Loading...
HomeMy WebLinkAbout16404 (3) 1_ � CITY OF DIAMOND BAx DEPARTMENT OF COMMUMTY&DEVELOPMENT SERVICES ` 11660 E.Copley Drive Suite 190 � (909)86a3195 Fau(909)861-3117 PRE$S . �'..., Buu.nnvc r�rr arri,icA�orr FlRMLY oJOBSITE APPLICATION ,����l PERMIT (1 P/C ADDRESS DATE � NUMBER V R � ISSUE TYPE OCC APN LOT TRACT DATE CONST. GROUP � OWNER ADDRES ZONING SETBACKS � CITY � ZIP���TEL � _ qEAR Rw ❑ APPLI ANT T�� SIDE/SIDE STREET RW ❑ � CONTRACTO SIDE ❑ g CIDnDrRESS ZIP TELg ' - P(�P��� u9 ARCWENG/ �Y � DESIGNER ' NO.DWEL. N . N . � ADDRESS UNITS STORIES BEDROOMS � CITY ZIP TEL. � OESCRIPTION Sa.FT. FACTOR PSF ADJ.AREANALUATION p� OWNER-BUILDER DECIARATION SFRlADWREM O 1 MERESY AFRRM UNDER PEWLLTY OF PERJURY TMT i AM EXEMPT FROM THE CONTRAC70fi5 U- G8f9gB/C81pDR C9/5EU11SfORT1iEfOlLOMNOREA90N(SEC.7o71.68USINESSANOPROFESS10N5COUE:ANYqTYOR (fj OOtMTYMMIGiRECUWESAPERMR7000NSTRUCT.ALTER,MPROVE,OF]AOl15H2ORREPAIRANYSTAUC• : LLE Pe�iO/D9dc - 71A1E PRIOR TO RS ISSUIWCE.PLEO REWIRES T}iE APPLICANT FOR SUCH FERMIT TO FkLE A SIGNED : � tTATEYENT TNAT HE OR SXE IS UCENSm Pl1R5l1MIT TO TNE PROVISIONS OF TME CONTRACfORS U- CENSE UW(CHAPTER 0(COIAMENCHJO WITN SECTION 1000)OF DIYISION 9 OF TliE BUSINESS ANO PRO-� '.- � POOVSP9 FfS510NG OODE)��T FiE OR SHE�pCEMPT THEREFROM AN�THE BA515 FOR hIE ALLEOm EXEAIP-� 7qH.ANYV101AT10NOF8ECTION7oJ1.68YANYMPUCANTFORAPERMITeU&1EC79THEMPLICANT70 - Z Re•Raof - � ACMIPEW�LT'OFNO7MORETHANfNEHUNDREDDOl1ARS�f5ao).): - ^ OL�'+�MEqOFTNEPpOPEH7Y.ONMYEMPWVEESWITNwAQE5A57NEIHSOLECOMPENSATDN, 0 CORIRIBfC181 ' � WILL 00 THE YYORK AND THE STRUCTURE IS NOT IMENOED OR OFFERED FOR SALE 15EC.704A BUbI• -. �I NESS At�PqOFE55taJ5 COOE hIE CONTRACTOPS LICENSE LAW�OES Ii�T A7RY TO AN qNNER OF' _ j � VqDPERTYWFiOBUII.DSORMPROVESTHEREON,APIDWHOWESSUCHWOTiKHIMSELFORHENSELFOR (T. 7FSIOUGH MIS OR NEH OWN ENPLOYEES,PROVIDED TH+1T 8Ud1 N/PROVEMENTS ARE NOT MITplDED OR� m � ,OFFEREOPORSALEIF�IWNhVERTHEBUL�INOORIMPROVEMENT�SOLDYVITHMONEYEAflOFCOMPI.E.� . 710N.T1E OMMER�BURDER 1MLLlNVE T11E BUHDEN OF PROVINO TMA7 HE OR SHE DIC NOT BUILD Op MPROVE F�i THE PURPRSE OF 6ALE�. W ❑4ASOWNEROFiHEPROPEiRY.AMIXCLUBNELYCONfRACTINOWI7MlICENSEDCONTRACTOR3 (Z TO CONSTRUCT 1HE PHOJECT ISEC.70H.8U&l�SS AND VROFESSIONS CODE:iME CANfRACTORS U- V81U8tiOn ADJ.AREA tiJ CENSEIANfDOESNOTMPLYTOANON7JENOFAPROPER7YNM1lOBU1LOSORWDROYE9THEREON.AND, FL NM1qOOMMCT8PoR8lIpIPHWECT5WI7HACONfRACTOR(S�IICENSmPUiiSUMR70TWEWHfRAC�. : QUANTITY DESCRIPTION FEE � TORS LICEN6E tAriL�. J �1 AM FXEMPT WVDER 9EG B.d P.C.FOR TNIS REASON Q U � ¢ OATE OWNER � U � IICENSED CONTRACTORS DECIARATION W � Il�REBY�FFWA1 UNOEH PENKTY OF PERJURY 7FUT I MI LtCENSED UNDER PROYISIONS oF piAVTEH � � � i(OOGMENCWUVATHSECTqN7000�OFOM510N30FTF1EBU51NE551WOPFiOFES510N5CWE,AND Z MY LICENSE 16 N FUl FORCE AND EffECi. �� � � LICENSE q.ASS LIC.NO.z/ �� ; � � DA -� � CONTMCTOR C e � � WORKERS'COMPENSATIDN DECLARATION a � I HEREBY IIiFIiW UNDER PENAI.TV OF PERJURY ONEOFTHE WLLOWING�ECtAMTION3: Z � _IWWE/WDWILLMAINTAINACERfIFlCATEOFCONSENT708ELFaNSUHEFORWORKERS' � COYPENSATION,A9GROVWEOBYSECTION3TooOFTNEIABOqWOE,FONTHEPEHFOHMANCE W p OF TIE M/ORK FOR MMICM TMS PERMIT IS ISSVED. � �Fyj _I MMEANO NALLMWNTAW YYORKEHS'COMPENSATION INSUFLWCE,AS HEWIRED 9Y SECTION �L 87000FTNElABORCODE.FORTHEPERFORMANCEOFTFiEWORKFORWHICHTHISPERMITI3 � ISSUED.W yY0 c S'COYPEN3ATION INSURANCE CARRIEH AND POLICY NULIBER ME: CONSTRUCTION j c�wIER '� PLAN REVIEW zPOLICVWIAABER �- ELECTAIC < � (IH65EC11CNNFIDND7BE�OI.RE'tIDaFTHEPEAMi6FORWEIA�EDDq.W�4ltt0010Fl1E5S). PLUM9ING Z 1 CERTIFYTHAT W THE PERFORMANCE OP THE WORK FOH WHICH TWS FERMI7151SSUED,I MECHANICAL � SHALL NO7 EMPIAY ANY iERSON M ANY MAHNER So AS FO BECONE SUB.IEGT TO THE �/j WORKERS'COMPENSATqNLAW50FCAlIFORNIA,/WOMiREETHATIFISF10UlDBECOME �NSPECTIONFEE � SUBJECTTOTHE WORKERS'CONPENSATpN GROVISIONS OF SECTION�7000F THE LABOH COOE,1 SFWl FORiliWI71i CdAPLY WITH THOSE PRONS�ONS. �SSUANCE a � OATE: APPLICANF. SMIP � WARNWO:H1�UflETOSECUNEW�DRICERS'OOMPENSATIONCOVERAOEISUNIAWFUL,MlOSHAILBE ENEFGYP/C � SU&1EC71iNEMPLOYERTOCRIMW�LPENALTIESANOCM�FINESUPTOONEFiUNDREDTFIOUSAND ENEFaYPERMIT DOILARS(f100A00),MI MOITION TO TFIE COST OF C04DENSATION,DAIAAGES AS PqOV�E�PoR W � 9ECTION f7o!OF 7HE UBOR CODE,IIJlEREST,AND ATTORNEV'b FEES. RETENTION FEE: � CONSTRUCTION LENDING AGENCY PRE-ALT FEE: �• 1 MEREBVAGFlRM UNDER PENALTY OF PERJUR'✓THATh1ERE IS ACONSTHUCTION t.FNDINO AOENCY �'�� .��._...s... .. .—_"._." iOR TME PERFOPMANCE OF TNE WORK FOR WHICH TMIS VERM�T IS ISSUED�SEG foa7.CN.C.1. ' "' �"' � IENDER'8 WWE LENDER'S IDDXE53 ICERTIFY7HATIHAVEI�ADTHISMPUCATIONANOSTATETNATTIEABOVEINFORIAATpNISCORpECT. TOTALFEES ' ��� � IAOREETOCDMPLVYVITHALLCRYANDCOUNTYORDINANCESAN09TATEIAWSNELATNK7T08UILDINO �� � CONSTRUCTION,ANOHEREBYAVTVqRREREPRESENTATIVE50FTHISCOINITVTOEMERUPONTHE ABOVE�MIEHTIONED FROPERTY H INSPECTION WRPOSES. COMMENTS � DEfiM1/7EE NNAE IPPIPlT) `/ l � � SqNATUHE OF FERM E � DATE a� - - RECPT.NO. PAID BY VALIDATION F WHITE-0epartment Co YELLOW—Financa py, C.opy,PINK—Assessor Copy,GOLDENROD--File Copyy GR Appficent's Copy CITI( QF DIA11�9O�M[�},BAR _ I������TiA�E �EC�3�� F � � ��.-• �- _ �� � _ - ,:. � � ► '�����.�� �;��,�-..� ; 0 1� _ . �� - �'.- �� ._ �`"�`°������. : �'��: _. . "�����,�_ . � _ .. , _ .. SET BA�K � i� _, ., .J � ' FLOOR JC715T 1 _ : _ ;----�-t--- ----- _-__ --___----- __- FTGS?FCRt�"��'�TE L � i FHA REQ�1lTS . . ) . �__.__ ___ �_ , ELECTRIC G�O�`dD_ � --= ____�__._ ; ; UN[?ER FLt3C�R DUCT � � — — - -- --�._�� _ ..___.._ ��RUUf�� P��.���f�l!�;G ' ' UNDEF? FLOOR G(7f•iDUiT , . SLAB GR,�L��----- ; FIREP�A��-�fl�':>fff3��tON . -� �i --- -- --- _�.___._ � . �'L_ � _ �r��;�����}K� _ ; ; ' �i�E�L��E eo��s���� _ j � _ -- �_ __ _� vd��r�P sE�v�c� ; � r�i���: �or���E�r� �. . R(:tG£�SHERT�:1��_ _ � � `'�_.___'r' 8 FT.,BOND BEAM_, � ��=---- --____ ---� �R.4f�"3tJ£�NE�Ti�1�;T1Q�1 f � 1 - I E�iPJAL�BtJ[°JD BEA�� ; --- - _ s�d���i�4�i�i - . ��s� . ��/-�,�OL � PR�-GRADING �RC7t3�N rt���lT�lu 'V� � -- BENCHING ; --- RO:Ji��-i E?��T�?(C i �trJUGH C�RfiDtNG i � __________� t �__ _ �Ri:.u`::�� P�U�v1B�NG i : FINISN GF3ADING � � -- ��-,'�"��F;,s�JB TEST ; j PCOL ELECTFiIC ' � — ---- �-XT � �Tk-+':��lPJG ; { PCflL FEI�CING ' ; _.___ 'Tds'-.t�IP'�s�L�;T';�^3 ` ! . .: POL3L Fti�iAL � ; ; —`� �!' � ti ' ��-���ii i��J - -' � . .. . QI'���T��T�t�'..�'s,. ' . : .. _.�__...__�_ ____ � -- -�__..,._ � ��..�__. �^'��`�' L"� ,��3`�d� � _. DE�IGATi��NS � w � _.�_._________ : � .a•_?� s. F'!L'JaL Et�lG. __- -- ;------- -- - -- -- ------ . � c��=t' r' T7�Nl: � - _ l..t"stvC}�i,t�f'�il�"'iRIC�a. ------ --— __---- j �`Lr : i:!`_.L. ; ' ", ;', C���v'SITE I�RPS. ---�.__ ._.._____.__� � _ ___� ' � �a � .:5� � t='.�J�tL Z''..`.}R�1F!� s-�- - �� 7-- -. _- v. ----;-- --_ -- ----- ---- __. —_—� ' .�;?�` T. _ t`f-2.�L � i =1Ft=�?�?3. i=1�:A.� �c � . 3 �.T':�v� _ _ � _ !-i��l�l-§ �?��Pi. �li��i,^N� �---- m__..-�`..�_._ _ —; -- , ��:�rs•� i �[�Etii���.} �fi.3i)� `= ' _ _-- �A_ �—_._-- ' --- ------ ------- -- -- _ __ r-�--- --- ; ` NLL'���3�.°: I �i'dF_R':`t , , i _._ _____� _ _ ��_.. _� _ _.__� _�__.__��� � __._ � � � � �.-�-+�- �; .-- - .,.R.� __ _ , � s,�� _____ : � a�_,K'�.� .:�`���.a,��,�+ . _.. . �- — --- ---- _,� i __� --=---- _�—__-------- - . , ...��_� ____-_. _ _ . .. . _ ' . _ v I � . . _ _. . . . _ j j T-.9+.-'.ei��}��'`�� � � _...�� . ..��...w� _- ��,.......___ 7i w� �.__..._'____.___—�__"._._"�_—"'_,..__—__' __"'_"__-__.__.____-.�.___--`._`_�__-e-..__'_'_.__—_- :, t�..,_._..._._...a __ i 3 e� ..,.�..._ _._.-._" ""_�_._._.r___..._-.� �; �_ .. - ." ..._�.��...v.��_.�.___ .�_�__� � __'_ ._-«� i �. .. . . - �'. - . - � { � L-.' . . `�.��.�___"__. ______'�___'�_ _'_"_..` ___-___ ..__._-_._-.. ___..._._______.—__ _ ...._..-__T--_—_____"_ __.; F ; 1 _ . _ �.W..e_ ._�.�..� ___._.._.�._...s......__..._.._._..�_..._�_�....___"._m..T.___....__.___—_�-_...__.�..�.�.___..__.._...._..._.__�_..r..�___�j � p��e_�.--.�..-..._.._._.._. _. . .�_.___��_ . � _._.._______"� . . . . _. ._ .. . ' _ ' - 1 �...��.__ v._...�.� .__ _ ._..�.._. �._—__-- � �- � _ . . � ..-� . . � .�_.��__ _ _. . .�_� _�__�._ �.� _r__ ...�..� � �CY�.�����1{�tl- ..�.___�__.._. --.__._.__� —_�w._._ � C��C �i Eef:� uE%� . k. -- - -----__..------._.____.__..-----------------_�__��----- ----._�._.J ---..�_.�.�.-- { C .. .,.-._.,_�. ._ i .( . �. . - ��- � . ..::�. � . :. .- : t w'-�-'�", - --- __._a____-_.______.__�____._.__.. __.__.___.___ -------_.__.���________�_.____; v 4 f � -..�..__.�__- ----- ----_____��—_._�Tw___ �._ ._� � I � i � _� _._ ..__«.________�._.__._____:�__________�._____._.�.---- -----._ _ _...__.T.._�_; 1 E � ; �._....__.___` r �.�.�._— _._ .__.__._.__.._.__-.--..�.�._.._ - g ._ $ r �__-�_.. _ ` � ' :�.�.�,...-�.. . _:: ' . . ,° S '7 '- ' �' . _,..... .,. . __.._ ..� .�.s..e.___...��.—+--.-f---�`-__._._....�.'"'..._�..._ �. .�_..."'___..._._....._____'__..._'___._—_.._.,__..__._, _.�____._—__S # . . . _ . v.� _ .