Loading...
HomeMy WebLinkAbout17195 ._- -i_ ._.L_ . _ ... - - - CiTY OF DIAIl�IOND SAR ,� --- `�'"'' �'``---� DEPAR'fhqEle�T OF CC?MIv16JNIT'Y&DEVELOPMENT SERVICES � 2 L 825 E.Copley Drive " (9U9)$60-3195 Fax(909)8613117 PRESS "''%»N�'�' BUILDINGPERMITAPPLICATION FIRMLY y JOBSITE / APPLICATION ��, ���`'y�PERMIT .�° ;�P/C a ADDRESS_I + � � �\ Q-� � ��''i/� DATE °�� NUMBER # om � I5StJE TYPE OCC APN LOT �A�CT DATE CONST. GROUP °C OWNER °'C.Y1R�-r�YL.�¢� i.3�.iCS " �- O ADDRE�SzS es`�$r L� . ���+'►{+"�t l �CS a-! ZONING SETBACKS z CITY l�Gi11�Qt..-,3nar ZiP�l�f F TEL. 3��?—.39�3 FRONT RW ❑ � APPLICANT 7EL. REAR ❑ � SIDEISIDESTREET RW ❑ Z Q CONTRACTOR �c3�t= C�$, SIDE ❑ ADDRE S � C. L... ��g'P.-�:,�c� ^� � CITY t�Fi'r��"9 ZIP i.�.y�_�TEL.��t�11 ���'-- PROPOSED USE ��a 2 (���'r- �'U�� ����g'"� w ARCH/ENG/ '���� ��yy�,p�� �,�-y; ��� z '�ESIGNER NO.DWEL. N0. � NO. d ADDRESS UNITS STORIES � BEDROOMS � C17Y ZIP TEL. � , DESCRIPTION SQ.Ft FACTOR PSF ADJ:AREANALUATION O � OWNER-BUILDER DECLARATION SFR/A�D/REM �'�, p I HERE6Y AFFIflM UNDER PENAL7Y OF PERJ�RY THA7�AM EXEMFT FROM THE CONTRACiORS LI� Gflf8Q0/CflfPOfl �' W �CENSELAWFORTHEFOLLOWINGREASON�SEC.7031.58USINESSANDPROFESSIONSCODE:ANVCITYOR (n �� C,� �COUNTYWHICHRE�UIflESAPERMI7TOCON5TRUGT.ALTER.IMPROVE,DEMOLISH,ORREPAIRANVSiFTJC� W Patio/Deck �' w '�,TURE,PRIOR TO ITS ISSUANCE,ALSO REC]UIRES THE APPLICANT FOR SUCH PEPMIi TD FILE A SIGNFD w g ��,STATEMENT THAT HE Oq SHE IS LICENSE�PUFSUANi TO THE PROVISIONS OF THE CONTRACTORS LI- � ;'�,CENSE LAW(CHAPTER 9(COPAMENGNO WRH SECTION 7000)OF DIYISION 3 OF THE BUSINESS AYD PRO- � POOUSPe i:FESSIONSCO�E)ORTHATHEDRSHEISE%EMPTTHEREFROMANDiHEBASISFOR'HEALLEGEOEXEMP� (� "q `^y �"'�TION.ANYVIOLA710NOFSECTION'7031.5BYANYAPPLICANTFORAPERMITSUBJECTBTHEAPPUCANTTO Z Re-Roof r,a(;�y,y � ACIVIL PENALTY OF NOT MORE iNAN FIVE HUN�FiE�DOLCARS(E5[A).L Q ❑I,ASOWNEROFTHEPROPEFTY,ORMYEMPLOYEESWITNYJAGESASTHEIRSOLECOMPENSATIDN, 0 COf71fff0fd21 � Z '.WILL 00 THE WORK,AN�THE STRUCiURE IS NOY INTENDEO OR OFFERED FOR SALE(SEC.7odd,BUS6 J . �:'NE55 ANO PROFESSIONS CODE:THE CONTRACTOflS LICENSE LAW DOES NOT APPLY TO AN OYdNER OF � '''PROPERTVNMOBUIl�50RIMPROVESTHEREON,ANDWHODOESSUCHWORKHiMSELFORHERSELFOR m LL '.THROUGHHISORHEflOWNEMPLOYEES.PROVIDEDTHATSUCHIMPROVEMENTSARENOTINTENDEDOR Q ,OFfEREDFOflS/�E.IF,HOWEVER,THEBUILDINGORIlAPFOVEMEN'ISSOL�WITHINONEYEAROFCOMPLE- Z '�.,',TION.7HE OWNER�Bl11L�ER WILL HAVE THE BUROEN OF PROVING THAT HE OR SHE Di�NOT BUILD Oft � '�IMPROVEFORTHEPURPOSEOF$ALE). - y..- ❑I,AS OWNER OFTHE PROPERiV,AM EXCLUSIVELYCOMRACTING WiTH LICENSEO CONTRAC?Oft5 a �TD CANSTRUCT 7HE PROJECT(SEC.70p4,BUSINESS AN�PROFESSIONS CADE:THE CONTRACTORS LI- VZlueti0fl ADJ.AREA W �,CENSELAWDDESNOTAPPLYTOANOWNEROFAFROPERTYWNOBUIL�SOFIMPROVESTHEflEON.AN� ' � '�,WHOCONTRACTSFORSUCHPROJECTSWITHACON?RACTOfl(S)LICENSEOPURSUANTTOTHECONTPAP QUANTITY DESCRIPTION FEE � TORS LICENSE LAW.). � ❑1 AM EXEMPT UN�ER SEC. B.8 P.C.FOR THIS REAS�N Q � U � V" DA7E OWNEA F z W � LICENSED CONTRACTORS DECLARAiION � Q � I HEREBYAFFIRM UN�ER PENALTW OF PERJURV THAT I AM LICENSEO UNpER PROVISIONS OF CHAPTEP � � 9(COEAMIENCINGWITHSECTION70oo)OFOIVISION30FTHE8USINESSAN�PFOFESSIONSCO�E,AND Z `X MY LICENSE IS IN FULI.FORCE AND EFFECT. m d LICENSE C2L�^A�SS 4'��Q �-r-� LIC.NO. �'.9 4��'� ,�j � V DA7E ..] '.'��.` Qd A__ _CONTRACTOR��A�� ��.�w�.""- a , W �4 � WORKEFS'COMPENSATION�ECLARATION -� � a � IHEREBYAFFIRMUNDERPENALTYOFPERJl1RYONEOFTHEFOLLOWWGDECLAflATIONS: U (,ry Z Q � __IHAVEANDWILLMAINTAINACEFTIFICATEOFWNSENTTOSELF-INSUFEFORWORKERS' _ CAMPENSATION,ASPROVI�mBYSECilON37o00FTHElABOflCODE,FOflTHEPERFORMANCE U �' OF THE WORK FOR WNICH THIS PEPMIT IS ISSUED. � Q J� ,✓I HAVE AND WILL MAINTAIN WORKERS'COMPENSATION INSURANCE,AS REDUIRED BY SECTION Q 37000FTHELABORCO�E,FOR-HEPERFORMANCE�FTHEWORKFORWHICHTHISPERMITIS j ISSUE�.MYWORKERS'COMPENSATIONINSURANCECAR ERANDPOLIC7NUM6EftARE: CONSTRUCTION �� CARFIER��P�-`c��yd,�. ���ic9A.��� PLANREVIEW , - Z POLIG7NUMBER ���'N ��C�=�'Z dR- ELECTRIC �. Q Q (�HISSECT.ONNE�NOTBE�IPLETEDOFiHEPERMRISFORQ�'EHUN�PE�DJLWRS($100)ORLESS�. PLUMBING Z ICERTIF1'THATINTHEPEPFORABANCEOFTHEWORKFORWHICHTHISPERMI7ISISSUE0,1 MECH/1NICAL ""` - ` � (,� SHALLNDiEMPLOVANYPERSONINANVMANNEFgpqSTOBECOMESUBJECTTOiHE �' , . �- � WORKERS'COMPENSATIONLAWSOFCALIFOftNIA,AN�AGFEEiHATIFISHOt1LDBECOME INSPECTIONFEE�-� �y��"`� � SUBJECiiOTNEWORKERS'COMPENSAiIONPROVISIONSOFSECTION31o00FTHELAeOR ISSUANCE - V'k°5m fL �_����I"S �� V � GODE,I SHALL FORTHWITH COMPLY WITH THOSE PROVISIONS. �. , � SMIP '� . � . p DATE: APPLICANT: w � ENERGY P/C � ' � —� WARNINGFAILURETOSECUftEWOFKERS'COMPENSAiKKJCOVERAGEISIJNLAWFUL,AN�SHALLBE � S�BJECiAN EMPLOYEftTO CRIMINAL PENALilES AND CIVIL FINES UP TOONE HUNDRE�THOUSAND �-'�� i v u: ENERGY PERMIT'-._ ____---.- � DOLLAFS(y7o0,000),INAD�ITION70THECOSTOFCOMPENSATION,DAMAGESASPROVIUEOFORM � "'""-""� J SECTION 3I09�FTHE LAROR CO�E,MTEREST,AN�ATTOANEV'S FEE5. RETENTION FEE: � �. �. pW.. CONSTRUCTfON LENDING AGENCY PRE-ALT FEE: '. a IHEREBYAFFIflMUNDERPENALTKOFPERJIJRYTHNTTHEREISACONSTRUGTIONLENDMGAGENCY �, �- FORiHEPERFORMANCEOFTHEWORRFORWHICNTHISPEAMIiISISSUE�(SEC.30!Y/,GIVCJ. — . Z W �, LENDERSNAME F- IENpEP'SAOORE55 j � w' ICERTIFY7HATIHAVEREADTHISAPPLIGATIONANDS7ATETHATTHEA90VEINFORMATIONISCORRECi. �OTAL FEES � ��� � IAGREE7000MPLYWITHALLQNPNDCOUNTYORDINANCESANDSTATELAWSRELATINGTO�UILDING , � CONSTRUCTION,ANDHEREBVAUTHORIZEREPRESENiATNESOFTHISCOUNTYTOENTERUPONiHE � � ABOVE�MENTIONED PROPERTY FOR INSPcCTION PURPOSES. COMMENTS -' o � �.�6`LL l �c. m PEflMITTEE NAME(PRI T �� p �9 p � \ '4u m-s S.Y iY� � SIGNATUREOFPERMITrEE ' DATE = RECPT.�'0. PAID BY VAL�DATION ~ WHITE—Departmenf Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENROD--File Copy,GREEN—AppliranPs Copy .._ .................. .. . . .. .. .......� . ,-� � . �.. �.....:: . ... . .. . ._ . ..,. .-�:�� .�u �,,-� : . ,��, z . .,_.,.. � . .-. .. .. - , . -. ... ... ... . . _r _ ,a,�.� .. �c.:•. �..,;.�- . .�.,;...�.. . -,.,, :..,. .. .. ' � ' `'�,,�. ::.� .. , . , . �, . .. „� �..� �"�._.. � q �e �.5 *" H.,'` kq „�: .� c ���:;x "r� #,. "" � e m .„ ,�"� 5°� � �,Jr F r a^ ,"�� F5 F� €' . g "R � $ . 9 t�a, 9` 4:6 1 W �r 7 '^� '� Y� ,� � d , { t d� � [ � S -n # $ b 3a u+ � � �� �„��ys �W [, �. '.��"`.a."...,�: � � �'�..� ,�'n k � &.��_'�.� a.'��"�,. �'m ���`;,� �n...�x.�, � '.. '. a '� r d � � � �°�^_. � .""� � :�.�_�+�r.�u..��*�,"�..��1 �:n�"� k� �.a.. i.,�"...� r. r s r�. . ... . r '� ., �.�3 : , .' ..a :--..._....__.._.._._.,.__......._..._.._......__......_.� ....__..._...._ ..: .............. _.....__......._. _..__._.__. .,_.�._.._........ _. . ; $ ... .,..._._...__.. ......,._._ ...._........_._..._......._._......_..,...__� . __._-..._.,,_.__.._._ ......... ... ��. c C'�.. �'.,, . , ' ,, c �' � E ':'� P'. "� �a'. � '�. .._ M.,•"@ .. � ( �..�. __., . .........._,_ ..._ ._._... . ...__. ..__._. ..._'_ .... _ ._. ...._..._._...._ ...._ _ _........._. ................,,._.._.._.v._�_..........�.._,.._...... 'r r-�. f �, . .- t'� lf m t,.. '..�.✓ ''' ;;. . . y, � �1 �_._�._.,...._.._._.____ .."""' ....__�_...................._....._.. _..._...._.... ._ _.._..._..._. _.._..._._...... '.:._ .... _ _ ...... . .. .. __.._.....,__�_—___.. ._.�__. _ _, �y'^��c 4 i � "��L ' .�_ .............. _...._....._.._..__. ._............_ _.. ...'�I .__ �.':_ ..._...�...��.�_ �,. � �.�... ..€...._ -! €� � .._.... .__...... ..._......,.._�'...._.___ ...._...._... ........... ...........__. _._.. _._ _._.__... � ��..t�� f.�3 � � � E r �:1`� : .. ,__...____ _ ..__._____.�__.____..__..._ .._. ;._.___ __......._._.,..__ .. � ° �.. �,�, ; ;= ; �" . .__�_ ._.__ _,_., ..._..�. ______. m _ __.. .. �--��� �-?.y � � �� e � � �,,, _ _.. _ � � � � €'� � . � �_.. _. _ . _ ^,..J y.. r r �, i;,, ')p� �q' ' . � # _.. ..... ., .. .. .. _. " E�/"� ��C�.._ .c�����-..... ... ._.._�..__. ,� ... . ___..�_.._. _ _. _ ��, I`x �' f� �� � c€ � �"� �......,`�- . . .._... F L € ��t ����.s . _ .. . __. rt` @ _ a ',0 € . � � F' �� ���� �E �.�r � � r _.... . _ ._�,._._._ _.. _. .. . �_ ___.__._ ._, __ _ __..�,. � ._._._ _�_____._____�._.__ ; � :'��`..�� �:.f� ;` r � ,... _. _ ,�._._ �,, ___.....__... p._..__..v._.._...�.._. m w__. ._.. ._..._.. . _. .,w.. ..._,._ __.____.r._._.�_�__.__...._ � �;�;��. �' �,»�..�.,< ,ii.. i � _iM.. _� i ..._ _ ..'.....................__. .__ ...v ._ ......_.__..... ,...._._..._...... ._ . ._____ ..._...._._.. _ ._........_...._.._...._ � ._._.....�._....._...........__-, ....... , �;+ura..x..n " { !^�.�.:- ; � , � H i.._ ._..... .. .. : , '�. ..: : :: �"t € ' i. � �__ �.. . ...,..._....._............. ..«.-_._...., ......_.._........,_... ....__.._.. .._ _.__._....__.......... ...u.. ............._._.._ ___..,..._..__........_....,.,..._._........_._._,. .,..._.. -,.,. m. .., � ,.,. ,.� _ ..... _: � �7#"6�f�� i"b%� 1 . .. ,.. . F t_ '� ,', i P � _ y._. .....--_ . �_._._....__..__..,.__ _..__�.._ _., .__._..___ . , --_ . __ ___� _...__...__ ---A . r.��- �,�.� r �. I � E- , _ � � ___�_._._ .._,. _...__�___..�. ..._...�._.._.,_: . __._._ _._.._ ___....____..._ ....w.---_._�___.._.__.__y_.� i r,ifi�s , �� ��� � ��� t � � '+ € ; � .___._ ..__._._.__ _�.._.._ _.�_ ..._.e.____..___ .. __ ... ....._.... _. _...___...____ ..._.____----- ____----- �. � _�_, _u " r � � 4 �, _ �.�� ��:. � � � __ _ __..,�.� -- ..__._ ._ ._._.__ _.,_._______..._..... , , _. _,..._._..._..._ _ ..._... ...... __.__._._._._.._,___� _ _ �._ ut'>; ,,� .,_�..", t_�"tit� u i. . �` , : , __ _._,.�_...._. ____...a. ._._._._..� . .._.._..�..__..�_._ _ _�....___.._.. � _.... .,.._ ----_._.. . _._� ....___ _—___ ......._. .,.,�.._____�.. � ;�:._ � ��t : �'i"� . � 4 k � ,. _�. _ ._..__.._... .........._._._........,_.____�., .........__. f � ._.__.. . �._..._....'"_______. .._....._—_ .__._............_.-,.._.__._ ._. ._ �. �.�___._., � �,... .d� . °>}a � . , . � , �,;�-���,_s. , .. . �.s�"� � i r ._ _ _. .. ` _ � _ , _ _�_�. __� �..___ -.': �:: I '. ; i a i �' � ____..___.._._.�____.__......_ ; _ ._ ___..__._____._:r � _ _�.,,_ .___.____.,_ _ __, ____.. _...� ---..._. .____ __, �;>aa .�.! ��sm � .., � ;',�,�. _.��': �v. � . ._ .. _..___..�.._� ._�_....d_ _�_.__m�__._.__ ._.�._ .� . ,_ " -__....___._.. . . ____.._._._...__ .__._._,_._.. ,._,_____ __ . .__ __.._.____m=. �a�. 5 m ..��.��'-«.��2. ���. ' .. �." , s ... `.�..._. ..... .._�,.�._...........b.._..___....._,_..._._ ..�...,......____._._............__........................... ,_ _ ._ ...�__�...._ ...__.._.�.�_ � ._...._..._.._...__.— ___._.�_�___.._ r '.... �...�_. ._ "';,�� � �' `':«fl��s w;;. . � . ,p ��� ,r a :.... : ; � . .. . ....., ..,�_ , . . �._ ._r _.�c.. . . .... ,.. � � � g� . �_� ._._ L __ ....._,.. . --- -- -'--- _ ._ .�_ _ ..._.._...... _.__..a.__.._.._,._a.....__._.._�.._,....__._._..._..._..........�....._,..._�� i . i 3`', €,,.,:.. E.`i"F, I .I::.. . _.. , k `� ... j ._�...��. _ _. �_ _ _._, _ .� __.. ____ __.. _._._ 9 ".' � .E .¥ i � ' i t d€ . V �......�._�._,...,. �..._..... _......., ..".,_... � _............. ...:..._._..,�..........._...............__.._._..... .�... ......... ,.,._.,__�_ ........., ..........,......_....,..._..._. _ .., }......._ .._.._ ._._._..__ __._.�__ .._ _ } . .�„ � ........_.... ...._..�. . . . ._. ..�. f ... e...a.. . . .. . ,._ . ... . .. ........ . ... 1.:T "',. § *}5.4&¥ 'Y 8 q � , � :i S � � - . ,,.....,._,__.y.,,...�v...>..._i i--.a_�e.,,a..,�?",s=�.....�.a? ,a a<�::��*` �.a i____,.__�_.._.. �..._n�._._.._._.....v.._..w.... �_..�._.__.__,� . ° ` Y 'Y , � = .:� : � �r'x, � .. �. ���.",..........,...-...,a.........w,..._._........._.__,........�.....�................._........................_,..�.._...:._._b..._............._...._.,....._...«..,».._..w........�-..,,,........._._.�__..........,.,_.__..._......__._..._.,_,..._ ..e._....._��._.m.�....._.....,.........,.,.___.....,,,,_,g { ( E =,..a....._,,.�.._............._._.,....�.�_.�..._.... ..._.._........._._ __ ....._.._. ....__.._.___ �._.,.__.._ ._...,_..._.._,_ .._._.__ _'__,..._.. . ._._.. ...._.._.__,_._-�._._..........._._...._... ........_.....—� 1 :�.:..�..._.,��_,.�..�...._,,.,....,_.._�.............,..._�..____.._........,.,.,_.�..,.__.._�..__....._...�..__.__.........,...._._...,........_.._...__._........w................,_,.___.........._._....._..._.._........._.._,�_.__._...-..,..._._....,.,..._e...,..__.._...Y..�._�.��................_......___.....�...__._._..._..,..� t x I � ..._......_.._�._......"�. ......_..,..:.__..____�_.,,,..._.... �_..._v....__.....,_..._........__..,......._..___...._.__.........................._....._.............,......_.._....._..... _......._......,.,.._..�.._,..,.- 3�. �_....,..._.___._. . . . ....._.........__ ._.... ..,.._._..W���.................�e..__.._.......�.w, � �,_.._......................�._....a.__..a...................�......_.......,......e..=_.�..�....._..».,.,.,._...._..........,.......w......._.....�_.__...-.........�___......,...._..._...""..�._._..�._.............,_.........,. .. t ....__..�. ..._.................«.,.._�..�........__...,....._.__�...,w..,..,......,.._,._.....___._�........... _...# t i'. �................._.................m...e...__.�......_..._._.........,.._._......_.........._.._.,.._..�.._.........,....._._....._... ,._.._......_......_.,.,...._....,.........,.........._..__,.....,..... ..._..,...........�...._............_..._._..._...____" .. ...............____"._��...................,___....«..._._.__..__..___......._.. ................,.._....._._.1 . . _ .............. .,.�..._._._........,.....,..__�......_....a...............,......_.............,,.......,.,.......�.......... ._._«...................._.......,.......,,....�._...,..�........._..................�......_.............,....,___.._.,....,,........��__.u.,....._...____..._._...........,........._._... � �.' �:�.. �,-=,���` u _a ' �, µ _.__ �_ < _. _._ __._.___m.__.._�e.___..__._. ____._.,..W____.___m_.___.___,_._---__._...____...___.____. ,.�.�____�___...._. ; ��:�..� �� :; �!� �:______—____..._._,_._ ; p ������m�b�'a i €� �'�a.T��.,�'��,� ..... _�_--....._....._..._—_—._..._. __ _._...._.._ _.___...-- —._..�_ ._---�- -.__�_.._ ._._�� �� . __. —._,,.....�....�,_......��....__. C �� ..�������a��������3�������� �� � ' { ��re.'"���������`� g��i����� fd�:.. _ _ .._,_.........__ . .......w..__,.,,.._..._.. ,. ,..____._,._M.__.�._ . ...,._�.__. ._..______—. ....... _..__.__. . __... __....�..____�_._...�_.._.... t � ��'q����a�& �.��� ��` �� ��� ���� : ��;� 'e��„„ ��i+�a`��y�a�w��� ���� �'., t �*��§".�s ���r � �.a��,�s�'.�'� r�� a,; ___..n,.._......__._........._.._...__......_,,,_.....m....�............__..._.....,...._._,_...,.....�.�.._.._......._..._.___..,.._.__.. _,...._._._._.,..V. ,. ��.: �; � � a �,, .., ..__�......._....�.._..._..._ �____ 1 � g"�� a #�'��`"i :*��; �, � a�y e _ P �.8;� ���r�»�� „ ��ni� � +;y . ..._ ....,. ._._.._.__..�.�....,..........�,. �, g �3�& �a".� � ����?� � `��'�����'�,� ....._ .___..............._,...___._...__._.._.__..._..... _ ......_........__.m..._._............._.._._____�..._...__.....,....._____.._....._.__...._._..___..._ � a � ����������� ��'������ ���"�'<�'�.; . � __.._.._.. .........._�._,..... £. . � #������7�����„���"3���� �&�$ �; ....___....a_........._._._._._.._.._......,._._..._..... ._..,�..__._. ......_._...,,....,._.__-�-__...._._____..._......_.�..._._........,.m,........�.�..__...._...__ . .. 3 h� ����� � �`���������� ��� ������ s ,��!��� ��� ���a�� �� �m�� �+;� _—__.__ n � IX,� �s � r: � a� ,. ,...... ....._ ___ .._, .. _.. .. _...... _...._.. --.__ ._.—__ _._.— � �m � �ax��a-��' a�a�t�b��a� �� � �� ,¢� � �"��k � ; � r�_ �y .��.���a_+..���.�. �".��a"�..� x���.�����:.� ._..,,.,..._.A..__.,...�... ._..�.__...__,...,.. -�...........__. .. .._.............._._.._...�,. ...__...,.......... ..,,...____.. .A .._.,__.... .......�,__._....__"____.r._._...__.—____......__..