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HomeMy WebLinkAbout14212 �'�P��-� ��� CITY OF DIAMOND BAbt ��i� 24 DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES _ w 21660 E.Copley Drive Suitc 190 (909)860-3195 Fax(909)861-3117 PRE$S ���^�' � BUII.DING PERMIT APPLICATION FIRMLY � JOBSITE APPLICATION PERMIT P/C o ADDRESS 2223 Dublin Lane 3 llri1tS DATE ��22�9g NUMBER � �# ' c� ISSUE TYPE OCC R-3 & APN LOT TRACT 37026 DATE CONST. �1N GROUP p OWNER " ADDRESS ll 121 Ldri2 � ZONING SETBACKS � FRONT EXist see P1a�,N � CITY Di amoncL Rar_ ZIP TEL APPLICANT O ari TEL����6�- REAR ❑ � � SIDE/SIDE STREET RW ❑ CONTRACTOR Timberland SIDE ❑ o ADDRESS ciTv Brea ziP Te�. 714-579-371 PROPOSED USE S�e oARCH/ENG/ J.M. N.olan zzz DESIGNER �u ADDRESS �a a asas OS U1 e NO.DWEL. 3 NO. 2 No.. ee � CITY Ca1 abacaG ZIP UNITS STORIES BEDROOMS�_ 9,L3_QZ TEL. R1 fi—��4-49( �n DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREA/VALUATION p� OWNER-BUILDER DECLARATION SFR/ADD/REM O I MEREBY AFFlRM UNDEH PENAL7Y OF PERRIRY THAT 1 MI EXEMPT FROM 7HE CONTfUCTORS LI� GBfHgB/C9fPOR W CEP15EU1WfORlHEFOLLOWWIiREASON(SEC.7o3t.68USR1E5SANDPROFE5510N5CODEANYCITVOH (n C�7 COUHryWHICMREOUIHESAPEHMRTOCONSTAUCr,AL7ER�PROVE,DEMOUSH,OHREPAIRANYSTRUG W PefiO/DBCk Z 7URE,PRIOR TO ITS l4SUANCE,ALSO REQUIRES 7HE M7LICANT FOR SUCM PERMIT TO FILE A SIQNED �l� STAiEMENT THAT HE OR 9HE IS LICENSED PURSUANT 70 THE PROVISIONS OF THE CONTMC70R5 ll� w - � CENSE UW(CHAFTER i(COMMENCINO WITH SECTION 7000)OF DMSION J OF THE BUSINESS AND PRO� � PooVSpe � FESSIONSOODE)ORTHATHEORSHEISEXEMPTTHEREFROMM107HEBASISFORtHEALLEOEDE%EMP- (� TION.ANVVIOlJ�T10NOF5ECT10N7031.6BVAHVMPLICANTFORAPERMITSU&IECTSTHEAPPLICANTTO � Z Re-Roof � A CML PENALTY OF NOT MOfiE THMI FIVE HUFWRED DOLLARS(fb0o).�: . � 04ASON�NEROFTHEPROPERTV,ORMVEMPLOVEESWITHWAOESASTHEIRSOLECOMPENSATION, 0 COfilm0fG81 � WLLL DO THE WORK,AND THE S7RUCNRE IS NO7 INTENDED OR OFFERED FOR SALE(SEC.70M,8U51� J � HESS AND PROFESSlONS CODE THE CONTRAC70R9 LICENSE UW DOES NOT MPLV TO AN ONMER oF PROVERTYWFIOBURDSORIMPROVES7HEREON.ANDWHODOESSUpiWORKHIMSELFORHERSELFOR � eY L'I�LL• Q iHR0Ud1 MIS OR HER OWN EAIPLOYEES,FROVIDED THAT�SUCi1 IMPROVEMENTS ARE NOT fNTENDEO OR m w OFFEREDFORSALEIF,HON�EVER7NEBUIIDINf10RIMPROVEMEI�RIS50LDWfTHINONEVEAAOFCOMRE- � �'TqN,THE OWHEREUILOER W1LL HAVE TFIE BURDEN OF PROVINO 7HA7 HE OR SHE DID NOT BUILD OR — Z IMPROVE FOR THE PURPOSE OF 9ALE} . , � _ ❑I,AS ONTIER OF TiE PROPEHf`/.AM IXQUSIVELV COHTRACTINO Wfi!'IJCENSED CONTRACTORS �w TO CONSTAUCT THE VROJECT(SEC.7oN,BU91NES5 AND PROFESSIONS CODE TME WNTRACTORS U- Veluetion REA CENSE UW DOES NOTMFLY TO AN OWNER OF A PROPEflTV NT10 BUILDS OP W PROVES THEREON,AND � WFIOCOIfTMCTSFORSUCNPROJECTSWITHAC01lTMCTOR(5)LICFNSEDPURSUAMTOTHECONTMG pUANTITY DESCRIPTION FEE � � T00.�LICENSE LAW.). ❑I AM IXEMPT UNDER SEC. B.8 P.C.FOR THIS REASON J O U 3 ¢ � u" DA7E OWNER � U � W UCENSED CONTRACTORS DECLAAATION � � W 1 HEREBV AFFIRAI UNDER PENALTV OF PERIURV TIAT I AM UCENSED UNDER PROVISIONS OF CHAPTER � (� Y(COAIMENCINO MA7M SECiION 70a0)OF DMSION 9 OF THE BUSINESS M!D PROFESSIONS CADE.AND Z `u W LICENSE LS M FUIL FORCE N1D EFFECT. m 0 UCENSE CLASS LlC.NO. � . V DATE '�`y^ CONTRACTOR . a _ �LL � O � �.�.? �'WORKERS'COMP,ENSATION DECLARATIONr ''"� a . � - �� •I.HEREB,Y AFFlRM UNDER�PENALTY OF PER/UM ONE OF THE FOLLOWING DECLARATIONS: �� Z ` ' ♦ . � �� _I HAVE AND WILL MAIMAIN A CERTIFICATE OF�EONSEfff TO'9EI:F-INSURE FOR NOPKERS L.e '' _ ;�� ?e•.''4 � ••,. +. .. ,.r �..�'K^• ., Y.•' , �.. Q COIJPENSATION,AS P.ROVIDED BV SECTION 3700 OF THE LABOR CODE,FOR THE PERFORIMNCE U I OF7HEIMORKFORNMICHTHISPERMIT�ISISSUED. � �p '� W . . � \/` rv: . �-1 i..y... :.. . . t<#. . ',` • "" , � .:..,' '+ �..+.d'�' . 7 ,��?� •., :. I'.4;.-� • , � , a�I HAVE AND WILL MAINTAIN WORKERS'COMPENSATION INSURANCE AS FEW IRED BY SECTqN � � ¢ r 37000F THE LABOR CODE.FOR TNE PERFORMMlCE OF THE WOR)('FOR WIiICH THIS.PERMR IS � � ISSUED.MY WO{I EN ATqN INSU CAHRI AND P4l:�Cy NUMBERJ�RE: % � CONSTRUCTION " _ � ' ��• ' � � '• � , ] CAARIER � �1 �PLAN REVIEW _ � POLICYNUMBEH �. .. � � ELECTRIC ,._ . � . .. • �v,� � � � i, . 0 (f1LLSSK.'f10P�rEIDNO78E00MlE�EDOFiHEPERMtSWHaHEtA.lDRED00.t'F3i5K��)�LEss) "'PLUMBING � �'�]A • '• Z 1 CERTIFI'hiAT W TNE PEFFORMANCE OF THE N/ORK FOR WHlqi 7HI5 PERMIT IS ISSUED,I MECHANICAL ` 1}�L�1 I1.f�f1 • � (} SHALL NOT EMPLOV ANY PERSON W ANY MPNNER SO AS TO BECOME SU&IEC7 TO�7HE � • .- � (,/� WORKERS COMPENSATqN UWS Of CALIFORNIhµ�AOREE THAT IF I SFKKILO BECOME '� INSPECTION FEE - + �� � �.� SU&IECT TO TME N4RI(ERS'COMPENSATION PROVISIONS OF SECTION 37000F THE UBOR �) O. coo.i sw�� ni ca,+v�r vnn+rHose Prrov�srorrs. . �. . ' ISSUANCE _ (� � .' - �� , . p OATE:__���c�APPIICANT., 1 � , , , ,} - SMIP - yQJ �'� J WARNINO:FAILURE TO SECURE WORKERS'COMVENSATION COVERAOE IS UNUWFUL,AND SHN.L BE - ENERGY P/�TT'l� � _� SUBJECT AN EMPLOVER TO CRIMWAL PENALTIES M1D CIVIL FINES UP 700NE HUNDRED THWSAND a 1 j � DOLLAAS(f700.000),WIDDITIONTOTHEC0.STOFCOMPENSATIDN,DM/AGESASPROVIDEDFORIN ENERGYPERMI��}r � SECTION 370E OF THE LA80R CODE.INTEREST,AND ATTORNE'f5 FEES. ' RETENTION FEE w � /� / n� OCONSTRUCTION LENDING AGENCY PRE-ALT FEE: • � I HEREBY AFFIRM UNDER PENALTV OF PERIURV THAT THERE IS A CONSTAUCTION LENOINO AQENCV ��r'�•�, FOR THE PERFORMANCE OF 7HE WORN FOR WHICH THIS PERMIT IS ISSUED(SEC.3087,CIV.C.). .�-r-�--�—'-- Z w � LEPIDEF'S NMIE _ ^ C LENOEFTSADOHESS � TOTAL FEES � I CERTIFY THAT I HAVE RE}D THIS APPLICATION AND STATE THAT THE ABOVE INFORAIATION IS CORRECT. w I AGREE TO COMPLV W17N ALL CRV M1D COUNTY ORDINANCES AND STATE LAWS REI.ATINO TO BURDING � CONSTRUCTION,AND HEREBY AUTHOR2E REPRESEN7A71VE5 OF 7HIS COUNTV 70 ENTER UPON THE ' � ABOVE�MENTKKiEDPi70PER7V FORINSPECTqN PURPOSES. Z COMMENTS " � ti�� �1�-�C� ¢ P EENAMEIPRINn � � �� � . Cn � _ ✓� .� Z t � 1 / � SKi RE OF PEFlMfTTEE � " DATE � � . � . RECPT.NO. . PAID gY _ � vn��nnnriu WHITE—DepaAment Copy,YELLOW�Inence C.oPY,PINK—Asaessor Copy,GOLDENROD--File Copy,GREEN—ApplicanYs Copy l� _ �'� ��, -:`'.9,::�.'' ` � CITV C�F �I�il�Ofi9D ��R � II�I�F�ECTBC�� ��C�V�3� .� , . , . ..: ,, �. ��� , ,�� � �� ;; �. r . � � ..�� � o p .�r. n p ` .� ...: ° 0 ' .g �`��U�0 a ,,. � � � �: .,IYYY1fo,� a ,< IAt�R�Jlt• p lnT��` SET BACK , , . FLOOR JOIST , . FTGS/FORMSISTEEL FHA REOMTS � ELECTRIC GROUND UNDER FLOOR DUCT GROUND PLUMBING UNDER FLOOR CUNDUIT � S�AB GRADE ` FlREPLACE FOUNDATION TEMP POWER FIREPLACE BOND BEAfVI ' WATER SERVICE MID HT. BOND BEAM R�OF SHEATHING � 8 FT. BOND BEAM - � � FRAMINGNENTILIATION FIPIAL 80ND BEAM ROO.F.CUVER � PRE-GRADING ROUGH NEATlNG BENGHING - ROUGH ELEGTRIC ROUGH GRADING ROUGH PLUNIBING ' FINISH GRADING .. SH�WER/TUB TEST POOL ELECTRIC EXT. LATH/SIDING POOL FENCING WALL iNSULATION POOL FINAL CEILlNG I(�lSULATION OFF SITE IMPS. DRl(WALL NAILING " DEDICATIONS SEWER � � ' FINAL ENG. SEPTIG TANK` '` ' ' LANDSCAPElIRRIG. 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