Loading...
HomeMy WebLinkAbout16822 . ._ _ . __ _ _l-..._ __.__. _ . CITY OF I)IAMOIVI�BAR � ----� DEPARTI�NT OF COMMIJNTI'Y&DEVELOPMENT SERVICES I 21825 E.Copley Drive (909)860-3195 Fax(909)8613117 PRESS �`%»��'�' BUdI.DiNG PEKMIT APPLICATION FI R M LY o D RIESS Ib S� C.r C � DATEICATION � �� !� � NUMBER� ���#,C o� ISSUE dC� TYPE OCC APN LC)T TRA�T _ _ DATE L I r�CONST. GROUP p OWNER l�'G �5� 'C p ADDRES lV � ,u� ZONING SETBACKS Z CITY� . ZIP TEL.��" ��C� FRONT RW ❑ o APPLICANT ' TEL S DE/SIDE STREET RW ❑� z ¢ CONTRACTOR fl�'i OO SIDE ❑ , � ADDRESS � p �-��� PROPOSED USE CITY ZIP�'�t/"� 7EL. w ARCHIENG/ z DESIGNER i A J�/I � ADDRESS ! NO.DWEL. NO. NO. � CITY ZIP TEL. UNITS STORIES �__BEDROOMS c�n DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION � OyJNEH-BUILDER DECLARATION SFR/ADD/REM O I HEREBY.AFFIRM UN�ER P�NALTV OF PERJURY TNAT I pM IXEMPT FROM THE CONTftACTORS LI- Gdf89B/C3fpOft W CENSELAWFORTHEFOLLOWMGbEASON(SEC.7D31.SBUSINESSPN�PROFESSIONSCODE:ANVCITYOR (n U COUNTYWHICHREOUIRESAPERA�ITTOCONSTRUCT.AI,TER,IMPROVE,DEMOLISH,OFREPAIRANYSiAl1C- W � TURE,PRIOR i0 ITS ISSUANCE,ALSO REOUIRES THE APPL!CANT FOp SUCH PEFMIT TO FIIE A SIGNE� w Patio/Deck STATEMENT THAT HE OR SHE IS IJCENSEO PUFSUANT TO THE PROVISIONS OF THE CANTRACTORS LI- �' CENSE LAW(CHAPTER9(COMMENqNG WITH SECTION 7aa0)OF DIVISION3OFhIE Bl15ME5SANO PR0- � POOUSp2 FESSIONSCODE)ORTHATHEORSHEIS��EXEMPiTHEREFROMAN�THEBA515FOFTHEALLEGE�EXEMP- � � � TION.ANYVIOLATIONOFSEC710NI7a31.58YANYAPPUCANTFORqPERMITSU6JECI'STHEAPPLICANTTO ,Z R2-flOOf � ' A CIVIL PENAITY OF NOT MOPE 7}�qN FIVE HUN�RED DOLLARS IESoo�.): � ❑I,ASOWNEROFiHEPROPERTY,ORMYEMPLOYEESWITH�WAGE5A5THEIRSOLECOMPENSATION, '�❑ COrtIR1BfClel . � ' Z� WILL DO THE WORK.AND THE 5TRUCTURE 15 NOi INTENDED Oq OFFERE�POR SALE fSEC.7044.BUSI- J ' �; NESSAN�PROFESSIONS CODE:THE CONTRACTORS LICENSE LAW OOES NOTAPPLV TO AN OWNER OF �� PROPERTY WMO BUILOS OR IMPROVES THEREON,AND WHO DOES SUCH WORK HIMSELF OR HERSELF OF �: THROl1GHHISOPHEROWNEMPLpVEES,PR�VI�EOTHATSUCHIMPROVEMENTSARENOTIMENDEDOR '�m 0 OFFEREDFORSALE.IF,HOWEVER,iTHEBUILDINGORIMPRDVEMENTISSOLDWITHINONEYEAaOFCOMPLE �,, iION,THE OWNER-BUILDER WILL�IAVE THE BUFiDEN O'r PROVING THAT HE OF SHE DID NOT BUILD OR �� IMPROVEFORTHEPURPOSEOF�ALE). ❑I,AS OWNEH OF THE PPOPERTY,AM EXCWSIVELY CONTRACTING WIiH LICENSED CDNTRACiOP,S � TO CONSTRUCT THE PROJECT(S�C.7044.6VSINE55 ANO PROFESSIONS CODE:THE CONiRACiOflS LI- VAIIIdfIOfl / ADJ.AREA W� CENSELAWDOESNOTAPPLVTOANOWNEROFAPROPERTYWHOBUILDSORIMPROVESTHEREON,AND � WHOCONTRACiSFORSUCHPRO,�EGT5W17HACONTRAG'POR�S)UCENSEDPURSUANTTOTHECONTRAG QUANTITY DESCRIPTION FEE Y 70RSIJCENSELAW.). � �" 7 I AM EXEMPT UN�ER SEC,�' B.&P.G WR THIS REASON Q - � U u. ¢ � Z DATE OWNER U O� // �� O W f�� � LICEN$ED CANTRACTORS DECLARATION W I � . I HEREBY AFFIRM UNOER PENALTT OF PERJURYi}1AT I AM LICENSED UNDEfl PROVISIONS OF CHAPTER � / U. � 9�COMMENCINGWITHSECTION7dW)OFDIVISION30FTHEBUSMESSANDPROFESS!ONSCODE,AND Z � I X MV LICENSE IS IN FULL FOflCE AND EFFECi. I'�i � LICENSE ���� �, LIC.NO. ����� � �f � F-" / J U DATE :+"� CONTRACTOR G n- W � WORKE,RS'COMPENSATION DECLARATION a � IHEREBYAPFIRMUNDERPENALT1jOFPERJURYONEOFTHEFOLLOWINGOECLARATIONS: Z � _IHAVEANDWILLMAINTAINACEFifIFICATEOFCONSENTTOSELF-INSUREFOFWOflKERS' 2 Q COMPENSATION,ASPflOViDED�YSECTION37ooOFTHELABORCODE,FORTHEPERFORMANCE IU OF THE WORK FOR WHICHJHIS PERMIT IS ISSUEO. � � `� W� �I HAVE AN�WILL MAINTAIN WORKERS'COMPENSAilO�Y INSURANCE,AS fiEQUIfiED BY SECTION � 9�OOOFTHELABORCODEIfORTHEPEflFORMANCEOFTH[W KWRWHICHTHISPEFMITIS J ISSUEO.MYWORK ', dMPE ATIONINSt1RA ARRIER �7POLICYNUMBERARE: CONSTRUCTION _�� j caaaiea - PLAN REVIEW Z POL�CY Nl1MBER__ L ELECTRIC K � � 0 (iHIS5ECTICNJNE�NO7BE�I�MPLETE�OFTHEPERMITISAP,ONEHUNOFEDOCiLARS�$100)ORLESS). PWMBING Z I CERTIFV THAT IN THE PE�FORM'ANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED,I MECHANICAL ('3 SHALL NOT EMPLDY ANY PiER50N IN ANY MANNER SOAS TO BECOME SUBJECT TO THE ="""" (n WOFKEPS'COMPENSATION LAWSOFCALII-0FN10.ANfJ ReETHATIFISHOUI�B OME INSPECTIONFEE � k .._�'!�"'4`.'»`� � �TTOTHEW KEFIS'CONIPENSATIONPROVI51 SCFSECT N3JODOFT L480P � �- �-� +'�' '���.;\ �1 �i � '''� ' � FjIMVIPiCOMPLYWITHTHOSEP ISIONS ISSUANCE :� � )l PAII p DA7E: � �(APPLICANT. SMIP � �� � E � E4 6A y� J WARNINO:FaL�ftE TO SEC�RE WORKER3 COMPENSATION COVEAAOE IS UNLAWFU4.ANO SHALL BE ENERGY P/C ; _ _ , � SUBJECTANEMPIAYEF�OCRIMIMALPENALTIESAN�CIVILFINESt1PTOONEHUNORE�THOUSqNP ENERGYPERMIT �,-.._, �OLLARS(E100.000),IN ADDITION Ti0 THE COST DF COMPENSATION,DAMAGES AS PROVIDEO FOR IN J SECTION 37oe OF THE LABOP COD�,IN7�RE5T,AND ATTORNEV'S FEES. !��,, j� . RETENTION FEE: �_.,- - � � �� -,-..��w_ � �i.F I - •-. . �.,zr.-----...�r,..�,� � - � GONISTRUGTION LENDWG AGENCY PRE-ALT FEE: ' � IHEREBYAFFIftMUNDERPENALTYIDFPER URYTHATTHEREISACONSTRUCTIONLENDINGAGENGV _ _ FOFTHE PERFORMANCE OFTHE WQFK F�ICH THIa PERMIT IS ISSUE�(SEC.3097.CIV.C.). Z ��i LLI � LENDER'SNAME F— LENDER'SAD�RESS I � � �' TOTAL FEES ��� �� � � ICERTIFVTHATIHAVEREAOTHISAP°LICATIONANDSTATETHATTHEABOVEINFORMATIONISCORflECT. �' w IAGREETOCOMPLVWITHALLCITYAN�COUNTYORDINANCESANDSTATELAWSRELAiINGTOBUILDING � CONSTRUCTION,ANDHEfiEBYAUTHORREREPRESENiATIVESOFTHISCOUNTVTOENTERUPONTHE � ABOVE-MENTIONmPROPEATYFO�,RINSPECTIONPURPOSES. � Z w,,,�, _ COMMENTS - � �%i!� � m PERMITTEE ME(P � � � � I � � (/j SIGN EO PERMITTEE �. 0 TE � RECPT.NO. PAID BY VALIDATION � � WHITE—Department Copy,VELLOW—Finance Copy,PINK—Assessor Copy,GOLDENROD—File Copy,GREEN—ApplicanYs Copy � _ ,,, .� .. ..... ,._ ,._... , �_ ... .__: ,., �_, .�,.,�; y�„..,��,. _ .. ,.. .. '''. � � � � .. � .`. . �;� � � � � � .... �R ' �,;:a. �� �.��v�� ���� �r��,"', .� a ,., .. � t s� '� �a�y .. € �:::; r .:^ .. � � d-, + e x� k � : s �� .,� § ,m�s ��.d( �;; I � � �� � �: ' ' .� : a # r-,� ' E� 4"' �'� x �s � " € x; n ,,„ �;, `� �• a�a^„�&":•�,�^ a�.� � P z�'��.�r� ��°7'a r.r � � �' .. ��` 4 x i � T # '* g � � a � ' � l a� � .� C: E: � � � t' € � �� �, �t a ..3..^�.�, P:k . . „p�'a.-..^� K .,. ,. , x b. �.f �'r B..... �a � :�.# � t�' �. .,. x n> v.A �... ��,�; ..�.�,. �. .t.. � . ... a.�.:a,�ar$"',. � ^�-r r ,-,�r � ; . ,. E } ��- � " ' . . . ..::.�::, €n.r��� � ,,,. , ,.. `-a.. '_ � . �..,.......�.�..__ __,..___.._....... ._.»....._..._. .._....._„ _. ....._.............. ...�..........._ ._....._.._....�..�._.. ....__........ .._ ..._............._..,.........,._._.�._ � ......,.. ., .... .�. _ ;...._ _ -"j � r'Q i.x�.ri.��$t %S...,.;;. �. � ,.+"_. a ,; �•., �. . ._ .�. . ........ ......._ _._...._._ _�....,._..�.. ._ .._. .... ._.__.�. ._.... .. . . . . .. . .. . . _._.� , � .:...Y t:& ����, _^' i�.�. _; .':�- ... .,.,�y ._ ' t __ _ ' .,-...._,..._. _._ .___ ......__ __._ -,- ... ,. _ ._...__.__"'_.�.._... .,....._......,,...__.._"�. _,,..__,.�._.._. i � "�.i�.. t,.� ,..: aF w,..,r ; . . . . '. . . � �. -..._. �: �,,..' �'F"., i. � .- � �.. �' r-: k t ; ; ,� ......... ._ ... ._.. - _. ...... ... . .. , .. .� ....., .. .. .. . , . _..... ....�...�.. _._. _......._ � � '.. y ' E �_. . .o�`@ ��t`E: I j i '"" t y a.y,t �;� . , ... -. ...., _... .. .. . ,. .. . . _ A _ ......�. . ..._ .._... _._ . .._.. ,... � �„�:��r� . 3 t'�i„l P'.. � 44� I;i, . ,i � ,_ _._.... ..... .. ...............?...._...,_..�._...._... �,......_._..._..._.,_...._...... .�..__.....__... t ........ ....,,,.. ._. �,... _ ........-............_....._._�_. ..............._.. � I � $.'4 ��" l" � I t h�, 6 5 . mm .. I __ , € � r3 .,..,�_ ...._ _..,_.__ '"-' ' � � P�q g. s .A{t ig P: �"`��fl y,gys, . .. .� . . ._..._.. _._ __.. .,.......�. .. ..__..�_.. ... .._. , a •S. �r , � . .. _. _... ______.. . :T ". __... ___. __... ._.__...... ._.._.�.�.._..__.......... + ... . _ , t � P�;-w:r�-`` T x�' ga''a €_.:� i,.�` � ,'('.:" -'� � ; �" �i i � i �� .,m.w.. ..___. .__ ........ _ .. ......... .. .. . . . .. . ...... __.�. ...... ._...... ' � S t<..a' 3 s':$ '� � : i .� :`.. � � _ .y� ��.__.m__�..___�._____ ��.�_: E ; ___ _. __.__ �___. ._ _ _ _ _ _______.� __ ._._.____ _._ ______..___._ __ � 4 _ ; F'�;� �� -�r-� , � � � � ' _.;. � .._ __'.m. _..__.__._„_.... _ �_--...._—_ ___....... _ __.._,_ _....�____.. __.._. _..._._....___,_____..__. ;, ; ._.__ ._ �._. . ri��:s� ,�S.A t c., ¢ , a'�,��:; ; � '..�� .' w:. ..E �w,� !��:, � � _._ .'_... �. ......._.3..._,........._._...._ ..�_........_......._....,...__...v_�._A.___ �.:..... � ._....v._._.__.,... . ; ...._..�...................._ _ _..._.w..._._......,........_.. ....._ .......__"__� . �__ C i:"' € � r�,.. 4 ty x v'," % � :,4". :�",^ , � � 'Y .. .. .-._ _. ._{_.. __._...__.._ ..._._.__......._...................._........,,...... __._.,. . ._._..,..................... _.. ; ....._______,.__ _____._. ........_.....__.___..______.. :`.4.1t�.S�,r_�._a..: � . � _ � _ �...�.. ... 3' _..� . :. .._,_..__.___...._..._...... -_._..__�.._�. ._.,___............,............. _ ...._...._........__.......,......_.... ]�._...._—__.__...._ __._..�..... ....................._„......,,..,_....._...��,._._ �:ir'...�,.. [ , � .S":�. .�j ��. . � _. ..... _ . _._.:_.....„...,,,..._ ...m ._.�__.._.._...._......_..._.........................._.. .....„._ ............__......_.____ .._...,.,....._.........,....._ _ �.__....__............_�_.___..».._.... 4:;'�� -_����$ � . ..... .�` .(�e.r�.o-.,� , ._ .� ;- ...._...___.._. e_....._____ ' .._.._. __._..._..__ .. ____ ......_... . __.._....._._...._..._.... W__.�.�...,...�...._.,._.. __.._.....,.. � i .�'„nx� ��f''�.� a L,, E�r�ti l ., w:� . .... . .. ....� _� �,, - .:� ; . �,I _.__ .....:. �,...... . ,..._._ . . . ... � . : _ . ..�...._ .. . . ..._ ..__. ._��..____ . �. < ._..._ __.�.�, � . :'� 1 ;. �... I �"E..n : 3 �....�. .. S ' { .� ...�.._.._._.....,.................,..__ a,�.----..._...-..... ._._.<......_.�___._...._.......... . ...__........ ...,, _........_............_.......__'_ _ ._. . . ....._. .._.._.___ ._ ..._._._ ..._.._ _...._.. V � ..` d ��. a . 3 � r 'i P'.f.... _..__........................__.�_._.j i -a.v i .. .......,,..,,...... .._...�..�e,�..._....................,.,,,.. ...._ ___....... _..... . _......__..�_ .._......,._...,,.._...... . ....... 1 f ��.:�'.�' l« .a:: � �' i . . ,, .. [ i �'�:. },y_ a S :,j'1 . � . ', n � }..�...._ ..,..._ _�,_. �_.._.........3.._.._.�.-.._.,.._ ......._.._........ ._..._�_„ _,,,_.:._....._..;.. � . _.- _„ _ ..t ..,. .......__�__.__�... ._.._..._._.,...._._..__- ____._.._..._____..._..._.�._._ � ..a�_�'.. �"_��`�,�..� ! ` �}i� ,� i.. E � . ._ � __.v . ,E__ �..___ __........... ....___... .__._..—.. E . _'_' __...._,...._......__ .'_..___.... ___.�_�_.�........_... .._�_.....,.......... � za�,�� � �i� ` .":!'�,t� : `.. . _ _ _ _ _ _ .._ �._ ..,. __.._,_ -F_.__._.._.__ . 6 �.k� ��: � f�` { . € � ` . .(//p��J�� . ,:�`Y e S �_ . .. .. . .. ._. . % I ..s ....,_� ......._..�� G/ .,_.,. ...__.,._..._.m.,.......__. . M..,_..... .. ... ._.._.....,............ ......_.,.�.__,............... ._.. _ ..__.___ .. w,._... . r��Vf _e �W'i§ ° ""_�-�f " " ' _,i.�._ $ „ ,? , �__,�:�_ ._._.._,_.__._�..__..._.. ._�._:_._.___ :. ......_.�_..e�._.__._ __,�. _:_____ _. .._._. __..__..._ . ..__._._..._..._..____ . �, , � ;..... .._._._.__� ..� _ � ���r.,.. �,�,C'',�. d � _):��3< :'.�.. � rt3 ., _; € � _ � , _;:.__...._.e..__, s___..____w___�._..__� .. _.__ _._ .._.._..____._ __._.� _._�..._._. _.... M_.___.._._...___.__.__._-"� __ ..,.,. _ _ � " .,'^;"� � :a�� € f ,:� � • i �v� �" 1 i _i _ _._____.�..__ _._,_ _., _.._,_........._._ __._.._ _ .__....__.:___�._,.__ �__.... . ______�__�._ ___ ......_..__ -- ----___ __._.___ __......._._..------- � i .._._.�... m _ E M � _._M __..�,,_i � ��� � �¢��.'�f�t �������w�* ���'a�a�"� � �� y �� - . . A �._.�.._..,._.................._�___........�. .._.,_.__`__...,.,..�....._......_..__....._......_..._......_e._ ..._...,.__.._.,..,.a._x,�.:r,.a_s.�n �°:�m �.a�..�.... ���.r 4........a...z....,a_W._._._ .._.__...._._A..__.._._._._ ...._.._..�.__--___....�._�..€ t � K .�,�: . ..nt. xa n " .... K ... m.:,,, � ..�. � .W.� � ..,....,...._._.._......._._....,..,.....,............ .._.._..d-.__........_.._..._._.._...._..._...�....._,._.......m......._,__..e,........ ...__...�..-........,........,.__...e.....e...,�......._.._...�..,...._.............................._.._.�...._..._...._,........_....m.,.-..-.m_.........._._,_...,........,....._�_._s X ' , 3.�..,,....,.A...._...................�.._�_.�_.._.............,_,__ B s . �,..�_..�...,_.._..............,......,_.__._._..........._........._._.........._...__................._..__......_....................,.,.._.......__.._...._...._....,...._......�.___....._.�_..._.._..............._.......___.._.�_�.�..._...,......,.....,.,...._...._..._.._._._.................._�._. ' �.,,._.,r�_........__......................___................_..._._._�'__ _._......__ _—�_ ._...-._ _.....__._ _...—__ .__. ._...___'- _"_'__ ._..___. .._...._._._._._—.�._.�_� _ , ._--_'_......... � i '.._..,_...�._...,..,-_____._.».,__.....e.._......_�........-........._.._.�__�..._._....._._..�._._._.. ....._........,,M._�__.�._.,�................_�_....... _...._.._.._..............._.�._.._...__.-_...__........_...__..,_.�_.....�........._�..,._._..__. } g.,,......,_...___....,......_.._.._._.m..._�.........................�...................__.._...-.—_""............,...._.�..� . ... .._ _._.........____'__'_....�.. 7.....�' ........�..{ _........ .... _ . ..... . ..___— ____ ........�..—_—"�......_,..__. _.,..........___ ..._.. � _..... i �.....a...........».�.._�.�...................._.�_.._r._........_....-_._.��.,_�._..._._..._.........._.�.."_.._..�_..�...,......._..�_._.�.�._._..._....... .._. ..__.___.�......................_.._._.....,.........�_..._.._........._.�.......:..,...................._�......,.,.....,............__�._......._..........,,..,....-._._.__._.j � ...�,.. g��.::'gtl,,a���.� , a:f:'_'� .____....................... .. � .s...� � �,�� _.__,_..___._....._.._....._._._._.R._..__,._..._.._...,....,.._.__.__._...._.._,_..._.._...__._,._.._....�.__...._ �:. € ,.�:...: rz� �w ..�'�____�___.. ..�,_. __...__—_ _.._. ___._._..__ _._.___ Y....___.... _ _� � ��a-��� s�r� ���� � :&��,�� � �:8 __._...._....... . ...�..__......_""_____..�.,__.,...._..�......__..,.__............_...._..�......_._..._._....._.__,____.� ..... .. __.__.__�_.._._......_........... ..�._._.._..__.._.......___......,.....w_...�,_..... _� � p�������� c���* 'a ����t"�'��$����.�«: i �*���� ���������'��,�E��a�,�€aa���:� . , � ����& '� �„��a�.��a�����.��+3����¢M .�... ..._. �_.. . M._ _.._._,_ . �_._ . . _s. . . .. ... . _.. .,__�_ . . �.__ ...,...__�'-_____.�.�m. _._.i $ �a�d,�� 'a�.��. ��*��'�:� �ma� `�,,, . � �'" �.^„� n y^:*" .�+6„�. ���"� ,��-,�ar&",t � �+9"' ak' t g�:',�`"�'@ �:� _. ._ .�._.__..,,.._ .._....� _..._..,..._.v .__....... .. .. .__,,..�........_............. _.__._..._..... ..._ _.�_._......_........�............_�..�..,,,.,....___...._.,._. $ �a"���ea'��'� i � � � .s . .... . . _} �'b,,7 �.�" �9 y�".��3 s &� � g g� �.� � ��a.Y "S k�#���.:�� �,� . ........_�.._........._.__. �.....__._.._.._..._.._._�_............��...�.. ! g t .,........._........__..�.........e._...._,......_._.,.. .,._....._..............e......._...,_.,_.._,......,......,..._.__.___.___..,....,....,.,......_.__.............._ q;� ;�u �?,t� ��4�` '�'�.�-��'�,'. �.,„ �§� 5+, T a . .?�44���K.�"'�" �"�;"n"��'q ������' � ' y g�� 8�p& "{.�y.j�}��d.�a �s� �t�.: ........... .._..,.-....__.�......_.._........._.._...........,.,._.........._.�_._.�__....._._...........,... .._..<� .. ............._"�._....___..._w�__._.......,....'"'_....._.._._. _. _e........—...._.._.,_.._.._.� ' ���:�d�`u^���."�9�& �i$���d�'' ���.#. , :. 9 a���ui°�'�����������.�,.'������`��� "���- . .� .�' .� . t ,��� �,h���> ���rp��������r' �_�_w .W____..__ _..._._ _._._._�__._..�._��,_.__._...�. _w___ . ___.____ .� _____ 3����� ����s��'���'��'+� '��a'�a�� .� , , . .�.�+ aa.,,�,....��.��_ . . . _.....�...��"�;�.�:s..:e ._.--'_,___...._.........,.,_.___.._..,._,.b.........._�_...._,..,._........_. . I ...�_.�..._.. ._.._.._........._.__.._.._ _.._...�,......_.._�_.-_........__.._.,.,....�_.._.__.„,_._.__.,_......._.._..______ �