Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
12331
CITY OF DIAMOND BAbt � --�--���— DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES � 21660 E Copley Dnve Smte 190 W $)860-3195 Fax(909)861 311? PRESS .... »� a uu,n����`ai�`�t,rcAr�or� ` . �. '_ ,. :; :.; �, ..: FIRMLY .. � �:�,.., »r:'K.� �-�-} � JOBSITE ' • �� � ' � ���j� � f,� ApPLICA'tI�N L-� PERMIT � �-- " P/C o ADORESS � r "��� DATE NUMBER # c� ISSUE TYPE OCC r- APN LOT TRACT DATE CONST. GROUP °G OWNER �� O ADDRESS ZONING SETBACK$ CITY ZIP TEL. FRONT RW ❑ ApPLICANT TEL. REAR ❑ � SIDE/SIDE 5TREET RW ❑ r� CONTRACTOR �.s'�- SIDE ❑ OADDRE 8� � PROPOSED USE �� y ClTY 7 ZIP TEL. ,� o ARCHIENG/ � ,�,�"L � � DESIGNER NO.DWEL NO. NO. a, ADDRESS UNITS STORIE5 BEDROOMS � ZIP TEL. .i � r p� D�SCRIPTION SQ.Ft FAGTOR PSF ADJ.AREANALUATION � � OWNER-BUILDEROEQLARATION,_ _ �. '„� � ! "' � ' Q SFR/ADD/REM I HEREBY AFFlRM UNDER PENALN OF PERJUHY THAT 1 AM EXEMP7 FROM THE dONTRAC76fi5 LI� GflltigB/C6fp0�1 W CENSEIAWFORTHEFOLLOVIINOREASON(SEC:7o3i.5BUSIHESSANDPRtlFESS70N5CO0E:ANV6INOR (� CJ COI.INTVWHICHREOUIRESA7ERMITTOCONSTRUCT,AL7ER,IMPROYE,DEMOLISH.ORflEVAIRANYSTRUC• �W PBiIOIDBCK w7uRE,PFlIOH TO 1T5 ISSUANCE,ALSO RE�UIRES THE APPLICAN7 FOR SUCH PERNTI7 TO FlLE A`SIQNEO � STATEMENT TNAT HE OR SHE IS LICENSEO PURSUANT TO THB PROVISIONS OF TH�`CAN7RACTDRS LL � � � CBJSELAW(qi�FTER9(COFiMENCINdWITHSECTION�oo6)OFpIVI510N30FTHE�USINE5�3ANOPRO- �'�' POOUSpa FE5SION5 CODE�OR THAT HE OR SHE IS EXEMPTTHER�FROM AN�THE BASIS FOR THE ALLE6Etl'E%EMP- TION.ANVVtOLATIONOFSECTION7W1.5BYANYAPPLIGANTFORAPERMITSU&IECT5TNEApPL1CANTTO � Re-Aoof r A CIV1L PENAITV OF NOT MOflE THAFI FNE HUNDRED D0.LAFS(5500).). � ' � ❑I.ASOWNEfiOF7HEPROPERTY.ORMVEMPLDYEESWITHUJAGESASTHEIRSOLECOMPEN�5ATION, ❑ Commeroial - YALI DO THE WORK,�ND THE STRUCTURE IS NOT INTEND�D OR OFFEHED FOR SALE jSEC.7od4,BUSI- _,1 � NESSAN�PROFESSIONS CO�E THE CONTRACTOPS UCENSE lAA'OOES NOTAPPL`(TO AN OWNER oF PRpPERTY'M�IOBUILDSORIMPROVESTHEHEON,ANDNMOOOESSl1CHWbHK1iIMS�LFORI-IEASELfOR � � 7HRW�HHISORHEROWNEMPLOVEE5,PROVIDE�THp75UCHIMPROVEMEMSARENOTIN�TENDE00R � QOFFERFAFf1R5ALEIF,HOWEVER,4HE9UIL01N(iDRIMPROVE9AEN7iS'90LDWIiHINONEVEARbfCOMPLE• � TtON.THE OMINER-9UILDER WILL MAVE THE BUROEN OF PPOVING THAT HF Oq SHf D16 NdT BU7L0 OR � IMPROYE FOR THE PUflPOSE OF SALE). � �� "' � ❑I,ASOWNEROPTHE PROPERTV,AM EXCLUSIVELV CON7RAC71NG WI7H LICENSEO CON7AACTORS � 70 CONSTFlUCiTHE PROJECT(SEC,7044,BUSINESS AND PROFESSf6N5�CODE:�Ti�CbNTqAqYOR5'll- VelU31i0It ADJ.AREA L61 CENSELAWDOESNOTAPPLYTOANOWNEROFAPROPEFTVWHOBUILDSORIMPROVESTNEREbN,PND � � MRIOCONTFtACTSFORSUCHPFOJEC7SWITY.ACONTR0.C70R(S)LICENSE�PUHSUANTTpTHEWNTFlAG QUANTiTY DESCRIPTI6N FEE � TOPSLCENSELAW.), ..,/ J a O IAM EXEMPT UNDER 3EC. B.&P.G FORTHIS REASON .Q Z �+ 7 � � � � �� � OATE OK?JER w y � A^ � ¢ LICENSE�CONTFiACTORS DECLARATION � �f' .� l y aC I HEREBYAFPIRAI UNDER PENAL7V OF PEFJURV THAT IAM IICENSE�UNOER PflO�I510N5 OF CHAPTER� .~ �"` � Q� -" - •"7 Q � PRO('ESSIONS CODE.ANO � ...-. �.1. . J9' ../ •...... � 1.�. � i(COMMENCINO WRH SECiKNJ 7oo0J OF�IVIS�N 3 0F THE BUS�NESSAND Xai MY LICENSE IS IN N4L FOFCEAN�EFFE T. J (�+_ yy �� � LICENS S ` LIC.NO. � �! ��� � .��' :.:�..� � /�l � ' GF� rll m '��' I �,`�G�. �:ad, p � N. .. w DATE CONTRACTOR� � .� �- � � �, �� �f L Y '� � s � � ' WORKERS'COMPENSA710N DECLA�ATION ' � j° ��/!� ¢ ���t� ��O' `��p e U � IHER6BVAFFIRMUMJERPENILLNOFPERJURYONEOFTHEKOLLOWMGD�ECLARATIbpIS^�,���r'a"� � �'. � � C P � �., e, A _IHAVEANDWILLMAINTAINACERTIFlCATEOFC4NSENTTqSELF�INSt�q�FORv/�1RNER,S' y fl / � CqMPENSATbN,ASPROVIDED�BVSECTION3'7JOOFiHELA80RCADE,FORYfiE�pERFOR0.AANCE U �g�Cn C R 1 N� r 4 OFTHEWORKFORLYHICHTHISPEflMITISiS5UE0. � �� � � "�� �' � Q � w _IHAVEANDWILLMAINTAINWORKERS'COMPENSATIONINSURANCE,ASREOUIRE�BYSECTION Q 37000FTHELABORCODE,FORTHEPERF�RMANCEOFTHEWOflK�FORWHICH'MISPEFMITIS ISSUE�.MYWO 'COMPEN5710NIr�SURANCE AfiRiERAND CLICYNUMB£RARE: CONSTFlUCTION � CARRIER '� ^ PLAN REVIEW ,,.. � POLICYNUMBER_ .. � J � . '� . ,. . '� EL�RIS� . ¢ \ o (THIS5EC`IONNE�P70TBEp�1.EfIDOFhIEPEA�NI�ISFORCNEMJNbREOCLYWqSI �7��`). PLUMBIN i W I CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOif WHICH 1'NIS PERRAI'f IS ISSUEb,I MECHANICAL z (;3 SHA4LNOTEM7LOYAM7PERSONINANYMANNERSDA3TOBECOMcSUBJECTTOTHE ,,, {yJ WORKERS'COMPENSAT�ONUIWSOFCALIFORNIA,ANDAGRE[THATIFISHOUL�BECOME INSPEC710NFEE SUBJECTTO THE WOqKERS'CAPAPFNSATION PPOVISIONS OF SECTION 37D0 OF THE lA@OR � CADE.I A F ITPI GOMPLY WItFi SE PROYISIO �{ �SSUANCE � "' [] DATE� .���APPLICANT: � �� /M�� SMIP J - _y WARNING.FA1 IIFiE TO SECURE VJORKERS'COMPENSATION COVERAGE IS UNLAWFUL,AND SHALL BE ENERGY P/C � SU&IECTANEMPLOYERTOCRIMINAIPENALTIESANOCIVILFiNESUPTOONEHUNDREOTHOUSANO CNERGYPERMIT �OI.UIRS(Et00,0oa),IN ADDRION TO7HE COST Of COMPENSATION,DAPAAGES AS PROVIOED FOR IN � SECTION37oeOFTHELA80RCO�E,IFfTEREST,ANDATTORNEY'5FEE5. � RETENTIONFEE: a GONSTRUCTION LENDING AGENCY' PRE-ALT FEE: � � O � IHEREBYAFFIRMUN�EPPENALNOFPEtiJUF11'THATTNEREISACONSTRUC?IONIENDiNOAQENCY , - ' � . FOP THE PERFORMANCE OFYHE W091C FOR WHICH iN15 PERMITI.S ISSUED'(SEG 3097,CIV.C.).' �-`-- ... ,,,,,R.,, � . � - .. W - ' .,.. . , . . . . . . � LENDER'S NAME � ' � ' F� LENDER'SADDRESS � � � ICEPTIFYTHATIHAVEREADTHISA?F�ICATIONAN�STATETN0.TTNEABOVEINFORMAtIONISCARRECT TOTAL FEES � - � w 1 AGREE TO COMPLY N7TH A�l CITYAND COUNTY OR'JINANCES ANO STATE lAWS RELATINd TO BVILDING � � CONSTRUCTION,AND HEREBY AUTHORI2E REGRESENTA71VE5 OF THIS COJNTY TO^�MER UPON THE � ZABOYE-MENTIONED 7fiOPER F F1INSPECTION PURPOSES. Q COMMENTS__.___,_ , � ��� ��' ��. � -- �V��. ,� � PERMITTEE N ME INT) � �` � � I I� � SIONATUREOF ERMITT ,,, �ATE - ' � '�1':a I�1 . _ . . '` '� �..�,- . _ � - � RECPT.NO. PAID BY 11'1LID,4TION� � . , ...._ . . .., ~ WHITE—De rimentCo YEILOW�inenceCopy,PINK�=AssessorCo GOLDENROD--FileCopy,GREEN— Pe PY. PYe ApPlican4's CoPY , ., .. ,,, .r:�,��. :-7ri��::.. ,.. . �.:. q .,.,_..a..,.� ,.�tl.�d.':a �.5..�'r;. ,.� .:., ,Jt. ,:�vF ..:y;,i �k�y,,;5 . . . .... .. . ,=,•Fs .a...s7:. 1 .. ��.,.��t y ct�'�':s:�;'ij`b ��.�r:�nrt ir.,:;ea: � . �s:•., � . . .. . +,, . . _. . �`�'� �' � �� � �����°���` . - �.a �. . _ � e. �.. . � � � � � � � � � � � � s. . .. ������,�� _ � � , ����;�;����~~ , W4 . � _�� ___.__. .._ _____._ _. _ � �-�� , � � �� ����� � � � � � -�-�1 ��t��� �s�t_ � ` { �" � � # ���� ��C�'���"i`� __ _ � � �''���(��E`a�� C?��J�a�� _ � _ ______ r _ .... ______. ____�_... _.___..__.__ ..._._�;��� ._____°____ _ ___.___ �.� __�_ i�':��)..fi��6.. � t&�:�!���� i � � b..y"�"3�a`��� �e>��:�'t�i�t1��€` € .. -_---- _ -� ._._,_.w____�_� --�_ �.„,�__ .w� �_� ��� .a�?��� I ���__.__ ' �!���';.�C'`���tJ��d��`���� � � ` �_ � _ �__�_ ___ � .---___._ . .____ .�_...� � � �� _____._�_s.__ ___ �_ --�__� ���__�: � �_ `i"� �q , ��� `'r? I t i ,'J`-e�""r_C�_s���P�',ti�t��A�� � ; � _�� __..___i..............�..u.,..�..d�..��...� .....�..,w�.�.....__.,__._..,.... ._.�,.�»�__� _ - _� ��_ �� __ � '�k:'�G..��.�(-,Rl'�� �.. �� . ' � C�irc.��'"i�. �s41�'*:1�'a�€._�z� - �- .. . y . .�,„�_ .... _._,-..._ ---'°-t"--_.._._._._ _....._,�...�. ... � 1 .��������s���C� � �L �..�'�" ���� �5��1i°�i . .,. E _ µ----- . ,�___..__�.��. _..,w.. _.� �__�.�__�...�_._ ._ _w _ _ .__ �"��r>���"1��1�.�;�s�<..t�a"� �� i i �=��?�I �C'��ti° c,�;`�,"� ' : � _ .. . _.__._�_�___ . _ __�______ a,�� __ ��� —�-- � ___ �";'�"��°�- �P�tr'�e-s �� ' ; r�'� ���r�.,r`�rl��'s. . -_ -�-___ —j � �`�`,�.�#�>~�� ����' �* ` E �P_-��;�`��i�� ; - � �� .�_._4 ''-�--�-- ! �..� �,_.�__�___ �?������ �"'���£.% � ��__ ��.� 3 fiC�'�?�:�i"�i��i°�r;���" � i �"_-____ , � 3 � E _.m��_.._�_.__.�___._ ._—=,w __ � .�_ _._.. _ . _�.__..__ _.�.�_ � ���:.�a�"��-� ��' �'t���� a -t-_�.__...me_._ ( ���-l�,'�rf�r�t�k��;�i� � ---- ; .. �_ _ _ __ �_. __._._ _._ � _ _�� _ ���� ;r ;�=r� � � � , � t�:°�' �LFw r�[t:, - .. --- � ��.:_� � ._�.�.�_.__._ _�. ��. _�..�.��_ _ �,._�.. _�� ( _._ _.. ' �._ _ ._..�.. � �r� a,x�d..t�A+��.,�e�.��:i..� € i _ ��.�L.� ���vt���a� ! ,xt � � ..,.,......_._.<..._�..._�..{_._ ..__ _._ .,.�._�........._--____-�_�.�._..__.� .._,a.._.�__..._...� y g�.x,n q 9 p6�.�9f "g`�ak�j fr : f �ppry� a �y — � . .. . � „ � a•, �`'iaw. 1 4 {..„'Ib F ; 1 4J 9.... €�Pi €�._.«m...,.. »-g--- . r�._._ _.�... _._,._ _...�...T __....._.__ �..mm.... —§ g ^^�s I = a€'° �s a� s'°t��� k � � �� ---� � :-�� �#�"" ��� ��-��`����� _���. _____.�1 , �? �-'�€`I�t� �C���, ________ � _.�_____�_.. �_� _ ____ _._ � ' , j =,;^��� e �3� � -� _... � :��, �-�;-;�C�:�'s� ---�---_..��_ ; x. ,.. , �7� �..��t�. :.a�?=�s ,� �°: � ; E _...e.....__ �_.�l_ .,�__.� _.._ ..�_�.� ..._ _n, [ �?�'PI��;. C � � '�"``��K �:�C� � �_._____�_._._ �_.�_� � .... _,mm�...�Y_..___�__. . ._______ a., i ,��- x , �-......_e�m, .T..�. � a s r:_ t �?' � �_ � a'.5�'..¢� � $- 3�'d�. � j � 3_��.s�"»s�P ca �'/t�t�:.'�e � � j�.� _. ..__......m...�.a...._. .,...�.. ;� .,...�.r._.._._ g .... . �_..._ __. .__..._.......�........._ � �� �€.7 : i - ����E'�ti-���' E�a"E�s.'9. � 7 � ' .�.�......�.I __ �........ __ ....,.___ ._— � ..e.._.�._.._�....._ H � __ �. � ^tl � ' � �.�_ .. ..,,_ ___� ' � � ���`^����a��.��� w � �''�`;uE ��1;v� im� � - e ������..�,�..fi¢�,��'*µ9. ��� . ''Y".a.�..-- _.__m�. t i o--i�'� �....:'°t f .:���,..._....�.w. j...,..-...�...�..-m.. ..� _....�... .........-•---"""` ` �� �°.'L.:�a.�.".�$���°ttw ` .. .. ...m..pd_____.,..,...�..�..«__._[...�.......,. .,...._.,....,.�. ..,...i i �. � .n� � __.._.�.. _�__.. i ���t�'���� ��k' ��E�=��.'__ "rv"� 3 ._„ �� . �_.. € _.__m � � �.__�..__.. _ ._ _-_ _�. , __. f : $ 2.��^� �� �.-'''�"'s t„. . , � � � - ,�� 1a��{ r- �,. ��a�i� �l ` � ..�, . m...._-- ______ . .._ _ _.� _ ..._. .. _.�..W ..... _ —_. __ ..__ .. y � �� -�-_ �f .� -F-� 4� � � _.�_�_.._ � I � t's�;��$=�..�.'m�z�,��§:,� �G�r i I ���. e _.�_d..� �.�.__�,Tr�_'.�-.� �i .���_ _._.__ __._.e__�_._______�_�__�.__ _W�... ._.._..___..____._.�._ a` � _ . ..�..,__� _ �.�...�.� _..�__�_��w_.�..._. ..�...__.w.�_....._.�__.. , . � , � � � � _� .:.. �',,�,„__ y �....._„ � .. _m....�._._ _ .__.__�_____m_ �� _ s -_ ;,__ __ ,.. __�: ,,. ,__:.:.., . ._.:- ,.... ;;.. �.;. -,i, ry , i- y@ �+^� . . r ' - r,. . . .,.. ! .i. _. . .i` � � @ �.m'�,.,.$��€�.+:�9�.���� � ���� � € ._......... ..�.»--._.......,.._ ��..m., ..._._�---W`"'w"' � .. . �. . . .. . .. . � - .. a . � .. .. ' t. .. . t3� - . . "":".m.e.'"'} � 9 i �.�.........._....�,.�.......«-..«.....-..........-,-,.._.....,.....m....__..�,.........�..........�..............e_»-._....�........,..�..-...-_._..._._.-.m.....___...m.-...»--...._...... n.«....._....«� _...�.,.. $ . ... � .:a ,...T�...«_...__.�.,.«— ...,.—y .. . .. ..�.� . .,... . . ..... . . .. . ,:. ':�: . ' . ,. . . . . .'..'. . , ' i 6 . . .: . .. . ... . ._ . . . ;, € y,_...�._._,...._..._.....____.,...__... ...,..__._....._..,<................��.._�__.......m......m_..�....«.._._�.,.. ...r .. 'i .Y.ro... ...�w��� . . .. _. ......_v._....,. . . ....: .. ... � , . �......._�M..�«..=:,m-...._......_ ....._..m....,_,�.,,_-_.__......__�._...._..,.�..__.__...__.....—�.......,._.........__....m.�_�.._........_._...._._�.,_�_.�._,._..�._,,,...�....�...._,�_...._...___�_.____..:..._. �.. .......... ,F�_.._...._...'_..__.�__._i � � . . .. . . . .. .. . . ' � � ., . . � . �. . .. a - � : . . . ' '.' . .. - . -- . l � �..��».--«..,.._._„—.�«......._.�.,....,.a.m.,...,. .r,�...............__.....m-....,....«�.«... ....,...�..........._�....m..�...._.. " - . � � � .............._.._....,............_....�.....:...��........,...�..�._»:e.�._.m....�_._...........a....._...�..._.»,........_��....� E . . �� � '. .. � . - . . . ;.. .. .. ��,; } y � ........,e._......�.�...�......._........m»».�.._.,__..._ .�.........».w...-.,......._._..«...«.-._.... r.�a..a.,m......._. .. . � 9 G ...�_�.,.........._...._._ ' . .___�__ �_4 d...»....-.�.." am..--__._....,-�.._�_____......_.,.._._... � . z e .,..__.,�.:,. ..m.. .__..v.............__� ...,.....�_.__.:_._.__.�......_..�.r '.,.m,�. , ._.... �..�.�.�,."r� . .. j „ . ,.._...____. _._._...,�.mw._.___.._�..___.w.._._.k._�...��._._........_..�__ _ _...�:__ __-�___m: -__..�____�e. �:...._.� ._�..� " _ ! . ._��..,a_ �__._ _ ___�w.� a ��� � �ss�' � �,p"�� _`w- ! _ N .0 �,d._. p �'��.�'"g �'�"', 7 '"'9. ,,.... � N :�... .n....,_._� _�.µ.._�._...__ . ._._._......�.,._ �� � �� _�__.. � Y� � ^�';F � �W 1 � �,.n.m.�...w..--A.-';a�,c`s" . ..�y..p�..a..�'-yc G;;�"'-.�`"���„/-.`_c,,,.(.__,,, �>I��_�a,,.d„�,�� ,+'+f�� � �, 1 � ' :,.. ti ✓ � � � ( �.c ., �� L as�9 . _ ..,.:-.,-�r;-�.�;-a..,-s......... ...... ....__.__. . _____�_._� __...�..P.... -._�._. ,`-;-�r- --r� � �3 � , ' r .. . . . ,� _. �'�-�l��` � �/��� � ' „ - �__...__._.._.._..... �� ., •�:: � , ..� . � .. � s � � '• � __...._____..__..__..� _�.____,.�_,_-__._—__.__...rv...___._.._. _ ��_z ' _._ i _ __.. , �,. _._._ . _,�,� ���62 ,I� , g - . , , , _ _.__�. ____.�.______..� ._�_.._. � ; _�_�_—___. � �_ y..� . � � � .�— � _-��; ,�z,� € � :. ..F �.� .____.�,_...e_.��.�_� ____.._________ ____ ____ __.__ __.. �, � � x . _ -�� �� � �y A ��� ,� . � a� ___-___ _ .._.. ' � -�- _____._� .__ t ,, ��---_- � ...._ � ��� ` � � . � "�'�L��".�"��;� "S' ._,. �iJ`- – �� d�'� � � . � � �s — # � �;,� sn zat� _. .. .�..._._�. ��__�._._._.._�� .� � ...�� ___�________.�___—._._ . __.