HomeMy WebLinkAbout13361 ��� CITY OF DIAMOND BA& �
DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES
_ W 21660 E.Copley Drive Suite 190
� (909)860-3195 Fax(909)861-3117 PRESS
� ���-� BUII.DING PERMTI'APPLICATION ' FIRMLY
} JOBSITE �Q'O � �� t ►1 � APPLICATION 6�/L�pj Q� PERMIT )33�� P/C Q�I r�
� ADDRESS V�� DATE � � ��� NUMBER # l ��b
c� ISSUE TYPE OCC
APM1 LOT T��`CT DATE � CONST. GROUP
p OWNER 5 K•O.
� ADDRESS 0 b LN •• ZONING SETBACKS
� CITY D � ZIP�f� TEL. REART RW ❑
APPLICANT � ��. NOl.AcN TE SIDE/SIDE STREET RW ❑
' � CONTRACTOR � ' SIDE ❑
� ADDRESS PROPOSEDUSE � K- K-�7� r�?b N�l� 1N�1AK�
o CIN ZIP TEL. �� ^ ���5
w ARCH/ENG/
z DESIGNER J ��. � G
a ADDRESS NO.DWEL. � NO. 2_ NO.
� CITY �;A� ZIP E UNITS STORIES BEDROOMS
y DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION
Q OWNER-BUILDER DECLARATION SFR/ADD/REM
O
� I HEHEBY AFFlRM UNDER PENPL7Y OF PERNRY THAT I AM EXEMP7 FqOM THE COHfRACTORS LI- Get099/CefPOR
W CENSEUWPoRTHEFOLLOWINOREASON(SEC.7091.SBUSINESSANDPROFESSIONSCODE:ANYCI7VOR (n
U COUMYWHIGIREOUIRESAPERMRTOCONSTRUCT,ALTER�MPROVE,DEMOLISH,ORREPAIRANYSTRUC• W Patio/Deck
W NRE,PRIOR TO RS ISSUANCE,ALSO REW IRES THE APPLICAHT FOfl SUd1 PERMIT TO FILE A SIGNED W
� STATEMENT TXAT HE OR SHE IS LICENSED PUiiSUANT TO THE PROVISIONS OF THE CONTMCTORS LI-
� CENSE UW(CHAPTER 0(COMMENCINO WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND Pq0. u- PooVSpa
fESSIONS CODE)OR THAT HE OR SHE IS EXEMPT TNEREFROAI AND THE BASIS FOR THE ALLEOED EXEMP-
TION.ANVVIOLATIONOFSECTION7W1.5BYANYAPPLICANiFORAPERMITSUBJECTSTHEAPPLICANTTO Z Re-Roof
� ACML PENAL7Y OF NOT MORE THAN FNE HUNDRED DOLURS(S5o0).):
� ❑I,ASONTIEROFhiEPROPERTV,ORMYEMPLOYEESWITHWAGESASTHEIRSOLECOMPENSATION, � Commercial . -
NALL DO THE WORK AND THE STRUCNRE IS NOT INTENDED OR OFFERED FOR SALE(SEC.70/1,BU51� J
NESS AND PiqFES510NS CO�E:THE CONTMCTORS LICEHSE LAW DOES NOT APPLV TO AN OWNER OF
� PROPEHTYWFfOBUIIDSORIMPROVESTHEREON.ANDWHODOESSUCHWORKHIMSELFOHHERSELFOR � �
Q THROUOMHISORMEROWNEMPLOVEES,PROVIDEDTMATSUGiIMPROVEMENTSARENOTINTENDEDOR m
W OFFERmFORSALEIF,HOWEVER7NEBUILDINGORIMPROVEMENTI550LDWITHINONEVEAROFCOMPLE-
Z �TION,hIE OWNEf48UIlDER WILL HAVE THE BURDEN OF PROVINO iHAT HE OR SHE DID NOT BUILD OR ,
= IMPROVE FOR TH=PURPOSE OF SALE).
❑I,AS OYVNER OF iHE PROPERfV,AM E%CLUSIVELV COHTMCTINO WITH LICENSED CONTRACTORS�
Q TO CONSTRUCT THE PROJECT(SEC.7oH,BUSINESS AND PROFESSIONS CODE:THE CONTMCTORS LI- V81U8fI0f1 ADJ.AREA
W CENSE UW DOES NOTAPPLV TO AN ONMER OF A PROPERTY NR10 BUILDS OR IMPROVES THEREON,AND
� � WIqCOMRACTSFORSUCHPR0.IECTSWITHACONTMC70R(5)LICENSEDPURSUANTTOTHECONTRAG pUANTITY DESCRIPTION FEE
� TORS LICENSE LAW.).
J
Q ❑I AM E7(EYPT UNDER SEC. B.6 P.C.FOR THIS REASON Q
3 � '
� � . _
Z DATE OVMER V -`:�
W
F6 LICENSED CONTRACTORS DECLARATION W
CL I HEREBVAFFIRAI UNDER PENALTI'OF PERIUM THAT IAM LICENSEO UNDER PROVISIONS OF CHAPTER
d Y(COMYENCINO WITH SECTION 7000)OF DMSION 70F THE BUSINESS AND PROFESSIONS CODE,AND Z - - ... � n A P�fT
X W LICENSE IS IN FULL FORCE AND EFFECT. �'��k� V J ��J
11J � i
� UCENSE CLASS IIC.NO. J ���'}r��!i�T��•,�U 1�I��
VDATE " CONTRACTOR a ' �iAt'�1 i .
W �;'Ul�.,�i��r ��
� WORKERS'COMPENSATION DECLARATION -�
� a
� I HEREBY AfFIRM UNDER PENAL7Y OF PERIURY ONE OFTHE FOLLOWING DECLARATIONS: U
� Z
� _IHAVEANDWILLMAINTAINACEqTIFlCATEOFCONSENTTOSELF-INSUREFORWORKERS' _
COMPENSATION,AS PROVIDED BY SECTION 37000F THE UBOR CODE,FOR THE PERFORMANCE U
Q OF 7HE WORN FOR NM1iICH THIS VERMIT IS ISSUED. �
O
_I HAVE ANO WILL MAIHTAIN WORKERS'COMPENSATION INSURANCE,AS REQUIRED BV SEC710N
Q 37o00F THE IABOR CODE,FOR THE PERFORMANCE OF THE WOHK FOR WHICH THIS PERMIT IS
ISSUED.MY WORKERS'COMPENSATION INSURANCE CARRIEH AND POLICV NUMBER ARE: CONSTRUCTION
jGpqiEp PLAN REVIEW �
� aoucrr+uMeER ELECTRIC
0 (fF�SECTIONN�NOTBE001.FLEfIDOF7}EPERMTSFORONEHlRt7fiEDDOl1l�(5100)ORLE55} PLUMBING
Z 1 CERTIFV THAT IN THE PERFORMMICE OF THE WOHK FOR WHICH THIS PERMIT IS ISSUED,1 MECHANICAL
V' SHALL NOT EMPLOV ANY PERSON IN ANY MANNER 50 AS TO BECOME SU&IECT TO7HE
� WORKERS'CAMPENSATION UWS OF CALIFORNIA,ANO AGfiEE THAT IF I SHOULD BECOME INSPECTION FEE
S SU&IECTTO THE WORKERS'COM7ENSA710N PROViS10NS OF SECTION 3700 OF THE LABOR �c
CODE,I SHALL FORTHVATI COMPLY WITH THOSE PROVISIONS. ISSUANCE cr �
� SMIP �
p DATE: � APRICANT: .
� ENERGY P/C
J WARNINU:FAILURE 70 SECURE WORKERS'CAMPENSATION CAVERAGE IS UNLAWFUL,AND SHALL BE
� SU&IECTAN EMPLOYER TO CHIMINAL PENAL7IE5 AND CIVIL FINES UP 70 ONE HUNDRED THOUSAND ENERGY PERMIT
DOLURS(f100,000�.IN AUDITON TO iHE COST OF COMPENSATqN,DAMAGES AS PROVIDED FOR IN
� SECTpN 37080F THE LABOR CODE,IN7EREST,AND A770RNE1"S FEES. RETENTION FEE:
d CONSTRUCTION LENDING AGENCY PR��1'FEE:
� 1 HEREBV AFFIRM UNDER PENALTY OF PERIURV THAT THERE IS ACONSTRUCTION LENDING AGENCV I�
FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED(SEC.3007.CIV.C.�.
Z
W
� LENDEH'S NAME
�
F- LENDER'SADDRESS
� I CERTIFY h1AT 1 HAVE READ THIS MPLICA7pN AND STATE THA77HE ABOVE IHFORIAA710N IS CORRECL TOTAL FE ES �
W I AOREE TO COMPLY N7TH ALL CITV AND COUNTV ORDINANCES AND STATE UWS REUTING TO BUILD�NG
� CONSTRUCTION,AND HEREBY AUTFIOHIZE REPRESENTA71VE5 OF THIS COUNTY 70 EMER UPON THE
ZABOVE-MEHfION�7ROPEHTV FOR INSPECTION av'os!Es. COMMENTS ��
� //
.�� � v
�
m PERMITTEE NAME( I �
Q
N
� SIONATURE O DAT
� RECPT.NO. PAID BY O VALIDATION
WHITE—DepeAment Copy,YELLOW--Finance Copy,PINK—Assessor Copy,GOLDENROD--File Copy,GREEN—Applicant's Copy
CITY OF DIAMOND Br4R
8(�SPEC�'IC�n! RECOF�D _
�.. . , � ;
� p , � � . � 1. o .� �� e o �. � � s � m .
� .�
.a� �� .. _ .��r.. . ._.. .. . �.
SET BACK � , ' � ' FLOOR JOIST . '� ��:'��: ,� ; * .'� "
FTGS/FORMS/STEEL ' ' , FHA REQMTS
ELECTRIC GROUND � ' � UNDER FLOOR DUCT, .�•,. ti, ;.: ;, , ;.' ;;,, �
GROUND PLUMBING UNDER FLOOR CU�IDIJIT+ �.,. r� _ �' � �� -
SLAB GRADE � FIREPL G FOUNDA ION �-� �� • �� ' `
TEMP POWER FIREPLAG��BOND�B�AM � � �
WATER SERVICE MfD HT. BOND BEAM
RO6F SHEl�THING. �.�` - j ; i � � '�' ==, 8 FL BOND BEAM i
FRAMINGNENTI�IATION I � � FINAL BOND BE.AN,�. ,.,,, `
ROOF C�VER �'� � �' PRE-GRAb'ING - . �� w�-';:.•i'�%� '':�`' ' #
.;,
ROUGH HEATING BENCH1�1Gj' ��" - '� �� ' _';���<<��'t���4'�'
ROUGH ELECTRIC ROUGH GRADING
ROUGH RLUNIBING FINISH GRADING
SHOWER/TUB TEST POOL ELECTRlC
EXT. LATH/SIDING POOL FENCING
WALL INSULATION POOL FINA� '
CEILING INSULATION OFF SITE IMPS.
DRYWALL NAILING DEDICATIONS
SEWER FINAL ENG. �
SEPTIC TANK . �_ ,-, LANDSCAPE/IRRIG.
SEEP PIT/L.L. '- ' • �• " ON SITE IMPS.
GAS AIR�TEST FINAL ZONING
FIfVAL CONST. o ;�,,, �,., FIRE DEPT. FINAL
FINAL HEATING HEALTH DEPT. FiNAL
FINAL ELECTRIC DEV. FEES PAID
FINAL PLUMBIMG ENERGY
;�' � �� `l� '� $ �;
COMi�IENTS
, .
. 'S�. .,
� ,-
� �
, ;
SEPTIC,TANK SIZE �
SEEP PIT/U SIZE
- _ - � �
�� ����� � � -
�� x �
.�� e f � r�`�� � �- �, `.
;�s����^.�i',4��y'�iy � yp ,�,a`�w a� i
� � i
.�� �� � � §� '. � .
1 .a�����`�y,�''n{i�y�'� �y 4i�l � � �
���� � �i c��
�V R��.� Y� f:
;�y���..�Y��i ��€� ����'h 2, . $
�� � ` ���� ��� �
�'` � ��' 1
,:+�. � "t�� G k�rsx,� ��' �� �. . - � ,
�
�A:a .� § _ . , , ,, �
�,r x
� �� ;�
�, q''i�a i�"��" '��� '��. ' �'. � �V . _
i� �.3�, .h �� ' ' � \ � \ . 4
V".F ,� � ' �'• . ., t�
� �.�� �'� • •. . , , '�.'�� \� - , � ' .�,_