HomeMy WebLinkAbout11294 -._ .. ...._.. , ��
---�� -- CITY OFDIAMOND BAR (
COb7MUN1TY DEVELOPMENT DEPARTMENT
,'�-..0 2I660E.Copley Drive Suite 190 PRESS
(909)860-3195 Fax(909)861-3117
`"^' BUILDING PERMITAPPLICATION FIRMLY
Q ADDRIESS �170 D �o P,�E y v2 �a og APPLICATION L Z � PERMIT Z P/C
p DA7E NUMBE k
� APN LOT TRACT �SSUE TYPE OCC
p OWNE�YYln1 ELL �Ro� 'o. DATE CONST. GROUP
o ADDRESS__5R0/ S. �9 5Tc.PtJ��/6 � /DO ZONING SETFiACKS
oCITY L, /-,1 ZIP on J TEL. REART RW ❑�
o APPLICANT TEL. SIDFJSIDE STREET RW ❑
� CONTRACTOR �/ G GT t SIDE ❑
� ADDRESS / ' ERITu/l F T�2. � 7�
� CITY ��/�P/� 4Drnl� ZIP�f/75o"�TEL Qy3EP3y.7�/ PROPOSEDUSE
o ARCH/ENG/
. W DESIGNER NO.DWEL. NO. NO.
a aDDRESS UNITS STORIES 4EDROOMS
� CIN ZIP TEL.
�
cn DESCRIPTION SO.FT. FACTOR PSF ADJ.AREANALUATION
p� OWNER-BCILDEq DECLARATION SFFilADDlREM
O '
p I NEREBY AFFlRu UNDEH PENALTY OF PEH.IURY THAT�AM E%EMPT FROM THE LONTMC70R5 L4 Garage/Carport
W CENSEUWFORiHEFOILOWINGREA50N(SEC.70]I.SBUSMESSANDPHOFESSiONSCODE:hM'CITVOR (/)
U �pUNT'lWHICHREOl11RE5APEFMITTOCONSTRUCT,ALTERIMPqpVE,OCMOl15H2ORREMIRANYSTRUC- W patioJpeck
Z 7UHE.PRIOR TO RS ISSUANCE.ILSO REOUIRES TME APPLICANT FOR SUCH PERUIT TO iILE A SIGNEO
w STATENEHT THAT HE OFI 6HE IS LICENSED WRSUANT TO THE PROVISiONS OF TME CONiMCTOAS LI- W
� CENSE UW(Q111PTER 9(COMMENCINO WITH SECTION T000)OF O�V�SION 70F THE BUSINESS AN'J PRO• V"' PooVSDa
FESSqNSCODE)ORTHA7HEOASHEISE%EIAPTiHEREFHOAIANDTHE0A515FORTNEIILLEGEDE%EMP- (�
VTION.M7VY�OLATIONOFSEGTION7071.SBYPNYAiPLICANTFORAPERMITSU&lECTSTHEMPLICANTTO Z Re-Roaf
ACML DEwLLiY OF NOT IAOR[THAN FNE HUNOREO DOLU0.S�SSao).)� '
� 04ASOWNEROFTH[PROPERTYAHUYEMvIDYEESWITHWAGESl15THEIRSOIECOMPENSATION, 0 CpTmerCk'fl
Z WI:LDO THE WORK M9 THE STRUCTUFE IS NOT INTENOED OR OFFERED FOR SALE(SEC.70u.BU56 J
� NESS AND PROFESSIONS CODE:TME COMRACTORS UCENSE UW DOES NOT 11PDLV TO AN ONT�ER OF =
PROVERiY MR70 BUqD50H II.IPRpYESTMEREON,M1D WHO DOES SUCM WpRK MIMSELF Ofl MEqSELF OR
� THROUGHHISORNEROWNE4FLDVEE5,7ROVIDEDTHATSUp/1NPROVEYENTSARENOTNTENDEDOR m
W OFiEREDFORSALE.IF,NOWEVER7HE8ULDINGORIAIPROVEMENTIS50lDWRnINONEYEAROFWMPLE�
� ilON,1H[OWNER-&1ILDER WILL HAVE THE 9UR'JEN OF PROVING THAT NE OR SHE DIO NOT BUILf7 OR
= WPROVEFOflTMEPURPO5EOF5ALE�
w ❑I,ASOWNEflOFTHEVROPERTY.AME%GlU51YELYCONTRAC7WGWITHLICENSEDLONTMCTORS
� TO CONSTRUCT TME PRO.IECT(SEC.70��,BUSINESS ANO CROFESSIONS CODE:THE CONTRACTORS LI• VBIUA1t0� A0.1.AREA
W CENSEUWDOESNOTAPVLYTOANOYNEROFIIPROPERTYWHOBUILOSORIMPppyESTHEREON.AND
� Y.1iDCON7MC75fORSl1CNGRn1ECTSWITHAfANTMCTOR(S)IICENSEDFURSUANTNiHECONTfiAG QUANTITY DESCRIPTION FEE
Y T0135 LICENSE LAW.).
� ❑IM7E%EIAPTUNDERSEG B.1P.C.FORTHISREASON < �� �P�aeL �
3 c�
LL � a sw,T� N�
DATE OWYER U
Z �
� UCENSED CONTRACTORS DECLARATION W , ,
� IHERfBYAFGIRMUNDERPEN/�LTYOFGER0.JRv7HATIAMLICENSEDUNDERPA0N4pN50FCMAPTER Vr � _ -
� Y(C0IANENCwGW?HSECTION70o0)OFDINSION70FTHEBUSINESSIWDGROFESSIONSCODE.AYD Z
X MY LICENSE IS M FULL nFORCE M!0 EFFEGT.
� LICENSE CWSS `-' � ��.No. a 9�a y�3 j
V DnTE a-a�/-�I ' cowrrucronNl tl Lfc`/P ECEC•'T�i� a
� �-���L �
� WORKERS'COMPENSATION DECLARATION a
N IHEREBYAFFIRMUN�ERPENALTVOFVERJURYONEOFTHEFOILOwiNUOEd.AfU 5: '1f Z
� �IWIVEANDWILLE�AINTAINACER7IFICATEOFCONSENTTOSELF�INSUf1EFORWORKERS' _
� COUPENSATqN,A5 VROViD[O BV SECTION 7loa OF TMf UBOR CODE.FOR THE VERPORAI�VJCE U
. Q OFiMEWORICFOfiWMICMTXISPEflMITI5155VED. �
O
� _IHAVEAYDWILLMAINTAINYfORKERS'COMPENSATIONINSUMNCE.ASREOUIREDBYSECTqN
Q . 070oOFTHEUBORCO0E,F01iTH[PEFFORMANCEOFTHEWOqKFOAWFIipiTH15PERMITIS
ISSUEO.MYWORN S'COMPENSATIONINSURANCECARi71ERANDPOLIGYNUM0ER11RE: CONSTRUCT�ON
� CARRIEN �Pu BL�e x��' u rT PLAN REVIEW
� POLICYNUTA�E0. � ECTRIC
�� (THSSECilO��NEmNO78ECd.i'IETEDOF71fPER1dT6WHOHEFUOf1EDDOlUfL �ro�0aL�551. PLUMBING
Z �CERTiFYTHATWTHEPERFOfiMANCEOFiMEWOPHFORwHiq1TH15PEAMITI5155UED.l MECHANICAL r� /�� � 11
(7 511ALLNOTEIAPLOYANVVERSONINMlYMANNERSOASi08ECOMESUBJECTTOTHE �"P
� M/ORKERS'ODAIPENSATIONUWSOFCALIFORNIA,ANDAGREETHATIFISHOUIDBECOME INSPECTIONFEE -
SUOJECi TO TXE WORKERS'COMPENSATqN PRON�SIONS OF SECTqN 370o OF iME LAEtOR �
O cooE.isH�FORTNwinaca+a�rwin�rN�ow�or�s. „ � ISSUayCE
/
p DATE: a�a` 94 APPLICAHT: �(/CfiJ SMIP I��QQ
� ENERGY P/C
WARNiNO:FA4URE TO SECURE WORKERS'CGAPENSATqN COVEBAGE IS UNUwM,FNO SHALL B[
�y, SUBJECTANEMPLOYERTOLRIMINALVENAL7IESANDCIVILFINESUPTOONENUNDREDTMOUSMD ENERGYPERMIT
DOLLMS(f 100.000�.IN ADDITION 10 THE COST OF COMPENSATION.DNAAGES AS ORONOfD Fpq IN
� SEGTqN 7708 OF THE UBOR GOO[,INTEREST,ANDA7TORNEYS FEES. RETENTION FEE:
a CONSTRUCTION LENDING AGENCY PqE•ALT FEE:
O
� INERE9YAFFIHMUNDERDEN�LTYOFPEfWRYTHAT7HEREISACONSTRUCT10NlEN0�NG�GCNCY
FOR TNE PERFOMIANCE OF THE WORK FOR YAACH TMIS VEii1.11T IS ISSUED I,SEC.]OB7,CIV.C.).
Z
W
� LENDERSNAME
� F— LENDERSIDORESS
� 1 CERTIFY THAT I HAYE RE�D THU^APPLMJ�TION AND STATE TNATTHE ABOYE MFORMATION IS CARRECT. TOTAL FEES ��
w I AGREE TOCOMRY WITHALL CRY M1D CDUNTY ORDINANCESANO STATE UYVS RELATINC TO BUILOiNC
� CONSTRUCTION.ANDHEREBVAUTMORIZEREPRESENTAiNESOFTHISCWNTVTOENTfRUPONTNE
� ABOVE�MENipNED CR07ERTY FOR INSPEGTION PURPOSES.
o COMMENTS
= f�•�P� C_';4�r�L
� P E NAu[(PRI ) � —��_�/y �—
O
� SIGNAiUR OF PERMI OATE
. � RECP7.NO. PAID BY VALJDATION
WHITE--0epartment Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GOLDLNFlOD--File Copy.GREEN—Applwant's Copy
• . � ,- . -. '.� . � '. . .. � .. . •r; � , . ,. . .. . .i. . ... . •, ��.. . ...., t� . . .. . .. . . . . .... .
CITY OF,DIAMOfVD BAR . .. '. .
� . .. , - .
�. � INSPECTIOf�! RECORD '" � ' '
�
L��.k- ' �� �► � � �� �..�-����'�7r I,�k-�' ���i.C��' e � ( e .
SET BACK � � , � FLOOR JOIST - -
FTGS/FORMS/STEEL ' FHA REQM7S - - ' -
ELECTRIC GROUND • UNDER FLOOR DUCT •
GR�UND PLUMBING UNDER FLOOR CONDUIT •• ' • '
SLAB GRADE ' FIREPLACE FOUNDATION '
TEMP POWER - FIREPLACE BOND BEAM
WATER SERVICE MIQ HT. 80ND BEAM � � ' ' � "
R�OF SHEATHING E3 FT.BOND BEAM •
FRAMINGNENTILIATION FINAL BOND BEAM - -
Fi00F COVER PRE-GRADING •�
RDUGH H�ATING - • BENCHING � �
ROUGH ELECTRIC ROUGH GRADING
ROUGH PLUMBING - � FINISH GRADING
SHOWERIf UB TEST - POOL ELECTRIC • �
EXT.LATH/SIDING - - POOL FENCING
WALL INSULATION POOL FINAL
CEILING INSULATION �FF SITE IMPS. �
DRYWALL NAILING DEDICATIONS
SE�"JER FINAL ENG. .
SEPTIC TANK . . .. � LANDSCAPE/IRRIG.- �
SEEP P_IT1L.L. ON SITE IMPS. '
GASAIR-TEST ' - FINALZONING •
FINAL GONST. " FIRE DEPT. FINAL �
FINAL HEATING / HEALTH DEPT. FINAL � � -
FINAL ELECTRIC ��1y� — �� DEV. FEES PAID
FINAL PLUMBING EFJERGY
�e;��t���J. e
_ ._ _ _ : . ... . , - , .. , . �
COMMENTS ' �
. ,
,
:, r}:�,s, . .
ht?�' ,� � �i J 1 '. , . ' . ' ,
i
SEPTIC TANK SIZE - - - - '
SEEP PITN SIZE
i
,�/� � , , ; ;
; , . •
�� . �
. . . . . . --. _ .. �