Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
11170
A� - -/r"� ---� CiTY OF PIAMOND BAK � � ' COMMUNPfY DFVELOPMENT DEYAR7'N1ENT E` R�*-.r.;, 21G60Ii.Cupicy Drivc Suitc 190 PRESS (909)RGO-3195 F1x(JO))861-1117 '�'"""� I3UILDING PF.RMiTAPYI.ICATiON FIRMLY Q ADDRfESS �� (J �/�/✓�„S� APPLICATIO PERMIT f` P/C uis p - DATE ------ NUMBER.,-I� ik--- ----- m -- ISSUE : � TYPE OCC r APN_„__ • ,�OT 7RACT______._.______.,__ DATE CONST.___._____..,,._ GROUP ___ � ------- p OWNER _.,_ � �- -�---- — ZONING SETC3ACK5 o ADDR $S � ,(�+�.�/P/ __ W - -= IP T ^- ,� 1 FRaNT - ---- -- - RW �-- --- O CITY• -- - REAA ----- - --._._ f_,._..-- ----- o APPLICANT _______,____ TEL._.__.._,._,__,..__ SIDE/SIDE STREET.,,_.____.___ RW I_I - " ___ ---------..._- ��_ Q CONTRACTO �jO-_�./ _ SIDE _ � ADDRE S - - --..�.`�V � ,....--- r PROPOSEDUSE -- 1 �Y`�- ��� � w � CITY�[f ZIP.--- �aTEL. '�r��7�/ ' - - w ARCH/ENG/ ` %�� � '� � z DESIGNER_______ �- '� � ���� ---------- NO.DWEL. NO. NO� �-; � ADDRESS..._ � � ^ -- -- UNITS__.__.,_.___., ___ STORIES _,..___._BEDROOMS �: CITY------- Z!P _ TEL _ . � -- �ESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION � � OWNER•BI:ILD[R DECLARATION SFR/A�D/REM I p I HEREBY AFFIRM UNDFR PENAI.TY OF PEflJURY THAT 1 AA1 FXEPfP I FHUM Thl�_GUN IHACTUFlS u- Gaiage/Caiport � W CENSELAWFUR7HEFOLLOWI:.GREASON�SEC.�nat5f3USIVFSSANDPROFESSIONSCOJE:ANVCiTYf)fi (n _,___ ._ . ZW�NTYWHICHRE�UIFlESAPF.RMITTGCOVSTRUCT,ALT'cR,iMFii<iVc,�i:MO:ISH,ciliF�np;RAYYSTRUC- �(J TUHE,PHIOR TO Ii315SUANCE,AL50 fl[QUIFiI:S THF:APPLICANT FOR SUCf�I PEqNII"fn FILL-ASICNL'J �BIIO/DBCk � w STATEMEN7 THAY HL-Oii SHE IS LICENSED PURSUAN��V I I It%'11uVISIUNS OF THE CONTRACTOHS LI W` � -----� � C[NSE lAW(CHAPTEH9(COMMENCIhG WITH SECTIO"!]CG�)OF UIVKION J UF 1Hf SUSWESSAND PflO� � u' Pool/Spa, I �� FESSIONSCO:)E)ORTHATHEORSHE:SE%EMP�TH[fiFFHOMANDTHEBA515FORTfIEALLEG�UE%EMP- � — � � TIC�N.ANVVIOLATIqNUF51:C�lUN'/431.5BYA\Y�PPLICANTfOHAPEi141IT`:UHJF.CiSThEAPPLICANT70 zI HF�Rr.ot F ACIVII.PENAI TV OF NOT MOHE TIIAN FIVF HIINOHfO DOLiARS(SSOD).} (''� � � L'JI,ASOWNF.HOf�7f1[PROPCIITYORMYEMPL(1YF.FSbNIhIWAc;ESASTHEiflSO!ECOMPENSATIGN, 0 CaRIR1BfCldl 4 { z WIIL DU THE VJORK,ANU�II["•7171I1;I UHf:IS NOi INTeNDED OH OFFE4EU f Ofi SALL(SEC,'/L.:4,5:151- J ,___ � NESS AND PHOFCSSIOtiS CODE.THE CONTRACiOH51 ICi NS��.AW fi4[5 NOT APPLY TO AN OWNEH OF � t PROPERTV WHO[3UILDS ON IN.[�F70V[STHEREON,AND WI10!1ofS SUCI{V:URK HIMSELFOR HERSELFOR � [[ THPOUGHHISCI7HFftOWNEMPLOYEE5,PF10VIDF:L)1'HATS�GHIMPpOVE1.tENiS�HFN(t-1NiENJEU()R m' � w OFFcREDFOHSNi..IF,HOWFVER,THEBL'ILD!NGORI,UPROVLMFNlIS57LUVlITHINON'eV'eAROFCO�iPI.G � � TION,THf OWNtF BU!WER W:t!.IIAV�'fHF.RUIl7EN 0=PROVM(i t�1AT I�f�OFl SHF DICi NOT BUILD Ofl s � IM?ROVE FOfi THE PURPOoE O�SALF) �y��y j W !�I.ASOWYEHnFTI{F:PfiOPEfiT'l.AMEXCLUSNELYGOMRACIINGWIIHLICEN3EDCONiR�CTCqS — -�—V'C� � � TO CONSINUCT THE PROJECT�SFC.]nM1n,91151YES5 AND PROFESS!ONS l;ppG:THF.CONfRACTORS I.I- �. Ud�U311C1'1 - ..._ r..------- ADJ.AREA _..-------- W CENSELAWUDESNOIAPPLYTOA4DWNFHUfAf'F10PERTYWHOBUIL�SORIMPqOVE+T��[qFON.ANU ------�—� - � �' � WIIOCOYTRACTSFORSUCHPHOJfCTSWITHACO\iRACr017;F)I.ICFNSEDPURSUANTTOTHECOVTRFG QUANTITY DESCRIPTION FEE Y 1nR5110ENS[LAWJ. ; --_- � � -� s =:I AM[%EMP7 UNDER SEC.___. __,..____. ._—F1.8 P.C.FOR THIS REASON Q I (.,)�- — - � . .---.. . -'--------- --...-- - �C' t LL' UATE .-"'__"_OWNEH .. .-_. .... -....._"-_" '_'_ U -_ —� F��. Z — � LICENSED CONiRACTORS OF_CLARATION w � a - ---- � � 111ER[RYAFFlRMUNDERPENALfYOFP�RJURYTHATIAMtIC1:YSEUl1NDERFROVIS!ONSOFCHnP7FN � I d 9(COMMENCINCWIIHSEGTION7000�OFf)NISION3UFTHEBUSIN'eSS�NUPROFESJIONSCCGE,AND � __ __ 'X MY LICENSF IS W FIiLL FOH�f.ANU C�FECT. � � � e O ___ � LICENSE CLASC �� _'__.__.I.IC.NO. _._ __ _ �__. � y�' f.v J _— F uar�..,,. , corvrNncroa a — ui --- -__ � WORKEHS'COMP[NSATION DECLARA� N 4 � � � U---- -- I � IHEFEBYAFFIHR7UNDERI'FNALTYOFPtRJUHYONEOFTHEFOLI��WIhc,�'CtARATI0N5'. � Z f � _IHAVEANUWRLMAINTAINACEH�I�ICAIf:OFCON5ENT105fL��1\SUREFOFiWORKERS' = f ¢ COMPENSATiON,ASPH()VIDEDBYSECfION:fiCUOFTHElA00iic:0[1E,f'URTH[f'ERFORMA4CE U _______ � OF THE WOHK fOfi WHICH THIS PEHMIT IS ISSUED. W � � i O � -- _ � Q aHnoO�7H�FLA80RCOUE,fOFiTHpP(RFOFlIAAM1Cf()�ySUi7AN(.i,n.,NEG�nR�'6Y'-C-I'i�'. Q . e e " _ FTHEWORKFOqWHIC!17H!SPfRMI'IS � . . � � ! ! i _ ISSUCD.MV WO HS'CO ENSATIOY INS ANCC C IER AN�POi IGY NUMHCfI AHt. I CONSTRUCTION . _ _ J _-_. _ _ ____-_ . —_ __-�`__-— � ,t � CARRIER___ �� .--- � -. _ I PLAN REVIEW --.-_- i _ -- - -- � POLICV NUMBEfl_ .��.- � [LECTf1IC Z " " - _ . . .-__'_" "._ ..._' _"_'_ ...'-_ Q � 0 (iHISSEC110�M1tEUAY1fl3COJkP�EtEDUFhIFPF.PoARI'si'OHCM'EIII:NDfifAIX7lLARS!5100;�ORLESS). PLUM6ING ___' . .....____"_. ._. . .'_' '_'_....__'_ W MCCHANICAL Z 1 GCATIFYTHAT IN 711E PEFlfORMANCE Or'I'HE WOF%FOft WIII(;H TII�S f�fflMiT IS la'SUED,i ._. ... .____.- . .__._... . . ___.___- I (� SHM l NOT FMPLOYANY VCIt5041N ANV 1!ANNf-1t Sn AS TO BECG!AE S11f7.IE Ci(()Thf � WORKERS'GOMPF.NSAfIONLAWSc)fc:AIIFOqNIA,A��A�:f1f(�!11AT!�ISHOULDBECOA;E INSP[CTION�EE _____. _,_______ .... . .______ _- ._ - � SUOJ[CTTOTHEWORKfRS'CUMP'eNSATIONP!iUVI�lON50F5ECTION7�aoOfill[LA90i � CU [,�SHAL FO`,RT�IIWITlIf.OMPLYNAl111 . f'ROVISIONS. I.�'.SUANCE "��, —____""' ""-- "" ' "_"'_�>�_"'_ . p �ATE:� .._��...�Af'PLICANT..�.•� _"' $�'�IP —.. ...__'_"_" '_'_-...__ rc._ V I w ENERGY P/C � J WAFNIN(i:f�ILUFl[TOSECUflEWOHKCRS'CON?ENSAiIONCOVERAGEISUN�AWFUI,ANi)SHALLBE �- ---� --�------- - �---�----�--- LL SU6JGCTANEMPIOYFHTOCf11MINALPENAIIIESAN�CIVILfINk"SUPIOCIN[HUNDREO7HOLSANU � i.f`A'''�1 ENERGY PERMIT __ .+w. __ i r �OLLAIIS(S��xi.oW),INADU�TIONTOTHECO51(�I'(:<i;,APF:NSATION,UAA9AGl'SASFROVIDEDFORIN � � � - � ---�— . J SECTION 3IUtl OF THE LA�OfI CODE,INTERE51;ANUATTORNEY'S FEES. _ RFTENTION FEE C[ _ ____" ..._@__. . ..._..- ' O CONSTRUCTION LENDING AGENCY PRE-ALTFEE ---. ._---�---. ...---- -...-..- i � IHGREBYnFFIHMUNUEfiPENALTVO{"VI_f7.IlJRYTHATTHEFl(�.ISACONSTRUCTIOYLENOIti[.�t;lNf,Y I i � � � FORTHEPtflFOIl1.1ANC[OFTFIEWOIiKFOHWHICHTI{I;PcRASI115155UEDSEC3C3],CIVC ---' --�- ���\��`p-��- - --'-'- Z � � qN iP � ��,T I W -- -- �: ---'. .- � ....- I = LENDER'SNFMf_ � ' "_.. ._'_' _ "_'-'"' ""_ I '" "__'-__— F_ I.CWf�R'SADDRESS _ ___'__' '_-' '-_-- —"—'--'-"'"'_-"_ I � - - ---- --- r-------- � _1_ 9 WICERTIFY�HAT111FVI-READTHiSAPI+I.ICATIONANDSTATEIMATIii::qht1VC.INFORMAIlON1`1t:()IiNf(:i TOTAL FEES � � � � IAGf7f.FTOCOMPLV'NllilAlI.CITVANDCOUNfYOfNINANCESAND3TAT'cUW`:�7flATl.\(.TOBU�LDI�l'G � CONSTilUCTI ,ANDHEREPYAl1Tll0(iREREPRESEtJTATiVE5c1�IH'Sc;UUNi�TOCNi�iillP�ullfi, ACiOVE�M ONEDPf10PEfiT FORIN&PFCTiO. PUIiPOSES. Q � � , COMMFtiTS --. -- __----_-'_ i � �I � � �- - - � - ------:.__. _. ------ --.. ..... . - - - -- m PER E M!(BFlINT� ' • '��� 1 ¢ L" ' - . "-__ '_" - __-_-__— -- "..._._ . ` i '_'_'" � i�Yw.^. �_'—�'-" . __ _ ' � �-- -- --- - '�� ' �t - � -'__' _--__'� � IGNA �flEOFPERMITi[[ ' DATF �I-r VALIDATION_ = RECPT.NO. PAID 6Y _ ~ WHITG-DeFartmen(Copy.Y[LLOW-Finance Capy,PINK-Assessor Copy,GOLDENROD-File Copy,GREEN-ApphcanYs Cvpy i 4,��� . _ .. ._. . . _... . .. -_ - ` - - �' . ' . _ . . 7' „ . . `.'_I_ r"'"i.:.y_ ,.. _,_ .. ... . .... - '" _'. ., . ___ .. .. . . .__._ �4 1? � . a1,�e'.�� . . , . . 1' ' i � � i � I { • ! ; �. � . ; � � 4 ' , , i � I , i , ' i ` ! ! ' ; ' y t i ,. � ' } , ' , � � i � ' � . � . i ; � i ; ` ` � ` ' i , ' �. " i i : . S 1 E i � ' •. � � i ' . i - ! � �� . � ` � , ��"� � �— j' .— 4 � -'.-� +— � � . � i ! - t � i _; _" i i ; _, i k ! , � � i � � � i i � x � : � � � ' � � i I , � � ; ' ' i � � . , i � - . , � � i , ; � � . � ..`-- ' _. � . - r i � � . � �� r � ' i- �-' i� , '— - � � � ' � i .�t• i � � ' c;,� 1 ��� . . � i � � , ' . . ' , ' , , ` . . . , �y� ; i . i , , � - ' � � �, . , - ' � ' w� � � � R , �' ' � � � � ' �" ( �' t J y _ � T �§'1e . i . ' . - I �.. {.. }. GI� : I �' .5 . ' � ' i €„ I !' AI � .�. •�� J� — �'l ys ' � I . , �( ii "� i .I� ? - � . .wiS . . � ' -., I _ �i J. c �- i I � ' - � � . � . ' i . � � �..i � L I - . - k ,- � . � }I .. _ Y , ` ' ' _ . . .T 2 r � .� � � : . f' }� __�_ .� � � � � � � � �, - , , - , ' � � , , � , � . ���� S � �� � � . .� n�� ���; . I I ' i , � � , -. - , j � _ ; ' , _ , - �g' �`;;j ' i � I , � � - � . j 1 � . ' � . . � � . � � I- „ '4 ,r ' 1 . � i � i ' , ' - , _ _ �.L j � ' { I - � ' . _ � ' � i ' _ ' , � 1 � �.� . I i ' . . ' JJ . . . . . � , � � . . � i i � � � • i i -. �5 -. i t I � � � ' n. - 1 . � s��; _ __,� . , ;� � : �_ - � � , � . � � �-.�.��-', ' - � . � ; ���' � � ��� � ' . � ' � � ,1�T i . � , ' I 'Z?, � - � � _ P , �M-! �_ _ . . � _ _ - , .. _ , t� '� . , � ' ; . � . �.., - ' i � � � ..; i _' -..i . ' � � ' - � ,R���,�Y'�`�•i���'3'�'�d, t, � � _ � Y ,� s,.,y- 4 ; � � : : . ° 3S'� a . ,. t . � 5 I � -�,y§: � " � I . t ' f ( i i . - ��yt�c�5� ��'� "� � ,. s � �! ,i ' � � , i i � . ���s*�r ct'te��+`��''s^��"� . _ �; ' - 1 s s'� ,�a��������� - ����.�� ���'��� . � . ��� � ! '��g ��s ; h.�+ �",�' . . i � �.'1' �.+Y+. ` � � , . � - �'y.�r�5,'�t h ,i° `a y�`4 1 � , � ' _' 4�` ''._. '� - ' . - . . �... .,..__ ..._ . . I i ; � .� �'�"� � _ . . .- .�..,. ,. ,_ " "' . ,. . _ _.. , ... ..._.... , . . _�. . _ ....��F _� _� �;a � _ •