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CITY OF DIAMOND B AR �� �� DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICE /� � 21660 E.Copley Drive Suitc 190 �� (909)860=3193 Fax(909)861-3117 PRE$S �'��'� BUILDING PERMIT APPLICATION FIRMLY o� JOBSITE I;11� G r e. I jl Y • APPLICATIQN v� PERMR� S�2 P/C ADDRESS W rU �i� DATE E,L I' NUMBER � k � APN LOT TRACT ISSUE TYPE OCC DATE CONST. GROUP p OWNER �r1 C� �• �nr '!1 o ADDRESS��p FG�t I Y • �4 ZONING SETE3ACKS Z CITY��'C�ndnrl 8�� ZIP���TEL REAR Rw p g APPLICANT TEL. SIDE/SIDE STREET RW O � CONTRACT Ft.f � c. r.c I SIDE p q� ADDRESS • - PROPOSED USE � CITYMO`�1k h�l l o ZIP �TEL.�21�12`I S o ARCFIIENG! • DESIGNER NO.DWEL NO. NO. ADDRE55 UNITS STORIES BEDROOMS � CITY ZIP TEL. y DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION Q OWNER-BUILDER DECLARATION SFWADDlREM O p 1 NEREBY AFFlPM UNDER FENALTY OF PEiWRY T/AT I MA EXEUPT iFi01A iHE CONTMCTORS L4 Garape/Carport W C[NSEUwFOR7NEFOLI0MIC1011[115CW�5EG707t.68U5NESSANDVROFE5510N5CODE:l1NYC1iYOR (f� U ODI�MYN4/1piRE0UIRE5APERMfTlOCONSTRUCLALTERMPROVEDE1.qL'S�+,ORREPURANYSTRUG W P8ti0/D9Ck � TUiIE.PRIOR TD RS ISSUMICE.ALSO f1E0UIf1E5 iHE APVI�GHT FOR SUCH iERMIT TO iILE A SiGNED w � 6TATENENi TiAT NE OR SHE LS 110EN5ED WIRSWWT TO THE VRONSIONS OF iHE COHTMCTOfiS L4 � CEHSE UW(dUPTfR Y(COYYENCNO YVI7H SCCTION 7000)Of ONISION 7 OF iME BUSiNESS ANO PRO� � PooUSpa FESSqN3 OOOE�OitTHAT HE G1 SHE IS E]fEMPT iNER[FROA1 ANO 1NE BASIS FOR THE ILLLEaED ExEMv- TION.ANYV�OUl7�ONOFSCCTION70]7.6BYl1N`/AVPLICANiFOqAPERMITSl1B.lECTSTHEMPL�GNTM Z Ra-Roo1 � ACMLPENALttOFNOTMORElHM1ihE1NNOREDDOl1AR51isaa)): � Olti40VMEROfTHEPf10PERT7.ORMYEMPLOYEESWITTIwAGESASTNEIRSOLECOMPENSATiON, O COfI1RlBfCldl ' IM�LL DO THE WQi1C.AND TNE STAUGfURE IS NOT MENDED OR OFFERED FOR SALE(SEC.701�,BU51• J N HESSlWO VROFESSIONS LODE:7HE OCMMCTORS ULENSE Uw DOESlqT APpLV TO Il4 OWNER OF = FROVEKiYNF10 BUlDS OR IYPROVES TICNEON.ANO NAIO DOES SUpI KDRK MMSELF OR HE0.5ElF OFl � TMROUGHNISO(1NER0'NNF4PLOYEES,VROVDEDiHAT5UCHIYPROVEI.IENTSU7ENOTMENOEDOi1 CO OfFFRm WR 8ALE IF,/IOM�EVER TME BUlD0�00R MPROVEAACNT IS SOID WRMM ONE VEAROF COMPIE- Z 'TqN,THE ONMEi40URDER WILL NAVE 7HE BUR�EN OF PROVINO THAT HE OR 6HE D�D NOT Bl1�LD Ofl = MVRWEFORiIIEPURPO'EOF8AlE} W O�A4WAfEROF1/1EVROPEKf1;AME%GLUSNElY00NfMCTNQYrtTMLICENSEDCOHiMCTOH3 � TO CONSTFiIICf T11[7R0.1ECT(SEC.70N,BUSINE53IWO FROfE55lON5 CDDE 1rE CONTMCTORS U� V01UUIi0l1 ADJ.AFiEA CEHSE LAW DOES NOTAPPLY TO AN OYMER OF A PROVERiY WMO BUiDS OR IMPROVES THEREON.AND � W/qCONTRACT5iOR5UCMVR61ECi5WITHACONTMCTOR(S�LICENSEDPURSUANTTOTH[CONTMG pUANTITY OESCRIPTION � FEE � TORSl10EN5EUw.). � OINAE7�uPTUND[RSEG B.LV.C.fORiMISR[ASON U 3 � LL' DAiE OWNER f" � W UCENSED CONTRACTORS DECLAFIATION W � IH[RCBYAFFlIWUiDERPEWLLTYOFiER1UM7HATIAA/IICENSEDUNDEROROVIS�ONSOFCHAPTER ' ' p„ �(CpWCNGNOWfTH5ECT10N)00�)OFDMSqN70FT11EBV51NE55IWJiROFESSpNSCODE,111:D Z � �� C � �^��� � X MY LICEHSE IS N fULL FORCEAND EFFECT. m � uceru ss C"�J ��c.No. � 0 �113 � ~ J V DATE ' CONT d . � WORKEFIS'COMPENSATION DECLAFlATION ._ ¢ � . . ,.. - • V _ N IMEREBYAFFWYUNOERPENAtiYOFVEiWMONEOFTNEF011OW7NODCCLAMT10N5: � � � Z Q � �INAVEANDWiLLMAINiAMACERTIFlGTEOFCONSENTTOSELFaNSUR[FORWORKERS' $ COMPENS�TION,AS VROWED BY SEGi10N I700 0F THE LABOR LODE,FOR iHE DERFORMMlCE W OF iHE WORK FOR WMICH TNIS PEiU�11T IS ISSUED. � � I IiAVE ANO W:LL WRlTA?7 WWIKERS'WAIVENSATqH NSUMNCE,AS HFOUtRC�BV SECTION Q 77000F7HEU80RC9DE.fORTMEPERWRrAM10EOFTNEY/ORKFORYlMipITMI5vER1A1T15 iSSUED.MVWOR/y�'R�SC/O�MPENSATIONPISUMNCECMRIEHANOPOLICYNUM�ERMC: CONSTRUCTION � CAAR:ER \l/l1 rafYY'1(� PLAN PEVIEW � VOLICVM1A.1oER I �Y� 1 ?GS q 1 7 ELECTFIC ��'� �Y . ��� � 1 , 0 �sccronxEmnaresca.s�roaFn[P[aarraror�or��arois�oa.wuR+�lrni[ssl PLUMBING Z I CERTIFYTIAT NTHE iERFOiWANCE O�7ME N"ORK FO(1 wHld1 TMIS PERAIIT tSISSUED,1 MECFIANICAL � (,�J Swtll NOT EMPLOY ANV PERSON W ANY MANNER SO AS TO BECOYE SU&1ECTT0 THE r , N WORKERS'LOMPENSATIONUWSOFCALIF00.41tiANDAGREET✓ATIF15110UlDBECOM[ INSPECTIONFEE ^ S SUDJECTTOTNEW011KER5CCM�PENS PROV1510NSCFSECT 71000FTNElABOR ISSUANCE � -- � _ V CDOE,I SMILLL iORTHYVfM Cp.�PL wiT 1 MOSE DROVIS�ONS. o SM�P �.I�I Y F1:,:�J-'.tl�• p DATE:�'���) APPLICA : ' , . .. � ENERGYPIC RLIILDING - •1-•�r'1•1" WMNINO:FMURETOSEWAEMOHKERS'CWIPENSATqNCOV[MCEISUNUWFVL.AND LB[ � SUBJ[CTANEMVLOYERTOCWMINA�GENILLTIESANDCMLFWESUPTOONENUNORED � µD ENERGYPERMIT OOLIAAS(f 100.0001.R'7 ADOITION TO 7HL CAST DF COMPENSATUN,O�LUGES AS iROV10ED FOR IH � SECTtlN]�oeOFT1EUBORCOOE.pfTEREST.ANOATTOPNEYSFEES. RETENTIONFEE: d CONSTRUCTION LENDING AGENCY PRE•ALT FEE: O Q 1 HEREBV AiFliIY UPIDER VENAITY OF DERRINY 7HAT THER[IS ACONSTPUCTION LENDWc/�CENCY �Z- FOR THE PERFORMANCE OF THG WONN iOR WN�OI7H�5 PENAIT IS ISSUEO(SEG 70V7,CIV.C� W Z L[1mER'S NAME 5 � LENDER'9ADDfiE55 ¢ ICERTIF7TMATIMAVEREAD7MtSAVPLIGTIONANDSTATEiIUTTHCABOVEWFOMI�TIONISCORflECL TOTAL FEES � W IAGREETOCD��GLVNrtTXILLCRYANDCDUNttORDINANCESAN�STATEUN5REUINOTOBUtDINO � CONSTRUCTION.ANDHEREBYWiTKN11ZEREPRESENTATNE50L7HI5COVNTY70EMERUPONi11E . � ABOVE�MEHTIONEDGROVERTYFORNSPECiIONPVRPOSES. COMMENTS 9 1 ..,n a �•r .� �,at m VE EWWE(PRRlT) Q � � 8 U OF RAunEE OAIE RECPT.NO. PAID BY YALIDATION WHITE-0epenmenl Copy,YELLOW—Finance Copy.PINK—Assesea Copy.GOLDENROD--File Copy.GREEN—ApWicant's Copy , . . . . . .. .. ..... , .,_� .... . ..,. _ , .._.__. . ....... , � . ,. . , . . .. , .,. . . . . ...... ,. � ,... ... , . .. . � � CITY �F DIAt��O��D [3AP � � -;� . .. . . .. .�IRS�EC i IOP��REC�f�D "', �.,- � :1►�i�-������.Ci.���E. �,1_�C-. :I�E-'i�?'"��'"E'�J�9. (�'E�e��=�:''['(�J�E`f^ E1:.�]!'= I►r���-��c:'j`r..�:l--^-1 ._....---..._.._. ._...5.._.... .. - ----.. . . __...----------- - - -----..----....-- �- ------ ----- ---- --. . SET BAC}C . �; _�.:' . � l . - � FLO�R JOIST ��� ! � • � .. ' FTGS/FORP�9S/ TEEL � FHA REQ""TS �. " _ -- — ELECTRIC.GROUP�D - � � � UNDER FLOOR DUCT - — � - � GROUND PLU'�1r31NG � I UNDER FLOOn CUNDUIT SLA�GRADE � FIREPLACE FOU?JDATION • • TEi�4?POLVER ,- - FIREPLACE BOND BEAP.1 VJATER SERVICE � - -- -� - � h•11D HT. 60�lD'BEAR.1 - - ROOF SH�ATHlNG _. _ L ._. . 1 . 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