._._..._._.._..._—_____.__._.�.. _ i � ... ..._______...... ______..�,..._ ._._....._... ... � � � _..._. �_._._..___..._.__�_......_...._.........�__.... ...._...,.....,_................_.__________�._._....__....__...._.. ' _� z ' �.. ._..._.....____._____..._.....�..� � ._...,��..._..__.....�__._...______.._....._�__—__........._.__ � __, � r. _.._..____..______....._.........�..0 � � ��....�....... .... . _._........_____ . .. ..,..._..._._..._._._._ �._..._._.._............._.__'"__....._____ . . .._.... ._..... .. . __. ..�_....._,. . ._....______.____.�. . ..__.__ .....____.....�....... ...... . . ... ..._.__. ,,..t.... ....._.,._._ _._w___-�—......._..._._..._. _..___........ _._.__...� _____._____......,��.�_.._. .... ....... . _......_'_..__ _...... � � � � � ..__.._ . � ...._........_..._.. .Y.._.........._.._ ..�.--____ . ._..__ _.....�._._... . ___..... _..... Y ��� i + _P g._ .....� ._____. .. �'_ F �..�,t ._ . .._:_:.}t ."'_._................_... �_.�_. _._ .._ _._,. .. . ._. ..._..___._.. ...__.__ _.. ... � „ T ' , � _"_ .. ._.� .. .�_�_ .. ��...r_ ._. __.___ _ ... ___._...._.._ ........__...... ._.._..._._ . ._._.. __... . _ � �'7�S"'' '-..� S~'4�'� a.`f:.!.-� ._._'___..._. �,.. �., ' S � �"p_$'"�a3�"1 i�Je� �3 �"" ..... ... --__—...__�._.____ _. ..____._.__....._....__.._.�_ ......................_..._..__'--.______.___"_._.�_ ..3 � >54»+.... , k�..... ...._.. . . _____ _. .........__...m...,._.__ ? � ^ � � � —_.—'_.. ......_�.__..._.......__.�._�........_________'. ........._.......__ ......_.._........__...�.._._...___ .� . . .. . ............_' ............__.�...,,......._ ..___.'_ ' S p _".___.________...__..._.__ ....—_....__.._.........__.......... ..._.____.__ ,__ __......_— � I i ._.......... .....,.....__�. .._._.._.__._ ._.___,_ _.__ ...... _ � � _........._` _ ___ _._.._.__ ._.___ _ ._......._�_._____'_ _.._ �i ..__. _' __ __—_ .___- __�_.— ..9 � �� � . � �.i . . _.�_—.._._T� ___._.�_ ..._._.....____ ..__.. . . _..�__._"_i � �" � " ___.,_...............�___. . ........... ..—._...._.._. ___ .. ..._._..-�_......_._.. ....___.._.......__`" ___'__� ..,.........._......_ ........__m_.._.__...�..�..._,_,� � � 3 ._..,..._' '...�..�._._.._-_.,_ ._._._...�_...____....._____._...�._.___ _._.._'__ .......... .___..........._..._�__...�,..._ _._ ....._.___....._._........_....__S B � ( . .. _ . .::.m _____.___.._._._ •—. __....------�---- _..._._..�_..............__.._ ....._..,. ___. . _._....._....__"___._�._ ...........____. ._._. " . L.,....._.,...�...� _. .__. _ ____.___.� �...:.:: .. ::_�.�._ ,.._...._.__,.,......a..„_ !