HomeMy WebLinkAbout14-3428 u:','.Y'"��.__—_, C1TY OF DIAMOND 13AR
�I-Tr� I I i . i ; DEPARTMENT OF COMMUNITY&DEVELOPM�NT SERVICES �
<<�p�„� ,�.��.� 21810 Coplcy Drive,Diamond 13ar,CA 91765 PR�SS
��� �� � ',���� � (909)839-7020 Fax:(909)861-31'17 Building Inspection Hotline(909)839-7027 I
�\'`"'"°l" I3UILDING PERVIIT APPLICATION FIRMLY
� JOB SITE ADDRESS Jl�1 � APPLICATION DATE: s/ / P/C# � �
a ISSUE DATE: -�s/yPERMIT# ��"3 f Y�d j
z APN LOT TRACT r�-� /�
w OWNER I7(j� ✓.' � M ed l ev TYPE CONST. ��/'��/��OCC GROUP:
N ADDRESS
y CITY ZIP TEL.�D�'�I1"PJ y?�I ZONING F ONT KS RW ❑
� APPLICANT S�1 �+11 ' 1 c/ TEL.1�`(-3t0-3q(� REAR ❑
� / SIDE/SIDE STREET RW ❑
¢ CONTRACTOR �Q (�.� p e J' SIDE ❑
o� ADDRESS i y 1 z`I ✓P� �-u���� � s�7 PROPOSED USE
o cnY sh eir�u.� UG ICSZIP ��a3 TEL. OI�`QY�" S�I Ei
o ARCH/ENG/DESIGNER
w
o ADDRESS
#DWEL.UNITS t!STORIES #BEDROOMS
z CITY ZIP TEL.
m DESCRIPTION Sa.Ff. FACTOR PSF ADJ.AREIVVALUATION
a OWNER-BUILDfA DECLAItATION
� I hereby atfirm under penalty ot peryury that I am exempt from ihe Contractor's State License taw for the reason(s) SFR/ADD/REM
0
p indicated below by the checkmark�s),I have placed next to the applicable item(s)[Section 7037.5,Buslness and Garage/Carport
o Protessions Code:My city or county that requires a permit ta construcR alter,improve,demolish,or repair,any
w structure,prior to its issuance,also requires the applicant far the permit to file a signed statemenl that he or she � Patio/Deck
a is licensed pursuant to ihe provisions of the Cairtraclor's Sfate License Law(Chapter9)Commencing wiN Seclion w
� 7000 of Uivision 3 of the Business anA Prafessions Code]or ihat he or she is exempt from licensure and the basis(or � Pool/Spa
� the alleged exemption.Any violation of Secfion 7031.5 by any aOPlicant for a permit suDjects the applicant to a civil penalry C7
� of not more Nan tive hundretl dollars($500). ZQ Re-Roof
o (�I,as owner of the property,or my employees with wages as their sole compensation,will do(�all of or U portions � Commercial
� ot the work,and ihe structure is not intended or ottered for sale(Section 7044,Business and Professions Code:The m
Z Contractors'State License Law does not apply to an owner of properry who,through employees'or personal ettort,builds
� or improves the property,provided that the improvemenfs are not intended or offered for sale.If however,the building or
� improvement is sold within one year of comple6on,the Owner-Builder will have the burden of proving ihat it was not built
p or improved for the purpose of sale.).
U
(�I,as owner ol the property,am exclusively contracting with licensed ConVactors to conshuct the project(Section Valuation: Adj.AreB:
0 7044,Business and Professions Code:The Coniractors'Stale License Law does not apply to an owner ol Droperry who
z builds or improves ihereon,and who contracis(or the projecls wim a licensed Contracror pursuant to the Contracrors'State QUANTITY DESCRIPTION FEE
N
Y License Law.).
o U�am exempt from licensure under the ConVactur's State License law lor the following reason(s): a
� ¢
LL By my signature below I acknowledge that,except for my personal residence in which I must have resided for at least one w
o year prior to complelion of the impmvements covered by Nis permit,l cannot legalty seli a structure that 1 have built as an W
� owner-builder if it has not been construded in its entirery by Iicen5e0 contractors.I understand mat a copy ol ihe applica�le
� law,Section 7044 ot the Business and Professions Code is available upon reques[when Nis application is submitted or at � e ;A e C J �°
X the following We6 site:htt�v.leginfo.ca.gov/calaw.html. Z
o DATE: SIGN: � ; Ur S
� LICENSEU CONTNACTOR'S DECLARATION �
w I hereby aNirm untler penalty ot perjury that I am licensed under provisions of Chapter 9(commencing with Section 7000)
m ol Division 3 0l the Business and Professions Code,and my license is in full force and eflect. J
� ¢
� L36 /�' �/ p �
� UCENSE CU�SS: LIC.NO.: '7 2'7 0 T L z
oZ DATE: �I Z S� I `I CONTFACTOR: �a'��t f �
a WORKEfl'S COMPENSATION UECLAflAT10N g
� I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLAR.4Ti0NS:
oI have and wili maintain a Certificate of Consent to Sell-Insure for Worker's CompensaGon,as pro�ided 6y CONSTRUCTION:
Section 3700 0l the Labor Code,for ihe peRormance of the work for which this permit is issued. p�qN REVIEW:
� f I have and will maintain WorkeYs Compensation Insurance,as required by Section 3700 of the Labor Code,for
� ihe pedormance of the work for which this Dermit is issued.My WorkePs Compensation Insurance Carrier and ELECTRIC:
a PolicyNumberare: ,_ PLUMBING: �
� CARRIER L V��e S-F' MECHANICAL
� POLICY NUMBER�G UUU�'L U S 1 3� INSPECTION FEE:
N (THIS SECIION NEfD NOT BE COMPLEfEO IF THE PERMR IS FOR ONE HUNDRFD OOL.Lhf1S($10�OR LESS).
� ISSUANCE: i
� I certify ihat in the peAormance of the work lor which ihis permit is issueU,I shall not employ any person in arry manner so as to "
0
6ecome subjed to the Waker's Compensalion taws al Calilomia.Md agree that if I should become subject to ihe Woiker's SMIP:
� Compensalion provisions of Section 3700 of Ne Laba Code,I sh�oNn�vith co"p tlrose provisions. ENERGY P/C:
LL DATE: y 2-S ` APPLICANT:��� /��/ ENERGY PERMIT: �n
� wARNING FaiWre to secure Workers mC�pensalion coverage is unl ul,and shall subject an employer to criminal RETENTION FEE: ?/(f�O
w penatlies and civil tines up to one hundred Nousand dollars($t00,00D�,in addition to the cost of the compensation,
a damages as provided tor in section 3708 oi the labor code,interest,and attomey's fees. PRE-ALT FEE:
0
a CONSTRUCTION LENDING AGENCY BSAF:
w I hereby atfirm under penalty oi perjury that there is a Constmction Lending Agency for the pedormance ol the work br
= which this permit is issued(Sec.3097,Civ.C.�.
� LENDER'S NAME:
� LENDER'SADDRESS:
a i certity that I have read this application and state that ihe above informatlon is correct I agree to compty vnth all city and TOTAL FEES /�+�
counry ordinances and state laws relating to building consVuction,and hereby authorize representatives of this county to �J
z COMMENTS:
o enter upan the above-mentioned properly for inspection purposes.
J �
� � ( � �1�1 (�
m
a PERMfTTEE NAME(PRINn Y Z S � I
�
= SI6 RE OF PERMITfEE OATE RECEIPT k PAID BY: VALIDATION:
H
WHITE—Department Copy,YELLOW—Finance Copy,PINK—Pssessor Copy,GOLDENROD—Fi�e Copy,GREEN—Applicant's Copy
CITY OF DIAMOfVD BAR
INSPECTION RECORD
• o l • e - � o :5 e � � '
SETBACK/LETTER . � : :; " ;- , :, �'>, . ' TRACT AND LEDGER
FOOTINGS FORMS - - SWITCH GEAR
g�,qg:.<: . � ` COMMERCIAL HOOD
UG.PLUMBING : - - ' � ' T-BAR
UG.�EL'ECTRICAL . - - � INTERCEPTER
UFER.;GROUND `� c . - � HOT MOP/SHOWERPAN
SEWER LATERAL SEPTIC/CESSPOOL
MAIN WATER LINE HERS REPORT RECEIUED
SEWER CLEANOUT DEMOLITION
ROOF SHEATHING ROOF DRAINS
FLOOR SHEATHING ROUGH CONDUIT
SHEAEi-WALLS EXTERIOR"• �:'�: � :;_,� ;. ' POOUSPA ',; ' '� ' S
SNFAR�WALLS�iNTERIOR . � -�� ` ROUGH PLUMQWG ° ! x,.,.
FHAMINGNENTING ' ' � -� : .ROUGN ELECTRICAL'�; . ' { ' ' `
.�. �, � � � �. �
. 4
�-e �
ROUGH MECHANICA.L �� �, , ; „ .�`, .,, ,, `: , ,. ;� ,. ROUGH MECHANICAL ,,, .
C( 7 1
�GAS TEST.:: r`' , : `
ROUGH ELECTRICAL W(:,:��� .) `:. , . , ;: y, : �. .' : � ;: -
. ,
� : ,.. -
'ROUGH PLUMBING ' � ` 2� ' PRE GUNITE '� `
INSULATION WALL POOL PRE D.ECK BQNDING �.�•. �i� ,.
INSULATION CEIUNG �P-TFiAP t,�t. - ��' + ' � -
DRYWALL FENCE/�GATE/.ALARM . _
LATH(PRE} FINAL POQL -
LATH EXTERIOR WALLS:
LATH INTERIOR WALL FOOTING/STEEL
GAS TEST WALL STEEL 1�T( )2ND( )LIFT
SCRATCH COAT WALL BOND BEAM
ELECTRIC METER RELEASE WALL DRAIN/SEAL
GAS METER RELEASE WALL FINAL
. . . _ � ; ,, � :.
SPECIAL INSPECTION R0.FRAMING PLANNINGAPPROVAL r
,: ,
: .
FINAC;"BIiI�L.DING , - ROUGH FIREAPPRpVAL "�'
_
FINAL'MEGHANICAL ��' � c ,: ;_ FINAL�.FIRE DEPARTMENT ��
FINAL`;ECECTRICAL � ;-:. � . :�" -:, �� _ „i. .. , ' . . :;. . ' 'FINAL PLANNING':,'; - ` ` �'`
FINAL'�PLUMBIN� �� � FINAL ENGINEERING/PW ' ° ��� . � ' ° ,.��:��
TC.of,OQCUPANCY :;: '.. . - � ' `, :- .'. '.'`._ s � �: .'ro FINAL COMMUNITY SERVICES �;3. ., � �'
CERT:ofOCCUPANCY,' : - ; FINAC�HEALTHDEPt .,,t.^';, ,,,, � '
. .. ;. .
.. . . „ ., � � � �
`FINAL INDUSTRIAI:WASTE";'i ` = LL' "�:' . . ,.' ' �'
. „
�_ . _. � _ ,. . .. _r_:
COMMENTS: