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HomeMy WebLinkAbout15949 (20) Y. ^ �� CITY OF DIAMOND BAht � DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES 21660 E.Cc�pley I)rive Suite 190 „��� - (909}860-3195 Fax(909)861-3117 PRESS 9� BUILDING PERMIT APPLiCATION Ptan 2 B FIRMLY � JOBSITE 83� Can Ofl V1eW C'�. APPLICATION l PERMIT '� � P/C o ADDRESS y DATE �� �� ` NUMBER � � # � APN LOT �2$ TRACT 52267 ISSUE TYPE OCC DATE CONST. GROUP p OWNER Puite Home Corp. �''" ADDRESS 'L$4O� llon Karman AvP Su 7_(10 ZONING SET'BACKS z CITY Irvine ZIP 92b1ZTEL. 9�L9797lF4OO FRONT RW ❑ $ APPLICANT TE�. REAR ❑ SIDE/SIQE STREET RW ❑ � CONTRAGTOR SIDE ❑ � ADDR�SS d CITY ZIP TEL. PROPOSEDUSE SEWER LATERAL ' o ARGWENG/ �z DESIGNER NO.DWEL. NO. NO. 0. ADdRESS UNITS STORIES BEDROOMS ' � QITY ZIP TEL. N DESCRIPTION S4.Ft FACTOR PSF ADJ.AREANALUATION , � 0491NER-BUILDEADECLARATION SFR/ADD/REM ' O "� ', Q I HEREBY AFFIRM UJ10ER AENALTY OF PEAJURY THAT 1 AM EXEMPT FROM THE CONTHACTOqS LI- Qyf898/CaiP01f � � � . � � � '�, L1J CENSELAWFORTHEFOLLOWINGREASON(SEC.7939.58USINESSANOPflOFESSIONSCODE:ANYCITYOR ' (J, G7 ()OUNTYWHIC6IREWIREEAPERMITTOCONSTRUCT,AlTEF1,IMPROVC,�EMOLISH,OflREPAIRANV6TRUC- ' �,j,� PatiolDeck � 7UflE,PRIOR PO IP3 ISSUANCE,ALSO REf3UlRES THE APPLICANT FOR SUCH PERMITTO FILE A 91GNED ' ' W STATEMENT THAT h!E OR SHE IS LICENSED PURSUAhT TO THE PROYISIONS OF TFfE CONTflACTORS LI- � �'. � c -CENSE LAW(CHAPTEfl 9(COMMENCING YJITH SECTION 700C)OF DIVISIQN 3 OF THE BUSINESSAND PRO- �'�" POoI/Spa �. � AE5510NSCODE)ORTHATHEORShE15EXEM9PTTHEREPROMANDTHEBASfSFOfiTHEALLEGEDEXEMP- i , V �TION.ANYViOLAT/�AlOFSF_CTION9a39.56YANVAPPLICAN7FOqAPEAMITSl18,iECTSTMEaPPLICANTTO . � RB-Raof ' � ACIVILPENALTYOFNQTMORE7HANFIVEHUNDREDDOLLAFlS�5500J.): � . , � ❑I,AGOWNEROFTHEPAOPERTY,ORMYEMPLAYEESkN!iHWAGE5A6THEIASOLECOMPENSATION, � COfI1R18fC18I � , � . . . WILL 00 THE WOHK,AND THE$YRUGTIiRE 1S NOT INiENDE�OR 6FFERED FOA SALE(SEC.7044,BUSI- � � � ..NESSAND PROFESStONS C4DE THE C6NTRACTOAS LICENSE LAW DGES N6T APPLV TO AN OWNER OF � � � � ' ''�PflOPEflTYNMOBUIlD50RIAAFROVESTHEREON,AN��WHODOE55UCHWORKHIMSEIFORHERSEIFOR � � � tL .THROUGHHISORHEROWNEMPWW6ES,PROVIDEOTHATSUCHIMPROVEMEhTSARENOTINTENDEDOR . , O ..,.OPFEREDFOfiSALE1F,HOW`eYER,7HEBIJIL0INC�ORIMPFCOVEMPMISSOIDWRHINONEYc4ROFCOMPLE- � �TION,T4i6 OWhER-BU�LDER WlLL HAYE 7HE BURDB�t tl:PpOVING THAT HE OR SHE DID NO7 BUILD OR j � � ��IMPFlOVEFOPTHEPUFtPoSEOFSAI.E). . � I - � ❑1,A50Vf.NER OF TNE PROPERTY,AM EXCLUSIVE6Y CONTAACTING Wl7H LiCE1dSED CANiRACTORS 'd .T9 C4NSTflUC7 THE PRQIECY jSE6.To44,SUSINESS AND VPOFE5310N5 CADE:THE CONT4iACTORS U- V8IU8IlOfi ' AD.I.AP.EA .W '�.GEI45ElkYdDOFSNOiAPPlY7QANOWNEROFAPflOPERTtlWH06UiLDSORI?APROVESTHEflEQN,AN� , I '�� :WFIOCOPffYiACTSWASUCNPROJECTSV�lITHACDNTRACTOR�S)UCENSEPPURSUANFTOTHECONTRAG '�UP.NTlTY GESCRIPTION . FEE � ,� .,TORS IICEWSE tAW.i. � . . — o ❑I AM EXE�OPi UND'cR SSC. _6.S P.C.FUfi THIS REASON �U j � � �, W � DATE ___ OWN'cR__ __ __ ��i L41 o LICENSED CONTRACTQRS 6ECWRATIOM �-�j � � '�1 HEREBV AFFlRM UNCSN PEPdAL7Y tlF PEFUiflY THhT I AM UCENSED UNpER PROVISIONS OF CHAPTER '�� � . . � � '�,�,,,� �,�9{COMMENCINOWITMSECTION7oW)OFDNtSiON30F'THEBUSINESSAN�?ROFESSIONSCODE,AND � ' � . 'X;���MV tICENSE 15 N FULL FOfiCE AND EFFECT. - LLl '�� �� �5 Q �, i 410ENBE CLASS LIC.NO, � �� � _ �. ,. - � �O�ATE CONTRACTOR 0- W � aNORKEflS'COAh�ENSATION DECiARA510N a � 1 , � tHERE6YAFFIfiMUNDEAPENAL7Y4FPERJURYONEOFTHEFOLLOWINGDECLARATIONS: Z �, �iHAVEANDWILLNAINTAiNACERTIFICATEOFCONSENTT09£lF-INSUREFORWOqKERS' �� Q COMPENSATION,p5 FROVIDED BY SECTSOtd 37o00F THE LPHOfl CODE,FOR THE FERFOflMANCE +U OF SFiE WORK FOR WNfCH TH:S PEflMIT IS iSSUED. ,� � _IHA�/EANDWILLMAINTAIFdWQRKcRS'COMPEN$ATlONlNSURANCE,ASREQUIREDBVSECTiON � o, 37ooOFYHELABORWDE,FORTHEPERFCRMANCEOFTNEWOPlCWRWHICN7HISPERMfT15 _,J. iSSUE�.MYWORKER5°C04tPENSATIQNIPJSUR&NCECARRIEAANDPOLICYNiRA8E0ARE: CONSTRUCTION � caaRie�a PLAN REVIEYJ Z� FOLICY NUMBER__ ELECTRIC - d Q, (iHSS:-G'Y�'Nc�kX�TBEIX�APLEfEDOFTHEPERWiISFCNQYEHUf�PEbD:tLARS.�*osW)ORLESS). ' PLUM6ING �'�, '� 1 CERTIFV SHAY IN THE PERFORMANCE OFTHE iNOAK FOR WNICHTHIS PEfiMIT i51SStlE�,1 MECHANICAL _______ �i (J'' SHALL NOT EMPIAYANV PERSOfJ IN M�V MANPI�R 50.45 TO BECOME SUBJECT TO THE S I, '�j,.� WORK6R5'COMPENSATIONIAWSO�CALiFQFP4IA,ANDAGFEETHATIFISHOI'LDBECOME INSPECTIONFEE '�, �, SUBJECTTOTHEWORKERS'COMPENSATIONPHOVISIONSOFSECTION37UOOFTHEIABOR v�`� :�� COOr.�iSHALLFORTKWITHCDMPLYWiTN7HOSEPROVi510NS. ISSUANCE � ����� SMIP � �y. DATE: ._ APPLICANT: . .���,�. WAqNIYGFA1LUflETOSE�JREYdO@KEftS'COMPENSATIONCOVERAGEISUNLAWFUL,ANOSNALLBE ENERGYP/C _ ''i LL,' SU3JEGTANEMPLOYERTOCRIMINALPENALiiESANDGN!LFINESUPTOONEHUNORE�THOUSANO ENERGYPERMIT � DOLLARS($10o,Wol.��AD�iT10NTOTHECOSTOrCOMPENSATION,DAMAGESASPHOVIDEOFORIN J�. SECTION37080FiSiEtABOACO�E,INTER'eST,ANDATTORNE`CSFEES. RETENTIONFEE: Lr', ,OII CONSTRUCTION LENDING AGENCY pRE-ALT FEE: ___ _ ,��� IHEBEBYA�FIRMUNDEfiPENALTYOFPERJURYTFiP.TTHEREISACONSTRUCTIONtENDINGAGENCY � FOR YHE PERFOHMANCE OF iHE WORK FOR N'HICH THIS PeRM1715 ISSUED(SEC.3o97.qV.C.). . .L�llh. . �. �.�I� LENOER'SNAME_______._ _- , 1_-' LENDER'SAODRESS �.� � IC=i777FYT9iA71HAVEREADTH;SAPPLICd710NAND5TATETHATTHEABOVEIUFORMATIONISCARRECT. �VTAL FECS ' _ . �-'� � .,�;,� IAGFEETOCOMPItlWITHALLCINANDCOUNNORDINANCESAN�STATELAWSREl.A71NGTOBUILDWG . . ,�; CCNSTRUCTION,ANOHEpEOVAUTHOPIZEREPRESENTATIVE50FTHISCOUN'lVTOENTERUPONTHE � , .�,,�, AWVEMENTIONEDCROPERTYFONINS CT{ONPVAPOSE5. COMMENTS -� ��.�'.,. . . . J.' �'. .:,a;.'�,. PERMITTEE AMEI+'RINT � � ' � '�,�'..', ������ - ' � Uj'. SIGNA E O PERMITTEE DATE X�,, i?ECPT.NO. 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