HomeMy WebLinkAbout18212 � _ ... . . _ .
_ _. ----- - -----__ _------- -
J� CITY OF DIAMOND SAR /'—'�—'
� DEPARTMENT OF COIWv1UNITY 8t DEVELOPMENT SERVICES ,l�
21825 E.Copley Drivc
(909)860-3195 Fax(909)861-3117 PRESS
"'%:� BUILDING PERMIT APPLICATION FIRMLY
o� JOBSITE �,AN `«� ��� APPLICATIO G y PERMIT P/C
ADDRESS DATE NUMBER �•Z Z'#
c� ISSUE TYPE OCC
APN LOT�-�_ TRACT DATE 2� � CONST. GROUP
p OWNER
"" ADDRESS ZONING SETBACKS
z CITY ZIP TEL. FRONT RW ❑
g APPLICANT TEL REAR ❑
SIDFJSIDE STREET RW O
� CONTRACTOR SIOE ❑
� ADDRESS PROPOSED USE s� � F
� CITY ZIP TEL
o ARCH/ENG/
z� DESIGNER NO.DWEL. NO. NO.
a ADDRESS UNITS STORIES BEDROOMS
� CITY ZIP TEL.
c�n DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION
p� ONMER•BUILDER DECLARATION SFRlADD�AEM
O
p I MERE6Y AFFlHM UNOER PENILL7Y OF iERR1HY TNAT I AM E%EMVT iPAM TME CONTMCTORS U• (a`af0g6/CB�OR
W CENSEUWFORh1EFOlLDW�NOREASON(SEC.70.71.6BUSINESSANDPROCFSSIONSCODF:ANYCRVOR (�
U �UHTYyMIGMRE0U1RE5AGERMITTOCONSTiIUGT.ALiER�MPpOVE,DEMOUSM,ORREiAIRANYSiAUC- W Pdt(0/DBCk
Z NNE PRIOR TO R3 ISSUANCE ALSO REOUIqES TNE APGUGN7 FOk SUCH PERMIT TO FlLE A SIGNEO
� 8TATEMENT THAT HE OR SNE IS LICENSED PURSUANT TO THE PROV4510N3 OF THE CONTMCTORS U- LL
� CENSE UW(CHAVTER Y(GOMMENCINO MATM SECf10N 7000)OF DMSION 7 OF THE BUSINE55 AND PRO- P��Pa
FESSqNS COO�OR i1uT HE Oi15HE IS E%EUPTTMEREFROM ANO THE B�SiS CON 111EALlE6ED ExEMP•
� TION.ANYYIOLATIONOFSECTION70]7.6BYANYApPLIGMFOHAPERMITSUBJECiSTHEAPPLICMlTTO Z Re•Roo}
A CIVIL FENitLTY OF NOT AIORE Tl/AN FNE FIUNDHED DOLLARS If SOOI.k
� OI.ASOWNEROFTHEPROPERTV,ORMVEMPLOYEESWiTNwA6ESA57HEIRSOLfCOMOENSATION, O (+'pmmBfCiB� '
Z WILL W iME WORK,ANO i}1E STRUCTUfiE IS NOT INTENOED OR OFFERED FOR SA4E(SEG 7a1.BU51• J
NE55 AND VROFESSIONS CODE 7ME CONTMCTORS IICENSE lAW DOES NOTAPVLY TO AN OWNER OF
N VROVERTYW1108UI1D30R�MPROVESTHEREON,ANDWHODOESSUCHWORKHIMSELFORHERSELFOR = '
CL 7HflOUOMHISORMEROWNEMPLOYEES,PROYIDE07HATSUCHANPROVEMENTSARENOTINTENDEDOR m
w OFFEREDFORSALEIF,/IOVhYE0.1HEBUL0INGOHIMPqOVEAIENTISSdDWI7MMdJEYE�ROFCOMVLE-
� T10N,T11E OWNER�BUILDER WILL MAVE THE BUROEN OF PROVIN6 THAi ME OR SHE DiD NOT BUILp OR
Z tl�IPROVEFOHTHEPURPO5EOF5A�E1.
= Olti.`OWNEROF7HEPHOPERTV.AMEXClUSNELYCOMiUCTIN6MATHLICENSEDCONTMCTOliS
Q TO CONSTHUCT T/1E VRQIECT(SEG 7DH,BUSINESSAND PROFESSIONS COOE:THE COMMCTORS li• VdW911W1 ADJ.AREA
W �NSEUlW00E5NOTAPVLYTOANOWNEROFA7ROPERTYMlI�OBURDSORWPqpVE3T11EREON.AN�
� NTIOCOMMCTSFORSUCHGR0.JECTSWITIACW�TMCTOR�S)IICENSEDPURSUMRTOTHECONTMG QUANTITY OESCRIPTION FEE
� TORS UCENSE LAW.).
� O I AM E%EMPT UNDER SEG e.t P,C.FOH 7HI5 PEASON U
� Q
�l" W1E OWNER U
Z W
� UCENSED CONTMCTORS DECIAHATION W
� I MEHEBYAFFIRM UNDEN PEN/LTY OF VERRIRY 7HAT IAM LICENSEO UNOER GROVISIONS Of CMAPTER Ur
p„ Y(COMMENCINOWfTHSECTION7000)OFDMSION70F7HEBUSINESSANOPROFESSIONSCODE.�ND Z
� MV UCENSE IS W FULL FOPCEAND EFFER m
0 L�CENSE CUSS UC.N0. J �
V OATE CONTi7ACTOR a
W
� WORKERS'COMPENSAT�ON DECLARATION a
N INEREBYAFFIRAAUNDERCENALTVOFVEiWRVONEDFTHEFOLLOWINODE0.AMTI0NS: V
N �
� _IHAVEAN0IMLLIMINTAINACERTIFIGTEOFCONSEMTOSELFJNSUHEFOfiYVOFKERS 2
COMPENSATqN,A9Pi10Y1DEDBYSECT10N�7ooOFTMELMORCODE.fORTHEFERFORMANCE W
OFTHE WOHK FOR WHldi THIS OERMIT IS ISSVED. �
G
_I M�VE Ml�WILL/MiMAIN WORNE0.5'COMCENS�TION INSUqANCE.AS REOUIREO BY 9ECTION / O�
� J700 0F THE UBOR CODE,FOR THE PERFORMANCE OF THE WORK fOR WMICH THIS FEN.�IT IS /�
tS5UE0.�YMIORKER5COM0EN5AT10N�N5URANCELARRIERANDPOLIGYNUMBERME: CONSTRUCTION !I
j CMRIER PLAN REVIEW
� POLICVNUMBER ELECTRIC
� (nassEcrpr+rhmwrBEaw�imoF7�nvr.�rsFoaa�fuwr�ooau.u�sp+oqor��¢ss} PLUMBING
Z ICERTIFYTHATINTNEPERFOPMANCEOFTHEWOFKFORWHIdITHISPERAIRIS�S5UE0.1 MECHANICAL
C7 SHALLNOTEMPLOYMiYPER50NWANVMM7NER50A3TOBECOME3U8JECTTOTHE
UJ VIORKEAS'Cd.IVEN5AT10NUwSOFCALIFORNItiANDAOREETMATIFISHOULDBECOME INSPECTIONFEE
S SU&7ECTTOMEWOHKERS'COMPENSATIONPROVISIONSOFSECTIONf7000FTHELABOR
caoe.i snnu ronrnwirn c�rav�r hnn�r�ase rHovis�or+s. ISSUANCE
� SMIP
p W1E: APPLICANT:
W ENERGY P/C
� WMNINO:FA0.UHETOSECUREWOW(ERS'COMPENSATIDNCOVEMCEISUNUwFUI.AND5HAL4BE
�y SU&IECTANEMPIOYERTOCPIMINALGENALTIESIWDCNILFINE5l1CTOONEHl1NDHE07HOU5AND ENERGYPERMIT
pOLLARS(f I0o,000),IN ADDITION TO THE COST OF COMPENSATqN,OMtACES AS PROVIDED FOR IN
¢ SECTIDN�lOeOFTHELABORCODE.NTEREST,ANDATTONNEY'SFEES. RETENTIONFEE:
a CONSTRUCTION LENDING AGENCY PRE•AL7 FEE:
O
� IHENEBYAFFIRIIUNDERGENAITYOFPERIURYTHA7THEREISACON57RUCT10NLENDiNGAGENCY
FOFI TME PERFOfiMANCE OF TME WOqK FON VMIGH TMIS 7EN�7IT IS ISSUED(SEC.70G�,CIV.C.).
�
� LENDERSNAME
C IENDER'S/�DNE55
W ICE�IFVTHATIHAVEREADTHISAPPL�C�TqNANDSTATETIIATTMEABOVEINFpR/AATIONISCDMECi TOTAL FEES /�^O• e`•
� I AGREE TO CO�M7LV N7TH ILLl CITY ANO COUNTY ORDMANCES M1D STATE UWS REUrNO TO BUlDINO
� CONSTRUCTKKJ.ANDHEREBYAUTHOPIZEHEPRESEN7A71VE5OFTHISWUHTY70ENTERUPONTME
Z ABOVE�MEMIONED PROPERTY FOR INSPECTION OURVOSES. COMMENTS
p v ✓
� �L L�
m VEWdI - �NT)
y ��� �O
N SIQN D�TE
� _ FECPT.NO. PAID BY VALIDATION
WHITE-0epartment Copy,YELLOW—Finance Copy,PINK—Assessor Copy.GOLDENROD—File Copy,GREEN—ApplicanCs Copy
,.,..._.._�• -� �,. �.: ,...-r•�•:�. . ...._.� —:,-..-.p•.....,-. ,..;- �.`-i ..,. ,� .'i:_ . . .-.n .. - s '^"' . .�.s. .. .� . , ., .. , . ��t,- :+� .�..- . , -� � '-. . �
. .., . , _ ,�j i
CIT�( O� DIAMOND BAR
IhlSf�E��i'tOtr! RCCOt�D
. ._ _., , . , ----�.
,�
1.�`.�1:�������1 _ �����-� ;.(.`�����-- yJ.���f���;���[�1�� - ���:��-� . � ��� �"�!i�.��
,� - .
�.__..._._.__.... ___ _.._._.....� ., .�.._ . _ . __.._. --_.�._._. -- - - -. < �
SET BACK f � FLOOR JOIST •• , �
FTGS/FORMSlSTEEL I FHA REQD1ITS
ELECTRIC GROUND ' UPdDER FLOOR DUCT
GROUNb PLUMBING I UNDEp FLaOR CUt�IDIJIT
SLAB GRADE FIREPLACE FOUNDATIaN
TEMP POWER � FIREPLACE BOND E3EAM
WATER SERVICE I � i MID HT.80ND BEAM
ROOF SHEATHING 8 Ff.BONO BEAM
FRAMINGNENTILIATION FINAL BOND BEAM
ROOF COVER PRE-GRADING •
ROUGH HEATING BENCHING
� ROUGH ELECTRIC ROUGH GRADING
' ROUGH PLUMBING � ; � FINISH GRADING
SHOWER/TUB l"EST I ' POOL ELECTRIC
I EXL LATH/SIDING 'i POOL FENCING ;
WALL INSULATION � POOL FINAL
CEILING INSULATION � I OFF SITE IMPS.
DRYWALL NAILING DEDICATIONS
SEWER FINAL ENG.
SEPTIC TANK i LANDSCAPE/IRRIG.
SEEP PIT/L.L. ! ON SITE IMPS.
GAS AIR TEST � FINAL ZONING
�INAL-CONST. ��� � � �!RE DEPT. FINA!.
FINAL HEATiNG ' j ' HEALTH DEPT. FINAL
FINAL ELECTRIC � DEV. FEES PAID
FINAL PLUMBWG j ENERGY I
� I �
� ' � c :i��r di:;c�c c; . �, i
�.,:.._..
COMMENTS
SEPTIC TANK SIZE
SEEP PITIU SIZE
_. . ,I��
�
_ _ ;
;
:, � r
�
- ;
;;���� � .,;.�,,
I
, - , 'I, .. , �
_�.�_......��.�__. --.--r _ , ,
