Loading...
HomeMy WebLinkAbout16879 (42) �� CITY OF DIAMOND IIAR DEPARTMENT OF CO:vIMUMTY&:DEVELOPMENT SERVICES 21825 E.Copley Drive (909)860-3I95 Fax(9U9)861-3117 PRESS ��-�� BUILDING PERMITAPPLiCATION FIRMLY o� JOBSITE { APPLICATION PERMIT P/Cr) ADDRESS�.? �1� �11�P� �C Y �t�l ' DATE � NUMBER � 0 V � � DA EE NPE OCC APN LOT TRACT Z CONST. GROUP p OWNER - � S p ADDR SS �' L� ZONING SETBACKS FRONT z CIN - ZIP �TEL. .-�E. RW ❑ g APPLICANT � u TEL. �!=}W1� S DE/SIDE STREET RW p � CONTRACTOR SIDE ❑ o ADDRESS + CITY ZIP TEL PROPOSED USE C- 1 - o ARCWENG/ �- �z DESIGNER NO.DWEL. NO. NO. = CrDTMDRESS ZIP TEL. UNITS STORIES BEDROOMS � �n DESCRIPTION SO.FT. FACTOR PSF ADJ.AREANALUATION p� OWNER•BUILDER DECLARATION SFWADD/REh1 O Q 1 HEREBY AFFIRM UN�ER iENALN OF PERA/NY iMAT I AA1 E%EMGT FRpA TM[CONTMLTORS ll- G02g&�C2fPOf1 ' W CENSELAWiOitTHEFOLLOWINOREA50N(SEC.70.71.SBUSMESSINOVROFESSIONSCOOE:ANYCITYDR U COUNryWHICNHE0UIRESAPERMITTOCONSTRUCT,ALTERIMVROVE.DEMOLISH,ORREPAIRMIYSTRUC- W ! w NRE,PR�OR TO RS ISSUANCE.ILLSO fiEWIRES THE AVPLICAM FOR SUCH PERuIT TO FIIE A SIGNEO W Patio OCk � S7ATEMEM TNAT HE ON SME IS IICENSED PURSUANT TO TN[PRONSIONS OF THE CON7RACTOas LI• � CENSEU�W�CHACTERY�COuuENCRWWITNSECTqN70o0)OFDIVISiON�OFTHEBVSINESSANDPRO- POOVSpO � iES5pN5COOGIORTMATMEOR5HE15EXEAIPTTHER[FROMANDTNEBASISFOH7HEALLECEDEXEMP- (� V TION.ANYVIOIATqNOFSECTION70�1.SBYANYAPP�ICNfTFORAOERMiTSU&I[CiSTHEAPYLICANTTO Z Re-Rocf A GVIL CENALiY OF NOT MORE TMAN FNE HUNDRED DOlURS(f Soo��� Z~ Ot�W+NEROF711EPfiOVER7Y,ORUYEMPLOYEESNnTNWAGGSASTNEIR50LECOMPENSA71pN, Q MnLLDOTNE YroRK,M7U THE STRUCTUR[IS NOT W7ENDED OR OFFERED FOR SALE(SEC.TW�.BU51- J COTmBfCi21 � NESS AND PROFESSIONS COOE:THE CON7MCTORS IICENSE U'N DOCS NOT A7PLY TO AN OWNER OF VHOPEfliVYAlOBU0.�50HIMPROVES7NCflEDN.AN�WMODOES5l1CNWORKM11A5ELFORHERSEIFOR � CL THi10UCHHISORNEROWYEY7LOYEES,OqOVIDEDiNAT5UC/11M�ROVEUENTSARENOTWTENDEDOR m � OFFEREDiORSALE1F,11OWEVERINEBNIDINCORIAIPROVE�ICNT1550LDWITHINONEYEAROfCOMP�E Z TION.TME O`NNERBULDER WiLL HAVE TME BUNOEN OF FROVIN�TMAT M[OR SHE DiD NOT BNLD OR � IMVROVE FOR THE PUflPOSE OF SAlE4 ❑4A5 OWNER OF THE PROPERTY,AM E%0.USIYELY COMMCTIhG WfTH LICENSED CONTRACTORS Q TO CANSTRUC7 THE PRWECT(SEG 701�.BUSINESS AND iROFES5lON5 CAOE:TME CONTRACTORSII- V3luetion � ADJ.AREA L11 CENSEUWDOESNOTAPVLYTO�NOWNEROFA7ROPERttWHOBURD50RIMPROVESTMEREdJ.AND � W/qCON7RALTSFORSUCHPRn1ECi5WI7NACONiRACTOR�S�LICENSEDPUR5UAN77DiNECONTRAC- OUANTITY DESCRIPTION FEE Y TORSLICENSEUW). � IAME%EMVTUNDERSEC. B.tP.C.FO�THISR[ASON J � a � U u" DATE I OwNER ,�� P� M U Z FQ LICENSED COMRACTORS DECLARATION W CL IHEREBYAFFIRMUNDERVENALTVOFOERIUMTMATIMILICENSEDUNDEROROVI510N50FLHAPTER � d •(COMMCNCINC WRH SECTKKi 7000)OF DMSqN�OF TME BUSIN[55 AND PROFESSqNS LODE,�ND Z X MYLICENSEISMFULLFORCEMIOEFFEGT. m lll � UCENSE CUSS LIC.NO. j V DATE CONTHACTOR d W � WOFKERS'COMPENSATION DECLAMTION —i NIHEREBYAFFIRMUNO[RVENALTYOFPERIURYONCOFTMEFOLIOWINGOECLAfUT10N5. Z � _I/UVEANDYnLL1AAINTNNACERTIFICAiEOFCONSENTTOSELF-INSUREfOAYVOHKERS' a G Q COM7ENSATpN,ASPROVIDEDBYSECTION�T000FTNEUBORCOOE.FORTHEPERFpRMIJJCE W Q OFiHEWORKFORN711CMTHISPERMITISI55UED. � W _IHIIVEANDWILIUAINTAINWOAKERS'COMPENSATqNINSURANCE,ASREWIREDBYSECTqN /� 1 Q 71000FTMEL/�ORCODE,FORTNEPERFORMMlCEOFTHEWORKFORWMIp1TM15PERMITIS Q� / _� / ISSUED.MVWORKERS'COMPENSATqNINSURANCEGRRIERANDPOLICYNUMOCRARE: CONSTRUCTION /) � ��� Q � � CARRIER PLAN HEVIEW Z Pa�cYHur�tiER ELECTRIC ¢ � (I/a55ECIri�1:[mNOTBEODbTlETEDOFREPERMfT6PoRON[HUtf�FD00LLAR5(f�Oo�ORlE55} PLUMF3ING Z ICERTIFVTHAiNTMEPERFORMANCEOFTMEWOPKFORWHiq1iM15PERUITI5155UED,l MECHANICAL (} SNALLNOT EIdPLOV ANY OERSdJ IN ANY YANNEF SOAS TO BECOUE SUBJECT TO iHE y WORNERS'COUCENSATIONUW50FCAUFOHNIA,ANOAGREFiMATIFI5NIXILDBECOUE INSPECTIONFEE S SU6JECTTOTHEWORKERS'CdAPENSATIONCROV15pN50FSECT10N77o00FTHElABOR ' � CODE,1 SHALL FORTHWITM COMPLY WITN T�+OSE PROVISIONS. �SSUANCE ��j� � S�11P t `7 V p DATE: APPLICAM: w ENERGY P/C - —" � WARNING:FARUR[TOSELUREWOAKERS'COMPENSATIONCOVERAGEISUNUWNLANOSHALLBE � � SUOJECTANEMPLOYEHTOCRIMINA�PENALTIESANOCMLFNESUPTOO�EMUNOREDTFqUSMlD ENERGVPER �` ' /, � \ ' ' DOIURS�f I00,000),N/DDITION TO THE LOST OF CAMPENSATqN,D�MAGLS AS PNOYIDCD fOR IN �� /�� ¢ SECTqN 770!OF THE UBOfI COOE,WTEREST,ANDATTORNEYS FEES. RETENTION --E: ��1 1 ' n n n� • �['/l� a CONSTRUCTION LENDING AGENCY PRE-ALT FEE O � IHEREBYAFFIfiMUN�ERVENALTYOFVERNNYTHATTMEFEISACONSTRVCTIONLEN�INGI�GENCY Z FORTHEDERiORMANCEOFiMEWORKFORWMIGHTHISVERMiTI5155UE�(SEC.]097,CIV.G�. Ir��,T� w —�— --- -. . � lENO[R'SNAME " � � ' S � LENDER'SN'�R[SS w I CERTIFY THAi I HAYE READ iHISAPPLICA7qN�ND STATE THA7 THE ABOVE NFO�MATqN IS CARRECT. TOTAL FE ES - 1� � � � �I�1 �� � IAGRGETOCOM7LYWI7HALLCRYANOCOUN7YORDINANCESAN�ST�TEUwSHEUTINGTOBVILD�NG 1 { � CONSTRUCTIpJ.ANDMEREBYAUfMORIZENEPR[SENTATVESOFTHISCOUNTYTOENTERUPONTHE ABOVE-MENTqNE7 VROPERTY FOR INSPECTION DURVOSES. Q - 1 , I C 'MENffT��S._.�y)_�/_�_J�_,_y��j J 1- •Y�.l s�• �� � � �/v� V' � � m E MITTEE NAME(P Tj � � ¢ - �•�-- ' 'Z�d`a 1 -� � � ATUREO Y . EE '� DATE � R[CPT.NO. PAID BY VAIIDATION WHITE—Department Copy.YELLOW—Finance Copy,PINK—Assessor Copy.GOLDENFOD�ile Copy.GREEN—Applicanl's Capy ,_ , , io�l. I Z / �I s`: C�i '?I r��.f:�^i���i: �'�ftE� !f�'utiF��":'i(:i� r=;:=t:..3:�:�.: � ,—�____-------------- -.,._.._._._ __. _.._._.... ....._..---------- - - - ---_._.__....._------_._-- -----•--_.__- -----.�_._.__ I►�k-iC�=�"1'I�11`� z1::[= la`f=;:�� :'c t„�. iCE� ' c :['!C1►`i ri��i:4 I�`F�'1�!=.�['�'l'e1�t _.•. . ... .. . .. ..... .. .. . ... ._ ... ... ._: . .. . ._ __ . _.. . .. . . . __..... . . . ._.___.._.._..-- - _......- ---... _..... .. SET BACf: ' i ; ' � ' i LOOR J:�I�T i --- ------��-- - ------------- - ..__...__---�- --- ---- - - - ----- : . . I r FTGS'FOR"�'S;ST�EL ! ' '. ; �FIl�R�C��^.-1S _ __l — -- ----------•----------•-�- ----------- ----� ELECTRI�GROUND � ; i U�::�E=f; F!_O�R DUCI� ; � -- --�----� �--------- --- -- ----r - - - GF�OU��D PLUi:131(�JG I ______i � U'1DEr FLOOR COi�DUIT i � _ __ -----�--------- • --------- -- I SLAB GRADE I � ---- --- � I FIREPLi;C�_FOUPJDI�i IO�J- '----- — TE��1P POVJcR I __ � _ ___I_j_�IREr l.CE 6JPlU BEF.�.� I ___ I b"�dATCR SERVIC� � - --�— � � I",ID f1T. �?0"dD 8��:.", I i - --{---------- ------ ----- ------ ROOF SH�I,THlfda � g.3_pl � ------ � I � Fr. 60,•!D B�P,"," ---�---- ' -- FRAP.11tlG,N�:i'����,��d� •^-o .�-.. � �i FIiJAL E30�JD r EF;�,; i `t�_�l — ----- ---�---- ---- ROOF COVER I _ I ___ I I FRE-G�i�.D:t�_G _ I I HOUGH HE!',TIidG � ! I Ech:CfaliJ� � � ROUGH ELECTRIC I ; '� ROJuFi GR!',DIhJ�;, � ROUGH PLUiv'BIidG _� �----- --�• � FiF.IS�-I uR;,DItiG --�__ � -- SH��"JER/TU3TEST � ; ' . �_PCOLFI_ECTRI�' —r EXT. LF,TH,'SIDING ���I j I ; PCOL FEP.Gt•:a � �_ _ l"JALL IP�suvaTior� -�I � i i P�OL f=1,�llL _ I � CEI!ING INSULF,TI�N l � I I �r�=SITE I^.1?S. _; � DRYG^J,�LL IdAILING I __I_ ___I_.I DED�;;ATIO�JS I __� _ SE�ti'ER I I � FIfJAL ENG. i-----� - �EPTIC T/1NK � � LANDSCr1PE/IRR!G. I I � SEEP PIT/L.L. � I t� j or��SITE R:"PS. i I G.AS AIR TEST I I I � FIPJAL ZO�Ji'•1G j 1 FINAL CONST. 1�-(���--'r ': :~"E D�PT. FRJl,L I� J I . ' _ . FRvAL H�F,TING � . � � � HE:,LTii D�FT. FIiJAL_ � � _ Fi�•JAL ELECTRIC � l —� DEV. FEES Pl1�D FIiJAL PLU"JIBIiJG � � —� � EPJEF3GY � - � � I�---- _ �. _- --� -- � ��_ .. �R - _ . . . -- ----!------ -----------------!_: , �. _�: . _.._.... . __ :-----!- -- CUM�ti�IE�JTS SEPTIC TAPJK SIZE SEEP PIT/U SIZE — — —�___._-1y i..�_.._..._....__.. ._...--- -- — }��( _ � . --�- -- . � .i i . i i e . . \