HomeMy WebLinkAbout14209 . - � . . , _ ,
_1�� CITY OF DIAMOND BAB \ ��j ��
DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES �
� 21660 E.Copley Drive Suitc 190
(909)86Q3195 Fax(909)861-3117 PRE$S
���'� BUII.DING PERMIT APPLICATION ' � FIRMLY
� JOBSITE APPLICATION PERMIT �� P/C
o ADDRESS Z21� Dublin Lane 3units DATE 7/22/99 NUMBE ' #
c� ISSUE TYPE �C R-3 &
APN LOT TRACT "j]0.2h DATE CONST. VN GROUP
p OWNER Silver SW -
" ADDRESS 22.17 Dublin L2i10 ZONING SETBACKS
� ciTv ' ziP TEL. FRONT Fxist See Plan RW ❑
APPLICANT O ari TEL.�+�6 REAR ❑
� � � SIDE/SIDE STREET RW ❑
CONTRACTq .�.��1and SIDE ❑
� ADDRESS �� �d�u111 S r���
Cm' RrPa ZIP�$��TEU,14-57'-.�71
PROPOSED USE S2IIle
Pu ARCH/ENG/
o J.M. Nolan
� DESIGNER NO.DWEL. NO. NO.
ADDRESS a a asas oa lllt2 ' UNITS 3 STORIES 2 BEDROOMSc'ee P�"
. n cirr rllahasas ziP�.p2 TEL.$��-�?�►-�QG
, � DESCRIPTION S�.Ff. FACTOR PSF ADJ.AREr1NALUATION
� ¢ OWNER-BUILDER DECLARATION SFR/ADDIREM
O
� 1 HEREBV AFFRM UNDER PENALTY OF PEFLUfYV THAT I MI E%EMPT FROM h1E WNTMCTORS LI- G9f9(JB/C9fPOff �
CENSEUWFORIHEFOILOWINOREASON(SEC.7031.6BUSWESSANOPFiOFE5510NSCODE:ANVCITVOR (n
COUNTVWFTICNREWIRESAPERMRTOCONSTRUCT,ALTERIMPROVE,DEMOLISH.ORREPAIRANI'STRUF W Patlo/Dack
TURE,PRIOR TO RS ISSUANCE.�LL.SO REWIRES hiE MPLICANi FOR SUCH PERMIT TO FILE A SIONED w
STA7EMENT THAT HE OR SHE IS LICENSED PUfiSUANT TO 7HE PROVISIONS OF THE CONTRACTORS LI�
� CEN3E UW(CHAPTER G(COMMENCMH7 WITH SECTION 7000)OF DIVISION 3 OF THE BUSINE55 M1D PRO� � Pool/Spa
FESSIONS CODE)OR 7HA7 HE OR SHE IS FJ(EAIPT THEREFROM AND iHE BASIS FOR THE ILLEOED E%EMP-
TqN.ANVVqLATpNOFSECTION7031.bBYANYAPPLICMlTFORAPERMITSU&IECTSTMEAPPLICANTTO Z Re-Roof
, � ACIVIL PENALT/OF HO7 AIORE THAN FNE MUNORED DOLURS(f600).):
� 01,0.90NRIEROFTHEPROPERTV,ORMVEMPLOYEESWITHWAOESASTMEIRSOLECOMPENSATION, � CpmmBfClfll . �
YNLL DO 7HE WORI(,AND THE STAUCNRE IS NOT INTENDED OR OFFERED FOR SALE(SEC.70N,BU51� J
N 1�&4 M1D PROFESSIONS CODE:TME CONTMCTORS LICENSE LAW DOES NOT APPLY TO AN OWNER OF � Re air s e r 1`d av era e "�'
PROPEHfYWlqBU¢DSOROAPROVESTHEREON.ANDWFIODOESSUCHWORKHIMSEIFORHERSELFOp P $5750/ er llnit
Q 7HROUGH HIS OR HER OWN EMPLOYEES,PROVIDED THAT SUpi IMPROVEMENTS ARE NOT IMENDED OR m $17 2 5 0
Q ,UFFEREDFORSALE�F,MOWEVERTFIEBU0.AWCiORIMPROVEMEHT1950lDWfTHINONEYEAROFCOMPLE X3-
Z �TqN,THE OWNEfiAUILDER N7LL HAVE THE BURDEN OF PROVIN�THAT HE OR SHE DID NOT BUILD OR
� IMVIqVE FOR THE PURPOSE OF SALEJ.
� ❑I,AS OWNER OF THE PR07EHTY,M1 EXClUSNELV CONTRACf W0 VlITH LICENSED CONTMCTORS
TO CONSTAUCT THE PRQIECT(SEC.70M,BUSINE55 AND PROFESSIONS ODDE:THE CONTRACTOR9 IJ- V81U8fI0f1 .AREA
C@tSE lAW DOES NOTAPPLY 70 AN OVYNER OF A PROPERiY N?10 BUILDS OR IAIPROVES TMEREON,AND
� WiqCONTfUCTSFORSUCHPRQIECfSWITHA00NTSiAC10H(5)LICENSEDPURSUANTTOTNECONTRAG ou,armrr DESCRIPTION FEE
� TORS LICEHSE LAw.).
0 O I AA1 E%EMPT UNDER SEC. B.8 P.Q FOR TMIS REASON Q
3 U
l� ¢
DATE OVMER V
Z W
F LICENSED CONTRACTORS DECLARATION W
� I MEREBV�FFIAM UNOER PENALTV OF PERWRY 7HAT I AM LICENSEO UNDEP PROVISIONS OF CHAFTER �
� Y(CO�IMENCWO WfTN 6ECTION 7000)OF DIVISION 3 OF 7HE BUSINESS M1D PROFESSIONS CODE.AND Z
� X MY 110ENSE IS IN fULL FORCE M1D EFFECT. m
LLI
� UCENSE CUSS �� IIC.NO. j
V DATE l���•�q CONTRACTOR • d
W
. � WORKERS'COMPENSATION DECLARATION ���_� —i � �
¢
N1 HEREBY AFFlRM UHDER PENALTY OF VERRIRY ONE OF THE FOLLOW WO DECIARAT10N5: Z
� _IHAVEANDWILLAWNTNNACERTIFlCATEOFCONSENTTOSElF-INSI�HEFORM'ORKERS' ', . _ � � � " � ``
�� COMPENSATION,AS PROV�ED BY SECTION 3700 OF iNE LABOH CODE.WR THE PERFOqMANCE w
OF 711E WORK FOR WHICH THIS 7ERMIT IS ISSUED. � _ ,
p' � �2 .-:� �. ' �.�r._',_-.i1'��
I HAVE AND WILL MNNTNN WORKERS'COMPENSATION INSURANCE.AS.REOUIRED BV SECTqN
Q 37000F TME LABOR OODE,FOR THE 7ERFORMANCE OF THE WORK f-0R WHICH 7HIS PERA1R�15 •� 1 r'�'
0 ISSUED.MY WORICERS' PENSAT INSURANCE CARRIER Ml�POLICV NUMBER ARE:� '. '�� CONSTRUCTION�.+�-" <1��i� - � '� �
jc�wr�Eq PUW REVIEW ..
� POLICY NUMBER . , �. ., ' �• ` _ •�` . .ELECTRIC" „ � ? ' , ' �' i . - • ' •
(n4ssEcrnnrFIDrq7eeoo�rIDOFn�a�wKiswaaEia�a�Doal�asltiaolaa�ssF. _ PL'UMBING .. ��#Tl-fiA . - ���.''� .
w � -�'R '• .., " � .t+. •j �.t�1Y � � , . , .
Z I CERi1FY 7HAT IN THE PERFORAIANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED,I •MECHANICAL
(,� SH/�ll.NOTEMPLOYANVPERSON�INANYAUNNER50AS70BECAMESUBJEC7TO7HE. ' • , .
� WORKERS'COMPENSATIONUWSOFCALIF-0fiNI0.NdDAGREETMATIF•ISHOULDBEC0IAE-:' INSPECTIONF.EE t(� /�(► - -
SUBJECT TO TME WORKERS'COMPENSATION PROVISIONS OF SECTpN 37ao OF TME LABOR IS'SUANCE / �9 41Q �.� D,�
s CODE.I SHALL FOR7TIWITH CAMP,LY WITH TFpSE PqOVISIONS.(� /�/� O�T �.+� � ��e d '
� ��a �`_�nci1�►�l�( �I-. SM�P � . . � . . . . - .
p �ATE:. APPLICANT: I �+✓ iTl�
� . .� . ,, ENERGYPlG,�T I 1 ��'�� � - f�•�. .
WARNINO:FAILURE TO SEWRE WOFiI(ERS'COMPENSATIONJCAVERAGE�IS UNLAWFUL,AND SHPLL BE (�p�
. � SU6IECTANEMP�OYER70CRIMINALPENALTIESANDCMLFINESUP700NENUNDREDTMWSAND ENERGYPERMI� ��3L]i��j
DOlLMS(f100,000�.IN MDITION TO 7HE COST OF COMPENSATqN,DAMAOES AS PROVIDED FOR IN
� SECTION 3708 OF THE LABOR CODE.WTEFEST,AND ATfORNEV'S FEES. �� . . � ' � ` ' '4
; d•-•". '°�� '�RETENTION FEE,' ^ I I/�I
� � ,. CONSTRUCTION LENDING AGENCY - � PRE-A�T FEE:, ' ' , � � �'
O . : - � . �s-_��
� I HEREBV AFFlRM UNDER PENALTV OF PEflJURV THAT THERE IS A CONSTRUCTION LENDINO A�ENCY� �
FOR�THE PERFORMANCE OF THE WORK FOR WHICH THIS,PERMIT IS ISSUED(SEC.70a1,CIV..CJ.
. w . . . . . , i� '. ' � � , . ., . , t . . . .
� ••LENDERS NAME � �
�`
1— LENDERSADOHESS
� I CERTIFV THAT I HAVE READ THIS MPLICATqN AND STATE THAT TME AflOVE INFORAIATIDN IS CORRECT. TOTAL FEES
w 1 AOHEE TO COMPLV WITH ALL CRV AND COUNTY ORDINANCES AND STATE LAWS REUTINO TO BUILDINO � ' '
� CONSTRUCTION,AND HEREBY AU71iORIZE REPRESEN7ATNES OF THIS COUNTV TO ENTER UPON THE
ZABOVE-MENTIONED VROPERTV FOR INSPECTION PURPOSES. COMMENTS
� i� Aw���.r
�
PE EE NAME(PRINn �
N
� SNINANRE OF PERMITTEE OATE
� RECPT.NO. PAID BY VALIDATION
WHITE-0epanment Copy,YELLOW—Flner�ce CaPY.PINK—Assessor Copy,GOLDENROO—File Copy,GREEN—Applicant's Copy
� �ITV �� ��s�il���[� ��(f�
-�.i .. •`r� _ ,
1�9SP�,C�O�� �EC���
:� �"'�a.=� �.:�u.'�=nn�,.•, . ' p � `"�.1�� ' ��"fl � - , �'JG' 7 �I AJ � ��r�� �a`
- . , . .��, . .
. � .
.
� �:�� . �� o m
. .., . . . _ . .; , .. _. >. .
SET QACK � . OOR JOIST :. ` _ - .
, ,
FfGS/FORMS/STEEL ' FHA REC�MTS
ELECTRIC GROUND UNDER FLOOR DUCT. ,
GROUND PLUMBING � UNDER FLOOR CUR�DUIT • - � - . .
SLAB GRADE ' � � � FlREPLACE FOUNDATION �
TEMP POWER FiREPLACE BOND BEAM • • '
WATER SERVICE MID HT. BOND BEAM ..
ROOF SHEATHING 8 FY. BOND.BEAM ' '
FRAMINGNENTILIATION FiNAL 80ND BEAM ` � _
RODF.CQVF_R • PRE-GRADING � � . .
ROUGH HEATlNG • BENCHING -
ROUGH ELECTRIC ROUGH GRADING /
ROUGI-i PLUNIBING FINISH GRADING
SHOWEWTUB�'EST �?OOL ELECTRIC . •
�XT. Ir�TH/SIDING • POOL FENCING � '
WALL INSULATION POO�l.FINAL � ,
CE1L1l�lG IMSULATION OFF SITE IMPS.
DRYWALL N�11UfV,G � _ .. DEDICATIONS
SENI�R � • ' . FINAL ENG.
SEFTIC TANK LAND�CAPE/IRRIC.
SEEP PIT/L�. ��C'.�`,- ;�1 ^�'-':�,,. �N SIiTE IMPS.
GAS AIR TEST FiNAL ZONING
Fi�7�L CONST. " FIRE� EPT. FINAL
Fl"N:;�HEATING . HEALTH DEPT. FINAL
FI�J!',�_ELECTRIC DEV. F ES PAID - �
'.t^•::�.�PLUMBING ENERGI(
�----- ,� � � � O O o,, : —_
` �,CaM�liEiVTS - - - ---- -------- - -�--� -_., -- --- - ;--'�- - - - - - - - -- -_----�_..._.. �_� _ : . _ .
–!s–�.o _ � � • • �
A��� �, ��� J�
z -23;-�. _ . .Z.�_-� _ g�. �
_ �
-�� -co Zz.�-� r � �-c�.�..���J_ - �_ ' � - ------
�-��,,�
�—ZZ—�0 2�Tj — _,��.c,._��,.�..�_5� _
-� � �z�1 Z - l r��.—�e.������-��
3-�ro -at> z2l Z - z �- `' N � -Z �+��
3 ^30 - � 2Z l"� - .... �.� `� . � ;
3 _ �-2 � l -3 �
SEPTIE�T�INK SIZ� ��iZC?O -Z-zIZ - Z �w,,.� �'�1-�ti. 5=( � S"�— —
SEEP Pl�II�-�i�-E� T_ --�—
� �� � � ��� -� �t/t�.`��-`' �-�- ����t�� �. —�_� �17 -� ,-
' •� 4 �y � \w�v_� ,��'� ` ��4��Y�` _` _. __4 Gi_._
' V a aw,. , .y�., '
' _ �
- � � y�� � �� �_2o�-c�; �Zz(-t -3 `� �� � ��
, . � { � ..�. ------
�,�� �.: � � ; �
� �, �_ �;�:
� � � � ��z .�
�• � .
� '� � �� : .� �" . � � ---� '-�f' ���i � ��.�� :o , ����
�,.�� ,� ^ - °� _ . ', , -,
. i�y�'S�� ^ �� � � . � ,Y t _ ' �I� ��.�. _ � � �� _ ��
l.d ^1 '