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FACTOR PSF ADJ.AREANALUATION � OWNER-BI:ILDER DECLARATION SFFllADD/R[A1 O ' ' 1 NEN[6Y AFFIRM UI:OER PENALTY OF PEFUIRV TIUT I AM E%EA�PT FROM TH[CAN7MCTOqS LI• Gaf390/C31pOrt W LENSEUWFORTNE�OLLOWINCNEASON(SEC.703f.581151NE55ANDPROFES510N5CACE'.ANVCITYOR (n U CWNTYNM1IICHREOUIRESAPERMITTOCONSTRUCT,ALTER��PROVE.DENOLISH.ORREPA:RANYSTFUC- W .P3;10/�CG( ' TUR[,PRIOR TO RS ISSUANCE,ILLSO F[CUIRES THE APPUCAPIT FOR SULH PERMIT 10 FILE A SICkED S STA7EMEM TMA7 HE OR SME IS IICENSED PURSUANT TO TME PRON510Y5 OF TME CO�TRACTORS LI• W CENSE UW�CM117TER Y(COMMENCINO WIiH SCCTqN 70oC)OF pIVISipN�Of TME BUSINE55 A4D PP.O- LL' PooUSpa FESSIONSCAJ[IORiHATHEORSHEISE%EAIPTTMEREFROMANOTMEBASiSFORTHEpLLEGEDC%EMP• (!J VTION.ANVVqlAT10NOF5ECTION707t.58YANYAPPLICANTFORAPERMiTSU&IECTSiHEAPPLICANTTO Z i�e.qOOf � A CML�ENALTY OF NOT AIORE iNAN FNE NUNDRE�DOLURS(lSDo)): 0 OI,ASOWNEROFTHEGROPEFTY,ONIAVE�APLOYEESWITNK'AC[SA3THEIqSOLECOUPENSATbN, � Gommercial � � Z N".LL 00 THE M/ORK,�ND THE STHUCTURE IS NOT INTENDF.O OR OFFERED FOR SALE(SEC.7a�,BU51- J • � NE5511fND PROFESSIONS CODE.iME LONTRACTORS IICENSE UW DOES NOT AFVIY TO A':OWIlEROF � , PROPERT7 WHO BU1DS OR IMPitOVES THEREON,ANO WMO DOES SUCH WORK H:AISELF O�i MEHSEIf OR Q THRWGHHISORHEAOWNE�PLOYEES,VROVIDEDIHATSULH4NPROVE!AEN7SAqENOTWTENDEDOR m (' � OFFEREDFORSALEIF,HON�EVE0.TMEBUI�INGOFiiMPROV[MENTISSOIDV.'ITHINONEYEAROFCOMPLE� Z TION,TNE OWNER�BUILOER W:LL NA'�IE TME BURDE4 OF Pf10VIN�TNAT HE OR SHC DID NOT BNtD OR � qAPROVEFORTMEPURPOSEOLSALEG W OI,ASONM1EROFTN[PROPERTY,AMEXCLUSIV[:YCONTiUCTINGWITHLICENSEDCO4TMCTORS Q TO CANSTRUCT iHE PROJECT(SEC.7W�,BUSINESS AND CROFESSIONS fADE:iHL CONTRACTORS u• Vaivation ADJ.AREA � CENSEUWOOESNOTAPPIYTOANOriNEROFAPROPEflTIWMOBURD50RIMPRDVE5IMEREOY,MlD KM1IOCONTMCTSFORSUCHVRQIECTSW7TI�LONTMCTOR�S�LICENSEDPL'RSUAYTTOTHEWI7TRAC- QUA!JTITY DESCRIPTIOY FEE -_Y TORS LIGENSE UWJ. � pOIAME%EMPTUN�ERSEC. B.BP.C,FOqTMISREASON Q !J r I' r�% f� � U — . LL � DATE OKTIER F� o W . �r=�` cr .5, .. � LICENSEO CONTHACTORS DECLARATION W �rl fr�! -� � IHEREBYAFFIRMUN'JERPENALTYOFPERIURVTMATIAMLICE45CDUN�E:RPROYISIONSOFCHA7TER � �"� ti-/�I � � � 9(COMMCNqNGWITHS[CTION70oCJOFDIVISiONIOFTXEBUSIKE55ANOPROFE55'OYSCOOE.AVD Z � 1yjS � t X MY L�CENSE IS IN Ml FORCEAND EFFECL ����� � �y r �`y'"� ,/ 1� LU ` '_7.J /� � L�CENSECIA S �-3� LIC.NO. ��/ � / � V DATE/` GONTRACTOR � I_(j C � W , �U J � . � � .. WORKEFS'COMPENSATIOPJ DECLARATION � Q / � IMEREBVAFFIRMUNDERPENALTYOFPERJVRVONGOFTHF:FOLLOW!NGDECURATIONS�. Z � _IHAVEANOYVILI�.UINTAI^lACEqTIFICATEOFCANSLNTTOSELF�RISUREFORYTRKERS' _ Q COMPENSATION,ASPRONDEDBVSECTION�7000FTNELA[lOROODEFOFTMEVERFOR�IMICE W } OF iHE WORK FOR WMpI iHiS CER/AIT IS ISSUED."' • � . - ` . ,,, . • . .. . � - , � _.. . . W �INAVE/WDMlILL1.UIIdIAINWOfiKERS'CAMPENSATIONINSUflANCF.,ASREWiRE�BYSEGTY�N O 97DOOFTHEUBORCODE.FORTHEPERFOHMPNCEOFTHEWCRY,FORWHICHTMISDERMITIS � , �.� �,'�' ' � � •� - _ . ISSUED.61V WORKERS'COMPENSATIOh INSUFLWCE CARRIERAND DOIICY NUME1CqAHE: CONSTRUCTION Q � - .. _ ... ' . > cnnAien PLAN FiEVIEW � POLIGYNUMOER Z ELECTFIC ¢ 0 �faSSECipNtiLmNOTBE00h�l�LETEDOFhfFERURSPoRCtiEF4F�tYiCDOd1A1L,Kt�)�1E551 PLU1lFiING � ' � Z � ��ICERTIFYTNATPl7}1EPERFORMA�CEOFTHEWOfiKFORwH�CMTH15PERMITI5155UED.l MECHANICAL ' ' ' U' SHALLNOTEMPIOYANYPER50NINAYYMAHNEF50ASTO6ECOMESU0.)EGTTOlNE � � • . . y WORKERS'COMPEM'ATqNUWSOFCALIFORM0.AKD�GREETMnTIFISMOULDBECOME INSPECTIONFEE � � SU6)ECT TO THE WORKERS'COI.IPENSATION GflOVISI�YS OF SECTqN 3700 0F THC 1A�30R _O CODE.ISHAL�FORTHWITHCOM?LVWITM;ws o� ,>�oNs ISSUANCE • —0���� 'IQQ� - • - ��/ f� . . p DATE:/C I APPLICANT: �t ,SMIP�. i W ` • . ' • � WARNING:FA4URE TO SECURE WOR1(ER$'CO�OE45A. N LAVEAAGE IS UNUWFVL A.Y'J SNALL D'c �EN[RGY P/C ' � ' LL SU&IECTANE1APlOYERTOCR:MINALPCNALTIESANUCIVILFW[SUPTOONENUNDR'cDiH0U5JW0 _ EN[RGYPERMIT - � DOIURS(5100.000).W/�DDITION TO THE COST OF fAMPENiAT10N,DAM4CE5 AS P110Y.DCD FOft IN � SEGTION770eOFTHEUDORCOOE,wTERLST,ANOATTORnEY5FEE5. " �ETENTIONFEE: ' d CONSTRUCTION LENDING AGENCY PR[•ALT F[E: � O � IH[RF.BYAFFIRMU�DERPENALTYOFPEfUURVTMATTI1EREi5ACAN5TRUCTiONIENDI�GAGCNGV f0�i THE PEHFO WAANCE OF 1NE WOflK FOH WMIGH THIS VERM�T IS ISSV[7(SEC.7^.VI,GN.G�. . Z W - � lEN0ER5 NAME F-- LENDEFMS�DDRE55 � � TOTAL FEES � ICERTIFYTHATIIiAVEREADTMIS�PPLICATIONIWDSTATETFIATTIEAB01'EINFORMATqNISCOFPECi � w IAGREETOCOAIPLYN7T�7AlLCITYANDCWNTYONDMANCESAADSTATEU'NSNEUTWGTOOUILOMC � CONSTRUCTION,AYOHEFCBVAUTlp0.1ZEREPRESENTATIVfSO�TH15CdJt�TYTOENTERUPOHTNE Z ABOVE-MENiqNED PAOPERiY FORINSPECTION PURPOS[5. COMMENTS � �' •�J •7�,� L ��i�/'- s m VERMITiEE N�v • ' " � ¢ - _�����7 � � N ...runt oc v _ E � RECP7.NO. � PAID DY _ ' VALIDATION_ � WHITE-0epartment Copy,YELLOW—Finance Copy.PINK—Assessor Copy,GOLOENfiOD—File Capy,GFiEEN—Applicant's Copy CITY OF DIAMOND B/�R ` �' ��t , � . INSPECTION RECORD . ���^ - � � � �* e - o � D L,� , a e-� * �. SET BACK �`, ��` i 't� I . `• ! i f: :OR JOIST ' FTGS/FORMS/STEEL ' ` ` ' i '.REQMTS • ' EL�CTRIC GROUND l '`DER FLOOR DUCT � GROUND PLUMBING �. tL UNDER FLOOR CO�IDUIT • SLAB GRADE c t 4 -- �- FIREPLACE FOUNDATION TEMP POWER FIREPLACE BOND BEAM �• ' WATER SERVICE � MID HT: BOND BEAM � � • � ROOF SHEATHING � 8 Ff.BOND BEAM FRAMINGNENTILIATION FINAL BOND BEADJI ROOF COVER - PRE-GRADING ROUGH HEATING BENCHING ROUGH ELEC7RIC ROUGH GRADING ROUGH PLUMBING FINISH GRADING SHOWER/TUB TEST POOL ELECTRIC EXT.LATH/SIDING PODL FENCING WALL INSULATION PODL FINA� - CEILING INSULATION OFF SITE IMPS. DRYWALL NAILING DEDICATIONS SEWER FINAL ENG. SEPTIC TANK LANDSCAPE/IRRIG. SEEP PITlL.L. . - . . - ON SITE IMPS. GAS AIR TEST 1: � ) �p • FINAL ZONING FINAL CONST. • • � FIRE DEPT.FINAL FINAL HEATING ' HEALTH DEPT.FINAL FINAL ELECTRIC ' DEV. FEES PAID FINAL PLUMBING � � • � ENERGY. _ . • - , . . i .. • .. - ' • ' s *.�e . �. COMMENTS. . .. � �'.�-L��r��_/S���J`s O� Dnl A/n&�-(�t/ . t7 r / .� LW�=.S Ti�f�/ � ��redar�7L . �, l�ll!✓c: vl i ��—�.—f.fl�pcz.J t,x�� �� . .__..... " a 0 0 �zJ �, �v��z /G �,l f��,� �vG�..e✓J ��. n ? , �o�zyy i'FT,e: ,� �L� o� r� -�1.,;:, � �� � > s " ' c�z �4-f/1 olc Sy�r+-Z ,s-�i or c�c sr s�v�--a�_t�� / � � 7 �e�r� L,r':C�" �, ;c.�yt/l UE - , . ,. , - ��fr��rc-- ����� 0 9 . . . . ._ _ . .. -. t ! � r S�Jf1 fr � ,�IoZD a� 2Ct�rL cu��� �' �u,,�i cl�- SEPTIC TANK SIZE ^ �� � - SEEP PIT/U SIZE , _ •� �_ . � , l �, 1 ! �'`j��. � � . � `