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HomeMy WebLinkAbout13155 (16) ���. . y�_�'�� � :^;��- J� CITY OF DIAMOND HAR '� DEPARTMENT OF.COMMUNITY 8z DEVELOPMENT SERVICES 21660 E.Copley Drive Suitc 190 . � '� - (909)86a3195 Faz(909)861-3117 PRES$ ��'���^�� BUILDING PERMIT APPLICATION FIRMLY o� JOBSITE �} �n APPLICATION � � NUMB R �� p/C � ADDRESS 2-�—`� v�� C� DATE ISSUE TYPE OCC � APN LOT 5 TRACT �ZO DATE CONST. GROUP p OWNE S r1�� "' ADDRESS ZONING SETBACKS � CIN � 21P TEL`� REAR RW Q APPLICANT TEL. SIDE/SIDE STREEI' RW � CONTRACTOR 1/�, SIDE ❑ g ADDRESS PROPOSED USE��F f L pC�_3 C(TY ZIP TEL. � ARCWENGI f1_;,,.�„ /!`��t 1 DESIGNER �'l��"� �v ��� NO.DWEL. �70. NO. ADDR S UNRS STORIES BEDR�OMS � CITY IP TEL� N DESCRIPTION S0.FT. FACTOR PSF ADJ.AREANALUATION OOWNER-BUILDER DECLMATION SFR/ADD/REM �7(J pp 1 HEREBY A�L7RY UNDER PENALTY OF GERAIRV THAT 1 FM E%EMM FR01A THE CONTMCTORS L4 Ga�g��� U� W CENSEUWfORTHEFOLLOW710flEASON(SEC.70.71.68VSINESSANDPROFESSIONSCOOEANYCITYOR ' (n � (.7 COIMT'(YM1N.11REOUIFlESAPEPMRTOCONSTRUGT,ALTEILa1PROVE.DEMOUSM.OflREPAIqANYSTRUG W Pw�� �'I �j Z TURE iRqR TO RS ISSUANCE,/�150 REWIR[5 THE MPUCANT FOR SUQt PERMI7 TO f0.E A SiGNED W L J �� ETATEMEM iHAT ME OR SHE IS UCENSED VURSUANT TO THE PROViSION4 OF THE CONTRACTOR9l4 � CENSE UW�f7UPiER Y(COUNENCNO MrtTM SECTION 7ma)OF OMSION 70F 1HE BUSINE55�NJ Pq0. u' POOVSpe iE55�ON5 CODE�OH THAT HE OR SHE IS E%E�PT TME0.EFNdA AND iME BIlSiS FOR THE ALLEGED E%EAIP• TION.ANYVqlAT10NOFSECTION7W1.68YMlYAPPLIClU7TFORAPFRMITSUBJECTSTNEAVPUCANTTO Z papool F, A pNl VEN�LTY OF NOT MORE THAN i1VE HUNDRED DOLURS�tsoo),I: ❑4��EROFiMEPROPERTY,ORMVEM�LOYEESYniMWAGESASTMEIR50LECOYPENSATqN, � COrtIrtlBfCl�l YMLDO TNE WORK AND iHE STAUCiURE IS NOT MTENOED OR OFFEFED F�R SILE(SEG 7W�,BUSI• J � NE53 AND GROFE590N5 COOE:TME CONTMCTORS IILENSE U'N DOES NOT A➢PLY TO AN OWNER OF � 1 J �1(. iqOPERT`/N710BU1D40RIYPIiOVES1HEi1LON./JllINM1iODOESSUpIWOfiKHIMSEIFORHERSEIFOR VT �J (Z THq0UON1E50RMERONMEYDLOYEES,VibVOED7NATSlKMIA1vROVEAAENTSARENOTNTEN0E�IX1 m �1 OFFERED iOR SALE IF MOWEVERi1iE BURDPIDOR MPROVEMEHT IS SOID VA7HINONE YEAR OF COuOLE- L 'T10N.T1E OWNER�BUILDER VALL NAVE THE BUFiDEN OF ipOWdO iluT ME OR SHE DD HO7 BUILD Oil = MPROVEiORT11EPURPO5EOF3ALE} � O l A+`OWNEROF TH:PFqPERTY,MI E%QUS�YELt COhTMCTN6 MnT1 LICENSED COHfMCTOR3 TO CONSTRUCT THE VR0.IECT�9EG 7011.WS�N[SS AND VPOfL5510NS CCCE TME CONTMCTORS LL Valuation ADJ.AREA CENSE UW DOES NOTAPPLY TO/�N OMMER OFAPAOPEHTY MMO BUlD3 OR W PROVE9 THEREdN.ANJ � MnqCONTMCiSiORSUdIpNWECTSWI7H11CDNTRACTORfSJLICENSEDPURSUANTTOh1ECOHiMG pUAN'TITY DESCRIPTION- � . ' FEE � IORS 110EN5E UW.). . ' O I AM E%EMPT UNDER SEG B.t P.G FOR THIS REA30N U � LL OAiE OWNER � � J � LICENSED CONTRACTORS DECLARATION W I MEPEBYAFFIRM UNDER PENALTY Of VE0.tt1M T/MT 1AA1 IICENSED UNDEH►ROw510N50F CHA7TER V. � ��COMMENCINOY/ITMSECfqN70ao1�OM5i0N30FTME8U5iNE55ANDVROFES5iON5CO0E,AND Z � W LICENSE IS M FULI FORCE N�D EFFECT. m � IICENSE CLA� _� LIC.NO. ����� � J �j �ATE � corrrw�cror+� a w � WORKERS'COMPENSATION DECLAAATION Q � IHEREHVAFFlFWUNOERPENALTYOFP[RNFIYON[OFTHEFOLLOWMCDCCLMATIONS: U � Z Q � _IHAVEMIDW'LLWINTAINACEfiTIFICA7EOFCONSENiTOSELF•INSUREFORWORKERS' _ COYPENSATION.A9Pf10VIDEDBYSECT10N77000FhIEUEIORCOOC,fOHTHEVERFORMANCE W OF THE YVOIi�(FOR NMIG17HI5 OERAIIT IS t55UED. � C d �1 NAVE AND YMLL MAIMAN WOPo(ERS WMPENSATION MSUMNCE.AS R[OUIRED BY SEGTION �7oaOFTHEIABORCOOE.FORTMEPERW�UAANCEOFTHEWORKfOHWMiCNTHISiERMR15 •C{Q�'.`�'f� i55UED.lAYK1J ERSC04PEN5 T�ON�NSURANCEGRWERMIDVOLICYNIIIABERARE: CONSTRUCTION �7 _lw ��.+ � GAWER ��`� _ PLAN REVIEW /1 . _� Z roucrriuMe[a _ ELECTRIC _� �� O d � (TVtSSECICINNEIDNOTBE00A7lEfmOFMPERMT6FLYlONEHUN7(iED00l1NtSR�0o10R165j PLUMBING � O! � W �/'� �I'�J� _` Z ICERTIFY7FURWTHEPERFORIAM:CEOfTHEWOE'.NFORwHICf17HISPEP1.11TI5155UE�,1 MECHANICAL ��� VC (7 SHALLNOTEUCLOYANYYEN50fiP1ATf�MANNER50A5TOBECOME5l1&lECTTOTNE \ �Jj ' Y10Po(ERS'COAIPENSATIONUWSOFCALIfORNIA,/iNOAGREE7MATIFISMOUIDBECOME INSPECTIONFEE '^'�� ^1 � SUBJECTTOTHEWOHKERS'COAI7ENSA710NYROVi5�50F5ECT �7000F111EUBOfl 'ry�l.! !+-�O �v cno,i oannvm�eouv�r wnn� se p hs �s. ISSUANCE � �► s �� �- �,�i� O DATE:� �APPLICANT: SMIP l�,� , � WARNIN@ AILURETO S CURE WOtiKERS'COMPENSATION COVERAGE IS UNUwFUL./�NO5h1ALL BE ENERGY P/C � ��• �y SUBJECTAN EIAPLOYER TO CiiIM7UL PENALTIES MA CML FNES U�TOONE MLNDR[D THOUSAND ENERGY PERMIT DOl1MS(f f oo.0D0).N PD�IiION TO 7HE COST OF C04PENSATtlN,DAMAGES�l5 iROYIDED FOFi IN ¢ SECTION�70!OF iHE LABOR COOE,NTEREST,AND ATfORNEYS FEES. RETENT�ON FEE: "• 1} ��1 • �U� OCONSTRUCTION LENDING AGENCY PRE-ALT FEE: ``�..t r._ F� � � INEREBVAFFIRUUNDERPENALTVOFOEtWRVTHATTMEREISACONSTRUCTIONLENDINOAGENCY RU�� �- FOR TME PERFORMANCE OF TME WO`RN FOR WHICH iHIS VENUR I51S5UED�SEC.�oY7.dV.C.). � LENOER'SNAAIE��/q� r� � LENOEfiSADDRE53 t/� ��.�//�/ W ICERTIFYiHATINAVEREADTW3APGLICATION�NDSTATETMATiHEABOYENFOiLAATqNISCOMECT. TOTAL FEES ��� ��`�� 4�1(,J�/I �� � IAGFEETOCAIAPLYWITMALLGIlYM10GWNTYORDWANGESANDSTATEUWSREUT7WTOW0.DINC � CONSTRUCTION.ANDHERE9YAUTMOW2EREFRESEHIATIVESOFTMISGOUNTYTOENTEAUPONTHE . • � MOVE#1ENfqNED VROPERTY FOR WSPECTION PURPOSES. COMMENTS � O � ' � ��l�c m DEiU11TTEE Ww W � a � ZI� �(' � (n 91GNA REOFPERMIT OATE � RECPT.NO. . P,�ID BY � VAUDATION WHITE—DeDanmentGopy,YELLOW—Fnance Copy.PINK—Assessor Copy,GOLDENROD--File Copy,GREEN—Applicantb Copy . . . . . .. . . . , . .. , . . . . -. • , , . ti�-�..., • � CITY OF DIAIIfIOND.BAR . � . � �It�lSPECTION•RECORD ___._...._. . ... . . _,__..... ...�l� _ _ _. -�li+� �: , -: . � . ;�.�;� ; � ��: �. � ,�: � _ -. 'l�.i�c;. � ��� .�'r�j!�.; !1►.�`�r��+..°�J�.c n�� .� ' ,J r�,,� F �j •.�. ��E ��-�' �. ��• � �� '�►�-�: �_k� �'A��- C► �.����.�, +. :�� .. �.. .4^...,. ._....._._...._,....;_...__..,_,...:._..w...- .��.��: _�,. ......v_ �...,.� ,A.._ . , 'SET�,EiACt( . � , ' ' • � _ . _ i _•'` ' '� I FLOOR JOIST -- -� _ ,;I..,, .�r. r. .. :-�:. . • ,--- � . F7GS,'FORh1S,'STEEL ' ' � � FHA REQMTS . ELECTRIC GROUND. ._ ' - � UNDER FLOO DUCT;� � ` � _.. _. . � � , ._,:R_;..^� . .. GROUWD PLUDABING - • UNDER F1;O�R=�UP•IDL1(T'-�,,;'. ;' ,:.� •� '���•�.,T� SLAB GRADE- _ . FIREPI��_•'sFC'JUDJDlailON->� :��';�—. � t. ; ,�1 . ' TEMP POWER ' FIREPLACE BOND 6EAti1 �.• •-.:�;1F:��`•�.^ � �^JATER SERVICE MID HT. BOND BEAP,A � .' ����; �� '>'-, �� � , ROOF SHEATH:iJG �t� Sl� s l. %, �'�%� • • 8 F7. BOND BEAM - . FRnP�11NG,�rcNTILIATIOtd FINF,L'BOND BEAM �ROOF COVER I • PRc-GRADING ` ' "` �` `" ''�t ' ROUGH HcATING 6ENCHiNG� t;-�1��4���`, � .-�`�-��;,:�:';�:_.{- �� ROUGH ELECTRIC � • ' ROUGH GR��N�t.,'� � -, � ROUGH PLUh181NG '��' FINISH GRADING ' SFIOWER,rTUB TEST- '' ` � POOL'ELECTRIC � • � E�T. VITH/SIDING - ' ` 'i ""• � J� POOL FENCING � ' U'lAtt 1NSULATION - - POOL FItJAL CEILING 1NSULATION � ' OFF SITF IMPS. . . ,DRYLVALL NAILING - - � �; c �EDICATIONS ' - SEI�"r ER � FINf�L'E�dG. SEPTIC TANF: � LANDSCAPElIRRIG. - �EEP P1T/LL. +�,';�J�'�: ON SITE iF:4PS.. u��.A1RTEST ' FINALZONING � - . r:�.AL C�NST.�(� 1, �V FIRE DEPT.,FINAL FiNAL N��l ING ' . HEALTH DEPT. FINAL , � . fl"JAL ELECTRIC DEV. FEES PAlD - - �f=t^!RL PLUtrBIN3 ' ENERGY . .. i --.— . . I . —�---- — � �...-a-<.c,.x . '���C.��{ G) C�t:f '.���_�;w'. L• .�.:.t.� ... �ayz,.<:-- - -- - � - , . �_T�,'1� ` 1:•i�t;-.- � . ��� `,J���; - . � 'F .. _ � I'.. - - --- ------- --. _. _ _:�._�_ .._ . � �or�rr,nEr�Ts � . ; .f.,... � . 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