Loading...
HomeMy WebLinkAbout17421 CITY OF DIAMOND Bt� °r ---�'�`--J DEPA1tTIa�NT OF COr�UNITY&DEVELOPMENT SERVTCES � �^ I � � 2 t 825 E.Co�iley Drive ' '"��` (909)860-3195 Fax(909)861-3111 PRESS '""-,�`' BUII.DINGPERMITAPPLICATION FIRMLY � JaBSITE J'� (� APPLICATION y PERMIT P/C o ADDRESS� �3��/11,- ✓ DATE // �'� � NUMBER � � # o ISSUE TYPE OCC °.° APN LOT 7RACT DATE CONST. GROUP � OWNER T�-- O p ADDRESS � ZONING SETBACKS z CITY �[�, ZIP �EL.� f -�o�? f FRONT RW ❑ p � REAR ❑ o APPLICANT _ ''EL. SIDE/SIDE STREET RW ❑ ¢ ; a� CONTRACTOR i5 r SIDE ❑ � CITY ES�I$ < �ZIP� TEL. [a "r %� PROPOSED USE �� w ARCH/ENG/ =Fa . z DESIGNER NO.DWEL. �� NO. NO. �� d ADDRESS UNITS STORIES BEDROOMS � CITY ZIP TEL. � DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION u> O OWNER-BUILDER�ECLARATION SFR/ADD/REM p I HEREBY AFFIRM UNDER PENALN OF PERJl1FiV iHAT I AM EXEMPT FROM iHE CONiR4CTOqS LI- G3fH9B/CB�OIf � W CENSELAWFORTHEFOLLOWINGREASON(SEC.7037.SBUSINESSANOPROFESSIONSCODE:ANYCINOR (fj _ U COUNTYWHICHREQUIRESAPERMRTOCONSTRUCT,AITER,IMPflOVE,�EMOLISH,ORREPAIRANYSTRUC- w py110/D@Ck � W TURE.PRIOR TO ITS ISSUANCE.AL50 RE�UIRES THE APPLICAM FOR SUCH PERMIT TO GILE A SIGNED STATEMENT THAT HE OR SHE IS LICENSED PUHSUANT TO iHE PPOVISIONS OF THE CON7RACTORS LI- � CENSE LFW(GHAPTEFi 9(GOMMENCING WITH SECTION 7o00)OF DIVI310N 3 0F THE BUSINESS AND PF0- � PooUSpa � �FESSIONSCODEJORTHATNEOPSHEISEXEMPTiHEREFROMANDTHEBASISFORTHEALLECaEOIXEMP- (� , � � �TION.ANYVIOLATIDNOFSECTION7o31bBYANYAPPLICANiFORAPERMITSUB.;ECTSTHEAPPLICAhTTO Z Re-Roof '�, '6!'6i �A qVIL PENALTY OF NOT MORETHAN FIVE HUNDflED OOLLARS($500).): � ❑I,ASOWNEROFTHEPROPERTY,ORMYEMPLOYEESWITHWAGESASTHEIRSOI'cCOMPENSATION, ❑ Commercial �' . z WILL DO THE WOAK,AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE(SC-C.7044,BU51- J ��.NE55 AN�PROFESSIDNS CODE:THE CONTqACiORS LICENSE LAW OOES NOT APPLV TO AN OWNER dF � ,�PROPERTYWH00UILOSORIMPROVESTHEREON,ANDWHODOESSUCHWORKHIMSELFORHERSELFOR � � "THROUGHHISORHEROWNEMPLOYEES.PROVI�E�THATSUCHIMPROVEMENTSA3ENOTINiEN�EDOR m � QOFFEPEOFORSALEIF,HOWEVER,THEBUIIDINGORIMPROVEMENTISSOIDWITHINONEVEAROFCOMPLE- Z �.TION,THE OWNEfl-BUILDER WILL HAVE THE BUFDEN OF PROVWG TMA7 HE OR SHE DID NOT BUILD OR = IMPROVEFORTHEPURPOSEOFSALEJ. w ' ❑I,ASOWNEROFTHEPROPERTV,AMEXCLUSIVELVCONTRACTINGWITHLICEN6EDCONTRACTORS � 'TO CANSTflUCT THE PROJECT(SEC.7044,BUSINESS AND PflOFESSIONS CODE:THE CON7RACTORS LI- V81l1dCI0f7 "�� ADJ.AREA W '�CENSELAWDOESNOTAPPLVTOANOWNEROFAPROPERTYWHOBUILDSORIMPROVESTHEREON,AND _ �,WHOCONTPACTSFOflSUCHPROJECTSWITHACONTRACiOR(3)LICENSEDPURSUANTTOTHECONTRAG QUANTITY DESCRIPTION FEE Y TORS LICENSE LAW.). � ❑I AM EXEMPTUNDER SEC. B.8 P.C.FORTHIS FEASON � - � Li � OATE OWNEfl _ U Z W � � LICENSED CONTRACTORS DECLARATION W Q � I HEREBY AFFIRM UN�Efl PENALTY OF PERJURY THAi IAM UCENSED UN�ER PFOVISIONS OF CHAPiER �. p_ 9(COMMENCINGWITHSECTION7o0o)OFDIVISION30FTHEBUSINESSAND?ROFESSIONSCODE,AND � X 'MY LICENSE IS IN FULI FORCE AND EFFECT, m 0 �LICENSE CLASS�+� LIC.NO. �� ��+�� j I V .DATE ��_��Q� CONTRACTOR ��iqyq� �°-�e J Ll.( � WORKERS'COMPENSATION DECLARATION a � U � I HEREBY AFFIRM UN�ER PENALTY OF PEFJURY ONE OFTHE FOLLOWING DECLARAilONS: U) Q � _I HAVE AND WILL MAINTAIN A CERTIFlCA7E OF CONS�NTT05ELF-INSUFE FOR WORKERS' _ COMPENSATION,AS PPOVIOE�BV SECTION 3700 OFTHE LABOF C��E,FOR THE PERFORMANCE CJ Q OF THE WORK FOR WMICH THIS PERMIT IS ISSUcD, � ' O W _I HAVE AND WILL MAINTAIN WORKEPS'COMPENSATION INSURANCE,AS REQUIFiED BY SECT;ON Q 370aDFTHELABORCODE.FORTHEPERFORMANCEOFTHEWORK�ORWHICHTHISPEftMIiIS �` �� ISSUED.MY WORKERS'COMPENSATION INSURANCE CARRIER AND POLICYNUMBERAPE: CONSTRUCTION ��d' •. j cnaaiea PLAN REVIEW � � POUCVNUMBER ELECTRIC ¢ (1HISSECTIONNEmNOT6E�dREfEDOFhIEPERMfTISFORONEHUN7RED00LlAR5(5700)ORLESS). PLUMBING � Z ICERiIFVTHATINTHEPERFORMANCEOFTHEWDRKFOflWHICHT;-IISPERMITISISSUE�.I MECHANICAL (,�J SHALLNOTEMPLOYANYPERSONINANYMANNERSOASTOBECOMESUBJECTTOTHE ' . � . ' ., � WORNERS'COMPENSATIONLAWSOFCALI=OflNIA.AN�AGREETHA�IFISHOULDBECOME INSPECTIONFEE �- � SU6JECTTOTHEWORKERS'COMPENSAiIONPROVISIONSOFSECTION37000FTHELABOR ' CODE,I SHALI FORTHWITH COMPLY WITH THOSE PROVISIONS. �SSUANCE �W l9 e 1 C� �°' s1 f°I h�6 � � SMIP � �S f.:a , l-�w3 p DATE: APPLICANT. ' y W ENERGY P/C ' u !� � —� WAFiNINGFAILUPETOSECUREWaRKERS'COMPENSRTIONCOVERAGEISUNLAWFUL,AN�SHqLLBE �� ��—y SUBJECTANEMPLDYERTOCRIAAINALPENAL'fIESAN�CIViLFINESUPTOONEHUNDREDTHOl1SAND ENERGYPERMIT - � ' ' � DOLLARS(51oo,oDo),INAD�ITIONTOTHECOSTOFCOMPENSATION,DAMApESASPROVIDEDFORIN '�: -�- -.._....._.---- - . /.� �� J SECTION3'IoeOFTHELAeOqCODE,INT=REST,AnIDATTOflNEY'SFEES. RETENTIONFEE: �• � d CONSTRUCTION LENDING AGENCY PRE-ALT FEE: O �� IHEREBVAFFIRMUNDERPENALTYOFPERJl1RYTHATTHEREISACONSTRUCT10NLeNDiNGAGE!�CY PoR iHE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUE�(SEC.30 W,CIV.C J. W � LENDER'S NAME �, F_'- LENDEA'SADORESS � ` '� � I CERTIFY TH�T I HAVE FEAO THIS APPLICATION ANC STATE THATTHEABOVE INFORMATION IS COPRECT. TOTAL FE ES ��.r� W 1 AGREE TO GOMPLY WIiH AlL CITY ANO COUNTY ORDINANCES AND STATE LAWS flELATING TO BUILDING � CDNSTPUCTI�N,Cl�ID HEREBV Al1THOflIZE REPPESENTATIVES OF THIS COUNTY TO ENTEfl UPON THE z� A90VE-MENTION b PFOPERTY FOR INSP'cCTION PURPOSES. . COMMEN7S - Q ��. [I� _� � —C�--- -- - m PERMITTEENAME( INT) � ¢ �f y � --- � � SIGNATURE . P MI DATE "A �. RECPT.NO. ���� PAIp 8Y VALIDA110N � WHITE—Oepartment Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENROD—File Copy.GREEN—Applicant's Copy . � � _ �. � � � �, � s � . � , � w'�' � � :� . . _ ��, � �. . ,...� �I'I p,a t:�.a ,�n ,�� q�,� `� r" a ;a x � 'j��,+ f 5 �� t �q � + �: t y'.,s � � �. # �. .� �+"` �''° a" , k � ,;:�€�� .� � ���R�$� � � ,� 4�5 � � � � a .1..� �! 3 �'x X ' � �� a.� 'a �x � � . d 4 � � � � �d �v � ��p � . � ¥ � � 3..� k' S , a '� * �, ' � " � � � P a'" � r'�a ,.t u r .�a��� �:� 9�q '. & '"��N.�;:4_��� :s. ,.a�� �.�. ��:��TM,� r.,�"...�b �..r.. . �`f. 3.�^`.» �:, :� ,.& �.x"i.� �..��a c .a,.. '� .��€,�,.a:� x� x..� , '� x a...:�„c.�..�'�"�.`�. t a��s m .�.re ..'��+�..ra..n�1:`� :,�,:° �':'� .�,-':�. ., . � .�.I.. _,..: �-,:Q..: ,,. t e , . . a��, . ' ._ i .._ „__ ._ _ i .____ ___.. _. ............. . :._,. . _. __._.__ ........... . _ ; ,..._ ........._.._....._ _ ,......._...__...,............��.._..._,......._.._... . � i� N .a..21 ,.z:'� . "`4 ? . y � _ [ . ..� .�,_.a.... ' ��, ��` i,�.�.�..�__...__. _...._,.___.._._.�._.��_.._......_...........__...._............_.._ . ..._.._...._.....__,.. _..> - '�. i ........_ ...... � .._..... _._...__._-^__._ _ ........_..,_._..._�_ ...................._......... .: g, � € ''{i. '� -y , t„ ��.' . mmf .,.. . .,.�. '� �,_ -.. �,.r.�.__..�...,_...n__,...._..._.__,_..�.... .,._._.._..._,�........ ......_..._...._.....__.,_....... .._._..........,.....,............. ...... . � '—"_...... ..�_ _.. .. .......... .,.:..-.. : ........ ..„... _. _._ _.__.__.__.__..0 .._�.._ .. _ _..._._.._ 7 € � + �' � �)t ,� r �',i ' J ;p' ' ._ , , —,. ; _ � � ,__....__._____ �___ — � __._ _. _._ .,._ __. , � ., __._ � , _. w _ -.._ _ ______._ _ _ _._.__ ..... .� _,s � a,,. ; t ;� r., ' , .�'•!..;•:�>.r,^',a � ,'. , , u .�.. �__..�.._....._ _._....... _w._ . . .__-- _ _. _. �. _ ._......__ � .._...._.. _._._.w .__ _...___.__.._. .rv . ._ i �^ z ; : -, �-� , . � :'^ P �` L' . x 't �. l.'1 f': .��� ,�. _.,,_. ._.... . w.......,s_.._...�.....�e..............._. ...._.....,«............_.__ ........................,.._.,......_..,_. ..._.. ...... ..... ,,.._...�._ ._.....�_.................,.....,,._ _............ .._,__.._ _.._.__�._ _........( 1.�. �+��= � � r � E � � � i� •, � � ; S ���a„Y a,���::{M,�� l' �P ��v,ir •��...... � � � '� 3 �.�',...__............... .. i. ...,.. ..._.. ..._�� ... _....,....__....��_,....... .._........._. .u... .,. .. .�....._._.�._.. .,..._..._ ._ _...�. . ...........�.. . ..... �. . a✓�":4r"1 ��.�.��pt. �:i€_€ � l;b� �68i' r� i ,=it ._._ � .��.. . . -._ . ....._ ...�____ __...__ .. ... .._ __..._. . ... ... . ... . Y";�,C �b, �-&, �'�'G?� �� 's "^ � k r� ..._ _. _ . �,.., _.._._ . . ............._.,._._ . .._..... i-r,�!'✓�"',—.._ ._....__._ ._ ._... __.._._............. ...._...... __ .._._._......_._.._ _..........,.,.................__.._ ._.._..m_ __ � . '�.. s ���.,Ea.��', `9„ r,, !' 3 ,-I r� .3 _,� . �� _. _.��. �. _ _. � �, _ __... ... . ._.. .. ___ � ' �.�,"±K. �, _,t �' i�� F � F � ; � E.-; �',. � "_ �.. . -: .. _-- '---._.._............. ................_...._,..,,,......_.__ ..__.___ a __. ... ._ _ ........... ----. .__. ,.....,..._ _ .......,,..._......._._..._ � � S� .._t .'..� �.. �.,..x'� 1..........,..... .¢_...�.__�....,.. �.«........... ................_...._....,......_..._..,.. I �� k ...j..._......_...._.._ E rt x F F � ti � . € if �" ,� a _ .. ,.... _ , ..._..._._.._�.... .. .. ___�_ �_._..__._...._......................_....._.._.._. � �,J���. 1 t � � _t ...,. „. .._.. ..,... ...e. .._._ ........._. _ ......... ...._. ._ ._.. ..._...... �......_.. . ... _... ...... ...... ... ......__ ..._�� _'; 1 , C�P �.� .... . E �{ I � '�. .. ` ¢ ., . � �3.�'4.. E .___ __ _............_ �... _.... _� �...._...,_,._...� .....� i S�t'.� 34` � � I ,: : . . .._._..,._._ __. _ ..,..._ a � � � � �,.. ..... .�.....««.....�...�_—_.._... —;--...._................... ........._....__,,.,....�.. �_ . .. ..._ . . .._ : . .........__ <_.� y.r.,:,e.��r;r .:'"d a s'�a' u,. ;. ' € �.,,� �. ...., �„ ......._. ..y,...,....,�....._......,,...,.._._._ __..�.�.......__"__......._..._._._._�......_4 . , . � J3 "...< . ,.. i 9 � ...... __...;...._.__._.._.,...... .._.. _._......,_..........W._.._...,......_....,.,.._.... _, � . ............,...,.._..._._...___�..__:_......__._ ._ ._.....____....._.._...,......._._..............._...._....._._ " € �."3"�� 5,f".irl� @:'� 9__.E�;a 1°.r";.'C.,. ... a;L � � � _ a. , a m i .... ..._,_ ._ __.._ . ...._._..-- .._ _ _._...._ ._..__ _ �._ ._.._---..._.�....._._._ ......._ ..........._.__ ..�...._.._.,._........_....________...... __ r--_.. � ..._. . . ...._..__ .�,; ,�-,. ,. ; � ,,,,,,� q •, � .,., d .„Y�,,.µ , i ., .. I_ :.,. . ..,.... �.._.....,......�..,....'... .. ...:............_..._ . ___._ .... ......... ...... �.. . ........,.........,... ....,t.._..._._... .>'_'.__. !� .�......,.�.....� ._...,,....,,. .._." .._.. ....;.... _.. .��;:4 k 1 � �a�-� � i �'4§ �.� @ @ 'l��� .. i � .,.�._.............. _ .. ._ .._.._.._,....._..,..........,....._ ._ ..... `.__......._..__._..._ _..._.._...........w......_....._.._....__..—:�_____ �. ...__, _ .___,,.,_-..._..._................... . _.."_'�.. , . . __.__.'___'.._._,_....._._ ,.. '' e�.. ' x €'.:4���.t � �,�..l.w...�`..�e..._._..............�. t l .� ; � ....._"""___.,....,,.,....,....,.......:� n... ...,......,.e..............._.......V............____....._..._.___.......�.._..-.........,._ _.. ._. __-_'_..____._.._ .. .....,...................,....._.. �__. i, ',,�„r..!� ..._ . . .. .. _.�;`k��� :�. . . . _ _.....�.... ...... ......�. ,._.._._. ._.... . .._.,.. 'mm .. ..a. � .._._. . ..__ ._._._..._,.._..............._.. .. . _......._ ,� �;���� ._��1� h'-�� _� ��� � ����E��� �-� .� �;� � __ -._ _ .. _ -,--- _ _. �._._._ ____ _----�___.��__.. _3 r,, , Ea��;.,�`,,�C� L�� � «�,mm k =�. ... _ _� _.. _ � � ..� _ _a_ .._... �._._. .__.__.....,_._.. ._...,._.. .w.�_._.__ .a _ _ ._._._,.�, _..,. _.. ��... ,_._._.�_.._.__ .. _��'��»e�.�.. m G.'��::::` .. :'.a �� _,._ , ..-,.._.o �-'r� . ....h.._ _._3 „ �. .. .. .�: . . _._... ,.......... .._...._. ..._._........ ..._ . . __� .._�___ .. .,.... ._...�.�. .._.._.... .. . r��6q' �., "@ �.f {rt"3 a� 4 'a a"i �,*Y � - � , � .... ._.....___. ...._ � ..�_._..._ ""'_ �.. _.._.,... " _ _ _—_ _...__ � .._...._. ..— _._-w......_.._.....�.__ , i € E _. __.,_ ..'__. _ _..__.._ ...._.___. __—' �.,,_,. .} � g,,._.s,..'...,. . .,.... . . ... . .. . ....... _ .., . ... .. .. � 1 ..._ _._.._. ..._.._...,. p � :. 6� m � � L A� �,�� .. ��'g i ; �,,.....,.._.��..._............__._..�.._._..._..........m._,_.�___.__.,.., ....._..,.;_......_,__ ..__............._....._...___........_�".�,:�r,��.�a.:..�...� "•��a..�'..i.a�`.�.,�.,�� ___ ' _�. . ...._......__.......:.........._...... _............._.. _... ..-..._.... ._.. ��. _ ...... __,___,__._.. ... - ",.� ,.:._:-._._._...__. . _ . . . _ - � i .,��,. � �� -�'P �:� . � �..d''§..,J S. ..�'_x-: 5 ' ' 4.___.....�_ ,.._................ ..___.._.,__.__.__.......,...,..... __.�_..__............._...._..,.._..�"__"..,__.. .............,..,....,.........._...,.__._....__,.._....,,,..................._...-,,..,....._.....,_..,_�—.m..._....._ ....._._...... '�"�� £ .�'_,__ �.._._ _—_'__ �........................................__.�......................._.._...�....r._.._....__............_...., .....n_�.�.__...,...,........._..._.....____..�_.. ,__._..._......_........,.._..__...._......___ - 8 . .E . ___..._,......_._..............__...............�.�._..........._......,..._._..__.�_ § __�,._._...�._._.,.......,_._�..�� I � i'. � ':'__....,,.... .._.. ....,.,,._.__............................__..__...._,:.�_.._........,......,...-..._...___....._......_. � N ._....._................_._.._.__.....�.W.._......_...._........._...�._,,..,._.__...,....,......._......_........_...............�..___..�_._..._._,.._......_..._.._ �._._�.__—. _�.`�� i L , ,.�..... .___....,. ,m, ; e ._._...,,.........._._..._.__.._._.�._...,......_...�_......v,_........e.._ ...,..._..__. ,_,._.___ .. ..__,....__. ''_.. -........,.,.._..,� .� ..__._.�—._..�_���...__._. i � , � ,-__.__ .__..,..,.....__..�_.._.,____.__..._..._.__.._.�.-'-...„...__......_._.__._.�.....„....___,.,_..._..._...............�,...,....�._...___._ :� ,_._.. ..._._._.,......_,.__..�_..___..�____�..__.�.,_,.._.,._____._........_.__........._..�._____._...,__. .. � "_'-'-._.....,�...� ._..... ; _ _... ..�._. . .�._.......... . . .__._...�._,.�._.,__.__.._....._.�...._._.��:....._...,..........,_.._._-___�_.. .�._._.._..........__..,.._..� . � r�„z. . ' :.:.f": _._.._.._..___._......__._._..._..._ ._..........._�..__..,..___.__�._. . . �m� .... . .....__..._. .. ._. �� .�..:. .. ..�.. .......___,...._._..._.._....._..._..___..._..�..�.....�_,_.._.s,�.__._..�._.......e_:_._._..,....._.�.. t „�'�a.,. t � 3;i s w f r_� _�.______ _�_ __.____.. .�_.._._v_..._._, � T��"� �re�l s r.��r�t �" ..__ .a._�_...__._____.�_.._.M.___.._.____ _.,,___... _ ..._..._.__..._° a '�r . �':�&r�a��.�,� �re a� � �R ._T_......__.._..._....._�.,..._____........_,.._......._..._......,..._....._..,......_......._...__.._._...._...._. �����,,�����a�-���M���„��„: ����t�����'§ a re,�t 4��,�.�s s�6 �%�'�'x���''8�.�;� ..�.. _. . .........._ �L ................._.�.._._......µ....,_�.. . _...._. ���#n�������'��'���"�"������"`����'��°�p --- .... . .. . ... .. . ... .. .. . .. . .. t m3w����a.v�,� �� �p���i���;�,, . � ��.�;�'�'�a„��,�� � �S „���' &�� .._,.__..........._... ,........_.._.�.e..,,».,w. ........._..._,........,._.__.....,.........._..._..__._... ..._._................_._.._._�...........,. .....v_ _..__.,.._ _�_.._............._�....,_... ... _ r t" v-�' �+., m m 3 a � q "' t �. ��� �:�i��:�^r�k�,�r8����""s �', .�, ^ s ��''�����°���� ���������� k �, __._._.._.____.._. ._...____. .... ...____,_.___.._____ �._...._____.__..__._. ..._��__._..__ ; --_._ . ._........._.__..__....,,._ �, , a„�� �� �:�� �;�� _; �� �`� �, � � �'� g�a�q� ��"'"��,�'�'�"a i �d�t�^a� �.� �"a k�"� di � :;� a. �'a���" � �:� ma���a-�°� � ��'� , .. _______.-..._�._,..�.._._ ....._...__.._.__..�.... __..._._.,__-_,_ _. ._.._.__.____..._._��,w.....�___._.____._..__ ..._�_w..__�._� ,r�� �,��� � �� � � e �KK . ��a'7�" �t"�d ��*��a�"� �$,.��. - ....�............__ .__.. _-�------._.....____._�.........,..._-- ��� �� 4��N��� ������y��,�m�xit� _ ._ ____ _ _ _. ___v ___. - �i__-____- -� t �r�":���+3a ����..*.���u,�� �����a ����.�� .,...._...,.,..._.............___._,,....,...,,...__._.._.w._........,_......�"'.__.....,......_........�.._._.�.......__.__......._ ........._.....__.... _..___'�_. ..._.._._.__.........._....�........_......,._.._._..._.......,.....____..,_.._. ... € �.* "� $ �& 'q � � � � �E��' �����_� ,� ��.����,���.. � �.::..�,,,�....,�w,..,�.._.,a��._�� .,e.,.....,�.m, a,a._.. __.,._.,....m..n .a..�,�._„_m.,.,_.. _..��......___ ....m.m,..._�_� ....__.�_�R.__._...._.._,__. ... .,_.,�._._....��..�_,_�_a. _:�.__,�...._._.,