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Home My WebLink About18261 (28) EXPIRED --.��. - -� D PARTME�T OFC OIvIIvIUNTTY&�DEVELOPIvIENT SERVICES 0 C T 0 9 ZQ02 21825 E.Copley Drive (909)860-3195 Fax(909)861-3117 PRESS ��'%«��" BUILDINGPERMITAPPLICATION FIRMLY � JOBSITE ¢ ADDRESS.��S -��G'o.0 � A�6' �� APPLICATION � � � PERMIT � P/C o DATE NUMBER # � APN LOT�� TRACT ISSUE � �' TYPE pCC °C OWNE�E� �'/r// GV DATE CONST. GROUP O o ADDRESS lb G �" ZONING SETBACKS Z CITI�� b ZIP 6y�TEL O FRONT Ryy p g APPLICANT TEL. REAR p SIDE/SIDE STREET RW ❑ � CONTRACTOR c O / SIDE p ADDRE S � CITY /qH�.S�/H ZI .,6"�'� PROPOSED USE �IU � A �O oARCWENG/ z DESIGNER ' � ADDRESS NO.DWEL. NO. NO. � CITY ZIP TEL. UNITS STORIES BEDROOMS � � DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION � OWNER-BUILDER DECLARATION SFWADD/REM O p I HEREBV AFFIRM UNDER PENALTV OF PERJURV THAT I AM E%EMPT FROM THE CONTRACTOqS LI� GBfegB/Caf(10R W CENSEUWFORTHEFOILOWINGREASON(SEC.7031.5BUSINESSANDFqOFESSIONSCODE:ANVCITVOR (n U COUNTVNM{C!{qEOUIRESAPERMITTOCONSTRUCT,ALTER,IMPROVE,DEMOLISH,ORREPAIRANVSTRUC� w NRE,PRIOR TO ITS ISSUANCE.ALSO REWIRES THE APPLICMIT FOR SUp1 PERMIT TO Fl�E A SIGNED W Patio/Deck � STATEMENT THAT HE OR SHE IS LICENSED WRSUMlT TO THE PROVISIONS OF THE CONTRACTORS LI� , � CENSE LAW(CHAPTEH i(COMMENCINO WITH SECTION 7oo0)OF DIVISION J(1F THE BUSINE55 AND PRO- LL PooUSpa � FESSIONS CODE)OR THAT HE OR SHE IS E%EMPT THEqEFROM ANO THE BA515 FOR THE ALLEGED EXEMP� C7 TION.ANV VIOIATION OF SECTION 7071.6 BY ANV APPUCAN,-FOR A PERMIT SUBJECTS'fHE APPLICANT TO Z Re-Roof A CIVIL PENALTV OF NOT MORE THAN fNE HUNDRED DOLURS(f500).): � ❑I,ASOWNEROFTHEPROPER7V,OqMVEMPLOYEESWITFIWAGESA57HE1RSOLECOMPENSAT'iON, � COrtlrtlefCl81 Z WILL DO THE WORK,AND THE STRUCNRE IS NOT IN i ENDED OR OFFERED FOR SALE(SEC.7a41,BU51� J � NESS AND PROFESSIONS CODE:THE CONTRACTORS LICENSE LAW DOES NO'AVPLV TO AN OWNER OF � PROPERTV WHO BUILDS OR IM PROVES THEREON,ANO MM110 DOES SUCH WORK HIMSELF OR HERSELF OF Q THROUGH HIS OR HER OMM EMPLOVEES,PROVIDED THATSUCH IMPROVEMENTS ARE NOT INTENDED OR m Q OFFERE�FORSALEIF,HOWEVERTMEBUILDINOORIMPROVEMEMISSOLDW17HINONEVEAROFCOM7LE- Z TION,THE OWNER�BUILDER WILL HAVE THE BURDEN OF PROVINO'HA7 HE OR SHE DID NOT BUILD Ofl � IMPROVE FOR THE PURPOSE OF SALE). w ❑I,ASOWNEROFTHEPROPEHTV,AME%CLUSIVELYCAMRACTINGWITHLICENSEDCONTRACTORS [t TO CONSTRUCT THE PRQIECT(SEC.]Ou,BUSINESS AND PROFESSIONS CODE:THE CONTPACTORS LI� VeIUBIIOfI ' � ADJ.AREA W CENSEUWDOESNOTAPPLYTO/WOWNEROFAPROPERTYWHOaUII.D50RIMPROVESTHEREON,MID � NMOCONTMCTSFORSUCHPRQIECTSWITMACONTMCTOR(S)I.ICEIJSEDPURSUANTTOTHECONTRAC� QUANTITY DESCRIPTION TORS LICENSE LAW.). FEE � ❑I AM E%EMPT Ut7DER SF_C. B.8 P.C.FOR THIS REASON Q � U u" DATE oWNER ~ Z U �Q LICENSED CONTRACTORS DECLARATION w CC I HEREBV AFFIRM UNDER PENALTY OF PERIURV THAi I AM LICENSED UNDER 7ROVi510NS OF CHAPTER � � e(COMMENCING WITH SECTION 7000)OF DIVISION 3 OF THE BUSINE55 ANO PP.OFESSIONS CODE,ANO Z `X AIV LICENSE IS IN FULL FORCE AND EFGECT. m � LICENSE LASS �O+�d LIC.NO.� / ��vQ � V DATE �-�•O� corrrancroa� �(!D a � WOAKERS'COMPENSATION DECLARATION Q / � G � U �� I HEREBV AFFIRM UNDER PENALTY OF PERIURV ONE OF THE FOLLOWING DECLARATIONS: Z /Q� �Z IHAVEANDWILLMAINTAINACERTIFICATEOFCONSENTTOSELF�INSUREFORWORKERS' a Q CAMPENSATION,AS PROVIDED BV SECTION�7ao OF THE LABOF CODE,FOR THE PERFORMANCE U Q OF 7HE WOR)(FOR WHICH THIS PERMIT IS ISSUED. � � w I HAVE AND WILL MAINTAIN WORKERS'COMPENSATION INSURANCE,AS REOUIRED BY SECTION Q 7700 OF THE LABOR CODE.FOR THE PERFORMANCE OF TH ORK FOR WHICH THIS PERMIT IS ' ISSUED.MV WORKER�PENSATION IN CE CAR�qND POLICV NUMBER ARE: CONSTRUCTION J j c�RRieR_ ��if�� PLAN REVIEW � Z �icrHur.�eeq � �.�nZeo ELECTRIC ¢ p (n-assEcrqNr��no7eE�.v�ErF�oFn-Epepnvr�s�oaoriE��ooalu�sRiro�oa�Ess). PLUMBING w Z I CERTIFV THAT IN TNE PERFORMANCE OF THE WORN FOR WHICH THIS PER ISSUED,I MECHANICAL ( (J SHALL NOT EMPIOV ANV PERSON IN ANV MANNER SO AS TO ME SU .T O THE � WORNERS'COMPENSATION LAWS OF CALIFORNIA, AG MAT IF I OU BECAME INS?ECTION FEE '� SUBJECT TO THE WORNERS'COMPENSATION PR 10 SECTION 00 THE LA90R .�. � CODE.ISHALLFORTHWITHCOMPLVWITHT S. ISSUANCE ' � ^ p �ATE�� OP APPLI , SMIP W J WARNING:FAILURE TO SECURE WORNERS'COMPENSATION COVERAGE IS UNUWFUL,AND SHAIL BE ENERGY P/C � 'SU&IECTAN EMPLOVEfi TO CRIMWAL PENALTIES AND CIVIL FINES U7 TOONE HUNDRED TFIOUSAND ENERGY PERMIT DOLLARS(f I00.000).IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN � J SECTION 3708 OF THE LABOR CADE,INTEREST,AND ATTORNEV'S FEES. OC RETENTION FEE: OCONSTRUCTION LENDING AGENCY PRE-ALT FEE: � I HEREBV AFFIRM UNDER PENALTV OF PERIURV THAT THERE IS A CONSTRUCTION LENDING AGENCY � FOR THE PEFFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUEO(SEC.70B'!,CIV.C.). Z W � LENDER'S NAME � LENDER'SADDRE55 � ICERTIFYTHATIHAVEREADTHISAPPIICATIONA7JDSTATETHATTHEABOVEWFORIAATIONISCARRECT. TOTAL FEES w I AGREE TO CAM7LV WITH ALl CITY AND COUNTV ORDINANCES AND STATE UWS flELATINQ TO BUILDING �� d � CONSTRUCTION,AND HEREBV AUTI-IOR EPRESENTATNES OF THIS COUNTV TO ENTER UPON THE , Z ABOVE-MENTqNED PROPERTV FOR I PE TION PURPOSES. COMMENTS � � --' d/ � � m PERMIT7EE NAM IN � ..�/j'L�'a ��-o�i. . � SI PERMITTEE DATE = RECPT.NO. PAID BY VALIDATION ~ WHITE—Department Copy,YELI.OW—Finance Copy,PINK—Assessor Copy,GOLDENROD—File Copy,GREEN—ApplicanYs Copy �9T'� fJiF �8��7��4� �A6� BP�S��`�'8�?i� ��GL1�34� � �" ° ' a�� s�` �� .�� q;"�;��.�.��'k �4`� .p ` o��`°� . ,, .. � . SET BACK � FLGQR JOIST- '" '. . FTGS/FORMSlSTEEL _, _ _ % FHA REQM7S , ELEGTRIC GROUN� � _ �� UNDER FLOOR DUC7 � . .. �r---- GROUND PLUMBING UNUEr� FLOO�i CCJ��DUIT ' � �• -, • �� SLAB GRADE � FIREPLACE �bUNDAl'fON � ' ` � � TEMP POWER FIREPLACE BON� BEAM - WATER SER�IICE MID HT. F30ND BEAM - � ROOF SHEA7HING� ' ' 8 FT. BOP�D B�AM'.`. ` ", ,- .. - - FRAMING/VENTILIATION FINA�BOND BEAM ROOF COVER PRE-GRADlNG ROUGH HEATING BENCNIPJG ROUGH ELECTRIC RC)UGH GRADiRlG ROUGH PLUMBING �I�JfSH uRAD�PdG SHOWER/TUB TEST POQL ELEGTRIG EXT. LATH/SlQING � PDOL FENCING WALL INSULATION _ PUOL FINAL j GEILING INSULATION QFF SITE IMPS. QRYWALL NAILING DEDICATIDNS SEWER FINAL ENG. ____l _ � SEPTIC TANK LANDSGAPE/IRRIG. SEEP PIT/L.L. ON SITE IMPS. ` GAS AIR TEST t F(NAL ZONING FINAL COfVST. �� FiRE QEPT. �INAL FINAL i-►EATING HEALTH DEP"(. FINAL � FiNAL ELECTRIC __� �� ,DEV. �EES PAID �_�� _ � FINAL PLUMBING � ENERGY .._.._._. O .� 1 � .�S .. COMMEiVTS . ; �. � , . _ . � � . • . . SEPTIC TANK SIZE �SEEP PIT/U SIZE --- `--^-�� --�-- - . � � '�:. — � - � - � , ..Y '�.. -- --- — � � � % . �.. � �,v .✓. . s� - � � _� � � � � _ .