HomeMy WebLinkAbout14308 CTTY OF DIAMOIVD BAA �
DEPARTMENT OF COMIv�[JNITY&DEVELOPMENT SERVICES
21660 E.C�ley Drive Suite 190
(909)860-3195 Faa(909}861-311? PRES�
BiTIL�ING PERMiT APPLICATiUN FIRMLI6
o DDRESS `�C4�1 ��—��� DATECATION Z1 q NUMBER��P�
� �
$ , 15SUE TYPE OCC
APN LOT TRACT DATE CONST. GROUP
°� OWNER �.1t�-R�..1Q."�17R���
" ADD SS���� Z0IVING SETBACKS
W CITI'��} ZIP�1 � TEL. — �i FRONT RW ❑
� APPtICANT TEL. REAR ❑
SIDE/SI[lE STREET RW ❑
CONTRACTOR �-Pir L�'����'j�C-�=��J�c� SIDE ❑
ADDRESS ��"X�a7tJ�T2Y f�°'�3' —
� CM V.4.x�u'1� C�1 ZIP n-- TEL�'�"�'S�� PROPOSED USE
� ARCH/ENG/
DESIGNER NO.DWEL. NO. NO.
ADDRESS UNITS STOR{ES BEDR�MS
� CITY ZIP TEL.
N DESCRIPTION S�.FT. FACTOR P F ADJ,ARENYAIUATIf�N
� OWNER-BURQER i�CIARATION ����EM
� 1 NEi�V AfFlHM UNDEN�FN�LiY OF PEfUURY iNAT 1 NA pfEMVT FRdI THE CO7rROCTORS lb Qgfelflq/C8(QOft
�ELAWPoRTNEFOILOW�NGAEASONISEC.7o31.69USJNE55AN�PflOFESSiON5LV0@PNYCIiYOR (n
GOtYRYVNi1CF1RFAtRitES�P..�7MR7OWNSTPUCL�lTE0.q1VROVE,DEYOIISH.OHREaNHANvSTAI/G 11J PatiolD6ck
7UpF,pit10P TD R9 ISSUMILE,ALSD REOu1RE5 R7E APpL1[ANT WR SUpi PEfWR TO fllE A SiONED W
STAjFj1ENT THAT HE Oq SHE�5 LICENSE�PURSUANf TO TNE PNOY�S�ONS OF THE COMTMC70Fi8 Lb
� C61¢�lAW ICHAPTEN 9 I��M�N�Hi WiTFi�y'ECf10N 74W)OF DINIS�ON 7 OF iXE BI�INE55 M10 PA4 � PooUSpa
fES4GN9 CODE7 OR iNAT HE ORSME f5 EXEYPT THEAEFRON AND THE BASiS FOp 7HEALLEOED EXE61P-
TION.ANYNOLATIONOFSECTION7W1.6BVANYl1PPLICAMFOft�PEAMITSUBJECTSTIEAPPUCMITTO Z Rg.R00(
r ACN4P@MLTYPFNOTMfR7E7H/NFlYEM/NOFEOOOt1M5li�+�'aI�T
� ❑I,A60WNEROFTHEPiIOPENTY,OqMYEMPLOYEESWI7HWAGE5l1STNEiRSOLECONPEALSATqN, � Commerciei -
WJII,p0 THE WOq(,Atm TF/E STRUCiUqE 7S}70T WTEIAEO Op OfFEREU FOR SALE I�C.76M,BUSI- J
/ES4 AND PA6FE9SION8 CODE:T/IE CONTNACTOR9 LICQi4E UW DOES NOT APPLY TO.1M UNAiER OF
� � PqpPEpTYMMDBUILOSpqqWflD*'ESTMEREOM.AN�Mh�ODDESSUp1VA0RKHIµSEIFORNENSEIFOq �
� T}1pfAlONFpBORMEROYNAIROYE6S,PRDYIDED7H4TSl1CHIYPROVEMENTSARENOTMRENDEDOR m
OFFBi�FOR SN.E ff,lqNIEVERTME BlHL01NG�R�MPROVOIENT IS SOLD WffNR1 ONEYEAROFCOAIPIE-
TIOM,TI�OMIIFA-0UllDER MGLL HAVE THE Bl1RD9/OF PFOYIN(1 TlIAT HE OH SNE Dq hqT BUItD OR
� NIPf1�lYEFai(NEPUAPOSEOFS�IIE}
� ❑6�BON!l�AOFTHEPROVfiRTY,AMEXCiU51VElVCONTIUCTINONA'fNIICENSEUCONTMCTORS
Jp�,pN,y7p�,lq7 7/1E p{�p,JE�S(&EC,1dJ,gU61NE5S ANO PROFE6.ION5 CODE:'1}iE CONTRACTOPS LI- VBIUef10l1 AQI.AREA
4�1 C&ISELAWDOE9t1OTMPLYTOANON4IEROFAPROP�q7rVA-pBUMSOHIMPROVESTHEH£ON,AND
Z MpqWN�iWCTBiORSVCNPMLECT9WITIACON7MCfOP(S�LICEMSEDPURSUNJTT(1TMECONiRAG QU/�rjj� QESCHIPTIOM FEE
t �onsuca+sEuw.j.
� O�AMEXB1P7UtAER3EG. B.dP.C.FORiH15RfA5G1 U
a
� DATE OMMER V
� UCENSED CONTRACTOR$�ECIARATION W
J
� W
� IXERFBY�fF1f611RlDEqPENAl7YOFPEFtRlMTHATIAMUCENSEDUNDEflPROVISIONSOFCW�PTEf1 Z ` � ^ �o,�
( s Y(q01p16NC11p WRN SEC710N 1000�OF OMSIOtl 30F THE 9USMESS M70 PROFESSION3 CDDE.AND �� ��
IiY UCEMSE 18 97 FIILL FORCE�ND EFFECT. m
O C 3C� �$ZSZ
uceNs�cuss uc.no. �
� un� � ��corrrnncroa _ a
' WOAKEFS'COMPENSA710N OECIARATION �
� � INEAFBYfFfIR4UNDERPENLLTYOFGERA/MU4£OFTHEfOLLOWIN4DECLAMTI0N3: U
� �
� �_IHAVEWDUALLUAMTM/ACERTFlCAT£OFCONSENTTOSELidNSUREfOqWORKERS'
� COMaENS�TIWI,A5PH01M[1EOBYSECTION97ouOF?MEU80RCO�E,PoATi£VERWRMANCE U
i OF THE WOqiC FOR M6HIGi THIS PFFMI715155UED. �
I W 2
_�WINE N!p WILLNA'MAN!MIOHI{EAS'CGi�ENRA710N IN3URANCE,AS PEWIRED BY&ECTpN
Q 87000F7MEUB9RCO�E.FQfi7HEP6RWi�10EOFTHEWORKFORWFIILMTHISPERMi719
issUED.r�v wowcEns'co+w�Tiow Ir�sUwwce c�n R u�aot�cY eiw.iHSR naE: CONSTRUCTION
� �wEq '�L_ �' PLAN REVIEW
� aa+cv�A � � � _ �'� � ELECTRIC - -.
b
(IMsSEc�t7NNEIDND���oF�lEOEta.�il4taqtr�Erta�nrs�DalAaSR�oo�OtiLE� PLUM�ING
Z I CERTIiV iXAT M THE PENFOWNNGE OF hIE NtlRK FOR MMICFi TN13 PERMIT IS ISSLED,� �ECHANICAL �^1,���y-�--
(�' - Si1ALLNOT fiAJPLOV ANY PERSC1�1 M ANY N�V1NEfl So�5 TO&EGOME 5UBJEGT i0 TME ' ��-4J�
� WbWFERS'(%71NEN`SK70NUW$OFCtL�F�+�'7U.ANDAGRFETH�TIFISNOlXD9ECONE �NSPECTIONFEE
St161ECTTOTHEKtlRKEP3'COYPEN9ATIONPRONSIOSd$OFSECTIOH37000FTHELABOR �SSUANCE
WDE.ISHPI1FORiHW�7NCWPLYWI S1�EP�aJV15�0 .
� ��U APPLICAM: SMIP �9��' � � iUii�
p OAtE: '
W - � ENEPGY P!C '^
LLW�fiHIKK�:iA0.UiiE TO SEq1RE WORNEPS'COAIPENBATqN COYfiqdGE�5 UNUWFLL,AND SNaLL BE ` �
8V91ECfANEMPLOYEHTOCFWINKPEN�ITESM1fIGMLFINFSI�pTOONEHUNOflEDTFi7U5AN0 ENERGYPEFMIT A ' '�'11'-T`'i�"' `"
DOU./�R${5100,000),INhDDIT1OHTOTHECOSTOFCOMPENSATION,0AMl1GESASPROVIDEDFORIN ` Y.-e«._
Q SECTION 9loe Of 7HE LABOH�'AOE,INTEREST./�ND ATTOflNEYS FEES. �` �''f�� �!:..(''.:j
flETENTIDN FEE: �
� CONS7RUCTION LEN�lNG AGENCY ppE-ALT FEE
1 HERE9Y AFFIPM UN�ER PENALTY OF PERIURI'iHATTHEPE IS A CONSTHUCTION LENDING AGENCV
Pop THE YERiOPMANCE oFTME WORK FOfl W WCH TtNS VERMR IS ISSUED�SEC.3087,CIY.C.).
Z
� IENOER'8 NNdE '
�
� LENOEIYS/�WRE55
� ICERTIF'�'�TINFVEREAOi145APPLIGTIONAN�57A7EiW�TTMEAEOVEINFORMATIONISCORRECT. TOTAL FEES �S- f V
� I AOREE TO COMPLV WITH ALl CRY MA COIINTY OHO��NMICES AND STATE UWS REUiNN3 T0 BUILDING �
CONSTRIICTION,AND NEFEBYAUiMORIZE REPRESENTATIVES OF THIS CQUNTY TO ENTFA UPON TNE
S� �BOy6•M5M10NEDPPOPERTYFORINSpEGTIDNPURP09E3. COMMENTS
� ��,.. ���t
�
m PEHl11TTFENAME(VNN�
� -1�-�
�q SbNANRE OF PEHYI7TEE oATE
� RECPT.NO. � PMD 8Y VN.I�NTIpN
NMIIE—Dooartment Co[ry,VELlO`N�in9r�ce Cooy,PINK—ASaensa CoQy,GOIDEN ile Copy,GiiEEN—ApplicenPs Copy
� m T � � � cn « o n � rn � � � b � � � � a � � � m
mm � ��- ��zz � � rtmm �rmX, � = Oo00 � oy �
�� � i'_� k���� � p '� -mr� -��a ��� rr • OcccOx' O -irn � 0 n � "�
D rr � t- � G7 L� G5 -n '=� -n m(v c ,,.� m
�C1 � c, .'0 1 m T f7 �; 'i7 O :� A � � 7> fn z S S O Z fn 7J -ty � z � ^n A .
r"�r' m p -t -a {"' m � � � m x U tn z u� O � o o t�
�� � � t� -�'i1� m �' :� �`� � Cz � r � mC ;; mm �• a .� cs �+�
��^, � �-1 f� � G�{r �'` � (fi � C C 1"rE p Cit m � Sl�m � r G7 �a i .
--� G7 ,�7 -I —ti �" Y C � p Cy �_c^_1 47 _4 77 "� C 37 m C 7t U7�
�}� tfj �i—j�? !. � � -{ Ql I"� Z -�i = C� � rJ C'!J -
{�t(n G7 n� Z � C3��' �r � �} i� z m m c --�( .
��� � � pt �> � � � 'D � � � �'
__._� `�--�_ -� � � � Q I i . " _�_ �
� � ` � i ! � i 4
� , � ! ; � C
, � � _ _ _ _ _,-_
� � � ,�
� �
1 � ,� � ��, j � � • � �
�
,.� � _ � - � �
� � a
,_.___._ _ _ -- �_- - _ � �, ,�
m o zl-n -n �r -n,oa �fivv � nmb �tm � �nmc c -*a -n '.�'' C7
E � nrn � z � � zrn -nO00EZOm � z � xz z = � (�
m < A � ✓, -n y � p m m a o y O �
� � �n j�c7 r -=��� r C� �' � �"' �(� G7 = � r-�m ��� � � � �7 � � �4�.°
m s m ��m�t7 m �' --d -n -n m E.x — �n m p � rn
� Ru', � �� �?'� v z '� m -' z m y G� � zy O z m n n -n -n b? � �e O
� �-o � a � `n c, o n+� G`3 o c � o�m m p p � � �
f�;�. y �
-n rom7 -oLn z r � � a, Zo � z --i cn � � �
as -, � � cn�� �z � z � - a � wm � oo ° � m -� �
i � �l� � � � ul� � � � � � � a � �
1 � �� � m � o � `� �'
� � i ( � oc
` � � ��__?(_ � � - -
{ :j ' � � ( I , � ; �
� �
� �
� � . __ _ _ _ �_ _,� a
,
�
� + I , f � !
i � �
f ' � � , �
� ! i ' � , ' I I ' � � �
!