Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
11363 (5)
- CITY OF DIAMOND.,BAR COMMUNITY DEVELOPMENT DEPARTMENT � :,,.� . 21660 E.Copley Drive Suite 190 �� �� �D PRESS (909)860-3195 Fax(909)861-3117 '""' RLTILDINGPERMITAPPLICATi N FIRMLV� Q DDRESS ~ � � APPt�ICATIDN PERMII` ��� P/C DA7E ` NUMBER # � ISSUE� � � TYPE OCC APN LOT TRACT � DATE CONST. GROUP p OWNER U�� ADDRE S r � , C C4 ZONING SETBACKS oCITY . � ,�IP�—�—� TEL. FRONT _ RW ❑ 0 APPLICANT �'✓ /Z �t--�•-`O'tl-C.�TEL.����3—=.�X".°-C!� S DE/SIDE STREET RW O z ¢ CONTRACT _ F .fL. C..S , SIDE O ADDRE S � � '`P � CITY I L'_ , Zlp � TEL. O"^'. PROPOSED USE w ARCH/ENG/ w DESIGNER NO.DWEL. NO. NO. � ADDRESS_ UNITS STORIES BE�ROOMS � CITY _ ZIP TEL. � DESCRIPTION SQ.FT. FACTOH PSF ADJ.AREANALUATION � OWNER•BI;ILDER DECLARATION SFR/ADDlAEM Q — — p I HEREBY AFFIRM UNDER PENALTY OF?ERJURY THAT I AM EXEMPT FROM THE CONTRACTORS LI� � Garage/Carport W CENSELA'NFORTHEFOLLOWIkGREASON(SCC.7o31.56USINESSANJPROfES510NSCPDE:ANYCITYOR U COUNTYWHICHREQUIRESAPERMITTOCANSTRUCi,ALTER,IMPROVE,DEMOLISH,ORREPAIAANYSTRUC� W patio/Deck w TURE,PflIOft TO ITS ISSUANCE,ALSO REQUIRES THE AAPLICANT FOR SUGN PERMIT TO FII.E A SIGNED � STATEMENTTHA7HE OR SHE IS UCENSED PURSUANT TOTHE PROVISIDNS OFTHE CONTFiACTORs U� . � CENSE LAW(CHAP7ER 9(COMMENCING WI?H SECTION 7ooa�OF DIVISION 3 OF THE BUSINESSAN�PRO� � PooVSpB 0 FESSIONSCODE�ORTHATHEORSHEISEXElAPTTHEREFR�MANDTHEBASISFOPTNEALLEGEDEXEMP� V TtON.ANYVIOLATIONOFSECTION7o31.5BYANVAPPIICANTFORAPERMITSUBJECTS�HEAPPLICANTTO � Re-Roof _ _ _ __ � A CIVIL PENAL7Y OF NOT MORE TFIAN FVE HUNDFED DOLLARS(5500).)�. � — � ❑4ASOWNEiiOFTHEPriOPEflTV,ORMYEMPLOYEESWIThIWAGESA5THE10.SOLECOMPENSATION, COffIR18fC18I z W,LL DO iHE WORK,AND THE STRUCTURE IS NOT INTEN�ED OR OFFERED FOR SALE(3EC.7044,BUSI� �,1 _ NESS ANO PROFESSIONS CODE:THE CONTFiACTORS LICENSE LAYJ DOES NOt APPLY TO AN OWNEF OF � PROPERTYWHOBUILDSOFIMPROVES_THEREON,ANDWHODOESSUCHWORKHIMScLFORHEftSELFOR � � 7HROUGHHISORHEROWNEMPLOYEES,PROVIDEOTHAiSUCNIMPROVEMENTSAFIENOTINTcNDEDOR LL1 OFFERFA FOR SALE.IF HOWEVER,THE BUILDING OR IMPROVEMENTIS SOL�WITHIV ONEYEAROF CAMPLE- � TION,THE OWNER-BUILDER WI'.L HAVE THE BURDEN OF PqOVING THAT HE OR SHE DIO NOT BUILD OR Z IMPROVEFORTHEPURPOSEOFSALE). � ❑I,hSOWNEROFTHEPROPERTY,AMEXCLIJSIVELY'CONTPACTI�GWITHLIGENSEO.CONTRACTORS W � TO CONSTRUCT THE PROJECT(SEC.7o49,OUSINE55 AND PaOFESSIONS CO�E:7HE CONTRAGiOFS LI- V81U8fi0� _ ADJ.AREA W CENSELAWDOESNOTAPPLYTOANOWNEROFAPROPERTYVJFOBUI'�_DSORIMPPOVESTHEREON,AND � WHOCONTRACTSFORSUCHPROJECTSWITHACONTRACTOR(S)UCENSEDPURSUANTTOTHECONTRAP QUANTITY DESCRIPTION FEE TORS LICENSE LAW.). � � ❑I AM EXEMPT UNDER SEC, e.S RC.FOR THIS REASON O � � DATE OWNER Z � LICENSED CONTRACTORS DECLARATION F= � I HEflEBYAFFIRM UNOER PENALTY OF PERIURY THAT IAM LICENSED UNDER PftDVIStONS OF CHAPTER � 9(COMMENCINGWITHSECTIOfJl0a0)OFD�VISION30FTHE3USINESSANDPflOFE5510NSCODE.AND Z � + X MY LICENSE IS IN FU L FORCE ANO EFFEC7. m w ; � G'�, �� � � LIGENSE C ! LIG NO. � _ � �� �I V pp7E_� F CONTRAGTOR �, �- W i � WORKERS'COMPENSATION DECLARATION � I HEREBYAFFIRM UNDEP PENALTYOF PERJURV ON[Of THE FOLLOWWG DECLARATIONS: U) ."'._...'_"— Z _IHAVEANDWILLMAINTAINACERT�FICATEOFCONSENTTOSELF-INSUREFOFWORKEaS' ¢ CAMPENSATION,ASPROVIDEDBYSECTION37000FTHELABORCODE,FORTHEPERFORMANCE OF THE WORK FOR WHICH TH�S PERMIT IS ISSUED. 0 W I HAVEAND WILLMAINTAIN WO�KERS'COMPENSATION INSUaANCE,NS pEDUIHED BY SECTION Q 370o OF THE LABOR CO�E,FOR THE PERFORMANGE CF THE WORK FOR WHICH iH15 PERMIT IS � ISS'JEO.MY WO/RK�EflS'C MPEN,/SA'TION INSURANCE CARFIERAND POLICY NUMBERARE: CONSTRUCTION j CARRIEF ( /�- C.^..-7f-J'��� !I,� ('* PL4N REVIEW � POLICY NUMBER ��„��1,.{� i�,` � E�ECTRIC Q iH P RMRISWRON=HUrDREDDOLLhPSSiP]ORLESSI. PLUMBING �_ � (iH�55ECTIONNEmNOTBECOMPLETmOF E E ( 1 '�- � �~ W MECHANIC.4L Z 1 CERTIFY THAT W TFE PEflFORMANCE OFTHE WORK FOR WHICH THIS PERMIT IS ISSUED,I C.�3 SHALLNOTEMPLOYANYPERSONINANYMANNERSOASTOBECUMESUBJECTTOTHE Uj WORKERS'CAMPENSATION LAWS OF CAUFORNIA,AN�AGREE THAT IF I SH L'LD BECOME INSPECTION FEE SUBJ CTTOTHEWORKERS'COMPENSATIONPftOVISIONSOFSECTlO 37 OFTH I�.BOR � ?�k� F= ISSUANCE �� � CO�E ISH IFOflTHWITHCOMPLVWITH PROVi510N5 C � SMIP p pq7'E; � ( APPLIGANT� .- — W ENERGY P!C J WMNING: AILU TO SECUFE WORKERS'COMPENSATION COVERAGE IS 11NLAWFUL,AN�SHALL 8E � SU&IECT. EMPLOYERTOCRIMINALPENALTIESANOCIVILFINESUP700NEH'JNDRE�THOUSAND ENERGYPERMIT ��� ���l�� OOLL4R5(5100.000),IN PADITION TO THE C0.5T OF C0�IPENSATION,DAMAOES AS PPOVI�ED FOR IN � SECTION37080FTHE LABOR CODE.INTEREST,ANOATTORIVEY'S FEES. RETENTION FEE: ____ W CONSTRUCTION LENDING AGENCY PFiEALT FEE: � �.p�y� � IHEREBYAFFIRMUNDERPENALNOFPERJURYTHATTHERcISACONSTRUC710NLEN�INGAGENCY 7��! 7HJlJ�T' PD3THEPERFORMANCEOFTHEWORKFORWHICHTHISPERMITISISSUEO�SEC.3aW,CIV.C.). A,I. , . Z .. . . .. _ . . , . W = IEN�ER'SNAME �. . .,..:. .......�:'.�..' � —_'__— F= LENOER'S ADDRE55 - -� � � � / �,i+' � ICEflTIFYTHATIHAVEREADTHISAPPLICATIONANDSTATETHATTHEA80VEINFCRMATIONISCDRRECT. TOTAL FEES . � . ` h� W t AGREE TO COMPLY WITH ALL CITY AND COUNTY OROINANCES AND STATE LAWe'REIATING TO BUILDMG � � CONSTRUCTION,ANDHEREBYAU?HO7IZEREPRESENTAT! SOFTNISCOUNiVTOENTEftUPONTHE -.- . . . ' - ' z ABOVE�MENTIONEDPftOPERTYFOFINSP!ECTI�NPURPO 3. COMMENTS ����� � K 1 � m PEAM� AME(PRIN - �� Q �� ;., . � SIGN P RMITTEE DAT l - = RECPT.NO. _ ' PAID BY _ � ,,_VALIDATION ~ WHITE—Department Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENROD—File Copy,GREEN—ApplicanPs Copy , .._ ,:,... _rv., ._�_.r.,- �..r,�. �_,.....�-�...�. _.;-..,� , - . �. . . ��.�. _� _ . � . , <r� .. �.. � `�'° � � ����;�.� �� ��� � � °�'���� �::���� .. � .. ; �, �.� � . ; � .. _ � a 1� . � .. � � �Ed a�� ..��� �� � • w �� � . ..:.... _. _ ,,.-... .. �n .. . .. .,,.,. .� ..,. .� _ • _ �.. �...;. :�, . ,�• :.:� . . ._.:�.: ,.... � : . .. . .. . . . . .�__�. .. . _ ' " .. ' . 7 s�3�' "B�'i,..+� .. � . � . . �5..�a'['P`x,��J6C I � � rt- tr7 J^ _� _ _�_ _ _.. k C"Lt� ��_����.� ___.. __ . _ . __ ..___�. �_ � 1 r' �,.7r: �"3'� .�1��:�..�,...�... P_--i----__ �...._.._.�..__�..__ ^'_—_. --- ----- - �. - ._,.. .�.. s ..� _ . -- _ .� _._� � �� .. 7 r`" . - I�t�4,..°'�� �8 � ( �(d�.?�i`;r s"C.ti.)�t`Ew"'', ia�,.+.^s€ . ... � § :;_ . �,�__.__,...____ _._,._.�..�...�. � _._ �.�.____ _�__. ._,_.�._ � �.+-%�"�u�'�ia ���?�9�?k� t�� �� �-i �`���1��i i��;io4L+�iT � ::I..P'����k-"L i . . ..�._._.� ��-��L.�'ai✓5...1-�ViYL.+?S1:i,a€Y_. ..u__ ...� ,.._'" .,.. ".... ___...n.m.�t_.,_ _q _..... ._.....—_._ _ '. ___.....:.....� ���t��° � ����`i I � �i��' �i�:�-_i�' �a�����;�1�a=� - 1 -� € si....�-_ . ; 'r . � ___�_....__....._�_ !� ,.� �--5 ����� �a�i� _. . ' � _.. . �._� _- �#i _�i � �. _.. -�.__..m�.�..���.�-,.. �.�•� €.�. ���u�� . : ._.._._m__... ....-0...a - _ ���¢��^„ .._._ � ^��g 7.^.' _____._ ______......_.__�„w,.� � [`14s'�� `0S'r..�...�x`�€'Z@�..A i � �, e:3'.d6L� �JL.Y�.!�s� __.,, E �____. ' . i 4 _ ._... _ ...�..._.....�. �t ._ ._....... m � Re"' � °�'�;d�t:�d'°77�� �8-ti?`adt�V` > � � g'�'°i¢l:m L7�I`xi'i�s &.:�Pii�-3 - �i C�_... "�" ._. __...._-.-.—a__'.�._ —.._._.._.._..,,...�....,...__„_ .__� -- --`-`--�" -�-- - J—'— � �� _ �f � �G..� �?.��'1'a�""...�'e '7__.»�-�{ 1 �i'S% %d,'���"ii�l'.��� � e ...___. � `_---• ..�..._ .___ ;..._.e._..___�...._.....,......._. � . ���'��?�t �;��i!�� � p I ���r`a����` ______�._ ��_._o-__n._. � � _�___.,v, . �_.� - __ ` ���.a�-��� ' s�{�"'`asi� ' ' "i..�i���aF�t-a%�'i�1� C ___ � ..______� __ _.._ �__ ._.__. _ �Y;_ ._;.. �,.��,��-� �"�.b.������. �!�`���r� ����J��C'a � � �. � _ _._._.__ -- _____� _ , —____W �__ � _____-_; '�.�..'.�`v��,r a�.�� G';.��'��..�vPw.�__ i � �`^.�ti??����.'�s�[C�� .._ _� ..�.._.� � �i�z"4 ��"���ia��l�'t�; F'�C7 rc���,.i��� 4 �_..,... -......r.a.....mi._._... �i.....__......._....r. . _._ ..._ ....«.............��.� ��«....�v....�m,....____. � ���»T"� ���`�c,��r��� `��aCJ �='�'�;;1�. i � j_._ q e.....P--.-77�..«...-__._ _....,_ .__ � _,_.� _.....,,.�. _�............_..._.-Y g y _... e_C__�.____.. a� # x % q t?.`2 [YaS�@d�..8^���9� � �i"� �I �IYII"v. . . $ I � i �_ _ ..._.�._ ._.�_.............__ � ' _ _.- . ,_� _.__' � L��eS ' ��'i-'t,��.,�'��..h� � �t"���./��iL���� � __. � .�'"___--_._ —�-�� ..�.....`�__ `� t .�s..�' ' �� _ ___ ,_.._ _ a 3'°�,�'�eL,����,�. .�_ .___ _ � �. ,. !'__ J.._. ....�_ EP _.m.....«.��__�.._ . jE���. -4��r -�0§�� _.__ _�....�. . Ldri�t..��ivr'���.le�,�i`��.t�. - � . . . � 3 ° -. s-r. _._.._ �'q__ f .�..,_�_ � � _._. ,�,.,..,� 4 ^a�'h.�' ��r ��.,. � ; .�'.�i°� �s � l�',f�, �_µ. . § �.._....._W_._.__ � � .._.....�,,.. .._._ s 2/�`�a�:r5 ���r. � .__.--'__ ���.�:�:�....w. �___....__,..._._ �(�^��s:_���s�s'�� i _""� � ��_.:.�_.._. . �._. . _»M_..__ �.. _�_ .___.....m�..7 � ���'��:� .s-��Va�,�'e �i�����- E"'Y°i. �€��;.� -.,......._.,.A_._Wa 1 : § __—_.._.�.,.......�.__.Y..._ ��a��?��.���:�.!�h�f:; -_,�_ b� ; �-'r�.�-�`r� �f�€�!, �I�V�L� �`_'____d _�._._.__.e. �...� ���4aa�!_�Lt����;:.___ ,�.aw._. ..._._____.�.� � ��'�. �°=�� F�i!v __w � __�_� � ,� _ . i� �� __� __ _ �.__. __________ __ _ _._ � � � 3�#�?s�i ;���;���t,a � ��$'��F��'E .__ � —� .. ..-t- . .._._:.._� _ _.._ ' ______.._.._. _.r_.___._.__.__"� __ _....... i p .�...,.mm.�. .....�.....�,...... ..�.. .. ..:.... r �. . � � t _ ..........."......._....� � � p GD ........ . , � � . .. � ' .. �. .' .. "' I � .. . . . . _�._,.....� � °`'�a. x':. �' yrc,a C v. � .. .. i..... ,a � �t�:�g��� ��'� � � g _. € � _ „ � � ",:. - � M _ .____ ..... , . . ` __ _ ___._ ,, � __ � �----.__ �� _ _._---__._�_.� � S _�.___.� � . § � � �t __�, _ ----- �� _ „ ,. I ' ,., �___._��� t-�_ _ _w------ _ ¥ t ' . ( �d.. __ s e"'_ �e x� µ __ � __._ .� �� ______� a' 4 x, _ , , _____ �.. - , _ . ____— _ _ � , ____.____. � ��-:��`#� �,������.� � „ ::: a �., ,� , . � � �� ���t�� �'r,,�-, . ----_ _ _._.__ � ,�, �.._� , , - __� �;��. � ;,: £ �, __ _ ,. . , , , .: _�_ ....�_. � C � . � K _�____�� � � � x a�s�: _. _ ` _'�'� ; � �t�� �;��_. : :. � , o-.:- -..�'�� ..::�_..:. �� �`�:: _ . , �_ � . ., ,� � ' ._ : ..:.:.. .:.. . - .. -,-. . � , -_�k . -.. � .- . �..� �. ,� � � '..,. . "__.... �b... ..�.:..._._. . . . . . _____.�—.�. _ _.______.e._..___ """..� �� x�r��� � ..� @ �.. . -- �:. " . _ . . . .--- -- q � �... . . , � € � .... ... .. : � � " 1 .• . :� :,.. ...... .. _ ._ � .... . ...- ::...... , . - . � - .:: _ .:::: . . . � �.� . : . . . , �� .. � . : ... .. .. - ... � . . . . .............._-t