Loading...
HomeMy WebLinkAbout16193 � �-� ��� � _ _��� CITY OF DIAMOND BA& � „� DEPARTMENT OF COMMUNITY 8t DEVELOPMENT SERVICES ' 21660 E.Copley Drive Suite 190 j (��'����� (909)860-3195 Fau(909)861-3117 PRESS %9�°�� BUII,DING PERMIT APPLICATION FIRMLY "'"� ,_. QATE 3'� \ NUMBER _ _ , . ,. .<�..,.,, .., � JOBSITE qPPLICATION PERMIT �—' � (�� P/C o ADDRESS " � I p c� ISSUE TYPE OCC APN OT TR CT DATE CONST. GRpUP p OWNER " ADDRESS , ZONING SETBACKS Z CITY G+"�-� j�l�- / , ' FRONT RW O g APPLICANT EL. REAR ❑ � SIDE/SIQE STREET RW ❑ CONTRACTO SIDE ❑ � ADDRES . PROPOSED USE o CITY � ZIP TEL . wo ARCWENG/ � DESIGNER NO.DWEL. NO. NO. ADDRESS UNITS STORIES BEDROOMS � CITY ZIP TEL. � DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREA/VALUATION � OOWNER•BUILDER DECLARATION SFR/ADD/REM 1 HEHEBV AFFIRM UNDER PENALTY OF PERJURV THAT I AM E%EMPT FROIA THE CONTPACTORS L6 G8fe9B/C3fpOfl e CENSELAWFORTHEFOI.LOWMGREA50N�SEC.7031.5BU51NESSANDPROFESS�ONSCODE;ANVCIT/OR (n � COUNTI'YhfICNREWIRESAFERMITTOCPNS7RUC7,ALTER,IMPROVE,�EMOLISH,ORREPA�RANVS7RUG W pgti0/DeCk W NRE,PRIOR TO ITS ISSUANCE,ALSD RE�UIRES THE APPLICANT FOP SUCH PEHMI�TO FlLE A SIGNE❑ W � STATEMEN7 THAT HE OR SHE IS LICEN5E0 PURSUAN7 TO THE PROVISIONS OF THE CANTRACTORS LI� ! CENSE tAW(CHAPTER B(COMMENCINQ W�7H SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PRO- � PoDUSpa � FESSpNSCODE)OFTHATHEORSHEISE%EMPTTHEREFROMANDTHEBASISFORTHEALLE6EOE%EMR � TIDN.ANVVWLATqNOFSECTION70.91.5BYANYAPPLICANTFORAPERMITSU&lECTSTHEAPPLICANTTO Z Re-Roof � A CIVIL PENALTY OF NOT 6WRE THAN FIVE HUNDRED Dd.LARS�5500).)� � ❑I.ASOWNEROFTHEPflOPERTY,ORMYEMPLOYEESWITMWAGESA$THEIfiSOIECOMPEN3ATION, � CommefCi21 - MALL DO TNE WORK,AND THE STRUCiURE IS NOT INTENDEO OR OFFERED FOP SpLE(SEC.7044,BUSI. J NESS AND PROFES510N5 COOE:THE CON7RACTORS LICENSE LAW DOES NOT APPLY TO AN OWNEA OF = � PpOPERTYWFiOBU1LOSOqIMPROVESTHEREON,ANDYMODOESSUCHWORKHIMSELFOFHERSEIGOR ('L THRIXIGH HIS OR HEROWN EIAPLQVEES,PROVIOE�TH�T SUCH IMPROVEMENTS ARE NOT INTENOE�OR m � OFFERE9FORSALEIF,HOYVEVER,TMEBIlILDINOORIMPROVEMENT1990LDWITHINONEYEAROFCOM%.E Z TqN,THE OWNER-&11LDEP WILL HAVE TFIE BURDEN OF PROVING THAT HE OR SHE�ID NOT BUILD OR = IMPROVEfOHTHEPURPOSEOFSALE�. O I.AS ONMEfl OF THE PROPEHTV,AM EXCLU&IVELYCAMRACTWG Wllll LICENSED CON7RACiORS � TO CONSTRUCT THE PRCJECT(SEC.7od4,BUSINE55 AND VROFESSIONS CADE:THE CONTRACTORS LI� V21112110l1 ADJ.AREA W CENSELAWDOESNOTAPPLYTOANOWNEROFAPROPERTYWHOBUILDSORIMPROYES7H[REON,AND � NM1IOCONTMCTSFOPSUCHpROJECTSWIiHACONTRACTOR(S�UCENSEDPI!�RS�1M'TTOTHEIXNRRAG QUANTIN DESCRIP110N FEE Y TORS UCENSE UWJ. � J � ❑i AM E%EMPTUNDER SEC. � B.8 P.G FOR THIS REASON U � � � DATE _ OWNER_ U � W � UCENSED CONTRACTORS DECLARATIGN -� � w i- I HEREBYAFFIRM UNOER PENPLTY Of PERIURY THAT 1 AM UCENSE�UNOEfi PROVISIONS OF CHAPTER � p� B(COMMEMCINO WITH SECTION)000)Of ONISKKJ 3 OFTHE BUSMESS AND PflOFE5510N5 CO�F_,AND Z � X MY LICENSE IS IN FU.L FORCE AND EFFECT. ��^� f" m llJ ,/ � H� LICENSE CLA�<<`��L�Q NQ. � J � .'� V DATE_��a =�—�CONTRAC'OR_ - d W � WORKERS'COMPENSATIpN DECLARATION a � U N i HEREBV AFFIRM UNDER PENALT'OF PERIURV ONE OF THE FOIIAWING DECLARATIONS: Z Q � _IHAVEANON�LLMAINTAIfVACEfiTIFICATEOFCONSENTTOSELF�INSUREFORWORNEFS' 2 � CAMP@75A:�ON,ASPRQViDEDBVSECT1ON31ooOFTHEUBORCODE,fORTHEPEPFORMANCE W O iE WORK FOR WH!CH iHIS PERMIT IS ISSUED. � O ,1 HAYE AND WILL MAINTAIN WORKERS'COMPENSA'ICN INSURANCE,pS REOVIRED BY S'cCTiON O 370a OF tNE LA80R CODE,F061 TME FERFORMANCF.OF THE WORK fOR WHICH THIS PERMIT IS ISSUEO.MV/YlG��(ERS�'C/OyJ PENSATi�NINSUFlANC CA IERANOPOIICVNUMBERARE� CONSTRUCTION � CARRIER `��""�� .e�� PLAN REVIEW � PouCV NUMBER_��,E,�� .�_'.�— E�ECTRIC "' J o �rr�ss�-cr�cwr.r�rvorAE��mo�n��w�rrs�onnor�er�nEooa��sl5�ao��a��ssa PLUMBING ��S Z I CERTIFM THAT IN THE PERFORMANCE OF TNE WOFK FnA WH�CH THIS PE�MR IS ISSIIE�,1 MECFIANICAL (,'J SMALL NO7 EMpLOY ANY PERSON IN ANY MANNER 50 AS TO BECOME Sl1BJECT TO THE � WORKEflS'COMPEN TIONLA'N60FCALIFOflNIA,ANOAGREETHATIFISHOULDBF.COME INSPECTIONFEE �. SUBIECT THE KF.RS'COMPENSAT VISKINSOFSECTION3�JOOF'HELABOR � COOE,I S ALLFOR WITM GOMPLY WITN HOSE ISIONS. ISSLIANCE 0 DA7E: APPLICANT: �. _. _ SMIP � W � ENERGY P!C --� WARNIN6'.FA UHETO CU9E WORKERS'COMPENSATION CAVEFlAGE IS UNLAWFUL,AND SH p�q.[��p -�Q� � SUBJECTMIEMPLtlVERTOCRIMINALPENALTIESANUCMLFMESUPi00NEHUNOFEDTHOUSAND ENERGYPERMIT �• " -' � WLURS(iloa,000).IN AODITION TO THE CAST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN ¢ SECTION 3708 OF THE LABOR COOE,INTEREST,AND ATTOqNEY'S FEES. RETENTION FEE: W CONSTRUCTION LENDINGAGENCY PRE-AlT FEE: � -- �;— -- CC I NEREBYAFFIRM UNDER PENALTV OF PERJURV THAT THERE IS A CONSTRUCTION LENOWG AGFNCV � FON THE PERFORMANCE OF THE WORK FOR WHICH TIi15 PERMIT IS ISSUE�(SEG.30B'!,CIV.CJ. Z W � LENDER'S NAME -_ F- LENDER5AOORE55 � ICEflTIFYTHATiHAVEfiEADTHISAPPLICATIONANOSTATETHATTHEA9WEINFORMpT10NISCORRECT. TOTAL FEES W 1 AGREE 70 GOMPLV WITH ALL GIT'AND COUNTY ORDWAN AND STAT[UWS RELATING TO BUILDING p� ppp � CANSTRUCTION,AN6 HEflEBV AUTHORIZE REPRESENTATI S OFTHIS COUNTV TO EN7ER UPON THE /. �/'�_`~ �71', � ZA90�jIDN�PERNF RINS CT�uAros 5. COMMENT `-•�-� v 0 � �i _ _. m PEFiMiTTEE INT) j'/g a � �N Cn 1, ' — N SIqNATURE OF ERMITTEE �AT. ' = RECPT.NO. PAID BY VAUDATION ~ WHITE--Depahment Copy,YELLOW—Finance Copy.PINK—Assessor Copy,GOIDENROO---File Copy,GREEN—ApplicanYs Copy . ,. ....:�.t. ._. .. .n..w...,,. ..... ..... .... � , .,,.�,,:e �;,. � x.� .y.� ,1�'t�„� � z ..;Y' c� q�,r» ��ry��`�� �. , ... . ..� .:.,e .v;�r:� ��h���. �,., � ,:,,/n>� ,S�.".'�!C. , . . ... . .. . ... ... . XY�:. ._ . . ..,. �. ��:Ip ���� �� ���°������ �� ���������� ���� .. ��� �����s E:a��� � � �.� �°� ��� ��� �� �, �� � ' : m. � .�` �� � � ����.�`�;�,, � �. � °���� ���� �"�� � ����':: � � �,� �� '' ��;w� � � � ���� . c��„ ., � ��� , �.:�� ..�i"��^a.z� e� �:�.a a� .��s ...: � _� : .. :��: � ma�a� ' x������*�..��� a s;a,:..:� �c?ar��� . _. € d_ € :'s.t 1 E"" .(+'�C*y"�" � , �9 t ..._ ,.._ ..� _.... ...__ _......__�,. ..... . _ d -� � ^�' I v4�. �'"C- . ..� ��. ' �,.., . � C"L`� �.� . �.s � � ` . � .. .. ....� � = - _ —� _ " _ _ i � � � _ _�— — � —� z R C�.,c�i. ;-: ; + � �"t .� -' __ �� -ac..E: i t ag �� Ctt sr° � ._ � � ��__-�____._ ._.__.�__ .. _ _.�.rv.�� _.... __.... ..__ _.._._._.__.r_�...�._.._..� .� . .. . .. _...___....____.�. ...___ _____................. ...a.....�.__..._.......,.....�. . . ( _:� , � �... �� y I � I E,����!� � " r � ` ,-� � � , __.. i_. . ... s �'" ,...d ,i- dt?,�� ' . _—_____....................____ _ .... � r� � , , �__' 1 ' � - --- g ;_�� ' � �_ �. _ �-ar`�s� �C`� e�.��°�^ Ils�s�� �_ � _ a .._ ...... ...,..._ .._.._.. _� ..... . __. _.__ .._ ....,...,.. � .L�. . ._�. _...._...,.........�.,._........... ....... ¢ . „ _. a �v �,�B � _" �r'!.r.£'� � '��i a a ..'t� �_ i — __ — _ , � __._ . _ _ _ 4....�.�..�. � r . � o:j��'l �&-k-" '?l.� �i�S '�� �'� � E .....,........:.......�..�.�,�..._.._...._., � � �.�a � I _........_�, _..__ ..... � � .. ____ft g'��,_p..y _�€.._ _ _. i .ca _ :-. :h Y-�'1 S..H'i,1'� : { 3 p --:�.� � 1 p �� ! i� � ' ... , ��� a �.F�� i ; . . . � � 5 & _ . _ _. .'__�....__ _...... .__.__ ......_.._.._...._.____._ . _. ... ;� _ ...._._ T ._ . �_._._ e .........., __"'. . g �j [�Is�� t a':t 3 -. &° ' a t"= .^ . '�° ..�m . , . .. .� °-s : l, .. =�i .�;�$ ; 1 ��- �a� � .� 1--..:..^ # ........._i.... ...._�._._..__..._._. ....___•. � �,.. �' . . �� . _� .._ __.._.._........_.. __.,....,..._.. __..__�..�......_._...._..._. "'... ........._..v ... _._���._. . .�.. .__...,._._ _., P .'�.�.; w.L.3�' � '�. . ' . . � # F;'t �; '.:Li.;�? �q;;�:; �� ___.__'L.._—......_......._.__._.�.�..._ �s 4 .._ . . ._.1 . �. — ..�.. _.. . ._ � .... ._ _.. _._ _ ..._, § -' ' ' :` � �. .. I_� . . i � €,sC`'�c:.��"``.��a«'ma � 1 � ��. . r ._ __ __.._ ____...� � ..-- . � �....... _.� ..... .,__..�.. _,_..__._._ ....__ ._.,,. � � €t -� ;A: c�'. ��g� � i c; �. €�; '_�'�:�3 � � � a ._.._. . . ; _� ' � _ _ ___ _ _ _ ._.m�_.._.��.�.�. _.... .„ � � nr� i�i � 9 �� `� :�,i'..?���+`a I ( a _ _, ___._� ... ___ _ __. � __ . _M____m.__________. ...1 ....__._n...,_�_�_�._.� .,. ' ��� � � `� �� ...i .. ..... �._.. � 1="<3C � a��( I`�t� ... €_ t..�.� ...; . j . .._ _..__... ___ _ . .� ...._. �_ .._�____. �.. � ! � "� — ; '� n �` € ' �v'�s i � t'�b E ���" �,ri�k.; € { r...... _.... .......^ .............................. _..._.................1-........,....."___.._..._..e..,,...... . .......... ......_�._—__ _._._...._.,.,.,_ ' ,.,..,..,..,.......�. 3 { l k .g^g ; ' I . . �',, ` bVJ L� k�. ^^i_.._.��._��._.�.._. . .�.....�,_...,......_.,...... 6 :�..�� L tt. >..Yd:Cs,o� I �i_d. �4-i''.... ._..�..._...................:....»............._...t._._M.........._._.,......,...._.._ : q ......._..i..�_'__�_._...,....._,_.�_��_.�_......__._.m......���_..._.___ .._.,_ __.__....._............_. _ ......_..... ....._..,,...._.._.: .. ...> ,. . £� � f, ,�..p � 3 E .... � .. . . . - �" '_�C 3� _'�.:.-- ` � � '� - 1 r _ , � n � �_._.___�..__�___._ _ _._�.�._: _w____._. .�. � _, .._..a«.. ._....____. r +'°\Y' ., h4 dx':�..i E i � � I 1�'t��{„�._....._....._..,...w_... .......,, .. .. � x � � ...�,....,...... . .�-...__.._._.� !. . . ..�g � . ...1..... . .. . .�. ..w.�.. ......�._....�.. .. ._.�._._'____...... ... .�...�.,.�. �. .. ... .»�§S t � �s� . , .. _. .,_._,__..._,_..._ _.._..,�._...._ y_...._.�._....�,....._._..._.._..__.._. :�.., _._ ......�,.. ......... _._.__ _.'_ � � . €"�$��k�. � � �,..�,t'e�. _�._�r'',._ r.�"� .�,.�.... . ___ .._.. _..�.. M1 :.� . : i � � � . a .r.._. .._..,. . _ �_.._ . . . . �..._.�....,......_...a._...�...,._.....�........_._, ........ _ _�,' _..: 3 .-:€ d , � � r^�� rYt �� fA +� � . � � „ -_. . .,.�.�....... . ,._...;..._i...m,..._�...�,.„...............��..�.__...__...�...__......_..-�____"_ j. ... .. _,�,._..,....,...,... _ ..._� � , .. _.. � E^" P 9 A -.A 1� A�5�.:.,. � __.............�... x __..__ ....�....._....._ ._ __ .__� ,: r ,�� : . . 3 ... ......,.. _.�_____... ____.i�.......e.............1��......,.....__...__... _..........._.....�.. � .........._ . .. _ ,..................... .-,4-. ..... , : ... _�. ._.,. _ . _.... . __ ..............:............:_.._..__ � . �j'ti. i�. v ��.-,-E, j �-Ca t ���t�., '` .�1�';�._ , 3 . ; �.. ........_ ...................._ .�...,..._.... _ .............�.,...._;..._"" ` .. � . ......_..__ _.__........ ..... .. ___.....�..,..._._.. .._........m...�,..........___...__,..._----.-;. _..._.._ . .... .............._...._. _......._ ...__._ i � .. .. � _ ..,� �. .€a:.,�._ �...., , , . , ..... __� ' .: __.r C"a� .. .... . .. ... C'�..r�'t�...9�� �s._. . �: ."'�:_ .� ... - ,.,.... ......�._._.._____ .... ........ :, .__.__. . -.,.__._......... ,,. ...___._.....____. �. ; ..:�. ¢ ..e 4, tl�.i .: .. ... .... .. _ €'? .w"? ..:� j . " . ; _.., _. ...._ . ... . ..,.....,. . __........_..,.,k.,....,..._ .. . .. . .�_._._. .._ ____ _..._.. .:. �. �; � ` � '. b :.` f , . : .� - ; j ,. ..� � ... . __�............�...._ �-.... ....,.._.....a _........_...__ .:_. ,�.....,......�-"-...�...�,. ,_.A....w_._._................._.. ....._........._...... .,.......,__..._.. __..� __,......_._ __•_.._...—.____..._..:�: .�-...._,,., _ . ' �J 1 i .�-.__. � 1 .. ._. . .. . . ....._, . �.._.C....� `>.. �c-r i •, ""T�'�;T'�"> �`?t �s�g �s,�, __ ......_ --. .. . ._____, _....._ . '�... . ,. � � � :........................_...._.�n na. .____........,.__..__(...�...,... ._..�.�,..,,.,.w...�.....u. w�_____;_�_........ ���``-�`�i����`�i�,.���:3-�:.�:3�:`�: �.�� .,.<..... ' . ... .......... ._.._.._. ..,....,.. ......... ._ ... . . .. . . . . .. - .. ,..J . . . ' . ,r - . . � rt,r .�.„, fl �:., .. .:r�. ..ne....,.m . .:�3 .. : -' ..m_b....�................._._m..__.......-..__..._,.................,.�-,..._....,........_�...._..�...,.....,......_.......__.'""___.._........-,....__,..._....,...�...................,_............_.�..,..._........ .. j .__........._..,...,.._......._.__ __..................... ........�.�.....,. � ( � - .. ' - � . . ._,. 3-_�._._,-_.__..____...._�.._„__...... .........._......,... . ...._.__.._._._.....___�.. , �. ➢ z................... ........._......�.._....r....._,._........,......�.,.._.,.,...,_,...... ..y....,........_.--..._..._.._._.._...._,...,......_..._......_.__..._....._,.,........._. _.._..�.__._.T__._ _ _. - ����. ....... , _...�.,._....... ......._._...._.._...�.�___............_..._...._........,..,. .............. . ..... 1 f.�.«,...s,_.w.........._......,W.,..........�......�....�........a._.. ..._...._........,m..,,..._.�.�.,...,.._.�.._,,......_..�.................-�..........,...._.__... ..........._......._.....,......_._._..�....... ........._,.....,.,._._........_�..._..._...___,..�._.._..._.................,...................... ..,_. '�. ; ' .' .. . ""_. ' .. � . . ; . . � ,..:. . � . .._..........._.......P.w..........__......_._...� ..............a ._..F.----w-.�._..:,�.:._ . ._......,..._..� ....._ . " _ '. ._ . ......_._... ..._._._ ._.._._...»..._....._,._�....__�......_...........:...._ .._._.. .........._..........._�..�.-.... ..,.......... .�.. .....� ..._.....___. . . . .. :-� . ., .. p i: i . . , .. ...., m. ... � .. �' . .: : ����.� ......_„.w�.v .. � ._..�....._.._._ .__._.�.___._._.,i_.—_.__-__................ ._ __.— ' _____ ._-..._,._� —_ .__.....'.....�...�._....:...,...-..,.....,„.'..,..._.:._'.... .........:.::4...�e....1._...:..,.._._.._1 J=..�4�, �S...a 5 v.�� ., e.rP�„"��.Y- �..�TM ' ' , ' .' ' .. . . , � ', j ........._..._ __............ p"'N�- 5,:_ £ <«.. . .. - .. _._.. . .__ _ ' ..............._. ....._..__._� .. - _�.:. - .. . . .. r '�'�§.�:. r: � �"�'`ml°F���A�_g��� � ..� . ..... ........ .. .._.._, .� .._ ... . .. . � � �� � �5*"' �`s�#` . .'" ' . . . . . o- �. ���. � � ����., . 8 . . � �.���� �����a���'���� 'r �: - . ....__ ......� _....,. .. .. .. �. ....._ ._... . __._ _....._ .. .� _,_. ....,_. � ; ��� '�9i.""��,���t �d���.� . ... ...-. ....._. ___...._.._. . _............ .........._....,..,..___.__.._,.__, .,. ..._......._..,............... . . ,_____ ___...,...... _.._.. .._ ..._.__ _._. ._........ _., ,3 q # 4 �A.9 `�'� �kdq��e� � - . € $:,� �����,�$ �&�,.. _ _....__ ___._,_....,_. __. ___ .. ___ . __........ ...__._,_— .... ___ _ _ __ ., ......___.... _ .... . . _._ __ '..._ .. .,_.... .x� . . .. . . . . �:�.Y, '" ��-�" � �s� - : ���� ,� �� � �� � �� ,� � __ .._.. _ _ �� �� � ��' ����� � ����� .._.._ M._.. _ .---. ..__�_.___.. ___.._ �w_._._. _ _..._..,._ _ __.___ _ ' �� �,��� � ��� � ___,.�... . ... �___ , ��� � �,��� �� _ � , �mm;�� �,� ����;�.����-����`�i rr �_�.._..m_.._.� ...._ _. .... .___. _.___ _ __ _ ; . .�.. , �..,..�.._�.��,...v�,� .,...�...�.�. • �_ .T._�,�._._.........._. _.� ..__,___.. .........__��. .a�.._.... .._...__ _m. .�.,_�..,.._...__._.�,.nA ._ � .... _�.�....._ .�_ ����,