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HomeMy WebLinkAbout17508 (30) �` CITY OF DIAMOND F3AR /�' / I i DEPARTMENT OF COMMUNTIY&DEVELOPMENT SERVICES � E �` 21825 E.Coplcy Drive (909)860-3195 Fax(909)861•3117 PRESS "'-���� BUILDING PERMIT APPLICATION FIRMLY } JOBSITE Q I/_ S. Q�I SD I �/�/ APPUCATION I � ��.,(1�ERMIT �+�j�� P/C o ADDRESSs1 l!J DATE_ � v UMBER �O p � APN LOT TRACT ISSUE TYPE OCC p OWNER � \/�� DATE CONST. GROUP o ADDRESS ZONING SEfBACKS z CITY ZIP TEL �� '�`� REART RW p g APPLICANT TEL. SIDFJSIOE STREET RW O QCONTRACT - SIDE ❑ ADDRESS � CITY ZIP TE PROPOSED USE w ARCH/ENG/ z DESIGNER w NO.DWEL N0. NO. = CDDRESS Z�P TEL UNITS STORIES BEDROOMS � cn DESCRIPTION SQ.Ff. FACTOFi PSF ADJ.AREANALUATION p� OWNER-BUILDER DECLARAT�ON SFWADDlREM O � 1 NEREBY AFFlRM UNDER PENALTV OF GERAIRY TMAT I AM EXEMPT FROM THE CONTMCTORS L4 Garage/Carport W CENSEUwFORTHEFaILOWWURE1l50N(SEG7077.68USINESSANDVROFESSKKJSCODE:MIYCITYOR (n U CDUNTyN7{IpIqEWIRESAPEHMRTOCONSTRUCT,ALTER�PROVE.DEAIOIISH.ORREPAIRANYSiRUG W W NRE,PPqR TOITS ISSUANCE.AL50 REWIqES THEAPVLIGWT FOR SUCH PERMITTO FILE ASiGNED W P]t(ONBCk � STATEMENT 1HAT HE OR SME IS LICENSEO WRSUAN7 TO THE CROV1510N5 OF THE CONiMCTORS L4 CENSEIAW(dUP7ERY(CDIdA/ENCW6WITHSECT�ON7o00�OFDINSION�OFTHEBUS�NESSANDCRO• � POOUSpB FESSIONSCOO�ORTHA7NEORSHEISE%EAIPTTHEPEFRWIAN�THEBASISFORTHEAlLEOEDE%EMP� (� TION.ANVVIOLATqNOF6ECT10N7071.SBYANYAPP�ICANTFOqAPERMITSUBJECTSTHE�PPLICANTTO Z Re-Rool F, A CMLPENALTY OF NOT MORE i11AN FIVE HUNDRED DOLURS(SSoa�.�: z ❑�ASOWNEROFTHEPFi�GERTY,ORMYEMPLOYEE5WITHWAGESASTMEIR50LECOMPENSATqN, 0 COf11T6fC12I - Wlll DO TME WORK,AND 1HE STRUCTURE IS NOT MiENDED OR OFFERED FOR SALE(SEC.70U,BU51� �J � NE55 ANO VfiOFE5510N5 CODE:7HE CONTMC70R5 LICENSE UW DOES NOT APPLY i0 iV!OYMER OF ? PROPERTY NT10 BUILDS OR MPROVESTHEREON.ANO W}10 DOES SUCH WORK MIMSEIF OH HERSELF OR Q TNROU('MHISORHERONMEMOLOVEES.VROYIOEDTHATSUCHUA7ROVEIAEMSARENOTINTENDEDOR m OOFFEREOiOflSALEF,1/OWEVERII�EBU0.�INQOHIMVROVEMEMI550lIIWITMNONEYEAROFCO1dPLE• Z T10N.TME OwNER�OUILDER WILL HAVE TME BURDEN OF OROVINO T/uT HE OR SHE OID NOT BUILD OR � IAIPiL�VEFORTNEVURP0.5EOF5ALE1 W OL�OWNEROFTHEGROPERTY,AMEXCLUSNELYCONTMCTWOW17HUCENSEDOONTMCTORS (= TO CONSTRUCT iHE iRQ1ECT(SEG 7GN.BUSINESS AND PROFESSIONS CODE:TNE CONTMC10R5 LI- VaIU81I011 AQI.AFjEA W CENSEUWDOESNOTMYLYTOANOWNEROFAiROPEHttWHOBUILD50RIMPROVESTMEflEON.ANO � VMOCONTMCTSfOR5Up7FR0.)ECTSWITHACANTRACTOR(5)UCENSE�VURSUNITTOTHECONTMG QUANTITY DESCRIPTION �E � TORSUCENSEUW.). 0 O 1 AM D(EMPT UNDER SEG B.t V.C.FOR THIS REASON q � U � � DATE OYINER V Z W F LICENSED CONTRACTORS DECLAHATION W � IMEREBYAFi1fWUNDERPENILTVOFVEiiNHYTHAiIAMLICENSE�UNDER7ROYI5qN50FCHAi7ER � p„ Y(COMMENdN�YYITHSECTqN7000�OFOM5lON70FTHEBUSINESS/WDPROFESSpNSCODE,ANO Z `X MV LICENSE IS N FUILF C�F7�u D EFiECT. �+ m � UCENSE C �v LIC.N0.y V j U DATE CANTRACTOR / d , W � WORKERS'COMPENSATION DECLAFATION a � 1 HEREOY AFFIRM UNDER PENAL7V OF DERIURV ONE OFTNE iOLLOWING DECLARATIONS: Z 0 _IHAVEANOWILLMAMTAINACERTIFICATEOFCONSENTTOSELFdNSUREFORM/ORKEit3' _ � CAMPENSATION,ASPROVIOEOBYSELTION77000FTMEUBORCOOE.fORTMEPERWRMANCE W Q OFh1EWOiiKFOR4MIp1TH15PERMIT151SSUED. � � _IHAVEM1OWIlLMAMTNNMlORNERS'CW�PENSATIONINSURANCE,ASflEWIREOBVSECTqN O77000FTHELABORCOOE.FORTMEVERFORMMICEOFTNEWORKFORN?11G1THISPERMITI$ � ISSUED.MY R ERS'fA PE ATIONINSUHANCEGNRIERIWOPOIICYNUMBERl1RE: CONSTRUCTION ] CMNIER � �� _ _ PLAN REV�EW � F0.1CY NUMBER ELECTRIC T� � (n6SSECf1LvaNEEDN07BECa.sl£fmOFhEVErodiSFORONEHI.f�OREDOOLLARS�21m)ORtE554 PLUMBING v Z IGEHTIFYTHATNiHEPERFORMMlCEOFTHEWORKFORWnIp/THISPERMiTI5155UE0,1 MECHANICAL C'} SHILLLNOTEMPLOYIWYPERSONWANYMANNERSOIl5T06ECAME5UBIECTTOTHE � NpRNEHS'COMVENSATpNUN50FCALIFORNIAANDAGREETHATIF15/10UL�8ECOME INSPECTIONFEE S SUBJEC7TOTHEWORKERS'COIAPENSATION SIONSOFSEGTIONJ7000FTHEUBOR CYJDE,ISM LLF THL01APlYWITH v s. ISSUANCE Q '^u p DATE: �APRICANT: SMIP � ENERGY P/C WARNiNO:FMURE TO SECURE WORNERS'COMPENSATION COYEHAGE IS UNLAWFUL,AND SNALLBE �y SU&IECTANEMPLOVERTOCRIMWALPENiUSIE5MIDCMLFWESU�i00NEMUN�REDTHOUSAND ENERGYPERMI7 DOLU2S�f IOO.ODO),N AD�IT70N TO THE COST OF COYPENSATION,DAMACES AS PROVIDEO FOH IN t � SECTqN77oe0i1HEV�BONCOOE,INTEREST,ANDATTORNEY'SFEES. RETENTIONFEE: 1 �,� � CONSTFUCTION LENDING AGENCY PRE-ALT FEE: O � IHEREBYAFFIRMUNDERPENALTYOFPE0.IURYTHATTHEREISALONSTRUCTIONLENOINOAGENCY FOR iHE CEHWRMANCE OF THE V/ORK FOfl WHICH TH�S PERIAIT IS ISSUED(SEC.J097,CIV.C.�. Z W � IENDER5 NAME F- LENUERSADORESS /� W ICENTIFYTMATIHAVEREADTHISAPPIICATIONANDSTATETHATTNEABOVEINFORYATIONISCANRECT. TOTAL FEES � ,7 / � �S� p. IAGREE TO COMPIV WI7H ALLCRY ANO COUNTY ORDIN�VlCES MJD STATE Uw5 REUTNO TO BU0.DINO V � CONSTRUCTIIXJ.ANDHEREBVAl7TFbHREREPFESENTATIVESOFTNISCOUNTlTOEMERl1PONiHE Z /90V 1AENTION VROVERTVFORINSP€CTqN%%RPOSES. COMMENTS � � W � ¢ GERMITTEE INTj �� /� D/ � (A S�ONATUREOFiERMITTEE DATE , � RECPT.NO. PAID BY VALIDATION WHITE—Departmant Copy,YELIOW—Finance Copy,PINK—Assessor Copy,GOLDENROD—File Copy,GFiEEN—Applicant's Copy . �� , i�+ • ,. . .i .. .. . ... . ..... . � .r . �a:t"'x�:�'��V.�•,;y.'— . , �.-------.._-._. - i-tl � � .��� . .. . .. , , . . . , . r. . c�-r r• aF ��,�;��f�ilD 6f�,R I[ti��'EC i IOi i f��COt�D ��_.__..�._�____�__._._._ _____.___._._. , _ _, _., , . __.... M_ li��-�l���e,`�C1��►`� �,' =. li`E-7;.1:c 9,�'1.: 1►�F:�Rb ,.;�C�l►�j �1 1:�1� '1►��'i'l�c:��'oa.�} - ; _ _- --- ....�_.__.... _ ._ _. __ _...___..__�_� ------___�___�-�--..____.. _._ _._-- .--- .__.._._.,._.... . . _�._..____�. _.. SET BACY � � ' � FLOOR JGIST �,�', . ' � FTGS/FORP�iS'STEEL ! � � FHA REQti1T5 � ELECTRIC GROUND — _1 UNDER FLOOR aUC7 �-- GROUND PLUhJIBING j I U�dDER FLOOR CUP�!DU.IT SLAB GRADE l FIREPLACE FOUt•JDATION • TEMP POWER — I� FIREPLACE BOND BEAM WATER SERVICE i MID HT. �OND BEAM ROOF SH�ATHING l £3 FT. 60PJD B�Ah4 ' i FRAMINGNENTILIATION � I FINAL BOND BEAM i ROOF COVER I ~ PRE-GRADING ROUGH HEATING I 6E��CHRJG ROUGH ELECTRIC � ROUGH GRADING ROUGH PLUMBING I FiNISH GRADING SHOVJER/TUB TEST ; POOL ELECTRIG EXT. L/1TH/SIOING I POOL FENCING WALL INSULATION POOL FINAL � CEILING IN�ULATION OFF SITE 1�1FS. _l._ DRYWALL NAILING � DEDICATIOPJS 5Eb'VER FINAL ENG. SEPTIC TANK LANDSCAPEIIRRIG. � SEEP PIT/L.L. ON SITE I��PS. � GAS AIR TEST FINAL ZOP•lIPJG FINAL CONST. � � FIRE DEPT. FIPdAL FINAL HEATING � HEALTH DEPT. FINAL FINAL ELECTRIC DEV. FEES PAID FINAL PLUMBING . � � �, ENERGY ,�;sr� u/,a5/�-,.t I � v L �f� I -- L;�i rr ^J- ��¢ ._ _��__. -- CU�JiMENTS SEPTIC TANK SIZE SEEP PIT/U SIZE _'_�._______.� ,'��.I � i � `l�� ,i � . �, ; . � � , , ..w . .