HomeMy WebLinkAbout14335 (20) 1 -
. ,
.� - �
�,� . CITY OF DIAMOND BA$ �
DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES
21660 E.Copky Drive Suite 190 '
� (909)86Q3195 Faz(909j861-3117 , PRE$$
�'�^'' BUQ,DING PERMIT APPLICATTON� . FIRMLY
} JOBSITE ` � 1n �/ APPLICATION- /� PERMIT L� P1C
o ADDRESS.����� G'D ICt'�cN�AL�IYt�N �f; pqTE /� � % NUMeER // �S �
$ ISSUE TYPE OCC
APN l�T TRACT DATE CONST. GROUP
°� OWNER G
O
o ADDRE � ,��/ • �G� , ZONING SETBACKS .
�W �� �C�11/�'� ZIP �{�TE /4 �yD�SS�D REAR RW ❑
APPUCANT TE�- SIDE/SIDE STAEET
� CONTHACTOR �+ .�.T �E SIDE �
❑
� ADDRESS / J i�- �,
O �� /�/f�ti� Z�P Z J � PROPOSED USE �Z
� ARCFVEN� _
DESIGNER NO.DWEL NO. NO.
= CD YRESS Z'P �L UNITS STORIES B
�
N DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION
O OWNER•BUIL�Eq DECLARATION SFR/ADD/REM -
�
p �HEnEev uFlrod u+DEH vEr+un oF reitum'tru7�Iw ExEMvi iROM iNE CdrtMCiORs u Garage/CaTOrt �� - ,, •._
W CENSEUWPDRTHEfOl10WRqREA40N(SEG7w/.60U5R1ES5ANDiRDFESSqNSCOOEhM'UiYOR - � - -
t? COIMiYN4/1pIpEpJlq£gAPERMRTOCON5TFAICT.IITERIMPF10VE0EUOLISH,pqqEPNRFNYSTfiUG � � r
�?� tt1RE,PRqfl 10 RS ISSUNVCE,�1L50 REW IRE9 THE AvftICMli FOq SUpi PERMR TO FILE A SIGNED W Patio/Deck
� bTATEMEM iMAT HE OR SHE IS L1C£NSED PURSUAM TO THE DROV1510N4 OF THE CONiMC70R5 U-
� CENSE U.W(Q/APTEq�(Cd1�1ENCMf7 N7TH SECTqN 7000)DF DMSpN 7 OF THE BUSINESS I�ND PRO V' POOV$p8 .
FE59qNSCO0�OR7}UTMEOHSMEISIXEMPTTHEpEFH01AMiDTHEBASISFORTMEIILLECEDEJfEMP- (3
7qN.AN'IViOI/1TIf7NOFSECTIONM]1.68YM1YAORICI1MFOqAFERMITSUBIECT�iHEAVPLICM(TTO Z Re-Roof
'„� ACMIVENALiYOFNOTAIORETN/UJFNEMlNDREODOl1AR4(t50o1�Y ..
O Ol�3�MMEROFiHEPROPERTI;ORMYEMPLpYEE5Mn7NWApE9ASiNE7H50lECOMPEN5A7ON. � Commercial . - .
Z MiSl D�TNE WOfO(AND TME STRUCTURE IS NOT INTENDEO OR OFfEREO LOR 511LE(SEC.7W,BU54- J
�.� ME93IJD ViIOFES510N5 GOOE 7HE CONiMCTOR9{.ICENSE UW OOfS NOT MPLY TO AN ONTlER pF =
PROPEfITYNTiD plJ�,q pq IIAPqpyE9 iNEREON,M1D V1HpppES SUCM V/ORK MIYSELF OR MERSELF Oq
CC TMIOUOMM80qMEROMMFJaPIOYEE3.GiqViDEDiH11T5Up11MPqOVEMENTSMENOTMTEt�E00q m
�a� OCF6im�ons�iEiF.lqwEVE0.7HEBlxn!r�AoauaravEUExrWsd.nwrnnNaaErElwoFCOMa�E
� '710N.1NE OWNER-0UIDER vM1 HAVE TME BURDGN OF VROVNO THIR HE OR 3HE 0�0 NOT BUIID Oii
YiROVE WH TME PUHPOSE OF SALEl
w OIASO�WIEROFTIEVROPERTY.AAlEXf1USNElYCONTRACTT10Nnnlli^ENSEDCOMMCTORS '
• � 7007NST1iUCf TME PAWECT(SEC 7ou,BVSiNES3/VJD Pi10FE5FION3 COC�E THE CONTMCTOqg LI- Valuation ADJ.AREA
W CENSEUWDOElNOTAPPLYTOM/OWNEflOfAFflOPEfIT'/WMOBUID$ORWVFl4VESTMEREON,AND �
� �awrrn�crsFonsuavaa�crswitH�cor�rtn,�cm�sl��Ns�ruaswwrToniscarrrua �UANTI7Y DESCRIPTION) ' �'r' ,`: FEE
� OI W E%EYPTIMpEq SEG B.1 PG iOqTHiS REl�SON :� � D ,i
3 �
v Q
�=' DATE pWNEq F��-
� W v 5 • Q
UCENSED CONTRACTOfiS DECIARNTION W � ^ �
� IHEPE4YAfTIR4lINDEqPENµTVOFPEMIRVTHATIMIIICENSEDUNDERPHOVI510N50FCHAP�Eq '
� •fW�AUENGlOMrtMSECTqN7000)OFDM510N70FiMEBV5INE54MUVROFES5lON5C00E,AVD Z . ' .�. • � Z� �O
LLJ YYLJCENSEI3NM.LFONCEINOEFiECL m I W ��• S�
o �E�g L'-���.�. 77 � �✓/.�?r� / r_-- m, so
� or,tE corrrtuc�o�t��Q/Z r}' a c �
� �''/. o
= WCRKER5 COMPENSATION DECLARATION � .
� INEREBYAFNWUNDERPENALTYOFOEiWRYONEOFTHEid10WINGDECURATqNS: V S �.c��„ Z� ��
U7
� _IIUVEIWOWRIMAMTAFIACERlIFlG1TEOFCONSEHTTOSEINNSUaEFORNORKER5 = /y� `A � '/O• 4
� 004PEkSATqN,A3PROVIDEDBYSECT10N77000F7HEUBOHCOD£,FORTi£PERFORMIW�E U / G'r'f �/ Z 3j• ��
_� OF TIE M/ONC FOR YMlG/iM�9 PEIMIT 19155UFD. .. . � / h_ vl�� �. �O
O
W _IIUtVEMAVMLYAMITAC/HdMER3'COMOENSATId7IN5UR�WCEASRE�IUIREDB�SEtTlON
O J700 OF T1iE LABOR COOE,FOR TNE FERFORMANCE OF THE WORK FOF YMICH 7H15 PERMR 14
65VEQWWpitl(ER$'pp1AP(H$ATqNWSUHFNCECAARIER POIICYNUMBERARE CONSTAUCTION
� POIICYMIMBER � r � �� PLANREVIEW
zd ELECTAIC
� (iHS�Cfb+rk�WT�00�.ilF1IDOF7/EPEFi�TsiORWEFI�IXEDOCl1Ni4ftia%ORLE551 PLUMBING - ^w��-�-r
� I CENTIFY iNFT IN�F1E VERFORMMICE OF iHE NOiUC FOF MMIdI T1/15 PER1AtT IS I55UED,1 MECHANICAL .1CI��(.�,'�
SFLVl HOT EMPLOY NIY iER50N R1ANY MINNER SO AS TO BECOME 3V&IFCT TO TNE
(n wORKEH3'WA1vENSATIONUWSOFG�1iFORMAANpAGREE71U71FISMOl.LDBECOME INSPECTIONFEE -- - - - -
SUBJEC7 TO7HE YAqxERS'COVOENSATqN VipV15/]NS OF SECTION 3700 OF THE UBOR
S coo�is�+AUFormnv�rr�oornv�rwm� novisror�s. ISSUANCE .-.. ,. , �t1C! .(�J
a )p..i, �l J:1
- `p DATE: � APRICANT: __ -SMIP - -
J�� ENERGY P/C CILY T1T A�11�1 `7
J WMNIN2FIIWREMSECURENVRKER3'Cd.10EN5ATlON EMGEISUNUVVFUI,/�N�SMAlLBE �-. .1���'
, } SUBJECTANEMPIOYERTOCFiMmALPENALTtESANDCNRFINESUPTOONENUNDREDTiWSAND ENERGYPERMIT RTi����T��t�TrZc�T��^�r
OOUARS(t10o,o00).N/�DDITION 7DTNE COST OF COMVEN5/1T10N,UAMA6E9 AS PROVIOED fOR IN
' QJ SECT70Nf7oeOF1HEUBOA000E,WTEREST,AND�1TOiWET3FEE& RETENTIONFEE:
CONSTRUCTIONLENDINGAGENCY PRE•ALTFEE: "
� IHEREBYlIFFlipAUNDERPENALTYOFPEiLR1MTHlITiHEREI3ACONSTRUCTIONLENDBJOAGENCY �
� WNTHEPERPORI/ANCEOFTHEWORKWRWHICHiHISVEpA11TI5155UED�SEC.]097,CN.C).
� LEtAER'S HM1E
� IENDER7EDDRE33
� icennvrnun�uvenFnnnus�vr��ur��wosr�rEnuTn�e�eovewForw�TuriiswnnEer. TOTAL FEES _��
p, I R6REE TO COM7LY WRM ALL GIY�ND COUMY OFDINIWCE4 MA StATE lAW3 RELATNJO TO&1LD�NO
� COHSTRUCTpN,ANDHEREBYAUTFiDRIZEREPFESEMATNESOF7}IISCOIMTVTOEHTERUPONTHE '
�BOYEl./EilTIONED PIqOERTY FOR INSVECTION PURPOSES. COMMENTS
� Z � � N
5
m � �E�� I
¢ , f 2-
�
(p NAN E OF P ITTEE DATE �
� RECPT.N0. PAD BY VALIDATION
WHITE—Department Copy,YELLOW—Fnance Copy,P�NK—Assessa Copy.GOLDENRO�File Copy,GREEN—ApplicanYs Copy
�-T_.._._._-... �� - ._. ` f .. l—� �.�_- "I�,.�r r _ -�n � � m v D c � :
�-r 1 , ui�,Tco o c� � r1i cr v � z� 7� � cn G� m -n cn
!, C/i f!� . � I � ':n i -r*oi m 7] Ir rD- .-hi O c � �c O y' �U �'+�� w � n v�i � �'
.� �- �I' � �
. . ' �-i ��� • � I � � ri'i� i i -. •v c> T i� G� z t^ r: .i' i 2.�n-= � v � fi� z� � -n a ,1°
. � �� 'O C� �� , . � r r �r'I V '��I -i � r' _ cn '{,� � m S O G�- Cn O � 0 � n �� .
� � . ' ' �y '. J z � �� n -D_I N rri r' Z Z w � rn C C 1'rn y (�it�m A' � f�il. p �. � 9 � �g'�i .
��k -``,7, �� - � � r 2 � � � m r- � r � � � � m � z ��-zi � c> ��m � O m � '�
� - ' N(n ; � - G� �'` . Z � p � m Z - G) '��'�,r= � m , i m� Z m ��� .�i �
� � . . - . fTi�� � : � � � � L) n �� ��y G? , Z; Q m ,� . .
rri � i � ` � �_ I' G> r, �
\z �� � �
� =�i�l � � � �� ' — ° �
� I J � � � ia�
' ..__.._... �. I-..._....�._ � ' IQ? . �i Cfl - ' � i �' � ' .
, -' ' � r. ..' Q ;, rj � �/; I i�1,
y M p �
'�n V '_
� ' 1� -
; i ;`,
; ;� �;
��p '�
I ( o� � �
� �
- - � ' - I � m o
� ' '. ::• .., , - �
i , • (7 �1
i 171 O 2 T 'n O � ?7 O O 'v � Zl T 7J W � �7 ao � T T C C '� � � .� � �
� � m m y Z z Z m -n o O O Z O m � z � 37-Z- _ �
.. - -- -- - - � I� ' � -n -ri p r�- v' � � � � o 0 0 =.� n � r � x � � � m 7� 0 1y� z '� ;
- ,�i � m = mNm � mD � T -rnm x = � i � � � R' �' � 37 O
mn � -i m r L� Z D O �Z m � T O � 1I��
�. m � � O y Z frl Z Z m � L� C) C7 r r O . Rl
" • �" C/� m ;i 2 � 'a L� O D n D 77 G� � Z O O m m � p _'sV ul i�� Z
c v -o -nz � � � z � '- n � pD z � wmzw -n o otn -� ��'I C�.p
;�� � -� Z L� � � - � � � 37 Z Z .L� m D m � O.77 7] ' �S�_I, ..' O-.'�
" +�, � yr � � � � � � � moC n �: Q..�
. r p ��.', � , . ,. .
! � � � � T=
�; 1 Z � ` ' ;
' ; '��
�. , i '�,; ,�;��.
; � ��
u�i
, ; �,;
' A_ _ __ -. . '.�_. -- -' - -- - 1 -' - � - - - -- - � --
;.
� � , ��
_ _ - - - --
_
, .,,.. ,. _.. . , _ --. _ � ;,I
r ,. ,,. :,. _ . .._.. . _- _ - I , . .I �