HomeMy WebLinkAbout13083 (7) _�� C1TY OF DIAMOND BAB ' , �� ��� ��
DEPARTMENT OF COMMUNITY dc DEVE M S C S
„� 21660E.CopleyDriveSuitcl90
' (909)860-3195 Fax(909)861-3117 PRESS
'^�'- BUII.DING PERMTT APPLICATION FIRMLY
� JOBSRE � APPLICATION ` PERMIT �� " p!C
o ADDRESS DATE NUMBER� M
� ISSUE NPE OCC
�- APN lOT TRACT DATE CONST. GROUP
p OWNER N� �` i. �_d . ,r t�_
p ADDRESS 2�{`-IU� �, `I.f �-a—r - ZONING SETBACKS
�W CITY r ZIP TEL FRONT n RW ❑
APPUCANT � ��C'.— TEI.�S�S cl r REAR t � � tc�+� �
� SIDElSlDE S , qyy ❑
CONTRACTOR a SIDE
ADDRESS �
� � PROPOSEDUSE �� , � -- - --
CtTY�1v.� � ��`L 7JP 9��TEL3o5 '��/�!y ^ -
� ARCFUENG/ • 1 • .' r
DESIGNER NO.OWEL O.
ADDRESS
� C� P TEL UNITS STORIES EDROOMS
�
N DESCRIPTION S�.FT. FACTOFi PSF AW.AREANALUATION
� OWNER-BUILDER DECLAH/1TION SFA/ADOVHEM
p I MEREBY IFFlfM I�EH iEHKiY OF PERRJRY iHAT I IJI EXEutt FHOM TH iIACTORS L4 = - 1_
l).i CFNSEIAWFOR71fEFOl1�ATX7NEA50NISEC70J138U511E55ANDPROFE55 CODE:ANYqTYOA � Gara9a/Cerport
52 OQAfttMHICFIRE0UWE5A7EqUfTTO00NSTWIC(KTE0.��E OflREVNRFNYSIAUG, , W PBSNLDBGc
� TUFE.VNOq TO R9159WNCE,ALSO pLaUWES T11E APPLIG�Ni FOR 5 PERUR TO FkE A SiGNED W
Z S7A7EMpJi iHAi NE Op SiIE�5 LICFNSFD YURSUAt(i ip iHE i OF TMF CLWTRACiORS LF
� CENSE Uw�UTAVTER�(COYYFNCMiO VrtTH SECf10N 7000)OF 1 Oi THE 6USiNE55 ANO GR0. � PoaVSDe
FESJqNSCOO�OqiNATMEDqSME15EXEYP iNEREF TNEBASISiOR711EALLEGEOFXELP. ('
� TpDLAHYYIOLAT4NOFbECTqN7W1.{BT AP �vERWT5U61ECi5iFfEJ1GPLKINfTO Z ag.Rpp�
�„� ACfVIIiENALTVOFNOTMOfiEiHANi1yE ED (is001.k
O ❑4�OMMEROFT/1EPROPEHT`/ EFSWITNW.4GESASTNFV150tEfDUVENSATI(7N. Q �m�� -
Z 1MLL OU i1�E N�OfK NQ i1fE 5T fiE�5 UfTENDED OR OFFERED FOH SALE(SEG 70a�.BUS�- J
N NE53ANUPfqFE$.$1(1N5COOE T T LICENSEIAWDOESNOTAPPLYTOANOWNEqOF =
. iROPEHfYN4qBULD90AY S ON. NfqDOE56Up/NAi1KiL1LSELFdiMFASELFOR
L� TWOlXY1fYSORMEflOWN v .iFOVI� TSUGIYMROVE/AENT&ARENOTMENDEDOq C�
� OFTEPEDPDRSXE�F, VFJAFNTISSOIDWfTT9NONEYEMOFGOMPLE-
� �'TION.THE OWNEH-BUttD vE OF VHOWIf3 TW1T I+E Oil Se�E dD N07 BIUID OFi
IMPf10YE FOq i/1E PURPQS
� ❑LASOWHEROF R07E .AYEXCLUSNELVOOtliMGiINOMTIHlKEN5E0CplTMC70R5 . . .
TO WN57iy.1Ci T1�E P ECT� 70K BUSINE53 MD DIiOFE5510N5 OOOE iME CON7RAClORS LL V8ft13t10f1 (�,J,/w�
GEN4EUWDOEE AiYLY ANOVMERpFAiqOPERTYYMOBUlDSOqMPROVESTNEPEON,Mq
Mrncarts�cis awcciswitti�cartn�ciotqs�uc¢ns[caHuwwrro�ooHtw�a QUANiiTY OESCFiIPTION FEE
� Tais uc�sE � . ,
O I A4 P bEG &a V.G FOq THiS REASOH � �Nl�t � �(
V" DATE OWNEN �
� U
6 110ENSED CANTRACTORS DECIARATION W
fL �NERFBYKFWJ1I�f0ERPEllALTYOFiEJUUMTHAilAYL10EtSEOtIN�fRiROVIS10N50FGiAVTER
s �(COMIIENCNO WITTf SEGTqN 7000)�DMSION a Of iF1E BUSINE55 ANU PpOFESSpNS CODE.ANO Z ' �
l J MY LC,�+SE L41N FULL FOfiCE AND EFiEGL m
� LJCENSE L1C.NO.�Z � _ 7
�j wTr L' ��a�carrw�croa a
W
� WORKERS'COMPENSATION DECLAFilUIQN ! -�
� �
N IHEqEBYAFGW4U1qERiENALiYOfPERIUHYONEOFTHEFOLLOWWC'DECLAftATqN I ��7 Z Q�
V
� _IINVEAlqN7L1,YNITNNAGEiR�FiCA1E0iCOH�EXiTOSEtF�wSUREfOR ' _
0011VQlSATION.ASViIOVIDEDBYSECT10NalooOFTHELIBOliCOOEFORil1EPEAFORMANGE� W
/1 OF TTiE YIORK FOfi WMICl1T1M5 PfRW T 1S ISSUFD. �
/ 1 HAYE AND YALL MAY(iAP1 YlOR1(ERS'WMPENSATqN WSUHMICE,AS REOUIqED BV SECTION
�{.� �� HM C
< v 71�a�7NE LI90ii OOOE fOR RIE PERFORMANGE OF Tlff W WLC FOH W1uG17M5 PEAMR IS
0 15SUFAl!'f Npiy(Eq$'Cq/PEH rqr�wwRlC�.Gqq1ER AND DOUCY NU1ABEp/qE; ; CO ON
� CARWER (V P REVIEW
� POUCVNLMBFR I t I � r / ELE('iTRIC�i � �
� ��� L .
� (�s�+��7'sf�T�O���tuK�por�E� po�ursRtwla PLUM8ING !.
Z i cEancr nur w n�vEaco�wuace oF n+e wowc F �cn TN�s o t�s�sweo,i MECHANICAL
SFNLL/qTEWIOYANYPERSp1NN(VMANNER50� OBFO]ME ECTiOTHE
� worucEasca.�v�snr�uvrsasuuwrwiti A(1aREETNA isr�axnaFca.� fNSPECTiONFEE
SUBI T THEWORKERSCOAIPENSA7 G SOFSE SIOOOFiHEUBOH
rj cooE iofltm�nn�couw.rm aons ISSUANCE � . 1}
O _
p pATE; Ap — SMiP C`('7'[7 nr`r�r n�a
�
� Wuwirx�: !uL RETOSECUREWO�i1cER5' P SATqNCOVEW�GE15UtaAWM,N1p51MLLBE ENERGYP/C g����,�� n.rrmir
� suaiccturewv�,ovaArocwuwxv TIESAN6[MLFwESUDTOONFNJNDpFDiM0U5ANp �lERGYPERMIT
r DOI.LAFiS IS100.Oa01,N AODiTqN TO iM T OF COMPENSATqN,DNAAGES I�S PHOVWFD FOq W
� SEGTIDNI7WOFiHEIABdiCOOE REST.ANOAiTORNEYSFEES. {�E7EFJj�ONFEE:
OCAN TRUCTION LENDING A�ENCY PREALT FEE _
� IHEREBYAiFIRMUNDERDENALiYOFG ISACONS�7 IONLFNpwGAGENCY
fOR THE PEHFORNANCE OF TIE WO �OR WHI THIS V 'Bi5$�E EG 10Y7.qV.GN
Z
W
� LENDEf�S W1ME
� LENDER'SADORE55
W ICERTIFYTHATIMAYEqEADT1N5 T „�5 E.,,�T HE/�BOVEWFOWaATqNISCOqqECT. TOTAL FEES • '
� IAGREETOCOYOlYW1THALL • � WANGES STATEUWSREUTW6TOBUIIDWp •�
� QONSTAIICTIWLANONEREBVAUR Dii Ni�ilJES TWSCOIA(TYTOFNTEkIJPONTNE
Z �ewE��irrqnEopi ea o r c r rosEs COMMENTS
9 .
_
m PF1W� EE
Q
N
t/� RWTTE ATE
� RECPT.N0. PAID BY YALIDATION
WHITE—Department Copy,YELLOW—Finanoa Copy,PINK—Assesaor Copy,GOLDENROD—Fle Copy,GREEN—Applicar�l'a Copy
` - _ i
� � _ -- - - - -
-,: o - � , -._ i - - I- - - - - -- - - - -
_ �; � - � ,
- � , - - , ; "
. _ � - � � ,' ,
, " i � , ;. ; ,
, ��� �� _ - - :; '
� M ,
J
. . �l � � _ ; ; "
- ¢j o � � r I
,. � a .� -
F-
�
r
, - W I
�II
Q � ' ....�� -, � �'� � pa .� � �}r � �' Z . ,; 1 _
[O .Ir , 'a� o � zm ¢ w ' ? � v o- a � o � ! r _'. ' j .�,
-U. �}�I-, (q O � m p W m C'J p � Q Z � � � � Cry Z � Q K .
' 0 rrI� cnH � Z °� oZ a � r- � z t7i azu- aa � � -_
- Z"�,lJ �.Ti.l,p � � (y U � o o z � t7 � ¢ w z ¢ = Q c� a � � r_ w � -„ -
: 1i,-� C7 LL N Q Q m Z p Q Z U' Ur J W Z W F- Z d Q 0. � W �� . _ -
"r.
O � .1��� W CC `C�" J J F � � Q = 2 W LL lL F- Q LL V � N W S W } � . - � '
, � z �1 O � W W d Q. = m J L7 U C7 N _I J J fn U J O F- -� O J �- � i ' _' _ " .' �
a . "O Q o o Q Q p }- '� W Z � O O O w o 4 Z � Q W C > W � � ' _
' � . �J S Z Z lL 2 � L1J O z O O O LL W Z q Z Z CC W W 3 f' ' . _'_ ' _ ' . _' _
Q � �lL lL � � ti LL. 2r N lL d fd Q LL C� Q. d O O LL J O LL'tL- 2 ❑ lIJ .- �C T . .- ,
� W I! I
, O~ Z I��' ' � 1 .
� �7 i . i �
..�' •�,' � - i I !_
� i
1�.(, � - -
, /� r - - '1 -
;�
. F � , i
� • ivo�,wor�.-- i� �i ` , ,I .I _ ,� t
� ��� 1_
I_� �I .JI ..
I
'��V �I t•J\ , � �
u z � . ' .r.�.+w.-..�����' . � .
. i
� 0 �
� ,
, � .'J - , ' ' �.
� H
❑ '
- W 1- '
^<''
�.` r'
W
, Z
O
���f W Z — ('3 J.= U � tn Z — � N . , _ . .
f� �► �q :, � � � ; V � F- - z ¢ m � Z D ~ J . ..' � U � '�.. � . tA N � `
, � = z � � g . . . , . . �
' ,��'i,� s C7 -i W w Q Q w�� Q W � � � g 4 z Z "� [n � F- � t.. � , z� I"� � ��'
t MY crv d �¢ swwZ'� w � � � Jw U Z � 1'
� i�.�,U G o [[ ,D u� 2 C7 O 2 w a � = c� — � t��- F- F.O w � � ' u - ' " FQ-I_ � � � .
lj,¢ � a z � a Q cn z c� _ = T w F' z c� a ¢ c� a_ � c� s w a � �� c�a.
. � min � � naw �- � �- c� c� c� 3 � �, z � wF= c. a � JJ � � ' tia ,
�F- C7 w O 5 i- O q O � � � O F-� J J � 's a w cn�4 G ¢ c � W W ,�
� `tw rt � `w a O � O O d O 2 X t w ¢ w w w ¢��- � � � - '
� : : ";
. r ;u� LL w C9 rn F- � ¢ u- t[ rL CL ¢ c7 w � O n m u� c n c 7 � i C�i i�u.�. ��: C,' • � " tn cn ' _�.._.:.._._._ :._!__