Loading...
HomeMy WebLinkAbout14369 �r CITY OF DIAMOND BAB �,,,,,,� �---�'�' DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES _ W 21660 E.Copley Drive Smte 190 j (909)860-3195Faz(909)�61-3`119 "y,. PRE$S �°�' BUII.DING PERMIT APPLTCA�I'ION FIRMLY �� JOBSITE Q'2 � /` ���„�� � DATEICATION�°� � NUMBER�� #/C a ADDRESS p � c� c� ISSUE TYPE OCC APN . LO TRAC DATE CONST. GROUP p OWNER � ' � ADDR &S �,'I r ' ZONING SETBACKS � CITY ` " ZI i V� EL. .�� s � FRONT RW ❑ APPUCAN7 <: TE " +- .' c� REAR ❑ � SIDE/SIDE STREET RW ❑ CONTRACTOE � Cr �' SIDE ❑ ADDRES =-� O� CITY ZIP � TEL + -,-%� PROP�SED USE t��i ARCH/EN / � J � DESIGNER ��rt��^��`�-i _.____ � , � NO.DWEL. NO. NO. ADDRESS 7.<' UNITS STORIES BEDRaOMS �- CITY r ZIP��_�TEI. s1 u� DESCRIPTION SQ.Ft FACTOR PSF ADJ.AREANALUATION � OWNER-BUILOER�ECLARA710N SFR/ADDlREM O p I HEREBY AFFlRM UNDER PENALTY OF PERIURY iHAT i AM E%EMPT FROM THE CON71iACTORS lb ' �' G8fe9B/CdfpOit W CENSELAWFOFITHEFOII.OW�NQREASON(SEC.70.3t.56USINESSMIOPROFESSIONSCODE:ANVCITVOR ,(f� COUNiYWHICMREWIqESAPEPoAITTOCONSTRUCT,ALTEftIMPROVE,DEMOLISN.OHREPAIflANYSTRUF �W patla/Deck TUflE,PRIDH TO 1T3 IS$U�1NCE,ALSO flEW IRES THE APPLICANT FOR SUCH PERMIT TO FILE A S�GNEO � � STATEMENT THAT HE OR SHE IS LICENSED PURSUMIT i0 7HE PROVISIONS OF THE cANTRACTORS l4 �w - � GENSELAW(CHAPTER9(COMMENCINOWITMSECTION7000)OFDIVISION30FTHEBl151NES5ANDPRO� �u'� POOVSPfl fi FE8SION&�E7 OR iHAT HE OR SHE IS EXEMPT THEREFpOM AN�THE BASIS FOR THE AILEGED EXEMP- TlDN.ANYVKK.ATIONOFSECTION7o31.5BVANYAPPIICANTFORAPERMiTSU&IECTSTHEAPPIICANTTO Z Re-Roof �;�� . � ACMLPENN.NOFNOTMORETHM7FIVEHUNOREDOCUMS($5oD).): � pI,ASOWNEROKTHEPROPER7Y,ORMVEMPLOYEESWITHWA6ESpSTHEIRSOLECOMOENSATION, � Commercial . � Yr9LL DO THE WOHK,AN�ME S7RUGTURE IS NOT INTENOEO OR OFFEflED FOR SAIE(SEC.7044,0US6 �I �i NE&S ANO PROFESSIONS CODE:TLiE COMGtACTORS LICENSE LAW DOES NO7 APPLY TO AN oWNER OF � .�- � PNOPEfiiYWF108UqDSOPHAPROVESTHERC-0N.AN�WMOOOESSIICHWORKHIMSELFORHEHSELfOR = . �. 7Hq0UGHHI80RHEROWNEMPLAYEES,PROVIDEDTHATSUCHIMPROVEMEN75ARENOTINTENDEDOR m - Q ,OFFEREDFORSKEIF,HOWEVER'�NEBURDINOORIA9DPOVEMENTISSOLDWRHINONEVEAROFCAMDLE• _ � TqN.THE OWNEfl-BUIIDER W�LL MAYE TNE BUROEN OF PROViNG THAT NE Ofl SNE DID NOT BUltp OR MiPROVE WH THE PURPOSE OF SALEj. CII.ASOYMEROFTHEPROPEHTY,AMEXp.U51VELYf7JNTMCTINOWRHLICENSE�COfJTRACTORS ' �' To GONSTRUCT7}IE PROJECT(SEC.7aa,BUSINE55 AND PROFESSIONS CODE:TNE CON7PACTORS Li� V81U8�IOII ADJ.AREA W CENSEUWDOESNOTAPpLVTOANOWNEROFAPROPERTYWNOBUILDSORIA�FROVESTHEREON,ANO � � WMJCONTMCTSPoRSUCHPRQ7ECTSWITHAGONiRACTOR(5)UCENSEDPUR9UAN7TOTMECONTPAG QIJANTITY DESCflIPTION FEE � TOHS UCEN6E LAW.j. O J � � % ❑I AM E%EMPTUNDEa 3EC. B.8 P.C.FOR THIS FUSON .U L '� J� . � . � .... .., . _ . � OATE OWN6R_'_'—__.__—. . . ~ . . .. � - W � LICENSED CONTRACTORS DEClARA710N �j - - . � j _ INEREBYAFFIRMUNDERPENALIYOFPERJUfiYTNATIAAIUCEN5E0UNDERPROVISIONSOFCHAPTER � (L. D�COMMENGNOWIII#SEGTKNJ%GW)OF�IVISbN30FTHE8U51NE55ANDPROFESSION5CO0E,RN0 � ' X MYUCENSEISWNIIFOflCEAN�EFFECT. � � W ` � � LICENSE C SS� liC.NO. � � F-- � � DATE CON7RACTOR � �" �� 4 � W � ORKERS'COMPENSATION DECIARATION Q � U - � IHEflEBYAFFIRMUNDERPENAtTYOFPERJURY�NEOFTNFFOLIOWINGUECLAMTIONS: � z a � _INhVEM'OYYILLMAINTAINFCERT�FICATEOiCONSENTTOS[lF-INSUFlEFORIYORKERS' _ � . , " � � COMAENSATtON,ASPflOVIUF.DBY6ECTON37000FTHELA80RCOUE,FORTHEPERFt�R1AANCE �U OF THE WOHK FOR WHICH THIS PERtaIT IS ISStJED. � A W �IHAYEANDIVILLMPJNflUNWORKERS'COMPENSA7IONINSUf1ANCE,ASREQUIflEDBYSECTION 4 370oOF77-IEIABORCODE,FORTHEPERFORa9At4CEOFTHEWopKFOpWNICH7HISPERMITIS � ISSUED.MY WOkKER5'CO/n�g��S/AT INSUfl GE CAR IEH PND POLICY NUM9ERARE: CONSTRUCTION � cnaqiEa.. - Cs'!_�� ' � .C/� PLAN REVIEW _ � -+� � Poucvrauh�eR_ � ^�!_—�� �` ELECTRIG Q `� � _(MlssEt'TIONMES)tAiBEa:MPI.EiEocFn+EPEPoatlSfoaoNErnNd7REotX71MS(S1eo)oaLEssA PLUMBWG L ��i��a� F Fd� z i CERTIFY THAT IN THE PERFORMANCF OF TNE WUftK FOR WHICH THIS PERMIT IS IS5UE0.I MECHANICAL - - �°j SFNLINOTEMFlO�'ANYVERSONINAHYMANNE�uOASTOBECOMESUBJECTTOTHE � WORM[R6'COMPENSATbNLAW50FCALIFORNI0.��AGREF.THATIFISHOULOBECOME INSPECTIONFEE - " SUE3JECTT07HEWOflNEHS'GOMPENS TIONPflOVI5pN5 ECPION370oOFTHELABOfl C:,_� � � ' - � COOE,ISM FOR7N/Wt�THC0�IPLVWI HOS[PRPVISIO S ISSUANCE , ....� _ � _. W pATE; �� ��"{APPL�CANT. ,k ' '�' .' SMIP �,% ^ . � ENERGYPlC �,�`,s �k� � I..! a 1 .�•-t -'" � WARNINGFAIWftETOSECUREWORKERS'CAMPENSATI NCOVERAG ISUNLA FULANOSHALlBE i � SUBJECTANEMPIOYERTOCRIMINAIPENAL71E5AN�GIVILFMF.SUPTOONEHUt�IDREDTHOUSAND ENERGYPERMI7 ��'���-'��=���` ��� � NU.ARS(5700,000).IN ADDRION TO THE COST OF COMPENSATION,DAMAGES AS PflOVI0E0 FOR IN � SECTION37080FTHElA80RCWE,INTEREST,ANDATTORNEI"SFEES. ' RETENTIONFEE: W CUNSTRUCTION LENDING AGENCY pqE-ALT FEE: d ---------_... � 1 HEREBYAFFIRM UNDER PENALTY OF PERJURV THAT THERE IS ACONSTRl1CTION LENDING AGENCY � � fOP THE PERWHMANCE OF 171E WORK FOR WHIGH 7MI5 PEfiM1T IS ISSUED(SEC.3097,CIV.C.). , W �Z LENDER'SNPME_ ---�--- i � LENDER'SADDHE55 - � ICERTIFViHATIHAYER[ADTHISAPPLICATIONANDSTATETHATTHEABOVEINFORMATIONISCORRECT. TOTAL FEES �� . W IAOREE TO COMPLY WITH ALL CITY AN�COUNTY ORUIVANCESAND STATE LAWS PELATING TO BUILDING . � CONSTflUCTION,ANDNEREBYAUTHORIZEREPFESENTATIVESOFTHISCOUNTYTOENTERUPONTHE - � ABOVE-MENTIONED 9ROPEflTV FOR INSPECTION PURPOSES. COMMENTS � O �� r"L�,� / ! � .. . � m PE MITTEEN E(P ) � � . ((� f � � ��(27 � S� F �ER DATE . = RECPT.NO. PAID BY VALIDATION ~ WHITE—Departmen[Copy,YELLOW—Flnence Copy,PWK—Assessor Copy,GOLDENROD--File Copy,GREEN—AppiicanYs Copy �...� e_r.. �_�. "`f"_ �__ , -r . �._ .. �. � _ ,_ i { � f � � � , ( ( � ` l , I � _ � � � .. , �� ,�� ( , , E ',' � � ( �„ I ` i � � I � � � �.. � , i � a �� � �� � i � 1 � 3 �1 �.�� � � �' r #— f = � , >> 4 � � � �� � � �� � ; � I 3 � 1 t = � ,'� !, _ ;- � � f � , r � � � �� ���� � ��� ' � � � � � � ��� jr�� E � � ,� � { �� � ;'� :� �� � i , � i ; ; � j !; � � � ���1 � � i '� ' �iF E , 3 ;� j t 1 � �" � i i... � E � � `{ { I � i � "� � I — ( � � � I i ��� � �( j � I i E � � �.� .� i I ,� F I� � � € � � i ' . , �:� � � ` { � 3 ��` � F � � -, � '� _(__ +_ � ��{_ �� � € €__.. �. � . � � �, ; r I ` i � ! � � �� I � � .� E I � � � , � E � ; � � � � � t,. � mm;_-� _;, , i- ,. � � -�- � ; I , 3 � i i (. � { � ' i p i � � � � � t I� �E� { � � j i'-� � I �� � ��� � � ' � �� � ��� _ r � ; i � { r , � .. ; , _ � r E . � � � .( � � i ��� -� I � � I, ��� � i { , > ( � - � '; � � r� _ , � �� � � � � i j� 1-.�� � � ( f ' �� � � � �� � � (.� � '� � � � - � � i ! 1 i- I _ ' i ; � � �� t F ; I —�——' � ' _j--�—� — ;— '_�--�_��_� i j , � � � ` i � ' ! � �: ' �i � ' I I'- I i , � � ; � � i I � I ! (�' " ..� � i ; � E:: ____ — � ��" � � ; � ��- I � , , � I I, � i I � I� 'i�� � � �� � � � i i _ �„ ;�� � . 1 � { 1 � ! � � i � i i �,� � � \ t- °� � E � ( i � , i � � # � � ` I 9 } �. � k � ! � � � � E� ��- � � ; � �� .�- � E � �� � � ��� L I � � ; t ( j { - � � ' � j � ya� ��'�,�"X C,� f ' � 3� � i � � �'�' i' f i � � i � � i ( � � ,2 � � ` � C7 � '��.-.���''°'1' '^r � C.���� IC €��Ir�jI���E j' �-�.�i�� � � � � ( �� E �( I i (� � � r �- l i .� �� � � ' _ '� � J � � � � � � f ; � '� � 1 cr €�-- � %� �- r+ ( �,-. � , .i �.�,a�. € ��- 3� � � � , , � ( I _ ( i ; � � �- na= : �L[3,�`y :��� '`i�..� r.- t�'� � � � r � �� � s�" i C _" 3 .) ; I �. i, � � . � y `'7 v ^�k �� !�y„ _t? �.. I v � � G, A �i � F�� �� � �' � I � _ � � . i a s � ( f' � ! � � �, r A 1 .��, � - � i ! € � i �.�... � r� '-� � `� (� !>�� -1 �� f� � � a � '�{ ��z _ � � � s_ I� (. "� �I � � � _a a C �a � � r � i . � �� 9.� � i u cr ' - ; G � � .� E-- �� � � r�tu fs ���'' �� _1a . � � .�"�.s '� €�I« L? "�!-�'� �',�Wi „� s � j i i °� �° 4-'l��G I�,i I ro( L"i �r'i F:_"� €ki. 111� � _ 3{g' .i -..� �, � ',._I , � 7 � �_ , i��: L��L a ���ea i � c' r s1. u� �e�. I�7-n�:� i .� �- � � ' ,_ � '� _ -�-, 1 �'t �—F_� 4 r � ..� Z�..�.._.� ( � � � I � j � - ( I � � i � � + . _ �-, j �-�--�--, �'�� � �) : � � �� _��� � I � - r �j , � � i.... , �- ( i i .�) 1 ( ` i I � � t ' ``"� I i � � ' - f � i i � � � �.j � � I :.h�� � E r-° � s� , t 1 I � 4 � � �� � i k I I. � � � � � t ' s ; ( � i 1 i t i I . i �' � �. �� E �� ; . i ( f 's � � i � ' ' � � � � i � � � I i ( � � i � �E i ' i � �.� l - � �� k � � E � � 3 i � 1' ( E 1 � f i � � � � ` �� f �� �� � �i , ��� € . � � . � I ' f I� , �. a � � € _ . � t , � ( � ¢_ . � i .,. � 1 1 � � i i <.a. � f d � t � i 1 ` � I , 1 � II ; � � , I� � � � � , i jj � ' t � � � ° � � F ,�- � � � � ( '- � € � �� E { � � j . 1 1 � � ,� I . i � � � � � ! � f N p � . , � � j P/ � I � E � �'� y t � � ' � ° ` ' � ° ��. —� E � � (' , �� —t —�--i � � ; _s. �� 1-- r --� ' � ' i E ���� � � — � � � � � �: � o � �{ , � � � � � ; � � ( � : � � �:� �— , � � ; � ! � � � i ! � � � i � F r � �' ' ` � � � 3 ' �. i � � _ �� ; ��� � � � � ; � F ' � � ' i , ; � � ` �. �P� i -� � r�i_��� �_� �-� ! (_ �k�' '- ; � i::€,_`�.��_l_ � �, I � � M ������'� ���' i � � � E � � � � � j � ' � � I i i �. � � � E E 3 �t ( i x :.t� + � , ? j � i .��. i � , � � 4 .x --. � �° � �r� � ! �'� °� E..i - t €. � i I . + � � i � � . S � �� �[ � �t � � �� f '� _ i �j �� � � i��� i I _. a � .� � I-- ,�� �i !--� i s �� I � « -1 � � ,'�m. ',,Z � � � �=I z,I „` t x�I � � .� � � =; t i � � i�, � � -.� ? - � � s�� i� � �� �d� � ._�� zb� _ t � � ��� �_� � (t t-; ��.,rf _ � � � � i � � `- � � `;� � d ���i"� � � ,.�` ��� ,E ��� � � � � t ] �� � � " � � r,i i � � a ,� ' . � if'�� ic`�r � ��C ��� �i � � C' 3 �[� F N" � �I j � k i� � t,t�!.. i 7.i. ' � � __�.i ..�.t �r i �f' .� .� � i f i .. _ � �J" �� �.,m..�.� y �! L.. L C -.�_s._._ �l�._. .._ _._��._.�,...:m._�,._.[_1_.� .J. .. _� , _r ��___. .., �.�—.. � � --