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HomeMy WebLinkAbout14029 �^ �� CITY OF DIAMOI�ID BAA DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES �� 2]660 E.Copley Drive 5uite 190 \,,�,�. (909)860-3195 Pax(909)861-3117 RESS BUILDIIVG PERMIT APPLICATION FIRMLY y JOBSITE � �f� •�`,,.,„y APPLICATION r a_. h""Z ," PERMIT P/C o ADDRESS � CJ ��'1 V � , DATE_ `�6 �--� NUMBER # � ISSUE TYPE OCC APN LOT TRAC7__ DATE CONST. GROUP p OWNER ' � p ADDRE S ZONING SETBACKS � CI �� �ZIP��TEL. � FRONT RW r] APPLICA TEL. REAR _ U � SIDE/SIDE STREET_ RW + f-1 __ � CONTRACT R SIDE �;_ ADDRESS ' p CITY ZIP TEL. PROPDSED USE o ARCHIENG/ z DESIGNER w NO.DWEL. NO. N0. n, ADDRESS � CITY ZIP TEL. UNITS_ STORIES _ BEpROOMS U7 cn DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION � OWNER•BUILDER DECLAFiATION SFR/A�D/REM O p 1 HEREeY AFF1iW UNDER VFNA(,tY OF PEHJURY THAT I AM E%EMPT FROM 7HE CONTRAC70RS LI� Gefa90/C81pOR W CENSELAWFORiNEPoLI.OWINGREp50r!(SEC.7031.SBU5INESSPNDPROFESSIONSCADE,ANYCITYOq ((� U �NT`(WHICIiflEOUIRESAPERMITTOCONSTRUCT.PLTFR.IMPROYE,DEMOLiSH,ORfiLPA1RANY3TqUG W � TURE.PRqR TO ITS ISSUANCE.�LSO REWIRES iHE APPLICANT fOR SUCM PERMIT 1'O FILE A SIGNEU W Patlo/Deck � STATEMENT THAT HE OR SHE IS LICENSEO PUqSUANT 70 THE PROVISIONS OF THE CONTRACTORS LI� � � CENSE UW(CHADTER 9(CpµMENCIN�VJ1T}�SECTION 7G00)OF DIVISION 3 0F THE BUSINESS AND PR0- POOUSP3 — — FESSqNSLODE�ORTHATHEORSHEISEXEMPTTHEflEFROMpNDTHE8A515FOFTHEALLEG6DEXEMP� � � TION.ANVVKKATIONOFSECTION7031.5BYANVAPPLICANTFORAPERMITSU&IECTSTHEAPP�IGANTiO � Ae-Rooi r ACMI PENALiY OF NOT MORE THpN FIVE HUNORED OOLLARS(5500).): � ❑I,ASONRJEROF7HEPROPERTV,ORMYEMPLOYEESWITHWAGESASTHFIRSOLECOMPFNSATION, � COIt1R{OfCial WIIL DO THE WORK,ANO THE STRUCTURE IS NOT INTENOE9 OR OFF£HE�FOR SALF(SEC.7044,BUSI- J NESS AND PROFESSION5 COpE:THE CONiHACTONS LICENSE LAW DOES NOT APPLY TO AN OWNEF QF � PRQPER7YYMOBUIlD50HlMPROYESTHEREON,M'DNRIOODESSUCHWOflKMIMSELFORHERSELFOP � Q TNfqUfi}4HISORF1EfiOWNEMPLOYEES,PfiOVIDEDTMAT5UG11MPHOVEMEMSARENUTIM'ENDEDOR m + Q OFFEREDfOHSALEIF,H04JEVER'MEBUII�INGORIMPROVEL1ENTtSSOLOWITNINOiIEYEAROFCOMPLE� Z TION,THE OWNER-BIIILDER WILL HAVE THE BUHDEN OF PROVINO hIAT Hk OH SNE OID NOT 6UILD OR — � IMPROVEFOATNEPUqPO5EOFSALE). 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