Loading...
HomeMy WebLinkAbout12129 (11) _ _ -. _ _,.. _r ,___. ' -� �� � 1� . CITY OF DIAMOND BA& � DEPARTMENT OF COMMIJrTITY&DEVELOPMENT SERVICES � 21660 E.Copley Drive Suite 196 ' � ,�. 195 Fax(909)861-3117 . `�L°�7� I:D��P�12M1T'AP�'I.ICATTO�i .'" °�_ ;;. FIRML . ,.- � �� . . .:.... , .� :':, . ,.: .. .. : ,Y.f ' J..� . . . � JOBSITE ` /� `.ca ���,� �;.,.., .: �,�.s �M� APPUCA7VOhi,',���� �r� 'EF��T�M��vm..,.t? qnefi,. PIC'' 'a 1, ,r;r;r,�, � .. o ADDRESS - �� HC��j ZZ� ��� DATE �� Z� !G NUMBER ���r # ���3 r M � APN LO��-�\� T ACT I DA E� �'�'�`?-- !ss CONST. GROUP p OWNER �-��r � d' _ _ 'y ' ZONING SETBACKS , ADDRESS t- E^ �j . r' , FRONT RW ❑ � CITY /iUlI�..S v Z P l TEL APPUCANT '�k�E�'Y_"'',Ail� REAR , . ❑ TEL x . ? " SIDEISiQE S?REET RW ❑ � CONTRACTOR SIDE ❑ p� ADDRESS PROPOSED USE 'l�/u�?�i�- �'�I�l�-�Y � CITY ZIP TEL. , ,� w AACWENG/ ��j �L�A�� � �ESIGNER l 17J7 � ADDRESS � �Z NO.DWEL. NO. NO. � �y � '� � UNITS .� STORIES � BEDROOMS � � CITY, ZIP ' � �TEL � DESCRIPTION /SQ.FT. FACTOR PSF ADJ.AREANALUATION OOWNER-BUILDER DECLARATION ,_ SFR/ADD/REM t? / O ,S"�7 p I HEREBV AFFRM UNDER PENPLTV OF PE0.ri1RY THA7I AAd EXEMPT FROM THE CANTRACTORS LI� G8f8J6/C0(pOfi f_7� � r g O y W CENSELAWWRiHEFOI.LONlINGREASON�(SE�C.7o3i:3BUSIFJESSANDPiiOFESSIGNJ5CObE:ANVCITVOR (n � U COUNTYWHICHREWIHESAPERMITTOCON6TRUCLALTER;IMPROVE,DEMOLISH,OR{iEPAIpANYSTRUP �jJ py�l0 (� � ?j � � � y z 7URE,PfiIOR TO ITS 199UANCE,AlSO REOUIRES THE APPGCANP FOR SUCH PERAt1T TO FII.E A SIGNED � STATEMENT THA7 HE OR SHE IS LICENSED PURSUPNT TO YME PqOVI510NS OF TNE CON7PAbTORS�U� W �� ... .., ,. . +1 � � CENSE LAW(CMAP7ER e(WMMENCINO WITH SECTION�obp�OF OIVISbN 3 OF THE BUSINESS'AIJb PFlD- U" PO O Q� s DtC._.7" FESSIONS CADE)OR THAT HE OR SHE IS EXEMPT THEREFROM AN�THE BASIS FORTHE ALLEGED E�fER1P� TION.ANVVIOlA710NOFSECT10N7o31.66YANYAPPLICANT,FOFAPERMITSU&IECTSTHEAPPLICANT70 Z R-ROOf � ACMLPENALTVOFNOTMORETHANFNEHUNOREDDOLLApS(SSW).): " '''-' "'� .. , � ❑I,ASONMENOFTHEPROPERTY,ONMVEMPLOVEESWITHWAGESASTHEIRSOLEC06APENSATION, � COI11f118lCIHI - WR.L 00 THE WORK,AN�THE STRUCiURE IS NOT INTENDED OR OFPERED FOP SALE(SEC.7044,�BDSI- - J � NE55 AND PROFESSIbNS CODE:THE WNTPACTOR3lICENSE lAW DOES NOT APPLY TO AN OWNER OF = PHOPEHTV YNiO BURDS OR IMPROVESTHEREON,AND WHO dOE$SUCH Yi'ORN HIMSELFOR HER5E�FOR � iHipUGH HIS OR HEfl ONM EMPLOVEE$PROVIDED THAT SUCH IMPROVEMENTS ARE NO71N7ENOEDbR m W� .OFFEREDFORSALEIF,HOWEVERTHEBUIIDINGORIMPROVEMEN71550LDWl'MINONEYEAROFCAMPCE� Z TION,THE OWNER-BUILUER WILL HAVE THE BURDEN OF PROVING THAT HE OR SFiE DID NOT BUIID OR = IMPROVEFOHTHEPURPOSEOFSALEj. � . .. ... . . . '�'� G U w ❑I,A60WNEROFTHEPROPERIY,AA/EXCLUSNELYCONTMCTiNGWI7HLICENSEDCANTRACTORS ,. � TO CONSTRUCT TFiE PROJECT(SEC.70M,BUSINESS AND PqbFESSIONS CODE:�TtIE CONTRACTOpS LI� ValU8ti0 ' ADJ.AREA W CENSEUWDOESNOTAPPLVTOANOWNEFlOFAPROPERTYWHOBUILDSORIMPROVESTNEREON,AND � MhIOCONTRAGTSFORSUCHPROJECTSWRHACONTqqCTOR(S)LICENSEDPURSUANTTOTHECONTAAG pUANTITY DESCRIPTION FEE � TORSLICENSELAW.I. .. .. . . ... . .. . .. Q ❑I AM E7�MPT UNDER SE4 8.8 P.C.FOR THIS REASON U r � ... a��. . -r«i . .. . .. ��" DATE _____�_ONTlER V � Z W • � LICENSED CONTRACTORS DECLARATION W � ` Q �'w:n.; ..,�.,'.,'; : . 47C 1 HEREBY AFFIRM UNOER PENALTV OF PERIURY THAT I AM LICENFFO 11DIDER PROVISIONS OF CHA?TER � , � B(COMMENCIN(�WITNSECTION70C0)OF�IVISION30FTHEBUSINESSANDPROFESSIONSCODE,AND Z " ' "' MY LICENSE IS IN F11LL FORCEANO EFFEC7 4L1 q h � o ` �^e � IICENSE CLASS ''� LIC.NO. , �-7 �- ��� � ~ DATE + ,. R' (-. CONTRACTOR � }" a<' .4 � 2 W 6' • y' � WORK RS'COMPENSA710N DECLA ATION Q � � � IHEREBVAFFIRMUNDERPENALTYOFPERJURYONEOPTHEFOLLOWINGOECLARATIONS:y"- Z d Y� IHAVEANDWILLMAINiAINACERTIFlCATEOFWNSENTTOSELF-INSUREFORWORKERS' _ � CAMPENSATION,ASPROVIDED9YSECTION3700'OFTHELABORCODE,FOPTHEPERFOFMANCE `U OF THE WOFK FOR WHICH THIS PERMIT IS ISSUED. � � W _�HRVE AND WILL MARJfAIN WORKERS'WI�APENSATION INSURANCE.AS REQUIRED BY SECTI�N Q 370oOFTHELABORCADE,FORTNEPERFORMANCEOFTHEWORKFORWHICHTHISPERMITIS I��i!/f���y iSSUED.MY WORKERS'COMPENySATION IN��IANCE CAq IER AND POUCY NUMBER ARE: CONSTflUCT1ON a p �y p� -7$-L 4r jCARHIEF��'41'�,"' ... "' �L.+ PLAN REVIEW '�.y�J_'!,7 • � Z� [Jbt�� i�St�� � POLICV NUMBEF��"__�� ELECTRIC r �o �b� � (MISSECfroNNE�NOTBECORIPLE7EDaFhEFERrM ohiEHUnOnEODOL1.aRs(51ao1oqLESS} PWMBING � D P •Q � W Z i CEHTIFY THAT IN THE PEflfORMANCE OF THE 1YORK FOH WHICH 7HIS PERMIT IS ISSUED,I MECt1AMCAL C O� •O� (:3 SHALLNOT EMPIOYANV PERSON IN ANY MANNER SOAS TO BECOME SUBJECT TO THE � WORNERS'COMPENSATtON LAWS OF CAUFORNIA,AND AGPEE THAT IF I SHOULb BECOME INSPECTION FEE ' � SUBJECT TO THE WORICERS'COMPENSATION PROVISIONS OF SECTION 370o OFTHE LABOR C /n� = CODE,15�1ALLFORTHWITHCOMPLVWITHTHOSEPROVISIONS. ISSUANCE J v pDATE: - r^ APPLICANT. ....!„`I'''.�_ ,z�.' SMIP -yq �o� � ENERCY P/G I !.7_ b WARNING F Ufl[TO S RE WORNERS'COMPENSATION C VERA E IS UNLAWFUL,AND SHW.L BE c�.��/ �p�-vy�� LL SU&IECTANEMPLOVERTOGPoMINALPENALTIESAN�CIVILFINESUPTOONEHUNDREDTHOUSAND ENERGYPERMIT �{/""i�"f OOLLARS(5100.ODO�.IN A�DITION TO THE COSTOF COMPENSATION,DAMAGES AS PROVIDED FOR IN .�j C J SECTtON 37080F THE LABOR CO�E,IN7ERE5T,RND ATTORNEI"5 FEES. RETEN710N FEE: � `✓ �' a � � CONSTRUGTION LENDING AGENCV PRE-AL7 FEE: � IHEREBYAFFIRMUNDERPEN/LLTYOFPER.0.IRYTHATTHEREISACONSTRUCTIONLENDMGAGENCY S ' FORTHE PERWRMANCE OFlHE WORK FOF WHICH iM15 PEFMIT IS ISSUEO(SEC.3ae7,GN.C.). . Z 4� f� , W � LENDER'SNAME ���� � 6— LENDER'SADDRESS .. , , W ICERTIF1'THATIHAVEREADTHISAPPLICATIONANUSTATETHATTHEABOVEINFORMATKKJISCAPPECT. TOTAL FEES � (� � IAGREE70CAMPLYWITHALICITYANDCAUNTYOR�INANCES0.N0STATELAWSREIATINGTOBNLDMG � CONS7RUCTION,AND HERE9YAUTHOFIZE REPRESENTATNES OF THIS COUNTYTO ENTER UPON TNE � � ���� � � A60VE•1AENTIONED PROPERTY FOR INSPECTION Pl1RPOSES- Z COMMENTS �� p /� �r � t�in I'� !a �-,'i.� �. . _ �i b;."�+:..� L..- �, .. . ; ��. m PEFMITTEENANE(PPoM) ' � � ' Q . � f +dq� � Su3NANaEOFPEw.a7i� � �" ?''' - oA7E RECPT.NO. PAID BY ��"� e �'�VALII7A�'I(5N,., I '�. / s ~ WHITE—Departmenl Copy,YELLpW--Finance Copy.PINK—Assessor Copy,GOIAENR00--File Copy,GREEN-ApplicanPs Copy � - � . . . .. .. ,t ::�.�� r ��.�,c . ,. , . . . . . � , ��, . , .,. ,:. .s:;'� ....:. . . .. . - . � u�.. . ..,,� . ., . ...::r. �:.�. ; _�. .. .: ,:.,.; , . .. . . . .,.i.: i -.-.. .,.; � � ' � . , y r � ... ... .�. .. ... ... . . . ;, . �:�.,, ,.-,�a .. .:... . . ... . ..... . � ���� . �� ...' .�:£"- ' ., � . _ . - , �,�� �:,�. . k'� :ay,, . ... . .. . . � .: - ..: . ... . .� .. .. . " . .. .��.,: � ....�.a ,....,. ... � A . . .. ......; � � �. ._.:: . � . � �' . . . � .:.�. �. � . ' .. .. �: .- .� �. x .` �.:.. :, . . .: . � . . �. ; S�4��a�`; � " , t�\ ,,' ! E FL�C3r�vC)�5`1` _ �; � ` ' .. . . � ���. __ _..�. ,. _� �. _.� , . � . � . .��„� ��`.,�=���,`�a;"��=._ ! � ��- , ; �rafi� �i���`;�s�'��-, ,. . ` __--� � r _ � ��' �� , -��"' ��'"`�,�s ?__'���,.- ' ; �:�t� F8 F'�'��t �J�T` , ' �� � ✓''� q i ,,�''�±�,/�, _ .---_ i Q g� �5q.-' gry p'�(¢ [^'__[ _. � ,,,..ta1 � Vi'% ��;'§ 'i�3�:����5�. ' GJ ._� i $.�3'���i�" E F V���..6..�'i49f��[� . . � _��-�-- __ __ __ ___.��--�.-�-�_,___ v_.__ � _.� _ __� � �@ F9���-��.�� ��-�� ' � ���������������.��� ,t,_,�� . � � ��;a� �ti.:��r"�� ; _ _ m���'�'�.��'��������P� 1 -� �� � � � - 8.�. . ...F-.�......................._�w.« �._.__ � _._..,_..___�._._... _...._. -_.�..�._..._�..... .„..„_„.�__� i �PFk;s�..� ���.y�;],"`,� . .. ; ' �i���z'��"$�. ��.-':�� ��,_�.�.d$ � � c � _ _. _ . — _. . _.._. _ _ _ ..._..._.._ ____ �_._.. ,.�.--`-- .. .,.�__ F ' � r� �}��.� (���e��j �� G ; � � ��?�i�'���;� ! � . �� � � _ � .__��.. � _ _____ � �a-e��f �aF�F�" a�'t�.:t, 1i�i�� ' . � ���e Y;,.�.'._"._�._._ .�� ! �~Is���!_r��::r��� �� �i,�_.__.� � , �--� _�.��_ ��...._���__..__._� _.._ _.._ �_____ W �'�'�t=��?'n'�.�°i ��..a �._��� ` ��'F'iE-�I�i,�,L`�f�s� � � i,,,� �� ; ¥ �1,..,dS,��S::E��f ��8i��:d .»,a. _��'� --�.�....... O ....._. � �.JL.��dLsd„"'j�'� ..��i ' .*� ' ` �"'_.T.�.. • _ � i i _.S�'.."� 1r�_ ' .. „��»...� ' .««..«.«... _ .....__a _—'_.��,_.. __._ . � _.� .�a �p .. -r-�•n ��' , - ,,:� . Mn. Es:; a t.., _____q� "..�.�.'" .. - i � S f�,��' �?s.�.,+a. �.:v I � ( ,. ..''�ivt� �'t°4�!�>..�3��i �' . _ ____.._--�---n_�,�' _ _.�. ._ ..._�.�._ . �__W__-_—� , ��, � � ������,� � , �T���' ������: �������� �� � � �r��� �'����' �w -�'�� ------ �� �_�,.�.. b - _ � ��t�,"a,��s;r��a�T �`r ' � % •G'r �� €��`�� ��E���[�. , �._ _ _. �_.� y,. _ � ': ',,a r,��� �: � m-�- / ���.. �;��,' ; E��'G.`'.� r=E�C`l�'� ` � � �. ....� _....__�'_�__ ��-�c_i -�.�....._, .._..---v E-{--�--- -- — -- -- - --.€ �6°���A?w.i a��.�..���..`� �.§s�m�� �.� 0"3���..���'v'a'�a§.. i_ .�_.. . ..., . . � ._„._�_....�......_ �„:._____ ,_,_____,_"'_._�� �- _ _ ____a. ._._..�� ..�...._...�_ �� �„�s�'� (S``s�:i c�'<'�`.,r!.��'3�u1� _ . ' � i.zP �- `��A: ��`�,"�'"°c.�z. � E � ..,... - `__. --'...� p�� _ _...,_ �._ � �^t, tr, �. ���' j �i'a�a ¢� 10 � ���' �' . . � �� ��t't : �`� ��=�3�'�bG°7 } ; �_S �� � _ _ � � --____.__�_ � _ .�_�_�___�_. .__...�_ '�'�'�;,:�� ,, � �.�' S_�� ��'��r'� ��� , _�,� _m._ .- _,__. �'� � �r�, z� T.; � � ,:_.,' � ; � [ ' .���s�e.r-r� i��iiaa. �;.. ... " � �_— �� _� ._.�.e_.____m._.._....._. ~~� � :_ c �;N,.'�` , .�.�....__.. � __ ,,... �'�":i���t� '����`'� _.. _.. _.� � ,Mr r rs;�r s �� ...���.�� !A� � T-¢i�a��� ��a�3f h r�� � � � _._�.._________.... %..:c--24. ., $�a„71 {J 1� � > �..m . � 1'ad I a..La a -�- ...a.�. ��§_ . � �9�:�'.�. a.��� �€>W � <�.�� i � � a @i�'��s�-� �'��°3ry4-xi_ t '� __`_"'. �� �„.„._... _ ___�_. _T�-^'' . .__ _,� S��"i��.�i ~~e�`� q'Ve:a ' „/ 3 E"it f'��� �tw�'1.�`Yi���iiM � _. �_��._.. �_�� � �� n _ _��_ _ - _... � ��':�:' �' � `��t�+� � E _._ � i��XP ��c� ;'��;�_� __._. _.. _.Y...�..m,._ Y� g g{�j � $.�, .__�_, �._ _ _. .._.� ___ __�_�.._......_ _ _�.__ .._______. # _.. g^a��f � �,.`. � ��$:'i.�'4S�S�..#�r....s..,Y$��'ti�`d°�a..`.°.,. i 4 '. �"�I.'V....�'d4.A Y 3 � F a,....... m�...,..�...«,....___...,... ' � � .��..,... _._._._A m w ' . �,...,..,._... �..... • �����. _�;�.��-�. __�� ___ ___ > � < � � � __-____ . ; : , � �: , b. _ ___--__._.__. � � �. ...._���_ __._. _ �..�...����._. _ ; �� _ _ __ ___ _. _. -- ? � ��������..��� • - , � " n �.,:,������:.�,a� � � �. _._.._._���t_._.�...�..�__m_._.�. __ __..�.�_.��.� _ ____--_-0- � -----~-- --�-� .._ . � � _ ` ;.. � �.._. _ _�_____________�___.___ _— .�._---- ___ __�V _____�� �_ �� _._________� _.__ � ___..� _�___v-- —s- . __._.._.� _._ � �, , _ � �__�;--�.:�:�----__�_- _. ._m.�_ -___.�. ...�_____--___._�.�_.�.___Y.__..:_� �---------� . , ..., : , ,v . , _ _ . . } : � , , .., ;. � , ...�� .�.�_...�,� =__,._..____._--_ � �_.._� __. m._.�_.......�.�.e.____.__..�.._..�.._._._... m.�....__ ____ �.�_,� . . s � '�. ! . y , . � . . :..: ,.,: -� .� .-�..: ,. . ' . . .[, g ._.��.....,... �.e...�.m.._ ....�._ . .. . � .. ,. .. ._._..-,-..,---4 „..._._..�....�..�_.._..,��o..._._... �. ... .�j . . � .. . . . . . _. . . . . . , � 4 � � .. . . ..... . . . . 1 �..._���........_. _ _ _._.....� - ....—_� 7_..,...�.„�._ ,• .�____w...............�. �___m__�_._. ._s,.. . .. I .. .. .:�,...._..»..._ . .. . . . , . . . . . � . .. . . . ... . j '...� ...�.� ., ' '' I : ..-., .�.... � .._.'... ... . ...�.._. ..... � .. '. '.. .. . . � . . . . . , . . . ���N � x �` � l i , �..�,� _..,...e.�-. _..._ __'__.�,.-..._._.__ _.__._�...___.,..._•. . . . ""'n__""__ . . . � ' � .......3 .� m. . .._. .... ���t�� a�a�� ��ia..�.°" � . - . .. .,-, ,...,.,. ..,, .... .. -------�-�--�-------5. --..... ._ — . . . � _'�:.�r ° .<3 x �• ''°� . .... ..._. ..,..� ._..�.._. ______W.�..._ . _.. __.__. ...�. ______ _;_�._ __.___ � �P , , : � .. t^. �..�. —�_____:_._..�.. a * t� .�.m ..m__._.._ .. ... .. : .... ...... ... ... .... . . . r.. . . . .. � �� �_ __�___w -.... .. . �., , ,� , , :,, ... ..,.,. „ ...: � ...�.. . . , .: .. .-.. � N ,� ,. . .. -� � :.::i � ` '�� � � � . ;�.: :. - . '.. -__^.��, i�.:� � � � _�m�_..� .�_m� �._� � `- ' _— __. -----_.ma��._ _. � . : �-: _ ,. _� :,: . _ :.s ..,., _� , . a � ��; ' '"• ��� _— __ �_____. � �_ __ ;. . _..� s. � -- ^ - -- --- � � ' �r � � � � ` _..__ —_______.. ______ : ;; � _ , P a .,... . ::.:� :. ::�' �....�. .�.�.e.._....a.�......_�............. ...._...�.... ..., «�..,._...r..'.«...e..c.. v.m_...._a�___.�..�.._. ....... i : ' .:... :,� ' ' . : .. �. .. ..... i . .... . . ........ _ . ..._.. .. . _ ... . � . . ,, �; � . . .. � �.��..w.. ^ t f l�m . .:: .'::.. _.. - .� a.. -� k t.: m . - , .. . . �:` . . . .. ........ . .. ... ,. ...._,. . '� �.».�...�..,,...,.:�.,..«..«.. . ..,,. ..,.., ... ..,.�.,. .. ...