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: