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HomeMy WebLinkAbout18339 CITY OF DIAMOND IIAR � J� DEPARTMENT OF COMMUNTTY&DEVELOPMENT SERVICES ��y 21825 E.Copley Drive � (909)860-3195 Fax(909)861-3117 PRESS �'<'��� BUILDING PERMIT APPLICATION FIRMLY o ADDRIESS � ` �� �i/� � DATE CATION/„ 'Q O�- NUMBER_I�3 p/C���) ri � APN O TRACT ISSUE f"j �q O 7ypE p�C p OWNER � DATE � � CONST. GROUP " ADDR SS Af ZONING SETBACKS 0 $ CITY r ZI � TE FRONT R�/�/ p APPLICANT TEL. REAR ❑ �d.. SIDFJSIDE STREET RW ❑ � CONTRACTOR SIDE p ADDRESS � CITY ZIP TEL PROPOSED USE Vh D I � f� w ARCH/ENG/ n z DESIGNER a ADDRESS . � " N0.DWEL NO. NO. � CITV� ZIP�_ TE UNITS STORIES BEDROOMS � � DESCRIPTION SO.FT. FACTOR PSF ADJ.AREANALUATION ¢ DWNER-BUILDER DECLARATION SFWADD/REM O p I MEREBY�FFIRM UNDER VENALT/OF VERIURY TNAT I AM EXEMP7 FRq�A THE WNTMCTORS U- GafOg&'CBIpOR W CENSEUWFOHTHEFOLIOWINGREA50N(SEC.7071.68USINESS/WDPROFESSIONSCOOE:ANYCINOR (n V CONdTYWHICHRE0UIRESAVERMRTOCONSTRUCT,ALTERIMPROVE.OEMOLISH.ORPEPAIRANVSTRUC• W patio/Deck W TURL.VRIOR TO RS ISSUANCE,ALSO REW�RES iME�VVLICANT FOF SUpI DERIAIT TO FILE A SIGNED W � STATEMEM THAT HE OR SHE IS LICENSED WRSUANT TO TME VROVISIONS OF THE CONTMCiORS U� CENSE UW(CHAPiER i(COMMENCINO WITH SECTION 7000)OF DIVISION�OF THE BUSINESS A40 PRO• V' POOVSP3 � FESSIONSCOO�ORTFIATNEORSHEISE%EMPTTHEREFROMANDTHEBASISFORTHEALLEGEDE%EMP• C7 TION.ANYVIOIATIONOFSECT10N70]1.6BY/NVAPVLICANTFORAPERMITSUBJECTSiHEMPLICANTTO Z Re•Roof A CML PENIIITY OF NOT MORE THAN FIVE HUNDREO DOLWIS(f5oa�.�: Z ❑LASOYVNEROFTHEPHOVERTY.ORMYEMVLOYEE5W17HWAGES11SiHEIRSOLECOMPENSATqN, 0 COmm0fCl81 - NALL DO THE WORN,/WD THE SiRUCTURE IS NOT INTENDED ON OFFERED FOR SALE ISEG 70p,BUSb J N NESSAND GFOFESSIONS OOOE:THE CONTMCTORS LICENSE UW DO[S NOTAP�LY TO AN OWNER OF ? VROPERTY NM1/O BUILDS OR IMPROVES THEREON.AND WHO DOES Sl1CH WORK HIAISEIF Oq HERSELF OR CL THRIXIGHHISORHEROWNEYPIOYEES,DROVIDEDTMATSUCHMPROVEMENTSARENOTMENDEDOR m Q OFFEREDFORSILLEIF,NOWEVER7MEBURDINCORI/APROYEMEMISSOlDW1iMNONEYEMOFCOMPLE� - Z TqN,TNE OWNEH-0UILDER WILL HAVE THE BUROEN OF FRONNO TMAT HE OR SHE DID NOT BUIID OR 4 � MPROVEPoRTHEFURPOSEOFSALE} W 04A+`ONNEHOFTHEPROVERTY,NAE%CLUSIVELYCONTMC71NGN77HLICENSEDCONTMCTORS [L TO GONSTRULT TME PfiOJECT(SEC.7W�.BUSINESS ANO PROFESSIONS CODE:THE CONTRACTOqS U� VdIlJ3IlOf1 ADJ.AREA W CENSEUWOOESNOT�PPLYTDANOWNEHOFAPHOVER7YWF10BUILDSORMPqOVESTHEREON,MD � 1N1000NTMCTSFORSUp1PRO,1ECfSWITHAGOr1TRACTOR(5)UCENSEDPURSUANTTOTHECONTMG QUANTITY OESCRIPTION FEE Y TORSUCENSELAW.1. 0 ❑IAM E%EIIPi UNDER SEG B.1 D.C.iOR TNIS REASON Q ?„. ' U �=" DA7E � ER ��� F— O w � LICENSED CONTRACTORS DE LARATION W � IMEREBYAFFIRMUNOERFENALNOFVEMJilYTWITI/JAIICENSEDIINDERVNOVI5lON50FCHAV7EN V. � Y�COUMENCPI0WRH5ECT10N70oo�OFDM510N30FTNEBU5ME5SANDPROFE55iONSCO0E,M1D Z �� W UCENSE t5 IN FULL FORCE AND EFFECL m � LICENSE CLASS LIC.NO. j V DATE CONTRACTOR 6�. W � WORKERS'COMPENSATIONDECLARATION � a NIHEREBVAFFIRMUNDERPENILLTVOFPERRIRYONEOFTHEFOLLOWINQDECLAMTKKJS: Z 0 �IMAVEMDVYILLMNNTNNACERTIFICATEOFCANSENTTOSELF�INSUHEFORWORI(ERS' _ Q COMFENSATqN,AS 7FOVIDED BY SECTION 77000F iHE L1BOR COOE.FOR TME GERFORMANCE U Q OFTHEWORKiORWNICHTFIISOERMtTI51SSUED. � _IHAVEANDNILLMAINT111NWORKER5COMPENSATIONINSUMNCE,ASREWIflEDBYSECTION �r�• � Q �700 OF T17E LABOR CODE,FOR THE PERFORMANCE OF TME WORK iOR WHICM THIS GERMR IS Y7 � ISSUED.MYWORKERS'COMPENSATIONINSUHANCECARRIERANDPOLICYNUMBERARE: CONSTRUCTION _ �/ � CARHIER PLANREVIEW o va�cYwuMeER ELECTRIC � � (IIlSSEG�CriNEmNOT8E00M1i�ETE�OFTEPERMT15fORONEMI�DREDDOLLARS(St001pRLE5S} PLUMBING Z 1 CERTIFY THAT W THE PERFORMANCE OF TNE WORN fOR WHlql THIS PERMIT lS iS511E0,I MECHANICAL C7 SMALLHOTE1AttOVANYFER50NINANVUANNER50A5T08ECOUESUBJECTTOTME (/� WORKEHS'COMPENSATqNU1W50FCALIFORN1IMlOAGREETNATIFIS�KKILDBECOME INSPECTIONFEE S SU&IECTTO THE WORKEiiS'COMPENSA710N PiiON510N5 DF SEC7WN a7ao OF THE LABOfl ,�� COOE,1 SHALL FORT11W17H CqAP�Y WiTH TiOSE PROV1510N4. ISSUANCE � SMIP ,.�— p OATE: APPLICANT: - � WARNINQ:iNLURE TO SECURE WORKERS'COMPENSATION COVERACE IS UNIAWM,M1D SHALL BE ENERGY P/C LL SUBJECTANEMPLOVERTOCRIMIWLLPENALTIESMIDCMLFWESUPTOONENUNOREDTHOUSAND ENERGYPERMIT OOILMS(7100.000),N!ADOI710N TO T1E COST OF COAIPENSATION,DAMACES AS PROVIDED FOR IN � SECTION770lOFTMELABORCOOE.WTEREST,ANDATTORNEYSFEES A�ENTIONFEE: � OCONSTRUCTION LENDING AGENCY PRE•ALT FEE: � IHEREBVAFFIfUAUNDERPENALiVOFPEiL1URVTNATTIIEREISACONSTRUCTIONLENDINCACENCY - F01i TME PERFOFMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED(SEC.90Y�,GV.C.). Z w � LENDERSNAME F-' lENOER'SADDNESS W ICERIIFYT/1ATIHAVEREADTIISAPPLICATqNANDSTATETHATTNEA80VEINFOR1AATqNISCARRECT. T�TAL FEES 21 t'-J,�� � O• � � IAGREETOCOMPIYWRHALLCITYANDCOUNTVORDIN/NCESANDSTATEUNSRElATW6TOBU0.01NC � CONSTRUCTIQN,AND MEREBYAUTIOFRE HEPRESENTATIVES OF THIS COVNTY TO ENTER UPoN iHE Z ABOVE�MEN EDiRDVERTYFORWSPECTIONPURPO5E5. COM ENTS _' �Ci��S/' V��� � _i ` m PE TT E N (P i (//� -(/1 �� � T y Si TURE FPEi1MITTEE OA � . RECPT.KO. PAID BY VALIDATION WHITE—Department Copy,YELLOW—Finance Copy,PINK—AssessorCopy,GOLDENROD—Fila Copy,GREEN—Applicant's Copy � f�l Y'��"J�� �7' V� ..,� . . ... .. . . _ . , _ , . , . . , - , �-�� , „ . -�.,-,...r . . . . : ..,. •. ,, . . _ . .. �5���� OF DI�fJ1U�'i� R�=.� if�!�r��C s IOPd R�CGF�� ,��l���a�.��F!C�,1►�1 ��,Y��� _. (���-� 1�,�1�`�);C.,._...�, 1i�.�-'�,�1 � e,;C[��1►�l I�t��cG':= :I����I':I.e;�1te1� _. _ , . _ _ ..__ _._ . ____. .._. _.. , .__....- ---. _._._.._....._,. .V,__...__...___,___._.___...._ .. . _ . -� __.�_._..__ _. ---._._.�. ____.__�.__.__ __. _.__.__.__�___._.._ SET BACK i ) � FLOOR JO1ST. ,I � � ;l_ ,---- ._ � FTGS/FORM5l5TEEL ' ' � i � FHA REQP�I7S � ELECTRIC GROUND ' � UNDER FLOOR DuCT ( I GROUND PLUMBING _� UNDE O�Uf�IDUIT� . SLAB GRADE � j FIREPL�ICE F(�UtdDATION 'j TEMP POWER I FIREPLACE BOND BEAM � WATER SERVICE, I I MID HT. BOND EiEA�v1 ROOF SHEATHING � ^ �FT. BOND BEAPri FRAMINGNENTILIATION � FINAL BOND BEAM � ROOF COVER PRE-GRADING � � � - ' ROUGH HEATING BENCHfiJ�'T� ROUGH ELECTRIC I ROUGH GRADIf��G--�� ROUGH PLUM8ING �_ FINISH uRADING � SHOWER/TUB TEST POOL ELECTRIC EXT.LATH/SIDING I I POOL FENCIt�lG Wr1LL INSULATION � �POOL FINAL CEILING IN�ULATION OFF SITE 1��1PS. DRYWALL NAILING � DEDICATIOtJS SEWER FINAL ENG. SEPTIC TANK ��, �, LANDSCAPE/IRRIG. SEEP PIT/L.L. " � ON SITE IMPS. GAS AIR TEST FINAL ZOPJING FINAL CONST. �'�Z �!RE DEPT. FItJA! FINAL HEATING � HEALTH DEPT. FINAL FINAL ELECTRIC ' DEV. FEES PAID FINAL PLUMBING ENERGY � rl� '�.___�'_�.�'--��1�-��------�.__�_ � � COMMENTS SEPTIC TANF<SIZE SEEP PIT/U SIZE ______;,�-��_ � � ;���� . . '!, _ II _ , � � _ .