Loading...
HomeMy WebLinkAbout15995 �.�'�`v-G� ��_ CITY OF DIAMOND BAK G��3-�`a � - •° DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES C� : � y 21660 E.Copley Drive Suite 190 (909)860-3195 Fax(909)861-3117 PRESS �'�°� BUII.DING PERMTT APPLICATION FIRMLY . � JOBSITE �Q ' dt L./� �� APPLICATION PERMIT P/C o ADDRESS ���fv 1-NG���� �"i�t� DATE � t fJ/ NUMBER����� # c� ISSUE TYPE OCC -- APN_ LOT TRACT DATE CONST. GROUP p OWNER 3��� �5'�.o1�t-� p ADDRESS 4 F�z'�r%Y1.ls �- ZONING SETBACKS Z CITY QYaf'tI'Z ZIP 7 TEL.g'D9-�'�/-G�� REART RW ❑— g APPLICANT TEL. SIDE/SI�E STREEf RW ❑ � CONTRACTOR /'� �� �� -t ��' n.• ' SIDE ❑ � ADDRESS "3 .v.lG�t �'� GTY �'►'g�`w��� ZIP �7t2 TEL.t"Lz-yj��`/! PROPOSED USE o ARCH/ENG/ DESIGNEH � NO.DWEL. NO. NO. a ADDRESS UNITS STORIES BEDROOMS = CITY ZIP TEL. � � DESCRIPTION 5�.FT: FACTOR PSF ADJ.AREANALUATION � OWNER-BUILDER DECLARATION SFRlADD/REM O I HEREBV AFFIHAI UNDER PENALTV OF PERJURV THAT I AA1 EXEMPT FFOM THE CONTRACTOflS LI- G&f39B/C8fF10A W CENSELAWFORTHEFOILOWINGREASONI5EC.7D31.58USINESSANOPROFE5510NSCODE:ANVCITVOR (f� V OOUNfYWHICHREOUIRESAPERMI7TOCONSTRUC7,ALTER,IMPHOVE,�EMOLISH,ORREPAIRANVSTRUC- W pd2iO/DBCk w 7UHE,PRIOR TO 1T3 ISSUANCE,Al.SO REOUIRES THE APPLICANT POR SUCH PERMIT TO FILE A SIGNED W STATEMENT THAT HE OR SHE IS UCENSED PURSUANT TO THE PROYISION5 OF THE CONTHACTOFlS�I- � CENSE LAW(CHAPTER 9(COMMENCIN�WITH SECTION 7W0)OF�NISION 30F THE 6USME55 AND PRO- �'i' POOVSPd V FESSqNSCOD�ORTHATHEORSHEISE%EMPTiHEREfROMANDTHEBASISFORTHEALLEGEDEXEMP- (,�J v TION.MNVIOLATIONOFSECTION7031.SBYANYAPPLICANTFORAPERMITSUBJECTSTHEAPPLICANTTO z Re-Roof � ACIVILPENQTVOFNOTMORETHANFNEHUNOREODOIIAFSIfsoo).): � ❑I,ASOWNEROFTHEPROPERT',ORAIVEMPLOYEESWITHWAGESASTHEIRSOLECOMPENSATION, G� COrt1rt18fC181 - WILL DO THE WORK,AND THE STRUCTURE IS NOT INTENO6D OR OFFEFEO FOR SALE�SEC.7041,BUSI- J � NESS AND PqOFE5S19N5 CODE:THE CONTRACTORS LICENSE lAW DOES NOT APPLY TO AN OWNER OF � PROPERTY WFp BUILAS OH IMPROVES THEREON,ANO WIi000F.5 SUCH WORK HIMSELF OR HERSELF OR CC 7/1ROU6HHISORHEROWNEMPLOYEE5,7HOVIDE�THATSUCHIMPROVEMENTSAflENOTIM'ENDmOH m �1 OFFERED iORSQE IF,FiOWEVER 7NE 8UIl01NG OR HAPROVEMEM IS SOID WITHIN ONE YEAR OF COMPLE- � TIIXJ,THE OWNER�BUILDER WILL IiAVE THE 6URDEN OF PROVIN6 h1AT NE OR SHE DID NO7 BUIL�OR Z IMPROYEFORTH'EPURPOSEOFSALE�. _ ❑I,AS ONMER DF THE P'-1OPEPTV,AM E%CWSIVELV CANTRACTING WITH LICENSEO CONTRACTORS W � 70 CONSTRUCT THE PRQIECT(SEC.70M1,BUSINESS AND PROF6SSIONS CODE:iHE CUMRACTORS LI- VeIUaIIDtI ADJ.AREA W CENSE UW DOES NOTAPPLY TO AN 04NJER OF APFOPERTV WH0 BUILDS OR IMPROVES THEREON,fJVD Z WViOCONTRACTSFORSUCHVROJEC?SWITiACANTRAC70R(S�LICFNSEDPURSUANTTOTHECONTRAC- QUANTITY DESCRIPTION FEE � TOFS LICENSE LAW J. —- ❑I AM E%EMPT UNDER SEC. B.&P.C.FOR THIS REASON U 3 � --- � � DATE_ OWNEP �" ^ W � LICENSED CONTRACTORS DECLARATION W � 1 NEPEBY AFFIRM UNOER PENPILTY OF PEAJURY 7HA71 AM UCLNSED UNDER PROVI510NS OF CHAFTER � � � �� � i�COMMENCINCiWITHSECTION7000)OFDIVISION30FTHEBUSINESSAN�PROFESSIONSCO�E,ANO Z ��� MY IICENSE IS IN FULI FORCE AND EFFECL m 0 UCENSE GLASS C __IIC.NO. �C�Z� j U DATE S'�?L COPITR4CTOR A • � d W � WORKERS'COMPENSATION DECLARATION a = U � 1 HEREBV AFFIRM UNDER PENALTV Of PE WURY ONE OF THE FOL�OWING DECLARATIONS: Z O I MAYE AND'HILL MAINTAIN ACERTIFICATE OF CONSENTTO SELF-iNSURF.FOR WORNEHS' ¢ � — _ COMPENSATION,AS PROVIDED BY SECTION 37ao�F 7HE LABOR CCDE,FOR 7HE PERFORMANCE W OF TH"e WORK FOfl WHICH THIS PEHMIT IS ISSUE�. � O _ IHAYEANDWILLMA1NTAfNWORKF.FS'COMPFNSATiONINSUMNCE,ASREOUIRED0Y5ECTION Q 370C OFTHE LA60R CJUE,FCR TNE PERFORMNJCE OF THE WORI(FOR WHICH THIS PERMiT IS J A� 1 1�2D01 IS5UED.MY WORKERS'COMPEh7SCATION INSURANCF�CARRIEA AN�70UCY NUMBER ARE: COnSTRUCTION � CAPRIEP .T�F�f�'� �'� PLAN REVIEW�p � POLICY NUMBER___ �i`� ��6"���� 1 ELECTRIC �X T <l lJ � (THISSF.CIIONNEEDNOTEECTJh!PLEfIDOFh'F.PEiN&I'tSinRONEHI.WJRED00lLWS(SiCo)ORLESS� ?LUM8ING J 1 �_ � ICERYIFYTHATINTHEpERFORNANCEOFTHE'NORKFORWHICHTHISPERMITISISSl1E�.l MECHANICAL (�j� SHAL,L NOT EMPLOY ANY PERSON IN ANY MANNER SO AS TO BECOME SUBJECTTO THE � WORKEAS'COMPENSATION L.1WS OF CALIFOPNIA,ANDAGREE THAT IF I SHO�LO EECOME INSPECT�ON FEE __,.__.____ S. SUBJECT TO THE WORKERS'COMOENSATION PROVISIONS OF SECTION 370n OF 7NE LABOR CODE,ISMALLFORTHWITHC MPLVWITrITHOSEPROVISIONS. ISSUANCE o ' SMIP 0 ' � �._� A . ' . J W0.RNING�Fr11WqE TO SECUPE WORKER � MPENSATION COVERAGE IS UNUWFUL,ANO SHALL BE ENERGY P/C �-y SU&IECTANEMPLOVERTUCRIMINALPENALTIESANDCIVILFWESUPTOONEHUN�REDTHOl15AND ENERGYPERMIT DOLLARS(f700.o00�.IN ADDITION TO TFiE COST OF COMPENSATION,�AIAAGES AS PROVI�ED FOR IN ¢ SECTI�N37DBOFTHELA80FlCODE,INTEREST,ANDATTORNEV'SFEES. RETENTIONFEE: _ d CONSTRUCTION IENDiNG AGENCY PRE-ALT FEE: O � 1HEREBYAFFIqMUNOERPENALTVOFPERJLJRVTHATTHEREISACDNSTRUCTIONLENDINGAGENCV FOR THE PERFOR6IANCE OF THE WORK FOR WHICN THIS PF_RMIT IS ISSUED(SEC.3097,CIV C,). Z W � LENDER'SNAIAE _ __ F_- LEN�ER'SADDFESS_ ! � ICEFiTIFYTHATIHAVEREADTH�SAPPIICATIONANDSTATETHATTHEABOVEINFORMATIONISCARRECT. TOTAL FEES �(A� � � � I AGREE TO CAMPLY WITH ALl CITY AN�COl1NTV ORDINANCES AND STATE IAWS RELATING TO BUILDING �� ��- � CONSTRUCTION,AND HEREBV AUTHORIZE REPRESENTATNES OF THIS COUNTV 70 ENTER UPON THE Z ABOVE-MENTIONEDPROPERTVFORiNSPEC710NPVRPO5E5. COMMENTS � S v � � m . ERMITTEE NAME(PRINn c�i� �� r/l��� � SI U OFPEFMITT E DAT = RECPT.NO. PAID BY � VALIDATION ' ~ WHITE-Depertment Copy,YELLOW-Flnance Copy,PINK-Assesspr Copy,GOLDENHOD-Fila Copy,GREEN-AppiiranCs Copy ����� ��'" ����`�������� ���*� ��+� .. , , . �������`�"���� ����,`���� ,.., , . . ,., ��.:�.���'�',m�a '�7�'r_ �: �.:,� �q ��-�� �-�rc� " ��a.�,� ' �'��a g � � � �����n m � ��.. ���-� � �� �.��� � � �� �.�� � � � � �''� � � :w.. � s� '�� �- � ��" ... -�- � %� ,�. a �. � �r-t- ��m��� � � ad-x .. �.:3-��sr-.� .5�,�+ �T,�z�� ...: .�. .r. r,e• �. .,y� ... � '���'�'w,�^�,'�..... � '.?;� r�� �=������..: a��k-=�. � .�°.:.�,�g'��,r��„� c ' 1 . �.. I � �] '}/`"x� _ i � R'='a '' d � � _ ' I k 1 tl i-1�3� F 3 (�1 Y j � .�� . f �..tp. .....,.___m.___...... 3.-,_....... ,. '� c'.... . .......�.w.W�._ .._M__.......3_ , � ; � �.7 ` e�'-.�'v� '�...E-�, f _ � , ��z� �L. ,.'�„€�'X� � j p . .._..`f..,, .... .._. . _............ ......,� ..... ._ . .... ."'._ h ...._____ .._,......� ._ ....q q'"� ' gg� [_ '"`�; v ._ ..... .... '�4.'c- -�k..�.._,21. ��k...d _.._f-- __-. __�._—_ . . S.J04��E'?��' -.,.e�";:..3�4.35 �'i . � 7 � ( ` � .� _ � _ -- � � _ �._ — _ r ;;� y .�:;2 a€ F :if� . � .S 69 �''�� e_"f � .7� �. �, v � '� f .._ .� . s __ . __ . ..:... .. ....._;...._,__�._..,..,. ..__._...........___._._.�._..__. .._. -i ..._ _._ ...._.. ... _�_4....„.,�. ...._....,,.�..,._t_:.,..M._... ....._"___.. ..__..._. _.., � � �;F � �. � s��' ,.,j .. . : � .. _rv �^� k.( ii-:.>'�'�' � - .,� "-t, ,.. ; ..f e 4 � :.�,C,�� d �i �,�.1�� �.`' 4 f p ...� _ _.. ...,.;..,. _,�._,...._ ___�_ . .,...,._._ .... q- ....._ _.:.. ...... ...... ,..... ....._....�_..._ ... i i,...:`�x r r_,,_:. � . . � � s i.`�. � � d€>. r��. .'��k .�.. � ....... _}. . .. ... .. .. .__ ' ._ __ .._ .___ — ... �._ ..._ €. _ .._ � I� . � ° -�^�i �a �«a �= � I l � ��3 r-: ��s'�r*,:�t��;�d e � . _.E __ _ . __� � ._. _W __.�__.�._....__.._� .__ _ §s [ � , , �; � � � ( + �� i � ���a�`���; i � � _ __.. ,____ _ _ � U:�.__... _.__�_ , _ _. � ��ta` p s"�-� �a° � I� t'�r.9 � E ' �i�» 4"r._ �._�.s�;� � �� . � ....__:..._ _.___ �" - _�_,. ... . ` ....... . . ..._ ._ ... .._...._._...._ .,_ � ._.. ... ,..._.__,._. ......_............ .._._...._...._.�..�.._.._.._. .. . _.._. z ....._..__......_�....,..,_....._._.. . _y _��_____ 3 ,t' S j Y 3' i i s'°tw9 7,l'.P,p l3 '€� 4 L. _ .._. .. ....�.._................... '---_ . .. _... ....._. . . _ . _ ............ .....,._ .__ ._.. ... . �.. ____._.,........._��_._. ._ 1 f ��'� e � � . I � � ��� �'St� � .� � i '.... -� .: t.. . . . .......... . .. . . . . .... ._ �............�.....,...__..._... . k___..______. � � a 9 8 � t`+ '"� � J 3 r .t�' �te p�,s-a i t td x � �� `t . � _._ 1... 1 �� � I��'€ .`_.._ �_..__.._.m,__. � � __ _ ._ _.._. _.__.�.__. ___._�_..... _ �. ' {f €{ ; r� ..a� ��`a r-.- � E � �39 € '"-€ ,,uAo--'r��.✓3��=& _ .�_.._ .. - __ .._�__....__,.____— ............. . _ �....,,.w__�__......._._�...____�.._._..,... � .._. ___ ...� B .' � � � � ' , .. € � � ��l ��d4 �� t F'�r...^�+ ' .:-. . � _.. M____—!. __w____._�___.�..�.._ �1._.__ ._ _� .._...._w_______„�.� --- � � --- � _.._.�_____._��_.�._��_ � , �j �i'�"� �� 't� l �6�.a � , f ! � i""��. �a ���:.}*�t.E�a`i::¢ � � � � , .. g ..,. . ... .,_ . . ...._.F..... ...._.................._.�.6_.._. �...._....._.......�._.,.....�..,,_�._. __p . ..@_..-.�-..,.....................,.._........___.__..__...._.r�E.._...........,......_._... ._ _._.,. ..� _ f h r # .�.3 � S'� '"$\bP"44 �-�E,Jt�� E � . � € �`� .. ..... ....., :......._.._._.>._ ...�_......._....,......_..�.,.... _........_..__-___._ _.�.p�- __ ___.__ , � . ............—.�... 4 ..�...,__._.�.... �_. _ � .�1 €"�" Ih� d? `t .R 9 '`,t S�� ��..� �__.._ �mmm ,�. . .., .,.. '-� .' b 4tl � . 3 '..� €, . � ._ ... .... . .. ._...._. . ._...._n..................................... .__ .._ ..........__................. .. .. . �.m. w...�'a _._...,.._......W..... � � " ; � "� � x ? j � � .3�"� �l ia'��i r s i � .�...�.�_ � , .�� � 3 .., .. ...�,_....._ .. ..__.._._....,_.. . ... f . .. .... .�..... . .. p 6,. � - � �'-•F3�f G ��� � 'i .. .�._.�......v.._._._. ...:._..,._.......,µ.........._....,..__.._....._._m.. j... .... . _ ... ,_......... _ ........__d—__:,._................._....._.{ . ....,... .�.M....W...._ ...,.....P.m,,. .._._....,.. € .,-nT^ 8.� ! I ! . d �e.^ '9 � P...,._..... _ ..:,.... �. i � q ; �3�, ''�` 3 � �..: P )..a ..."� .. 1 �. . �� L _ ..�_....W_...........w...__A ..�� � ..�.._�_. ... ...�. _ ..., . ..,...r.......,,......�............�.� _.._ . _. _ t i s �� ., � � r� � :.. �.,. �, E 3 .. _ � ._._� .._ . ....wn....�_�...� � . .. � ,.� �� . x ....:,. . . . '.(F i f� - '� . E � . � ...�.._.g.......,...�.�_......».,.�.,..m..<.. � E 8 .... ... � � ....,.. -a ; � 'y .. ...v.�........ ...................................._..............,........._.,._....� ....._.... �. _......__. . ... ..._........... .___.,....................._..�.,_�,....� ji ... .� .+14.*. . - € .�: �„. ...d�..�.< e . "':�i,+�1'i,., ' . .. ¥ ....... �.-.:.-.m...:_. ::....m�........_............:�.........»...._,.. . .........� � � .. . ... .."_"_ . ....__ . ................_._..,........._. .........__.— : i �'t a��� 4�.� '_ ., [ -� ��,-ria.. .. �n ... _... . , .: � � , _..._ _.....�_� ._.. .....�..._..... .,___...,. ..._ �...;._�_... ._.�___�...�.... . �_E__._. e._____..�............._._.... ...._.._._.._._.�..,_...._ _...._..._.-.:..::,.......,...�........_._..._._......_.._.,.��.._..._... E � '':t y' � 3�k 4� C` r .,`� i _ , __.�_.w. F.______ ,.�.,._. ., �,.. e.,�_�. _. _.. ..__. __ � � � _ ___ �.... _.___... „ , :r,�r r . �L.: � �i � ! �. � _,._____.,.__._. . _ _...v�- .� �a�__.___�_.�_�._.w_....__._.,. �3 , .__. _.__... �._, _.__._�.______ ___.__._._�.__ _. ... _�. _ _ . � _._ 1.__._.v ._.......�__ � �M� �. . _ —���», �.���� � _ 3 ���� �� �,a��'�s�� ��'� � ; � e. _..__m__.�...__.....m_ ...:_.w_ .�_; .. .._,... r_�_._.� _..__ _._�.�___..:__ _._.��.�. 3�._..._�.... _.__.._._.�__..___..���'�� � ��������� ���, x� , ,�,i1t.� .,;�....>,M.., va�- . � .�' . � p ..w _a ` fmM � ` �""" �_.._._ .._.__..._...�.,.�..........._.._ � x'Q.w 3 6 .:.. Y ':.d , : �.>-.................. ... ........:........................................................._..,_... .i..,..AedS.-6r'-........,...�.___.....,.....�.........,.............«......,.._.._�«.......,,....-.._.......... .....�....�..........,....... ...._.e..,......._.........«......�_..............:......................�..�_..,,........ . ....._...��. Y9 . . � " , .. . . . :. .. , ...... f._. . . �.,� i".)SY .., .., . . t _ ' � ' . . 4�fl�.v.a � �. � , ..,�. . . . , . ,. , � :..m.._e..........................«_.....___..........�.�........_._.......«.................�.._.......�w.�. ._....'..:..._.�..�.�_�...�,.._._..._.,.,..._.'_,___.:._.._�____ . .�. .. ..,.�.. ., ',,i : . . . . ) ".W: .�� � .� : 4...,. . _ 4 � l ` .. ,. . r .y .. .. . . . . . \ ...y. >-__.u.__,....,........_... _........_`___. ., ..__.m..,�.....___..,:.....�,.....____.:,:._......�............�_,....�_..�...,.....�.___.__._..._._._._._.—'--- ..«�_.......:.....:�.._�L.' -_...� ;. . . �,_.j' + �� � ,,.,;: ar '"',F3�ra,iqt _....--. --- _._ .._._.._.. _......_ -___ _ . _ ., ?..�_�.___...� .�.,.�...._tww___.,.._ __ ...-___.._.__.._�� _...�__-____.__..___._..�.__�w__..:._----...__..__ _._�---_ .��.. , � �____ _.._.._ _ ��.� .____� . _..___. ..._...�.___.__ .... � n_____�._;�.......�.__...�._..__a____m__�_ __ � _�__��_ i --- _ __ _� --— . ..._____, .. 3 . �-- -- _.._......__ _. ..._. ......_.____._ _._..___.__ �.,._....,._. ..__..________.,._._.�_....._____.___... ._....... ....___.__.____. _.... __._�_.. .....,_._._.. _. . __. .........._..�._._ r�;'. ._ „ _ __ ..... _wr_.. ___._..__�..____..._.. ___. -- _..._... �..._ ........._.,__ __. ... _ . ..__...._._..___—__ ._..___.._. . ..._._..._ . ..._ ___ __. .. ____, � 8 _'_fl , :�'�Cm ;.. , . � ._......__.. _._..._ ., -�y� �,.: ...f� � ,,,. _ ..___._.._.._.__`-____...__. .._.�_._._..._�__,_............__._._�......_..... .... _.__._.. .....___..,_, .__......_.______.,___.._ __......_..__.._ ___..; �,R ..____.�...__.___._.-- , ,,r....c..s a _:; .a. �.. .__.... .._.W.._..... , '; t �f � �'�b:.� �"a s,��'=%g�-,�"'�a,S�"'��''t ...._..................__..._..._......__....._._..............._.__.__ _............... ........... „:� _ ,......,�... ...._., ..._...... ` �pt�'�'����� �������.m�,.. .._ . _.. . .. .�... . ... ��� __ ._.....-..,.„,„....._.__�._.. _....__ ...._._______._ .......... ._....__ �_._.__�.. ........ s �� � �� �.������Xsr�-, '�--�-----__ ._....._....__.._. ..........__. .._...____- "__.___..... 3. 9 � ����,��������� �� :. �.::� ��� ; €� `' �§ ��. _., _..__._._ __,__� _._. __..__.. __. ...... ... . .._..__._ . � �. �� � _ � � � �:��°�� � �������;.: _ _ _ _ _ r . �� ���� � �� �� i � ��� � ___ . _. ,. . __ _. _. _ _____ . _. ,_ ._ _. __._ __.. �_� � _._ s s � � � ������ ���� ��� � � �� � � � ' �� � �����g� �������� _ _ _ _ __ _ _ i &� ��� �,������s��t.�;� _.___�...._ ...___ ...�.. �.__.,..___. __.�.,..w...._ _..._. _._.... _.�w..._......._ .___.. _. .....__. � _...... � ���� §��� z h�"i�x�a5�±�� ' � ., � .y.. ..... i ✓ ' - , � ' . � .1.� ,��u.m-...":-,ffiN�4��$.�:i.:s�.�d�.�..e..,i . . ...e,.,..m._..._..�.�.._"�.:......... . ..._._.. ... ._._....... ... . ...e., .._...., . ............ ....._........_.... ................ .._......._.. ......... .. � .p . . . ....... . ... ........ ... ' � � . � l;.w........�.».e»m..: . . . .� 'q i . . . ...;