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---���--• CITY OFDIAMOND BAR � � COIvIMUNITY DEVELOPMEIVT DEPARTMEN'I' '�,,.� 2I660 E.Copley Drive Suite 190 � PR ESS (909)860-3195 Fax(909)661-3117 • ' BUILDING PERM[TAPPLICATION FIRMLY cii ( JOEiSITE:. . /� ( APPLICA ION • PERMIT /C o ADDRESS 2�� Z—� (r �i✓1��•i �l 1'�• ppTE NUMBER�� c� ISSUE TYPE OCC '. APN LOT TRACT DATE CONST. GROUP ' � OWNER-- , � ADDRESS ZONING SETF3ACKS Z CITY ZIP TEL. . FRONT � qW ❑ ' o APPLICANT - '" TEL. S DElSIDE STREET RW ❑ z ¢ CONTRACTOR �- � � S - SIDE ❑ , � ADDRES � �d �•� � � CITY rct�C • '� ` ZIP � TE u t PROPOSEDUSE o ARCHlENG/ ' - . W DESIGNER NO.DWEL. NO. NO. a ADDRESS UNITS - STORIES BEDROOMS � CITY ZIP TEL � DESCRIPTION 50.FT. ' FACTOR PSF ADJ.AREANALUATIOU � - ._ . _OWNER-BL'ILDERDECLARATION . SFWADO,'REM O I HEREBV AFFIRM UNDER 7ENALTY OF OERAIRY TF1A7 I AM EXEMPT fROM THE CONTMCfORS LI� Cjy�gB/CBfpOR W CENSEUWFORTHEFOLLOWINGREASON�SEG70.71.38USTlESSANDVROFESSqNSCADE:ANYCITYOR (n � . U COUNTYVJHICHREOUIRESAPER�IITTOCANS7RUGT,ILLTER,MPROVE.DEMOLISH,OAREVAIHANYSTRUC� , W Pd110/DOCk ' Z TURE.PflIOR TO ITS ISSUANCE,�L50 H[WIRES iHE MPLILANT FOfi SUCH PERMIT TO FILE A SIGNED ` STATEMENT THA7 HE OR SHE IS LICENSEO VURSUANT TO iHE iROVISIONS OF TME CONTfl�CiOHS ll•. . � $ CENSEUW�CMAPTERG(C0IAMENCINCWIMSECTqN70D0)OFDIVISION�OFTNEBUSINFSSANDPRO� POOVSp2 . � FESSqNSCODElOR711A7NeOR5MEI5E%EMPTTHEHEFHOMANDTMEBASISFORTHEALLEGEDE%EMP•_ (� V TqN.ANVVIOLATIONOFSECTION70]t.68VANVApPLICANTFORAVERNITSUQIECT57NEAPPLICANfTO Z Re-Foal . � � ACMLGENA�ttOFNpTAqRLTMANFIYEMUI:DNEDDOLUR5�f5oo).1: 04ASOWNEROFTHEPROPERTV,ORMYEMv�OVEESWIiHWAGE5A5THEIR50LEC04PFNSATION. ❑ _Z Commercial W:LL DO TME WORK,ANO 7HE STRUC7UPE IS NOT INTENDEO OR OFFERED fOR SALE(SEG.7oN.BUSI- J NESS A4D DROFESSIONS COOE:THE CANTFACTORS LIC[NSE LAW DOES NOTA7PLV i0 AN OWNER OF � PROGER7YYhqBURDSORIMPROVESTHEREON,/WDVh10DOE55UCHWOqKHIMSEIFORHERSELFOH � � . C[ THRWCNHISORMENOwNEAAVLOYEEQPRONOEDTHATSUCHIMPROVEIAENTSARENOTINTENDEDOR m QOFFEHEOFOq5ALE1F,F/OWEYERTNEBUiLDINGORIMPROVEMEM1550LDWITXINONEYEAqOiCOMPLE- ' ' ' Z TION.THE OWNER�OUIIOER WILL MAVE THE 6UFIDEN OF 7ROVINO TMAT ME OR SME OiD NOT BUiID OR � � IMPROVEFOFiTHEPURPO5EOF5ALE). � O 1.AS OWYER OF TME PR07Eft�l:AM EXCLUSIVELY CONTflRG71NG WITN UCENSED CONTMCTORS ' � TO CONSTRUCT THE PR0.IECT(SEC.7ou,BUSiNESS AND DRO�ESSIONS CODE:iNE COMMCTORS LI- VeluB�i0f1 ADJ.AREA � W CENSLUWDDESNOTMPLYiOANONMEROFA7ROPERttWMOBUILO50flIMPROVESTMEREON.ANO , � WHOCCNTRACiSFORSUCHOR0.1ECT5'MTN1100WTRACTOR(S)UCENSEDPURSUAHTTOTHECANTM6 pUANTITY ' DESCRIPTION FEE - " Y TORSUCENSEUW). , � � O I AM EXEMPT UNDER SEC. B.A P.C.FOR THIS REASON Q t� •J�� l.,'� � _ � �1 • � 1���� - ZOATE OWN:R � - V I T� ' 1 Q � O J � � � LICENSED CONTRACTORS DECLAi7ATION ' W _ ��� ( �r, � _ � - i ( •'3� ' INERFBYAFFIHMUNDERPENA�TYOFPERJURVTMATIAMLICENSEOUNDEROHONSIONSOFCHADTEq � �� � O �{ �'►� � 9(COMMCNCINCWITHSECTION7000)OFDIVISIONDOFTNEBUSINESS/WDVROFESSIONSCOOC,AND Z •f� I✓`5 `X uY lICE45E IS IN FULL FORCEIND EFCECT. � m - G_ a d , � LICENSE 1A55 � � UC.NO. v � `�� j � V DATE d� CONTRACTOR ' 1'�' . a W � WORKERS'COMPENSA710N OECLARATION a = U � I NEREBYAFFIFM UNDER PENALTY OF PERIUNY ONEOF THE FOLLOv�ING DECURATIONS: Z 0 _IMAVEANDWiLLMNINTAINACERTIFICATEOFLONSENTTOSELFaNSURLFORWORKERS' _ � � '" � COMPENSATION,ASPROViDEDBVSECT10N17ooOFTNELAb�RCODE,FORTHEOfR�OiWANCE W OFTHE WORK FOR WNICH THIS PERMIT IS ISSUEO � Q . . W _IHAVE�F1DW4l�.U.INTA�NWORKERS'C06�PENS�TIONINSUNANCE.ASREOUIRE�BVSECTION • , O 97ooOFTHELA00RCODE,FOOTMEDERFORMANCEOFTMEWORKFONWHiCMiHiSPERMrt15 9CJ•�7� ISSUEO.MYWORKERSC'�Ou PENSATIONINSURANCFL.CJ�FRICRANDVqLKVNIMBFRARE: CONSTRUCTION ' � � 1 j GRRIER .) I t T< T �"�� PLAN REVIEW � PoLICV NUM9ER � ELECTRIC � Q O (n�.SSECiCNNCmw76E0CMlEfEDOFTEPERANiSfORU.EH!ly1EDCOl1AiL"(StmI�lFS51. PLUMBING Z ICERTIFYTHATINTHEPERFORMANCEOFTMEWORKFORWNICHTHISDFfWITISISSUED,I MECHANICAL � � U' SHILLLNO7EMf'LOYANYPEHSONWAWMANNERSOASTOBECOMESU0.IECTTOTNE ^ � � VqFNERS'COMPENSATIONLAWSOFCALILOfiNIAANDACREE7/UT615HOULDBECOME INSPECTIONFEE � � � � SUBJEGTTOTNEWORNERS'COIAPENSA710NPROVISIONSOFSECTqN�lp00FTHEUIBOR ��J CODE,I SHALL FOiS7HNAIN COMPLV WIT�H iMOSE�qOV151 ISSUANCE 0 onTE:� h'�e J J J APPLICANL „r1��lJ•v_�U��"�`^�� SMIP OL� I� . J WMNINO:FMIURETOSECUREWORKERS'GOMPENSATIONCOVERAGEISUNIAWFUL,ANDSHALLBE ' -ENERGYP/C - y � � �� '1 � SUOJECTANEIAPLOVERTOCRiA1:N�LVENALTIESANDLMLFINESUPTOOkEHUNDREOTHWS�V10 ENEFGYPERMIT DOLLAflS(5100.Ooo�,INADDITKN�i0 THE COST OF COMPENSATqN,DAMAGES AS PROVIDED FOR IN � SECTION91080FiHELABORCAOE,WTEREST,ANOATTORNEYSFEES. � RETENTIONFEE: � � � � � ' a CONSTRUCTION LENDING AGENCY PfiE•ALT FEE: ' o _. . . � 1 HER[BY AFFIHM UNDER DENALTY OF pERNRY THAT TNERE IS A CONSTRUCTION LENDINC ACENCV - FOR TME PERFORMANGE OF TME WORK FOR WHICN THIS VERMIT IS ISSUE�(SEC.70V7,CIV.C.�. , Z . . . _ . .. . � W ,� LEn9ER'S NudE � } F- IErvDERSADOPE55 � ,� TOTAL FEES _ . .� �� ,� ¢ ICERTIFYTMATIH LREAOTHISAPPUCATIONANOSTATETMATiNEA00VEwCORMATqN15CARRECL . � IAGREETOCOA�P WITH�uCtTYAN'JGOUNTYOADINIWLESANDSTATEUWSREUTINGTOBUILDING CONSTRUCiION. 1�HEREDY AUT}qR12E REPRESENTA7NE5 O�THIS COUNTV TO ENTER I1DON 7HE Z /�WVE•MENTION PROPEflTIFORINSPECTIONPURPO^� . ' ' � CAMMENTS � 1 , � . ��••-.., � ..` � m PERMITTEEN .E{P • �� ' ' ' Q , � • ���� SIGNA 1R ')FPE MITTEE • DATE , � • . RECPT.N0. PA:D BY b VALIDATION - - �- � WFIITE-0epartment Copy.YELLOW—Financa Copy,PINK—Assessor Co y.G ENROO—Fite Copy,GREEN—AppiieanCs Copy . • . � • - , ' . .. -- � .. � �w . . � ,..,.. _ . ., ... ... . . . . e., .., r. . � ..,. ..�.s , .i�•.i. .. • . . . . . � . � �,. : CITY OF DIAMOIviD B/1R -. . . . " �� � INSPECTIDN RECORD ,,•. �, • � � � ' • � � • - SEf BACK � � • ' � ' - I FLOOR JOIST - � FTGS/FORMS/STEEL - - FHA REQMTS � ' ELECTRIC GROUND " UNDER FLOOR DUCT , , �• GROUND PLUMBING � � UNDER FLOOR CO�IDUIT . ' SLAB GRADE FIREPLACE FOUNDATION :. ' TEMP POWER - -- - FIREPLACE BOND BEAM ' + ' ' - - - - - ' � ' WATER SERVICE - -- � - MID HT.�BOND,BEAM :� � . � . ..' : . ,'. ROOF SHEATHING 7 8 Ff.BOND BEAM � FRAMINGNENTILIATION FINAL'BOND BEAM ' � ROOF COVER J 7i ) . � PRE-GRADING � ' ROUGH HEATING -- BENCHING -- ROUGH ELECTRIC �- - - " - - ROUGH GRADING ROUGH PLUMBING � � - � - FINISH GRADING • SHOWERlfUB TEST � PO�L-ELECTRIC - EXT.LATH/SIDING POOL FENCING WALL INSUTATION POOL FINAL CEILING INSULATION OFF SITE IMPS. DRYWAIL NAILING DEDICATIONS , , SEWER . FINAL ENG. .. . _ ^ _ , . . SEPTICTANK. ..:: ' - � ' ' _ LANDSCAPE/IRRIG.. . - � `� SEEP PIT/L.L. ', - - - - .ON SITE IMPS. GAS AIFi TEST ' ' " ' � �` ' FINAL'ZONING FINAL;CONST. ,• . L• c . . - -- FIRE DEPT. FINAL � FINAL HEATING ;: -; � ,� . � HEALTH�EPT.FINAL . - FINAL ELECTRIC_�. ` ..�. . . � - � � DEV. FEES PAID � FINAL PLUMBING � � � ENERGY _ , . �; : . . , • � � , • • --_ --- • -- - . . .._�...,__ - • • - � _ . . , � . COMMENTS- - � J, �_ - �, � , . � . . ` , . .. .-�� . , �-, - - � , . . , . !.�'�1� .��,i:'; � � � . r _ r p . . . . . � . , . . . ' .C1 , . ' ' - �� _r. �, ' , � ----- • . . . . , j', ,� - �`_l . , SEPTIC TANK SIZE � . --- � ._ .. SEEP PIT/U SIZE � , . , �,. ;� . . �'ti ' '�� � .% ' �� • _ - ; � : .,. �• t�... � � - - - -`� �)'`�1' . - -- ._ ----- �-------�-- ----- -- J- ��