HomeMy WebLinkAbout15706 (20) -_. .--,� CITY OF DIAMOND BAbt ✓
DEPARTMENT OF COMMtJNITY d�DEVEGOPMENT SERVICES ��
- �; . 21660 E.Copley Diive Suite 190
(909)$60-3195 Fax(909)861-3127 R.:• - PRESS
- BUiI.DING PERMIT APPLICATIO � � FlRMLY
� JOBSITE C r � �i�x�/? � APPLICATION C '3d ��ERMR i L�� U /C
o ADDRESS �Y � L ��( pq7E NUMBER �� �t
� ISSUE TYPE pCC
APN LOT TRACT DATE CONST. GROUP
g OWNER
p ADDRESS Z�NING SET6ACKS
CI7Y 21P TEL FRONT RW ❑
APPiICANT TE $�DElSIQE STREET RW ❑
CONTRACTOR ��'Z ZO � 51DE ❑
� C TDRESS Z'P � � � PROPOSED USE � IG� IU � N/�
� ARCHIENG/
DESIGNER NO.DWEL NO. NO.
ADDRESS
� CITY ZIP TEL LINITS STORIES BEDROOMS
�
� OwNER-BUILDER DECLnw�T10N DESCRIPTION SQ.Fi. FACTOR PSF ADJ.AREANALUATION
O
SFR/ADD/REM
I I�REBY AFFWM UNDEA►ENALTY OF PE0.RIRY TNAT I NA EXEMP7 FROM TFiE CONTHACTORS lF Ci8f8�B/C81pOR
CENSEUWPORTNFiOLLOWINOREASON(eEC.7091.68U81NE6SANDPqDFESSKKJSCOOE:ANYCITYOR (n -
COUHiYNMICHREOUIRESAPERMRTDOGI3TRUCT,AITERMVHOYE,DB.WIJBH,ORREPNRANYS7AUC- W Pd1101DBCk
1UFlE.PR�OFt TO ITS 189llANCE.AL80 flE0U1RE5 THE MFLK,MIT fOR$ULM PEpN1T 7p RLE A SIONE� W
STATEMINT TIUT ME OR SHE�UCENSED PUf15UAM TO THE P(i0YI510PS OF TME CONTRACTOAS LL
CENSE UW(QIAPfEF Y�COMMENCINO WRH 9ECTqN fOW)OF pM$1pN 90F THE BUSINESS AND PRD- V' P001/Sp9
FESSpNS OODEI OR TlIAT NE Of1 CHE IS IXEMPT 1NEHEFfbM AND 111E BA55 FOR TNE KLEOED E71EMP-
TION.ANYYbtAT10NOF�Cf�17037,6BYlWYAPPLIGNTPDRAPE1U11TSUBJECTSTHEMPUC�NTTO Z Re-Root 2,
� AqY1L iENALN OF NOT YOpE THAN FIVE MUNpRE�DOLLARS(t6ao).�: J .
OLASWMNEROF1HEPqOPER7Y,ONMYEMPLOYEESWITHWAGESASTHEIR90LECOMPENSATqN, COTrtIBfCiel
IMLL D�TFIE MWq{,M1D 7ME STl1UC7URE IS NOT INfENDE�Oft OFfERED FOR SALE�SEC.70s4,8U51- �
� NE55 AND YNOFESSIONS COOE:7lIE OONTMCTORS LiCENSE WY OOES NOT MPLY 70 A4 OWNER OF =
iNOPEFiTM WF108U0.DSOR WPROVE87HEREON,AND WhlO UOE5 SUCN WWiN FpMSELF OR NERSftFOR
� 1HROUOIi1M5OHNEflONMEY%AYEES.VIbVIDEDTHATBUCFiWPROVEI�fftliSANENOTOJTENO600R �
OFFFRm iORBALE 6 HONhYER iME 6lM.dNOOR 4PiWVEAJB�R IS SOID WrtNNJONEYEAROFCalA0.E
TION.TME OYMER�BURDER WILL NAVE 71iE BURDEN OF VROVNIO TIAT HE OR SNE OID NOT BUIID OR
MIPNOVE WR TF�PUqP06E OF BALEF
� O L�OM�NER Of T1E PROPERTY,M1 EXCLUbRIELY 00HTMCTINO WITH LICENSED CONTMCTORS
TO OONSTHUCT iHE PRWECT(SEC.7014,EU6NE99 AND►fiOFE551ON9 CODE:Tf1E CONTMC70RS ll• V81U9t101f ADJ.AREA
CO1SE tAW DOES NOTAPPLY i0 AN OWNER OFA PNOGEHTY M?108UI1D5 Oq IMPFiOYES iTlEREON,M$1
� �c��rrucrsh'owsuaiPra�c78WitHAcarriwic7oAlSIuc�BEDrunswvrttornEoorrtrua QUANTITY DESCRIPTION �E
� O I W DIEMPT UI�EN 6EC. 9.L P.Q FOR TNIS PEASON Q . .
U
�' DATE OWNER F .
Z U
� LICENSED CONTRACTORS DECLARATION W
� 1 NEqEBY AFFIRAi UI�qER VENALTY OF OE0.1UM THAT 1 AM LICENSED UNDER PROVISION6 OF CHAPTEi1 �
� �(OOAdMENCINO YVITH BECTION 7CW)�D1VISqN 9 0F THE BUSINESS AND PROFE55KKJ5 CODE,MiD Z �
NY UCENSE�N FULL FORCEANO EFF{C7: �
� LICENSE CUSS C liC.NO. O � �
� aere � coNrrucroa a
WORKERS'COMPENSATION DECLARATIO Q
� ItIEREBYAFFIRMW�IDERPENALTYOFPE0.WMONEOFTHEFOLLOWINGDECLAMTqNS: Z
� _�iNVEANGWILLIMMAINACERIIFMIITEOFCONSENTMBELFaNSUREFORNpRKERB' ¢
OOAAPENSA710N,ASPROVIDEDBYBEC710N97000FTMEUBORCOOE,FORTHEPERFORMANCE 'U
Q OFTNFWOPoCFORWHICNTlNSPERMRISISSUEO. �
_1 FI�VE AND WILL MAMAIN WqiKER6'COMOENSATqN INSl1RANCE.AS HEWIRED BY tECT10N (�L
O a7oo GF 7NE LABOH OODE,FOR lHE PERFOqMANGE OFTHE VlORK fDR WMq1 TXIS PERM�715 ](
ISSUED.YYWORKEpS'OOIMPHJ9A710NqISUNANCEGRHIERANDPOLICYNl1MBE ME: CONSTRUCTION [) �
� CARRIER '�Z ���F PLAN REVIEW
� POLICYMIM9ER `�l' - �L� � ELECTRIC
R�se�crc�+�raTeEoo�r�t�oFnfr�*rswna��aiwr�ooawu+sR+a�oi+tEss� PLUMBING �E �'
8
�. I�RTIFY71iATWTNEPERFOiWANCEOFTHEWORKf�ORWHICHTHISVERMRLSI55UED,� MECHANICAL
SHKLNOT EMVLOYANY VER90N W ANY MMINER 90A5 TO BE WME SVBJECf TO iHE
y WORKERS'COMOENSATpN U1W&OF CALIFORNI^Mip ApREE TfMT�18Vi0UlD BECOME INSPEC710N FEE
S BUBJECTTOTHENpRKERS'COMPB�ISMIDNPROY1S10NSOFSECTION97ooOF7HELABOR
s`uuco caar�rNnrnn�osep�nswNs. ISSUANCE �
O �/
� DATE: APPL�CAM: � i..ri_� SMIP T�7�-�
WMNINO:F WRET08ECIAEWOtY(EH9'COMPENSATIONCOVERAG ISUitAWFUL,ANOSHALLBE ENERGYP/C 1q1J
SU61EC7ANEMP�OYERiOGRIMWALPENKTESANOCMLFINESWTOqVEMUtqRE�liiWSMiD ENERGYPERMIT D A��
� DOLlM31i7ao,00c�,W ADUITION TO7ilE COST OF CORIPENSATqN.DAMAOES AS PROVIDED POR IN
BECTION97010F7HEUBORCODE,WTEREST,ANDA?TDRNEY'dFEE3. - RETENTIONFEE:
� CONSTRUCTION LENDIN6 AGENCY PRE-ALT FEE:
� IMEREBYAFF111MUNOERPENAL7YOiPER1URYTNA7iilERE16ACON5TRUCT10NLENDINpAOENCY � . -
Z FOR THE PERWNFIANCE OF7XE WORK fOR WHICN TXIS PERMIT IS ISSUED ISEC.�oY7,pV.C.�. -
l!.]
� LEf�EfiS N4� - _ - -
� LEIDERSAODRESS
� IA6HEETO��wm��T"crtrN+o�c�n�oago?ww sTµosi�r°Euws°�r�ONworon��oENii TOTAL FEES � ��
� CONSTHUCTION.MWMEREBVAU7HONREREPRESEMATIVESOFTWSCIX1NiYTOENTERUO'ONTHE -
S� ABOVEJAEN�IDNEUPROCER7YFORINSPECTIONPURPOSE3. L'QMMENTS � . � � .
� () ��
� aswamEE �
�
� SIOHII7U E DATE
� � RECPT.NO. - PAID BY VALIDATION
WHITE-0epartment Copy,YELLOW—Finanoe Copy,PINK—Aasessor Copy,GOLDENROD--File Copy,GREEN—ApplicanCs Copy
CITY OF D1A.MOND BAR
" �,....• { +s
� It�SPEC'i'ION �SECORD
_ _.�
. a �_���` E � • �� � - , � - � • .,: _ ��*.� �
�
���.. �x�-� ,._�.:
SET BAGK � • , I I FLOOR JOI�T ,.°,':- I �-_---_--- ---��
'FTGSIFORMS/STEEL � � FHA REGIMTS ; ���
ELECTRIC GROUND ' UNdER FLOOR DUGT
GROURlD PLUMBlNG � UNDER FLOOR Cf7�IdU1T ` �,R
SLAB GRADE ( I FIREp�AGE FaU�JDATION I
_—__�_^__ _
TEMP POWER � I �IREPt:ACE BC1(dD BEAM �
WATER SERViC� i T MiD HT. BE1ND'BE'AM ; { �
� �fi00F SHEATHlNG , ((�-3 , I' f 8 Fi'.B.Q.ND,SEAM , _
FRAMING/`J�NTILIATEUN I ' FINAL'BC3Nf�B�AM ---�--------- � _ -----
ROOF COVER i �. PRE-GRADING I
ROUGH HEATING ' BENCHING i
R�UGH E�ECi'FiIC � ROUGN GRADING _
FiOUGN P�UMBING I FENISk-�GRADING � ' ;
S}iOWER(}"UB TcST I I� POOL Et�ECTRlG � ! �
EXT.LATHlSlDII�fG � I PUOL FENCING I ! __ °
,
1NALL IiVSULATION � POOL FINAL � �
CE1LtNt�INSt1l.ATtOi�! OFF SITE IMPS. i �
DRYWALL NAIL(PtG ; I ; DEDICATIONS I i
SEWER — -� , FINAL ENG. ( I ,_ _�
SEPTIC TANI� i LANDSCAPEi1RRIG. i I �.�__ __
�SEEP PET1i�.L .- _' O"d SITE IMPS_---- j , -- '
� GAS A{R TEST ; 4 Fis'Vr�L ZOFdiNG I ____�._ � 3
� F1NAL.G:3PJS7. ;�(� ��j �,1, � FIFiE�JEPT. FINAL �i �
� � � i ,---�^`-V HEAL7N DEPT FI!`l�,� '
FI(vf��1-1cATI11tC'a � , � _ �.__� ?
�__�_
� FINa=�LECTRiC i � :-; D�tl,�EES PAI� j . '
�_.__ _�_�—_____ _____._._--
: �=3�l�;L PLUMB(Nc� � j ' I Et��R�Y � �
� � �--�— _—_----
; i � �`�����`
-- � ,
� :���r .'>:��ea�. --
if '._`,
�
: - ---- ------- <
; GU��EViENTS — �
� _�___--
3 - -----
3
. ., ��
�
• -- ---- _ I
� _ ---------_-----------------____—_;
. � —
�
SEPTIG TANK S1Z� ------ - ----�
SEEP PIT{U S1ZE_ - - ---__._3
,� �� :
, ,.
� � _ �.------ -._
� ��� '
E
£
_._. — "�.�.—�
. . ... . . .—..�___�
_� \ _ '—_.____.____._. ______—_ �. �
.. - . 1 � �:`.t� ' - . . �.d..'— _..�