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Home My WebLink About17141 �� cmroFn�ormB�x �XPIRED DEPARTMENT OF COMMUNTI'Y&DEVELOPMENT SERVICES � 2I825 E.Coplty Drive MAR 2 0 1002 (909)860-3195 Fax(909)861-3I17 PRESS ''�� B LDI , ERMITAPPLICATION FIRMLY � JOBSITE ' APPLICATION Q` G I PERMIT 1'�I I P/C��^��,Z--�Fj Q ADDRESS �I Z 7 �I�M 6�✓ V �� !.�� o �_ DATE NUMBER � $ ISSUE TYpE O�C APN LOT TRACT DATE CONST. GROUP p OWNER 1� tS Q ADDRESS � ZONING SETBACKS gCITY � ZIP �TEL., �� REART RW p APPLICANT TEL. SIDEJSIDESTREET RW p � CONTRACTOR SIDE ❑ o ADDRESS CITY ZIP TEL PROPOSED USE /I o �AREWEfVGT' DESIGNER K/ /4- .D V f tZu NO.DWEL. NO. NO. n. ADDRESS�t,'3S' 1a_�/ � ��_ UNITS STORIES BEDROOMS � CITY LCS/l�1/F�LF-�S ZIP C�O TEL. / •��f �n DESCRIPTION S4.FT FACTOR PSF ADJ.AREANALUATION � OWNER-BUILOER DECLARATION SF AqD�lREM O Q I HEREBY AiFlfUI UlIDER iENALTY OF OEiU1HY THAT 1 AM E%EMVT CPA4 THE CONTRACTORS l4 G3BQBICBfpOfl W CENSEUWFORTHEFOLLOWINOREASON�SEC.70.71.SBUSINESSANDFROFESSIONSWOEANYCtTYOR (n C� COUNTYWMIQIREOUIpESAVERAIITTOCdN57RlKT,ALTER�PROVE,OEMOLISH,ORREOAIRANVSiRUC- w patialDeek � 7URE,PRqR TO ITS ISSUANCE,AL50 PEOUIRES THE APPLIGM�T FOR SUqi PERAiIT TO FIIE A SIGNED w � STATEMENi THAT NE OR SNE IS UCENSED RIRSUANT TO TME PROVISIONS OF THE CONTRAC70RS l4 CENSE UW�d/APTER Y(COMAIENCINO N'17115ECTION 7000)OF DIVISiON 30F THE BUS�NESS AND PRO- � POOUSP3 � FESSIONSCOD�ORT}IATHEOflSMEISEXEMPTTIIENEFROMANOTMEBA515FORTMEALIEGEDEJ(EMP- (� TION.ANVVqLATqNOFSEMION7071.68YANYACPLICANfFORAPERMITSUBJECiSTMEMPLICANTiO Z Ra-Rool � ACMLiENALTYOFNOTMORETHANFIVEMUNDREDDOLURS�fsOol.k � ZOI�dN'NEROFTHEPROPERTV,ORMYE4PLOYEESVAIMWA6fSA5TNEtRSOLFOD1AOENSAT�ON, O COmrt�BrCl81 - YALL DO THE WORK,ANO THE STHUCTURE IS NOT INTENOED OR OFFENEO fOR SALE(SEG 701�,BUSI• J N NESS/Ul�GROFESSIONS COOE:THE CONTRACTORS LICENSE UW DOES NOTAPPLY TO AN OWNER OF � pqOPEifiY Vhq BU0.05OR IMPROYESTNEREON,ANO N110 DOES SUCH WOHK NIMSELF OR NERSELF OR WTHROU6HMISOflHEROWNEMPLOYEES.PROVIOEOTHATSUCHIMPflOVElAEMSARENOTpJTEN0E00R LD � OFFEREDWRSALEIF,NOWEVERTMEBUROiNGORMPROVE�AEM65qDWITMNONEYFMOFCOMPLE- Z TION.iHE OWNER�eUILDER WiLL IMVE T1E BURDEN OF VqOVWG TFUT ME OR SME DIU NOT BUIID OR � tA1PROVEFORTMEPURPO5EOF5ALE} W 04�30WNEROFTMEpROPERTY,AMEXCIUSNELYCONTMCTNGWIMUCENSEDLONiMCTORS � CL TO CONSTqUCT THE PROJECT(SEG 7ou.BUSINESS AND PROFESSIONS[DOE:TME CONTRAC70R5 Lb V81UetiOfl ADJ.AREA W CENSEUWDOESNO7APPLYTOhNONMEROFAPHOPERTYWF108UILDSORUAPROVESiHEREON,AND � M71000NTMCTSFORSUCHVHQIECTSWITHACONfMCTOR(5)LIC NSEDGURSUANTTOTNECONTM6 pUANTITY DESCRIPTION FEE � TORS UCENSE UW.). J �f � �I AM EXE�PT UNDER SEG B.i G.C.FOR MIS REASON U V �I!� OU L.�^� � � Z.0 1�QU L� zOATE ' OwNER U . F LICENSED CONTRACTORS OECLARATION W � INEREBYAFFIRMUNDEHPENALTYOFPEM/RYTHATIAMLICENSEDUJDERPROYISIONSOFpUPTER Z � /�/�� `./!I/� � O�COMMENdNONnTHSECTION70oo)OFDMSION]OfTHEBU5MES5ANDOROFE5510NSCODE,AND /'1 I � �� 1 �� MY 1KENSE IS N NLL FORGE M1D EFFECL Q] ' �/�P� " s i N K � UCENSE CU15S LIC.NO. ' �J V OATE � � CONTRACTOR. . . a � lI� W f � WORKERS'COMPENSATION DECLARATION ¢ a '� �K t C.0 � IHEREBYAFFIRAIUNDERiENAITYOFPERNRVONEOiTNEiOLLAWINGDECIARAT10N5: Z � � ��IHAVEANDVnLL►1AIN7MNACERTIflCATEOFCONSENTTOSEIF-INSUREiORNqNNERS' _ COMPENSATION.ASYflOV10EDBYSECTION37aoOFTMEU80i1CODE.FORTHEPERFOqMANCE �U Q OFT/L WORK FOR NR11C11 THIS PERAIIT IS ISSUED. � �I HAVE AND WiLI MAINTAIN WORKERS'COMPENSATION INSUMNCE,AS REOUiRED BY SECTION � � �7ooOFTHELABORCOOE,fOi1TNEVERfOqMANCEOF7NEWOPoCiORWH�pITM57ERA1R15 � ISSUE�.MYWURNERSCOMPENSATIONNSURANCECARR�ERMIDV0.1CYNUMBERME: CONSTRUCTION j CARRIER PLAN REVIEW � roucrNuuaEn ELECTRIC � (rtusEena+r+Emraoree�ErmaFnfrEwarsror+or+e�ua��oau�R+o�aH�ssi PLUMBING ��- �� Z - I GERTIFY THAT W TME PERFORMANCE OF THE WORK FOfl WF71piTF113 iENMITI5ISSUE�,I MECHAN�CAL - (7 S/ULLLNOTEMPLOVANVpEHSONWANVIAANNEHSOASTOBECO1JESl18JECTTOTHE -�-p�� i �^ � WORKERS'CAM7ENSATION(AWSOFCALIFOflNIA,IWDAGREETHATIFISFqULDBECOME INSPECTIONFEE J�--�� / \� � ' �--�-�'=J S , 6UBJECTTOTHEWORKEfiS'GdAVENSATIONPROVISION50FSECTI0N77000FTHEUBOR 000e,i sruu voan+win+caav�r wm�rFase Pnovisior+s. ISSUANCE n r�'� .O p DATE: APPLICANT: SMIP S E P / �/�� ' . � C� W � WAqNINQ:FA0.URETOSECUREWORKERS'COMGENSATpNCOVERA6E15UNUWFUL.ANDSHALLBE ENERGYP/C � SUBJECTANEA�PLOVERTOCRIMP111�VENALTIfSANOCMLFWESU7TOONENUNDFED7/10U5AND ENERGYPERMIT � / DOLLAitS(f lOD,000�.IN AD�ITION TO THE C0.4TOF COMPENSATqN,DAMAGES AS PROVIDEO PoR M � SECT�DN]70lOFTHELABORCO�E,NTEREST,ANDAITORNEYSFEES. RETENTIONFEE: �L- -- �*- �.�O oCONSTRUCTION LENDING AGENCY PRE•AlT FEE: � IHEPEBYAFFWAUNDEAPENKTYOFPERNRYTHATTHEREISACONSTRUCT�ONIENDINOACENCV Z FOR iHE PEHFOHMANCE DF TNE WORK FOfl WMICH TM�S PERMITIS ISSUEO�SEC.Jo97,GV.G). W � LENDEHS WWE � IENDER'SADORE55 � �CEpTIFYTMATIHAVEREADTNSAPPLICATIONANDSTATETHATTNEABOVEWFORIAAT10NI5CORRECT. TOTAL FEES � �� IAGREETOCOMPIYWITHALLCITYANDCOUNTYORD�NiWCESANDSiATEUW9REUTINOTOBU4DIN0 � CONSTRUCTION,ANDHEREBVAUTIIOHIZEREPRESENTATIVESOFiHISCOUNTYTOENTERUPONTHE r z ABOVE�MEMIONEDVROPERTYFOf11N5�ECT10NPURPOSES. COMMENTS 1 l � %HA-N ,�. I�v/ _ m VERMI7TEE NAME(PRINT) � �� 7� � U.' � S�GNA7VREOFPETi1�.T1� DAiE � RECPT.NO. _PAID BY VALIDA710N WHITE-0epanment Copy,YELLOW—Finance Copy,P�NK—Assessor Copy,GOLDENROD--File Capy,GREEN—Applica 's Copy ` � TM;{.�..h�',,��1 �l�n��C�YT r .r �. .ro �"NT-:��JrS.�Yi�:'1[��4�4m: :K'�»Iv�(�'l:^1:�. ��.'D"Zw �il".. ♦ .�..+.v.v�4k�•-v .t.�..� ^' „ .-1".V"�f• ... y �v ..�. '-� �v��.a4 � � .� .�.. ,:_ .,_;�=;.' �. CiTY O� IDIl�1V�D�JC? BAf� : . , ; ;.., ItJ�P�G�'iOFV R'�CORY7 . �..�t�. ��,`,'.,ii�l�,�,�,�1 � �l•n�� •��`�5��"'.4'�°� � �.. .I,i��.1�=.��A.Q�Mi� - 4Ji��{'.r'"+ ��T'? �m t . ..,...a� � :_...�.._..�.,�.�_.......�........... - ...-. � , a:,��.......: ._----•-- '•'-�---�—��-....... . .. SET BACK , � , y-��V � FLOOR Ja1ST _ • � FTGS/FORMS/STEEL �r � FHA REQMTS ELECTRIC GROUND I UNDER FLOOR DUCT � � � . GROUND PLUMBING ( UNDER FLOOR CU�!DUIT � SLAB GRADE � FIREPLACE FOUNDATION �� TEMP POWER I ; FIREPLACE BON�BEAM WATER SEAVICE i MID HT. E30ND BEAM I ROOF SHEATHING � --�'� ! 8 FT. BOND BEAM � FRAMINGNENTILIATION �.�`E(I '• I FINAL BOND BEAM ' ROOF COVER I � ~ PRE-GRADING � ROUGH HEAl"ING I BENCHING. • - ' ROUGH ELECTRIC � � ' -� ROUGH GRAdING � i�. ROUGH PLUMBING jr'�7�l-��=---�----� FIIJISH GRADING SHOWEHITUB TEST ; � POOL ELECTRIC EXT.LATH/SIDING � POOL FENCING � WALL INSULATION POOL FINAL CEILING INSULATION j OFF SITE IMPS. DRYWALL NAIUNG ��p-��' -p'� i DEDICATI�NS SEWER ! , FINAL ENG. SEPTIC TANK j { . , LANDSCAPE/IRRIG. j SEEP PIT/L.L. � ' • ON 51TE IMPS. GAS AIR TEST - FINAL ZONING FINAL CONST. � ' F!RE DEFT. FINA'_ • FINAL HEATING - ! HEALTH DEPT. FINAL ' F1NAL ELECTRIC j DEV. FEES PAID FINAL PLUMBING I ENERGY j � � , � � I - i o e f�ar^;l��C'� � P " COMMENTS `� ' • ! � : SEPTIC TANK SIZE SEEP PIT/U SIZE . _:�� _ - _ � ��,��, - ` =� ��; _, . < � � ! � - , , � . _ . . � }. . ,.��.._..,.._:..._��__....__... � ' ,