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HomeMy WebLinkAbout10598 (5) . . . ..._.. _... _. . . .. . � - CTI'Y OF DIAMOND HAR . ' , COMMUNTCY DEVELOPMENT DEPARTMENT .,.� 21660 E.Coplcy Drive Suite 190 . PRESS (909)660-3t95 Fax(909)861-3117. r ~'""'. BUILDING PERMITAPPLICATION /OJ � FIRMLY � JOBSITE ��� (i.C L�Gl/�yp ►,(C DATEiCATION n NUMBER�� M/C 4 AD�RESS � N � APN LOT TRACT ISSUE TYPE OCC DATE CONST. GROUP p OWNE�i TJF'�.lc•F " ADDRESS '� ZONING SETBACKS "' CITY ZIP TEL � FRONT RW ' ❑ FEAR � APPLICANT � TEL SIDE/SIDESTREEf RW O � CONTRACTOR �LCD UE�L. SIDE ❑ ADDRESS � CITY ZIP TEL. PROPOSED USE .i� � o ARCH/ENG/ DESIGNER �i7 NO.DWEL � N . NO n. ADDRESS � CITY ZIP TEL. UNRS STORIES BEDROQMS � v� OESCRIPTION SQ.FT. FACTOR PSF ADJ.ARE/WALUATION p� OWNER•8L'ILDER OECLAFIATION SFRIADDIREM • O p 1 HEHEBY AFFIRIA UHOER PFWLLTY OF VERRIRY THAT I AA1 E%EYPT fROAI THE COMMCTOR$LI• Ga�s�dC:e�OR W CENSEUWFORTHEFOLLOWNGREASON(SEG70.71.6BUSINESSANDVROFESSIONSCOOE:ANYCT'OR (n U COWTYN'NCHqEOUIRESAOEfWITT000IJSTP11C7,ALTERIYPi10VE,0E1AOL15M,ORREMIqANVSTRUC. W patia/Deck ,.wM��� TUR[.iRqR TO RS 155U�NCE,/�LSO RCWIRES TME A7VUCANT iOR SUdi FERMIT M FILE A SIONED W � � 6TAfFu14M TUT ME OII 511E 18 LICEN6E0 PUR6UNIT TO 7ME PROV1510N5 OF TNE CCNTqAGTON9 L4 LL � CENSE UW(dUPTEf10(COMMENCINO VATH SECiION 7000)OF DMSqN]OF TNE BUSlHESS AND VqO� POOUSp! FESSIONSCODE)OHTiURHEOR5HE15E%EMPiT11EREFRdI/�NDTHEBASISFOi1TME11LLEDEDE%EMP• (� TION.ANYVqlAT10NOFSECTpN7071.6BYANYAVPLICJWTFOflAiERMIT5UBIECTSTMEIPPLICANTTO Z qa.Roof A CML FENALTY OF NOT MORE THAN FNE HUNORED DOLLAiLS�f5001�Y � Ot��NEROFiV1EVf10PERTY,ONMVEMPIOYEESWITHWAOES/3THEIRSOLECONVENSATION, 0 (`,pmmBlCiel ' NfILL DO iHE WOfUC AND THE STPUCTURE LS NOT wiENDED OR OFFEREO FOR SALF�SEC 7a�,BU54 J N NE55 AND PROFESSIONS CODE:TNE CONTMCTORS UCFNSE UW OOES NOT APPLv TO AN OWHER OF ? OROPERfYN?10BVIlD40RMPROVESTHEREON.ANDYAIODOE55Ufi/WORKH�M5ElF0(iHERSEIFOR ' � � iNROUGHH90qMEROYK�ENVLOYEES,GAOVIDEDITIATSUCIIMFROVEMEN75�RENOTNTENDEDOR m OFFERED iOH SALE IF,1pwEVER TME BULqNOOR iMPROVEMENT 4S SOLD VrtTHN ONE YEM OFCOMRE- Z TION,iME OWNER�BURDER WILL MAVE THE BURDEN OF VROVINO TNAT HE OR SNE D�D HOT BUILD OR MPROVE fOR TNE PURPOSE OF EALEI. W �611I150NMEROFTNEPROPERiY./UAE%CLUSNELVGONTRACTINOWRHLICENSEDCONTMCTOR4 � TO fYJ}rSTRUCT THE 7RO.IECT(SEG 70u.BUSINE55 AND OROFESSIONS CODE:THE COHiMCTOR9 ll- VBIU9l'I011 qp,�,qpEq W tENSEUWDOE3NOTAPPIYfOANOWNEROFAPROPERTYNR108U1LDSORMPNDVESTXEREOH,MID � N?GCONTMCTSFORSUCHVRQ1ECiSNnMACONTRACiOR�S�LICENSED►URSUANTTOiHECOHiMC. pUA1JTITY DESCRIPTION � � rons ucensE uw.y FEE � O 1 AA1 DIEAIPT l�lOER SEC. ��V.G FOR THIS REASON ' q . . . - . 3 � . ZMTE � OVYNER � 7 � . � . �Q UCENSED CONTRACTORS DECU ION W ¢ IHEREBYAFFIRAIUNDERPENALTYOFPERIURYTHATIAAILICENSEDUNDEHCROVISIONSOFC1uPTER V. d f(COMMENCiNU WiM SECTION 7000�OF OM510N 70F THE BUSINESS AND iROFE95qN5 COOE,MIO Z � X MYIICENSEISNFUILFORCEANDFFFECL m ll.l � LICENSE CUSS UC.NO. � V DA7E � CONTRACTOR d W • � WORKERS'COMPENSATION DECLAAATION � � � INEREBYAFFIRMUNDERVENALTYOFPEfWRYONEOFTHEFOLIAWINODE0.AMTI0N5: Z � _IMAVEAN�YnLLMAWTAiNACfRTIFICATEOFCONSEMTOSELF-WSUREFOHNORNERS' _ COUPEN3ATqN.ASPROVIDEDBYSECTION77ooOFTMEIABORCOOE,FORTHEYERFOiYAANCE w Q OFTHEWORKFOi1YA11CMiHI5PEi1MI715155UED. � �W �IHAVEMlOVALLMAMAINWORKERS'COMPENSATIONINSURANGE,115PEOUIREDBYSECTqN �70o OF h1E LABOR CW E.Fdi T}1E PERFONAANCE OF TME WORK FOR Yv111p1 THIS PERMIT IS �/1J � , J ISSUED.A(Y�Wi1KER5'COMPENSATIONWSURANLEGNRIERANDPOLICYNUABERARE: CONSTRUCTION — //" j GARIER PLAN REVIEI4 � VOIICYNUGBER � � " � ' ��,. ELECTRIC 0 (nassEcrioNN[mNo7eEoo�rmovn[�tswna��a�atmoouutsRiao�oA�rssa PLUMBING Z 1 CENTIFY TUT N THE VERFOqMANCE OF TNE WORK iOR WNICH THIS iERMIT IS ISSUE0.1 MECHANICAI C7 SMALLHOTEUCLOYANVVER50NWANVYANNERSOASTOBECdAESUBJECTTOTHE r/ (/) WORKERS'COMPENSAiIONlAW50FCALIFORNIA,ANDAGREETWITIFISMOULDOECOAIE INSPECTIONFEE � S SUBJECTMTHEYlORKER4'WMPENSATqNiROVI510N50F5EGTqN]7000FTHEUBOf1 caoe,i s�uu corznnnrH cour�r win�rnos¢vHovisaas. iSSUANCE O • p DATE: APPLICANP. SMIP � ENERGY P/C WAiWING:iNLURETO SECURE VNHKERS'CaMVEN5A7qN COVEqAOE IS UNUINIFUI.,ANO 5lULL BE � .SUBJECTANEMPLOYERTOCRIYINALVENALTiE9ANDCMLiWESUPTOONENUNDREDT1qU5AND ENERGYPERMIT DOl1AR5 p I00.000�H ADDITION TO iHE COSi OF COM7ENSATION.DAMAGES AS VROVIDE�FOiI IN J SECTION77WOFTHEL1180ROOOE,WTFRE4T,ANDATTORNEY'SFEES. ¢ RETENTION FEE: � 0. CONSTRUCTION LENDING AGENCY 0 PRE•ALT FEE: � IMEPEBVIFFIqYUNOERVENALTVOFOERNMTMATTNENEISACONSTitUCT10NLFHDNOAGENCY � . ' ' Z FOR iME iER�ORMI�NCE OF TNE Wdi�(iOR Nn71CH TAS DEiW IT IS ISSUEO(SEC.7007,CN.C.� W � LENDER'S NA1AE C LENDER'SADURE53 � W ICER71iYTUTINAVEpEADTItSAPVLIGTIONANDSiATETHATiHEA80V[WFORYA770NISCORRECL TOTAL FEES � � � d IAGREETOCOMPLYWITIIALLCrtYANDOOUNiYORDNANCESANDSTA7EUW5REUTwGTOBU4DING ` �- � CONSTMICTION,AIONEREBYAUi1qHIZEREPRESENTATNESOFTWSCOUNiYTOEHfERUPONiHE . OBOVE•MEMpNED VROPERTY FOR INSPECTION PURPOSES. 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