Loading...
HomeMy WebLinkAbout16402 (22) I � CITY OF DIAMOND BAx --- -- DEPARTMENT OF COMMUNITY&DEVELOPMENf SERVICES � j � 21660 E,Copley Drive Suite 190 (909)860-3195Fa�(909)861-3117 A�e. .. :-�_: ., ,,. ,�.>.�., ; t PF�E$S' s��� BUILDING PERMIT Al'PLTCA"T�(�N FIRMLY 0 ADDRESS 3 L� Z.'rL ��'SI��L'. ��Ur'L�, ��D.r1 C�. APPLICATION I_,.� PERMIT ('� P/C DATE 1""���� NUMBER � ��-+� � ISSl1E � TYPE OCC APN LOT TRACT DATE CONST. GROUP p OWNER ��-F.4• I�1�� L. 5ni t l� � ADDRESS ('1 S''1�I�.00_J-.' �(�G I ZONING SETBACKS � CITY n" + t > ZIP�� TEL.�1 U`'! S`�Q �5� FRONT RW � APPLICANT�Ar"�F' TEL. REAR ❑ � SIDEJSIQE STREET RW ❑ � CONTRAC70R �� � SIDE ❑ � ADDRESS PROPOSED USE � CI7Y ZIP TEL. oARCH/ENG! Z DESIGNER NO.DWEL. NO. NO. � ADDRESS UNITS STORIES BEDROOMS = CITY ZIP TEL. � DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION y � OWNER•BUILDER DECLARATION SFRIADD/REM O [', I HEHE9Y AFFlRM UNOEF PENPL7Y OF PERJUIiY 7HAT I AM EXEMPT FROM THE CONTRACTORS U- GBf89B/CBfpoR W CBISELAWPDR7HEFOLIAWINQREA^„ON(SEC.7o37.58USINESSANDPROFE5510N5CODE:ANVCITYOR (n U COUNTYWHICMFE041HESAPERMITTOCONSTRUCT,ALTERIMPROVE.DEMOLISH,ORREPAIRANYSTRU4 W Pa4iolDeck wTUFlE,PRIOR M 1T9 19SUANCE,ALSO REOUIRES 1HE APPLICANT FOR SUCH PEFAIIT TO FII.E A SIGNED W � 51'ATEMENT 7HA?HE OR SHE IS LICENSED PURSUANT TO THE PAOVISIONS OF THE CONTRACTORS lI� � CENSE LAW(CHAPiER 9(COMMENCiNO WITH SECTION 7000)OF DIVISION 3 0F h1E BUSINESSAND PRO� � POOUSpa FE53qNS CODE)Oq THATHE OR SHE IS E%EMGT7HEREFpOM ANO THE BA515 FOR THE ALLEGED EXEMP• TION.ANYYIOLA7WNOFSECTION7o97:58YANYAPPIICANTFORAPERMITSUBJECTSTNEAPPUCANTTO Z Re-Roof F,,, ACM�V�AlALTVOFNOTMOiIETHANfNEHUNDAEDDOLURS�S5oo).�: � dl'fA50YRiEROFTHEPROPERTY,ORMYEMPLOYEESWITHWAGE5A3THE�RSOLECOMPENSA710N, � ComnlBfCifll - WILL DO THE WORK,ANU TIiE STRUCTURE IS NOT INTENOED OR OPiERED FOR SALE(SEC.704I,BUSI- J NE55 AND PFpF&SSIONS CODE:TME CONTRACI`ORS LICENSE lAW DOE5 NO7 APPLY TO PN OWNER OF � PflOPERTYNM1p9UILDSORiMPROVESTHEREON,ANDWHODOESSUCHWORKHIMSELfORHERSELFOR m � THROUGH HISOR HEN ONiN EMPLOVEE$.PROVIDED THAT 5Ud1�IMPROVEMENTS ARE NOT INTENDED OR W pfFgiEpFOp3µ,EIFFIOWEVER.TiE9UIlDINl30RIMPROVEMENTI550LDWR'HINONEVEAROFCOMPL&- Z �TION,THE OWNER�BUILDEF NnLL HAVE YHE BURDEN OF PROVINCi THAT HE OH SHE DID NO7 Bl11LD OR � NdPROVEFORTHEPUliPOSEOfSALE�. '� '"� - � � � � ❑I,AS ONMER OF THE PROPEHTV.AM El(CLUSIVELY CONTRACTINO WITH LICENSED CONTRAC70RS � 70 CONSTRUCT THE PROJECT(9EC.7oN,BUSINESS AND PROfESSIONS CODE:THE CONTMCTORS LI- VdIUBtI0f1 ADJ.AREA W CENSELAWOOESNOTAPPLYTOMIOYVNEROFAPROPERTVWHofiU!LOSORIUPROVESTHEREON,AND � WFfJCONTRACT5FOR5UCHPRPlECT3WITHACON7RACTOR�S)LICENSEDPURSUANTTOTHECDNTRAP QUANTITY DESCRIPTION FEE � TORS LICENSE LAW.). .. ❑1 AM EXEMP7 UNDEH SEC.������ 8.&P C.FOR THIS REASON Q ' l" E- ��yx 3 U , � CL � - .L" � - /L�� � V' DATE ONTlER �' /-' � � W .1� .''%'L C1 e.' .. C !C °. �� LICENSED CONTRACTORS DECLARATION �j ' � � . E` . ,� � I NEREBYAFFIRM UNUER PENALT'OF PER�URV TH�T I AM UCENSED UNDER PROVISIONS OF CNAPTER � .t� � Y(WLIMENCINO VATH SECTION 7000)OF DIVISION 30F THE B1151NE55 RND PROFESSIONS CA�E,AND Z �� � MYIICEN5E1511VFULlFORCEANDEFFECT. m 0 � �,,._ LICENSE CUSS LIC.NO. J V DATE COMRACTOR d W � WORKERS'COMPENSATION�ECLARATION —� U � IHEREBYAFFINMVNDERVENALTYOFPEFWRYONEOFTHEFOLLAWMGDECI.ARATIONS: � Z Q � ^IHAVEANDWILLMAINTAINACE(YT(FICATEOFCONSEPfTTOSELF-INSUREFORWOflNERS' 2 COMPENSATION.ASPROYIDED6YSECTON370DOFYMELABORCODE,FORTHEPERFORMANCE 'U OF THE WOFiK FOR WHICH THIS PEqMIT IS ISSUED. � O W _iNAVEANDWILLMAINTAINWORKERS'COMPENSATIONINSURANCE,ASpEOUIREDBYSECTIDN Q 37000F THE LABOR CODE.FOR THE PERFORMANC[OFTHE WORK FOA WHICH 7HiS PERMIT IS ISSUED.MYWORKERSCOMPENSATN�NINSURANCECARRIERANDPOLICYNl1M8ERARE: CONSYRUCTION yCARRIER PLAN REVIEW (� � POLICYNUMBER ELECTRIC .l v � (iHts9EC7qNNE�NOTBEOJNR,EiIDOFnffPEf7NTI5FORaJEHuwReDDOI.LnHS(Stao)ORlESs} PIUMBING w MECHANICAL Z I GERTIFYTMAT 7N TME PERFOpMANCE OF THE WORK FOR WHICFi THIS PERM�T I5 1SSUE0,l � SHALLNOTEMPLOVANVPERSONINANYMANNERSOAST08ECAMESUBJECTTOTNE Vj WORKEHS'COMGEN511TION UWS OF CAIIFOftNIA,AND AGPEE THAT IF I SHOULD BECOME INSPECTiON fEE SUBJECi TO THE MfORKERS'COMPENSATION PROVISIONS OF SECTION 370o OF THE LABOR -rj CAOE,i SHALL FORTHWITH COMPLY WITH THOSE PROVISIONS. ISSUANCE _ N _ / ♦ � SMIP ' p OATE: APPLICAM: , . � ENERGY P/C J�[7 C! 'B 42 �l i I '� . . WAflNING:FAIWRE TO SECURE WORKEflS'COMPENSATION CAVERAGE IS UNLAWFUL,AND SHALL BE '/�'�'Ty�T.. �y SUBJECTANEMPLOVERTOCRIMINALPENALTIESANOqVILPINE5UP700NEHUNDREDTHOUSANO ENERGYPERMIT DOLURS(f700.000).IN 0.�URION TO THE COST OF COMPENSATIDN,DAMAOES A5 PflONDED FOR iN � SEC7'ION970BOF'IHEIABORCODE,INTEREST,ANOATTORNEY'SFEES. ��'ENTIONFEE: � CONSTqUCTION LENDING AGENCY pRE-ALT FEE: � —•-��--' _...-..—_.___._..._... _. � IHERE9VAFFIRMl1NDERPENALTYOFPERJURY7HATTHEREISACONSTRUCTIONLENDINGAGENCY fOR THE PERFOqMANCE OF THE WORK FOR WHICH THIS PERA11715 ISSUED(SEC.9091,CIV.CJ. Z W � LENOER'S NAME , H LENOER'SA��RE55 '/�1 /� � WICERTIFYtHATIHAVEREADTHISAPPLICATIONANDSTATETiATTHEABOVEINFORMATIONISCORRECT. TOTAL FEES . / /,� � IAGFEETOCOMGLVWITNALLCITYANDCOUNTYOR�INANCESAN�STATELAWSiiELATINOTOBUIIDING ( f CONSTfiUC7�ON.AND HEREBY AUTIK)RIZE flEPRESENiATIVES OFTHIS WUMY TO ENTER UPON 7HE ZA80VE-MENTIONEOPHOPERTYFOHINSPECTIONPURPOSES. COMMENTS _ "()��,�0��€ 1,.. ,r�'n t�� .l� m PE�WIiFE NAME�PRINu - � � � ``'�.. � U ��� ��, ''�J� Ut) � � - �j SIGNANHE oF PERMITt E ' DATE _ = RECPT.NO. PAID BY VALIDATION � WHITE-0 flrtment Co YELLOW—Financs Co PINK—Assessor Copy,GOLDENROD—File Co GREEN— eP PY, PY. PY. APPlicant's CoPY .. . .. . ..... . . ,,, ,. ...;: ,,,., ., , , , .�.. . , ., , ,, , . �. r .. . _, w. . .r , � . �, ���� � � .:. ��� � ��� �� . � . �r w � p �` � , � ffi � � � � � . � � .,, $ � �. ���. � � :; ,� ... _ ��. �� ` .� �, :, � ,�,� �. ` ���C 'r�d�`',��t� � '� r ._ � � F �. � r �� � ''� F'� C}���Jt.,?�7 :—_ _____ � _ �� _�� .:_ _ _ ---�—~� �- _ -- —.. __ �r"�"�. I�:. ���!�.�°art��s_ i ;' ��N�`,��~���,�a � s _._ _.. _____� _.___.__�-.__. _�. __ __.__.._ _�� ___ �L�"`��°+:���iC�t?"J�• ;___------ t31vt;��t �L�`JE)�?�?°s^�" g ..��._ _ �____.__�_. ___ �_ _____.�____m__ _._ �.___ �-- ,�� : � rqc � � � a �� � n �,�^ �a �st�a L �. :�s:,�a-a.v9, . [ � ��� ,, , i �..P�}n c,C,a�II�L�!r , _ ._.���� ` � __ � _._.�___ __._� ._. __ � �_.._.____� � --, # :n��*�-����F=�:.�� � � _e:._.� �3r,�s-'LA�� �C1i.7]'J.���,�6.��fi�a �. I � . � �_______. , � _,_.. �i��t�st- `���'�"� � ` , , �����-�L�t:�����°���5���.r1 ? -� _a _______� — __.__ __..___._ _.._____ -- —__ _� __ ___— --; ' G$��� � :c �� _�___._=_� ! . � �iR�� ��' E?t?i+�L?�3��[�� � '" ; rw,m_��+.y_____ rs �(pp�p��_____ , __.�.�.._.__y____��.:._z^^�° [^;__ i ¢y.�p��,. ___ __ ______._ ' �t�tJ� -.����'�'��h?�tS'u�.„8 ' .. . ; .. . E _ -�..`.,..� ' � . � "'i J��'d� d'J�._.'M€Yl �..,,,.._.__.e.�-.�.._.�...__� .._.,_. .�. . .__...y. �_�_ .�....._... q �+ ,� � qp� _'�........._....-- p^� a,�-y� _g_�' 1 -�-.,. g .. _._g , _. �„. ........_-�- "'""`____.� �S'""�` at(Y t��+.,':3�v1 t*a 6.�i",,..€`'�^'s����s3'F �� �I��d"�C i'�@`s�'S €S�d'4SY7 1 i gg � x ... .. ?�._.- .�.._ .._... I.�.,.._. ..._.._ ._..�_ . .�5 "�_�_,�`-'� �� ..�rt.�._-_...,���� _L� s'`�-�,� Ca�#��}i�V+a __._ � �_.._ �.._.___.,_. �__...�_��.�__ , �_ � =��`'as�.�3't �^3'����''� � 1 t i ����9��i'�`4�`a i .... ............._�,y.„..�_.--:-�-.—�-�i ---- - —"`-Y'E.�.._ . ... _..__��. .�._.__"'__,....._.�. ..� ..... ...._.....�.__ ____... �« -_s_. ���.�"`d�� f �"i rt`'�"-'g�`; [ ( Fl�'3L �i-s Ct?t`"�1C''�i v - � �. ____W.____ _____..--- —� _.�____1_�.__ i �"��'"�-i ?' �� 't��'��d...__�[.�. s '((( FEVI�r-���4�;�i�C: � s _ � . y{{„„„ .__._.__u__.._�.__.�.._.__.:.___ __. �._._ w_._ __ ( p �-e-}-�}g+^+. __ a `rF'"z 'E���t-�����'� :�".�. (, 9 .��rPou__��T"i..�..�...)��`i.�te 3!"i[Ls � ( � .... .- .. , .__"..�,..._....�1_.._............._�._..._,.e,.,...m.. .�.....� .__ .. ._ ..., .w...._.;__"'-.,__ � �� �...������._�� � � ��������i€�`�� � i �J __ _. .�. __. _...,._n..AP...__. � �.....j _..,„,--_.w.w. _ _ q� q �9�y g r-}�p j ! � 4$�f'6�. S `d.:i�� �"5€ ��' ' � il.)�fl». 9t��L � �_. L ....—. .�4. ___..._._�.._ �....._.�.�..-.,....�_ �..._ _ .._ _.-�.__..e._ ._.-,...� . _._.. _. :in� ���ga ,�s�` t.�1����; ? � �rI �3t F`'��>.:$��ri��, ; � ___._.�..___._.._�. ._._ .____��...._ _�.___._ _�. ._.. �����'�,��. �5�� E°�t� � � i ' �' C�� As?��L� � _ ..�.��....._. � _._ �° _�__.___.___- _.__v__w .._a �. �a��? � f _` i j Fa���� ��C�: �.... ._. � 3 . �... _._ .._........._ _....,..-, .�.M_,._ ... .... . _...._........_.—._...,..� .�_._..... _ . ___�.�»n_.r._........._.,. . . -I----- . . _. . . __ �o-'`�1�� st�'^�� � € ' � �.IE���� 6�''� 4i��'�(�, y ....�.�.__. _� �______�.____�.____� �.___ ___..._.__. _�__L.... _..va a �L't��.' �7��1: � ° �.�'.�'�'� ���'m r�lF��.;. _�. .._ . . V ...�.. __�.-.--.�, _���......�w_ .�...�.....,�.....__._.�...n.�. �. .__. ...�._.. .. . � -. 3 � .., .� r �..�._...�.... �_._..�......__.. ��1��s� ;��( I � I ; ���I:�:`=...��.'��t� � � _ _.. _u�__�__�__ ._._ .___ . , 7 _�...__ i�..�....�. - . ._� ..�.._...�.......�...,_.�...� ��£:�qP�i, �".`�`�"''� , ' , ' �� -- r „,s _ �..�._. _._�____�._ ___-__.. � " � ' i-�� a..�r �" �`' 9_ i .µ.__..._�_....__..�.�..__.�.M_�_._�.. j �a�....��...____E � � � s =� >�� �� ....' ' ` � � � �� � �- � � � ���� ��� R , � � �mm�lC���,�C : � i � 1���� •- � __ __ " � cros��a �,�:�" �-���; ,.��� .�\ __ �+-�1. �:=������ � � .. �. � 1� .�_ -����. ___—_ _� _._.�..,__�_.____. _u_.._�_� �_ I � _.� __.___�., �------ e �a� �� � �.����� ��._ ` --.._�._._LL— ����a:�� �� � _.._�_._d ____ a - , �m _ �_. + _.,_� _ _ ___�_ �...� p i I � ���_..�._____.__ _��______._._ . _ �_ ��_ ._ _____�. � .�-� � , � �.��.�.� ____�.�..��__-____- , -.. : � �.._.��.._'.�_ � __a__. � , _�_��.� _�_._�.�____+ ____._�.._.�� ,;.,�_ �� �����-�,, _ �A���;�6=���a� ��.. � r�_. _...._.._._..a._.��_ __._.______._.��.�..___._� ._._..__�._.__..._o��. .� �._.._._ �m .��_�.a.�_�.._�.�. ___......_� , ; ��._��� .......___..�.,______.___.__�._..__.._.�_.___.._._.._..._w_.__.__._�.__.___.�.______.__._._..... ._..__�.__µ___ ..__.,__._._._._____.�..._-� � � ��r ..,________.._ . .:__. ...._._.. __ ..__ __.. _.. __� �.__........._�.m.d___.___ _....._____._.�__.�a.__�_� _.�..___..__...�._, .� _._....__. _____V.....---.___. _�._.._.___._.�_.______.__'.__._.._ _.� �_ ._ -e ' _" �._ _ �.__ �_..�_.__..� .�.� � � s _.�..,� .._._____a __..____....__ _._...�___. _��..,�___ _. .._. _._.__�.._._....._,___�____________.� � � .__,�����____ _.. .._.�._....�.. .�.� .._ _...�. _�...��_.�.� _ ;:, { • , r t; c ... r;.,. , . � W� ' ._.m.��___. - TM ' � __. �. ___._,__.�._._w__._��...��._ _:_...� - �. __�. »,..,. �9"�s— ... : . -���'���,s�����,.: �. .___-�---- , � , �,— � � :�- . : ` � �.;,� � �� � .1�� �.�..�..,�.�._ ____ m�. �_.. _.�__..�._. �.�_ ��___' , *� � � � , �� __ _�__.___._�...emnM�.. ..._�..__ _� � � ��� �' �� �� � � ; � : � ��� : �� .: _.��ma_.__ .m_...�._�_...___-�_ .._�..,.�._�.�__... .._._________ _.Y_....._.�..___ .�.._.__.._...�._._,___�,_.__...__ _..___. m � � � �: �. ' p ;, � � a � ,� � �a�. —_ _—_.._.____.___� ._._._�._.. R � �„ �.���� _ __.�__,m m_.....��.._.�..._______--____.__.� ______�__.__ _.m..�___. -.. ,� � � � . _ . . ��: � �� � �._ xz�, � �._ ____� _ �..��____---.__ _ �__.� ,___—____. � g ..�$ �� ������� `�" �°� �- _.._____w_.._ ____..._,_______—__. ._...—___---.._..__...__.........._._._._...�_ _..�_.__.__,:,..,m.�,...�.......__.:..i._ - + _m____� � � ���.. .. � � � � � � �� ��"� � : _�._ ___�._�..________ _____ __..____... �__._��_�.__ ___�.____�.____�__..� _.�__�w__�.._.____� � � : ; _ _ . _ � _ � � . , . ��_; � . ._. � _ . --€ u����:.:, .._�..�..�°.. ._ � _ —.�