Loading...
HomeMy WebLinkAbout14845 (19) CITY OF DIAMOND BAl� G������"�( g°'` ' ' - DEPART��ENT OF COMMUNITY&DEVELOPMENT SERVICES ,5'G-o / : w 21660 E.Copley Drive Suite 190 �=""C�' PRESS (909)860-3195 Fax(909)861-3117 FIRMLY ����� BUII.DING PERMl'I`APPLICATION _.. __ � _ o� JOBSITE �I�� I���A-�!]�,"ji/)fj �� DATECATION� i � NUMBER( #/C ADDRESS IE �"y I�O r' �"��S[/� c� ISSUE TYPE OCC APN L T TR CT DATE_ CONST. GROUP °C OWNER � ZONING SETBACKS ADDRESS � C• � CITY E ZIP TEI. RE�RT RW p APPLICANT �"' � TEL. SIDE/SIDE STREET RW ❑ � CONTRACTOR !� SIDE ❑ � ADDRESS � _ � CITY ZIP STEL. PROPOSED USE � ARCH/ENG/p � DESIGNER NO.DWEL. NO. NO. ADDRESS UNITS STORIES BEDROOMS � CITY ZIP TEL. � DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION � � OWNER-BUILDER DIECLARATION SFR/ADD/REM Op I HEREBY AFRRM UN�ER PENALTV OF PEPJl1RY THAT I AM E%EMPT FROM THE CONrRACTORS LI- G8f8gB/Cflf()OR W CENSELAWWR7HEF�LLOW�NCFEASON(SEC.7o31.58US�NESSANDPNOFES510NSCODE:MIYCIT'OR (n � CqJMVNMICNREql11RESAPERMITTOCONSTRUCT,ALTER,IMPROVE,DEMOLISH,ORHEPAIAANYSTRUG W PaIiO/DBCk TUpE,PRqfl TO ITS ISSUANCE,AL50 REWIRE3 THE APPUCANT FOR SUfXi PEHMI7 TO FILE A SIGNED W � STATEMEN7 iHAT HE OR SHE IS IJCENSED PURSUANT TO THE PROVISIONS OF THE CONTMC70H5 LI- � CENSE UW(CHAPTER B�COMMENCINO WI7H 3ECTION 7000)OF DIVISION 9 OF THE BUSINESS AN�PRO- LL' POOUSpB FESSIONS COD�ORTHAT HE OR SHE IS F�(EMPTTiEREFqOM ANO THE BASIS FOH THE ALLE�ED EXEMP. TION.ANYVIOLATIONOFSEC710N7031.SBYANYAPPLICANTfORAPERMITSU&IECTSTHEAPPLICANTTO Z Re-Roof � A CML PENAL7Y OF NOT MORE TNAN FNE HUNDRED DOLLARS(S5a0�.): i-y ❑I,ASOWNEROFTHEPRQPERTY.ORMYEMPLOYEESWITNWAGESA9hIEIFSOIECOMPENSATION, � CommBfCi81 � � VALL�O TH6 WORK�ND THE STqLICTURE IS NOT IN7ENDED OR OFFEV7ED FOR SALE�SEC.7046,BUS6 _I NE5SMID VHOFE$SIONS CODE:THE GONTRACTORS LICENSE LAW DOES NOT AGPLY TO AN OWNER OF N PROPERiVNM1iO8U1tDSORIIYlPROVESTHEREON.ANDWFIODOESSUCHWORKHIMSELFORHERSELFOR � a TF7p0UGHHI50RHERONMEMPLOYEES,PROViDED7HATSUCHIMPROYEMENTSARENOTINTEN�EDOR m OOFCERWFORSALEIF,HOWEVEiLTHEBUILDINGOqIMPqOVEMENTISSOLDIMTHINONEYEAROFCAMRE� z �TpN,THE OWNERAl11LDEH WILL HAYE THE BURDEN 6F PROVXJQ TNAT HE OR 9NE DI�NOT BUILD OR = IMPRPVE FON THE PURPOSE OF S.LLE). � ❑I,A54N?/EflOFiHEPROPEHTV,AMEXCLU3IVE4YCqNTRAC7INOWITNLICENSEDCONTflACTORS TO CONSTRUCT THE VROJECT(SEC.7041,BUSINESS AND PROFESSIONS CODE THE CON7RACTORS LI- V81U0tion ADJ.AREA GENSE LAY!DOES NOT APPLY TO AN ONT7ER OF A PROPERTY WHO BUILDS OR IMpflOYES THEREON.AND � NM1IOCONTRACTSFORSUpiPROJECT3YV�TNACONTFACTOR(SJLICENSEDPURSUANTTOTHECOMFAG QUANTITY DESCRIPTION FEE � TOHSUCENSEUWJ, 0 ❑IAMEXEMPTUN�ERSEG. B.BP.C.fOR7HISREASON Q � U � � UATE OYMlER U z W � LICENSED CONTRACTORS DECLARATION W OC I MEREBYAFFlRM UNDER PENALTY OF PEflJURY THAT I AM LICENSED UNDEfl PROVISIONS OF CHAPTER � � d Y(COMMENCIMO WITH SECTIOW 7000)OF DIVtSION 3 OF THE BUSWESS AND PROFESSIONS COOE,AND Z MY LICENSE IS IN FULL FORCE AND EFFECT. e� r-- m d � 0 UCENSE - UC.NO. � F �� J �j DATE I �� COMRACTOR n- W � WORKERS'COMPENSA710N DECIARATION —� U � IFIEREBYAFFIRMUNOERPENALTYOFPERJURYONEOFTHEFOLLONANOOECIARATIONS: � Z Q � IHAVEANDWILLMAINTqiNACEfiTIFICATEOFCONSENTTOSELFdNSUREFORWORKER5 = � COMPENSATION,AS PROVIDEO BY SEC710N 3JOn OFTHE UBOR CODE,FOR THE PERFORMANCE W �THE WORK FOR WHICH THIS PEqM1T IS�SSUEO. � W �I HAVE AND WILL MAINTAIN WORKERS'COMPENSATION INSURANCE,AS REOUIRm BY SECTION 4 370D OF THE LABOR WDE,FOR THE PERFORMANCE OF THE WORK FOR WFpCH THIS PERMIT IS 0 ISSUED.MYWORKERS'COM7ENSATKKJI SURANCECARRIERPNOPOLICYNUMBERARE: CONSTRUCTION � CARRIER � �� + PLAN REVIEW > l� � POLICVNUMBER� � ��'����.�� ELECTRIC � (iFiISSECfpNNE�NOTBE00NPLETEDOF7HEPE�1'ISibRONEHUf�DitED0011AR.4(E10�ORL�. PWMBING � w ICENTIFYTNATINTHEPERFORMANCEOFTHEWORKFORWHICHTHISPERMITISISSUED,I MECHANICAL z (� SHALL NOT EMPLOYANY PERSON INANY MANNER SOAS TO BECOME SLIBJECTTO THE � Wp RS'COMPENSATIONtAWSOFCALIFORNIA,ANDAGREETHATIFISHOULD6ECOME �NSPECTION FEE SU&I TOTH WOfiKERS'COMPEN POVISIONSOFSECTION37000FTHE OR 7 � c i sy,er Fii}IWITHCOMPLV WI o omsaus. ISSUANCE �ry �y � :V SMIP ��� � l 1�,�' p OATE: � APPLICANT. � ENERGY P/C WqpNING:FPILURE TO SECURE WORKERS'COMPETISATION COVERAGE IS UNLAWFUL,AND SHALL BE �y SU&IECTANEMPLOYERTOCPIMINALPENALT�ESANDCMLFINESUPTOONEHUN�REDiHOUSAND ENERGYPERMIT 1 DO{.LARS(S70o.o00),INAODITIONTOTHECOSTOFCOMPENSATION,�M.IAGESASPROVIDEDFORIN q.,����� •h�.� t �y, � SECTION31080FTHELABORODDE,INTEREST,ANDATfORNE1"SPEES. RETENTIONFEE: � �°� '4 a GONSTRUCTION LENDING AGENCV PRE-ALT FEE: O � I NEREBV AFFIRM UNDEfl PENALTV OF PERJUflY THATTHERE IS ACONSTflUCTION LENDING AGENCV FOR THE PEFFORMANCE OFTHE WORK FOR WHICHTHIS PEiiM1T IS ISSUEO(SEC.3097,CIV.C.). Z W � LENDEWSNAME . F- LENDER'SADDRESS l � wICERTIFYTNATIHAVERFAOTMISAPPLICATIONANDSTqTETHATh1EA90YEINFORMATKKJISCORRECi TOTA�FEES � IAGREE TO COMPLV W1TH ALLCITY ANO CAUNTV OR NANCES AND STAiE LAWS REL4TING TO BUILDING /���� � � �\�� CONSTiA1CTION,AND HEREBV AUiiK)RIZE REPRES ATIYES OFTHIS COVNTYTO ENTER UPON THE /a � � Z ABOVE-MENTIONEOPROPERTYFORINSPECTIONPU POSES. COMMENTS�df ��� i'` O � PERM� IPRINI� �� � � SIOM�TUR OF PERMITTEE 0 TE � FiECPT.NO. PAID BY VALIDATIO WHITE—Dopartment Copy,YELLoW—Finance Copy,PINK—Assessor Copy,GOLDENROo--File Copy,GREEN—Applicanl's Copy ....:...�. :, �--� ,-r .� .��r..� r. .:,. ..,.�,.,.,� �„ . .,,.:�:�; ... . .. . . , ... - t . . � i, .. � ., - . -...��� .. � �...... ..�.. . . , , . ., ... ' � . ;"li�-. . . .. . , ... � ._ . . ... ._. . . .. . . . . ����� � ���� ,... ,..._ . . . .. .. .,q ,.. ,�.^f 'k��a�9� `�*�Y:���,��, ,..��a� . � ... . .. •- . . . - ._. . .. � .. ..... - � _. ' ' "�.� : . �,.r_.. ...��,.':.. . ,,...,.. � ,�. . � . ._... : .. ,'4.�.bW. , ..�si:;h � , . � .. _ � :i' :;.ti: .�,q.: "'a. Y�t.#yrr""'+v. �.. �' v � .. `ry'�:�' ��� a��.'��`��".�. �'�� ���� .��' �q..� � � .. 9 ���� �.�.. :� �.. � a x ���� � �..,� • .� ��..3. � �,�t n .- .:� ..:� � , 4�:�. e? a �;:;. . .�. �����. � �� .. ,...«i a �:� '.�.' �'s;�.�� ( .a. � "� " � � �.)�f i�7€ f � , n� j] �,.. , � . .. � ..� _ .. � ( �v.ar-aT--. -•-�_._. �. � _ �• _ __._ . _ f. . ._..._ . .... —:-- .._..__ 1 —. _5.-..�... _ . ° F �e ,�t�C���tl�j � � s � � k � � �'�`1� �3�:���i � ' i : _" � __ ._ .. � � ..� _.�;_. _.�-.�_ _ __ —..-4_.� _._�_ �...:____. __�.Y_M._-___. .....�� �.� r r°�rcr]C„r'�i^sC" ��r � :i � _ � i���€i � �� � '1`'$�'}�S�a .- � t � �_ i F .._ �:_...; : ..._ �. -.. ._...:��____�._.,..__._. a---- . .= .,,��....._ �. � �.:., �m..�.....�.. i s"°t ��.� 's�k9 e � � i)���C"rS c�G3C� t£`C�'a,���"l __ �. ___ __ . ' � �f;�����'��C?t)r�zt'a����'� x - �.,1 __s s,� r* `�a`s�'§sc —� _ _. ._.__ .�.:. . . -:,y �_. €�-,, � L j _.. E y�"_ gh _ � . � g^��g }���y� ' ._ ._ _ �-_.._._ _ ..._.�_ 1 (� Z�'_L�C Y"�F�7tI,i'Y '_ �7 ,..... �A . ....... '»-i::.-�� ';1*�1�P'��.��=3.e"€6l a.'S 4.1.'_% tACX� ! ___^--r..�..........,_� . _ ........ _ i y-�-�p 7�a .-.) t.. � »�. ... �u� �µ N�.�r" �� �S$-"t dgy �- 1 . _ .�_ -.. .. . __ � ' , I' _�_ ;C�� �, z+��';��i� m_i _._m� � ^ .., I i �? �T �.���E�?��� �_ ., -���_.__. i ,,,, _ - —I __ _ _ _ _ . _ ._ .__ _ c-� +'ttt��'t ? t €€ r a i�1 3 _ __ _ '. 3 � "��1. �.,�vf` zc-���r�a 1 ___.�___ ._ __i _ _m _____�______...�_,. __:<.. ._ i _._��..__._W: _� �._ ._.. __ � _�________..__.._�_ .n i;.l � :.r�._r� �,, ..�_.._ � I r"�1�� �as`;r�',6� ��Ca x i . _ _._ _. .---- -_�..�_ _ __ ._.,_.�_._ ._ __._.. . B � . ' � � � �' , �����7�r�r�;"��'� 3 J _. _ � � $sE���� ���'�'� , � _ ------ , --- - ' __... E P,:r����, �g �S t t.` mm� s _ -' ' i G��)�J�e�?,-`��,'is'a��l� ..__ _---_.._�__ _ ... __...�. . ___ '-! t:> �` a�, � �:�Ya _" """_"1 ' . "" 3..�-��lr>� �a€�*� +�?ta _..__ ___ .___ __�._�. e_,,.__.r...___.._ _____�_ � � ._.w �_.... __..___. _ �� �� � � ,;-��$�r� .`s� ��` �a�' � i � €`�}�"_�L�' ���i; � ___— - ° __._______�._�_..�.... _— __ . _____�______.._� .____ �..�. �.__._� .� ._ __ � _,.� +�, . . , _._ �* �r � s",:$ k'a � 1'" '�`�R e--.Y f - j [ 4.a S i �'�� r $�Ln -. _. . _ �..�...._ ......... ..._ . ..._.......�... _.._._.. �_ -�..... �� �.- .___ : . . -�...:.... _____..�..._. � '��4� ° 3��_::1�i M6 s� _�5�,}.__ . _ . . .. - � �'��,}� i-'���i�1i. . :� . �.' .... ...$ }..�.._�_......,.... , ) _ __ _ �..__ � _.._ ;._ _..._._ ._ �...._� . . � _.� _ _ _ _ s—.__ _ .._-� � t `€:+g �:x ��S C;��:,;1 �i� � � � �o� ����..6d4��-� - `'. T � ` � ��:�°�� '�' - e��,���at� ' j � '7�G�����T1G�'a'�� �� __�___�---�--� _ �.�_. _ �� .. _..w_ ....___._:...�__.:_�x_�. :__:. _�m:_.______ .:...�� �� _ �__�_ , �a�1�§: s$.. �pal�`'a. �,"�L� _w _�__� � ,. _��. .... .,e,a__.:�...___.__. _�.... _ �_._ e..,. _�_ .t�.�°{�3�-.�'�' -'�. ; � G :€�"�"�� ` � � �:�°d`�.�..:�.� _.:.^��. ." :_.__ ( _. � _.. .. e.e..__-- ,� � _.�... ____,.. ...n....�..___ _ _.1.__....;� , e w p b � [ y .,,:: , ' � f -,� {� ,-- -� .... ��.3�T"'{ �§��L. & .... ... S .. . ,. ' .:.- .- ' � ��.,s\� -}S�- E��3�R _ "_ L_--. . _.......... >,.._...__. .. _...,.._ t..»,...,�.�.......�.,a..m,..........�.._ .� .� ...,_.�_�........_..._ _L....... .._._._.—. _.,_. F \ _ -.. »... .......,..�u. .i. . �. _ ....,+_ ..,..�.�.—.- � �'�, _ ; . � E +: i �..e t � �'��`'��;i 's =�C� . _ .. j.._. . ... .. . . E I . �€�.�? t..#..r€i .Z[.� � .. � _...__ ..... ................._. _...._,.. . ........._._._.. �..e.,.m....`.-....____..........,......:..._..,...__. . �._. ____ ._..__._.__ - ........___ .,�_3.__ .._.._.....�_ ....._. .. ..._.w.„.�,.. �_.._,�.._ . .._,...F - ._...._�.'.._ _... ..�._.__ .C`���.�s, �, a..'.�a"a'�.. . .. ..� .. _.. : .. . � l- P=''��F_,'`4��'"�". �''ca'i s,i._ , j ��... �.,�v n. .,. ....... ...._ � ... . . .. a . ...._.._,,,..,._�..,....� . . . ..._.�..._.:._.._.�.. .. ... .__.,_.,_�....� ' . _._... . $� ...._. .. _.�.. ,� �"[�"€a�YL 2"�:",Y-� �°�I� ' . _ , ,. . � . � y §-�w_�i`'"�-[ l�"Z'.d9 r�1R�1 � � .....- �� . � .. _ .. ...,: ..�-.--`-- :-� .,.�. -�' . ., � c. —.._€__._� ......._.W_... � A_.._._..._ \,.f;_ ._..... �ac..:.,,� -a � �, ������-,.119'"��-"�"�� �dl.`s :...> "� __..._..:..._.....��'��;' �'ti t,:�-.... .-.��- ..t � � "T,.�T��.a 1�`�,i13 .�.__ .� � e:� s� � _.�_�.... . � , , �. V_. T._._......__..._....._... . , �� __.._.....�.__ � �..,.� � �.._ . . . a. ( _ '� ,. .. ! -.r' 1 � ., ' ' . C � -a..., w»»......„.��.....,...-.,. . . �.,.... � . '" _______�._... _. ._... ...... � ..�..... � . ._ . _ „ � � �,.:w `�� �� � ` �rv c . , � {� ' , �� . .._._...a . , _ , .,.,. .. . � i . . .. ...__..._ _ . .. .. .. .. _ . .. � ...._.„ � � p�: �.,�� �"° I t;a3 8ls�%��4�§��,,;s _. .-. _. ,�_..._._ . .__�... ._ .�.._..��. r..�.............w...._._____.w. r__._.._m.�..._..._.��.��.._.___ _ ..._.�. __�.___. �._ � _ ,: . ::, _.._ ._.__ __n _ .___�._.__._.___. ,._ �� �_.__,��„._ .�� __ _ ..»..,.�..a.. _....., __ ...M...... ___.. __._..�_ ___._.��._._. _ ; _.... , � __ ;�...� . � �..._ .__._.....�_.._ .._�..:.�. __..��.. m .:�._.w�....____... m. _..:.;_r.__�._ ._ �_. _ �.Y_.._____ ._.n.e___w____ _ ._ __ _,._s�__ ` , . _ .�..�.�. .___ _.. _.�� , : _ . _ ��_.__.__._:....;_.e._:.___ _._.�.__..� . ��_ .._:_...__---___w.. .._. _..— ._ .__._ __ _.. _ _ .__._.__.__ . .._.__.�..._._,_..._ [' _.� i . � �. _.___._......__._.....__.. ._.......�_._...__........_. ........_........�......._..._. ...__._._�..____.� _.... �_...._�..__... ...:.._.,..._ __:�,..:.__e._.__.......__.._.__.__.......,....__._._.. _._.....:,.,..e,�;.—_.- ------- Y _ ` ��. '�.,_-:i . ...,+.} F� _.. _ . . ' . .. . �' . ._�....................,........__ ._.�..,as...._ �....«..........,, —._.-a "�.._.«_........__._ ...-.<,»_._.._._,.«a-_ ...��...._.._.�,...,......__.._.e....__._.,_. ......�....__.._......,,......_.,..,��....,�..._.................... .,.,.�._m.._...._.......__..__�____�.«...........� . . . . . .. .+. .... . �� . �... ,. . ..� . . _ . rv . .,� .. ,. . ..... ..�.,�� . . , .,.....n,..._...-k-. ..e.�... . .........._ __.r_.._ __�................_..,...�..... ...._�^..._....._.....�_..m_... __._............ ...,_,._.�.�.«..,,..,.-�.._. _... ' ._.... ........_�.. , � �_.. �'- '..�..... .......... �-rM �E. .....', ' , .'.. ` i �L..�. . _ ....� . .. _.. ..... . . .. _-.. . . .� .�--��... � 3 :5u' ... ... . ... '� . � . .. _ ..' . . _.... � . .. . .. ..�'__.: . ____._....__..�..._-,,..�.... �' ._..:........v.�:S_�...�...�..�_� . �...._..__ __"_'__._.�..._..._.,.....m.�n . .. _�.____.�_.._..».-�._........_._�....._.. _.,_..,....�,_.......,_. ..._. .._ . � .. . ..__ _ . . "_ __ � . � .. t . Y �..._.,»...: .......... ,..,..« ,��. �.. ....,P_ _...,_�.._....._ __f _ _.�___ .. . -. --� ...._r.,.s.n...m.._..._ e _.�...+ . . _.... ........ �, ' � ��n���c .:.���' �, s� . - P _.__ � as'�a.�� :�'`��7 ,r w"°�r`* . � ._.... _�_ �_�� .....� __-`_ _. _._,._ .�.�. _..._ __ ..._ ..._ _ _ .: . :,�� �; ..Y..,.... .. . . . - � �a�-.5,". _._,.........__��. _.�__.__._ ____�.__......____.. ..�..�._..... . .. . . ... � a . _ _.. . .._. . ? � ��':. � � .. . , . . , , .—_._...,.. �.�.._,_�.�._..�_....�.. ... � � � . � � �. �.__._... _ ___._ .._._.�._____. ___..._.__ _-- -- -- _._,_ _ _ _..�.�._.�. . �.,_ r_ .�. �_ __�. ; ��� � � . � � � � � � '� _ _._.� , ._—�P_ �___ _ � _�� -- . ` ��. �._�.. _._ _.._ _� � .� � �� ��� " � .._._ .___.___.�._ w:�e --� , � , _ _ � , . ����� „ � � & ; _.�,��. ____._ �_�_ �� .n._...._.__ _____.. �._ __ __ _._ .� _.... _�__.���.� � p,.: . _ . _ . _ I , , „ x� �_�____ _w,.�w� ___.._.�.____..__._.___. �._�,�....____�� ���._ _ �_ ._ . __.-, <..� ..�� � � _ . , - m . . , , �� ;�.m����_ �..r_ � � ._. - _-� _�_.. __._ _ �