Loading...
HomeMy WebLinkAbout12127 (14) �� CITY OF DIAMOND BAI� DEPARTA�4ENT OF COMMUNITY&DEVELOPMENT SERVICES '�� � : � . 21650 E.C'.opley Drive Suite 190 � 5 (9d9)860-3195 Fax(I09)861-3117 / PRESS ,...�....:.. '�' BUILDING.PERMIT APPI.ICATION FIRMLY QJOBSITE _ DATEICATION �^� •..RD NUMB R I 2��- / #,C Q D—2-� I, Q ADDRESS G� L � � � � ISSUE a� q�,/TYPE OC� APn LOT TRACT �ATE__S'" � !' 1 D CONST. GROUP p OWNER — j�� - ADD ESS . E�:. ZONING SETBACKS O CI�?+L ,�2 pwl{� ZIP_�_ TEL�'�Z.�_ FRONT RW '7 RFAR _ ;� �� APPLICANT TEL. S!DE/SIDE STREET RW O z � CONTRACTOR ��T�Tr_�QL_� SIDE ❑ � ADDRESS ���-1A�1� pROPOSED USE_ � CI7Y�, _ � ZIP�__ TEL. _.�,�_�_ �-- w ARCWENG/ r z DESIGNER • e, ��;S��O��s (� ' a ADDRESS ��Gu'-'�-�" f��" O.DWEL. NO. NO. � UNITS STORIES BEDROOMS � CETY ZIP TEL. — v� , DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION � OWNER-BUILDEH DECLARATION SFR/ADD/REM O I HEPEBY AFFlRM UNDER PENALTY OF PEFiIURY THAT I AM E%EMPT FROM TPIE CONTRACTORS LI- Gale9e/Cefport W CENSEUWN0.7HEFOLLOWINGREASON�SEC.7037.59USMESSANDPROFESSIDNSCADE:ANYCINOR ((� __ C.) COUNfYWHICHRE0UIHESAGERMYiTOCONSTRUCT,ALTER,IMPROVE,DEIAOLISM,OqPEGAIqANVSTRUC� W Pa(i0/DBCk W TURE,PRIOR TO ITS ISSUANCE,ALSO REOUIRES THE APPLICAM FOR SUCH PERMIT TO FILE A SIGNED u STATEMENT 7HAT HE OR SHE IS LICENSEO PURSUANT TO 7HE PROVISIONS OF TNE CONTRACTORS U- � CENSELAW(CI111PTER8(COMMENCINOWIiMSECTION700o)OFDIYISION30FTHEBUSINESSANDPRO� u' POOVSpa FESSpNSOO�E�ORTHATHEORSMEISEKEMPTTMEREFROMANDTHEBASI5FOR7HEALLEGEDE%E1AP- (j TION.ANYVIOUTIONOFSECTION7037.SBYANYAPPLICANTFORAPERMI75U&IF.CTSTriEAPPLICANTTO z Re-Roaf � ACINL PENALT'OF NOT MORETHAN FNE HUNDRED DOLLARS(SSao�.�: � ❑LASOWNEROFTHEPROPEtiN,ORA7VEAIPLOYEESWITHWAGESASTHEIFS�LECOMPENSATIDN, 0 CommerGial WILI DO hiE YVORK,IWD hiE STRUCTURE IS NOT INTENOED OR OFFERED FOR SALE(SEC,70a4,BUSI- J � NESE ANO PROFESSIONS WOE:THE CONTRACTGRS LICENSE LAW DOES NOT APPLV TO AN OWNC-R OF = PflOPEflTY WF10 BUILDS OR IMPROVESTHEREON,AND WHO�OES 3UCH WORK HIMSELF ON HERSELF OR � THRd10HHI50RHEROWNEMPLOYEES,PROVIDEDTMATSUCMIMPROYEMENTSARENOTINTENDEUOR m ' QOFFEHEOFORS/LLEIF,HOVYEVER7NEBUILDINGORIMPROVEMINiIS50lDWRHINONEYEAROFCAMPIE- � TION,THE OWNER�UILDER WILL HAVE THE BURDEN OP PROVING THAT HE OR SNE DIO NOT BUILD Ofi � IMPROVEFORTH�PURPOSEOFSALE). �� ' ❑I,AS ONMEH OF THE PROPERTY,AM EXC W SIVd.Y CONTRRCTING IYITFI LICENSE�CONTRACTORS Q TO CONSTRUCT TVE PRQIECT(SEC.7o4a,BUSINESS MID PROFESSI04S COOE:THF.CONTHACTORS U- VeIUaS�Ofl _�_ O O D ADJ.AREA W CENSELAYIOOESNOTAPPLYTOANOWNEROFAPROPERTVWHOBUILDSORIMFROVEfiTHEREON,ANO � WFIOCOMAACTSFCRSUCHPRQIECTSWIhIACONTRACTOR(5)LICENSEDPl1p5UANTTqTHECOMFAC� QUANTITY �ESCRIPTION FEE Y TORS LIGENSE LAW.I. ... O ❑I AM EXEARPT UN�ER SEG, B 8?.0 FOR T,H'S RF.ASON q .?� U . , . . . . . l±- � -- DATE OWNER___'_____"_"_ U Z W � UCENSED CONTRAGTORS DECLARATION W � I HEREBYAFFIRM UNOER PENAL7V OF PERJURY 7HA71AM LICENSED UNDER PROVISIONS OF CHAPTER � � I �R.LT� b(�J �rt'�iI]�-'� C��9� � Y ICOMMENCNO WITH SECTION 7000�OF DIVISION 3 OF THE BUSINFSSAND PROFESS!ONS CO�E.AND Z ��yy MYLICENSEISINFULLFOFCEANDEFFECT. � �' b, U S j �O 4E Q m � LICENSECLASS�_�q ,LIQ NO._��L , � J `�J� �`p r q/1 S.6 U DATE_D'- � I C�y�_ CDNTRACTOR ���� n. � ��� �y,� [l ' / - ! ¢� WORKERS'COMPENSATION DECLARATION -� � _ d � I HFREBYAFFlRM UNDER PENALTY OF PE0.IUHY ONE OF THE FOL_OW:NG�EC�ARA'IONS: Z � �I HAVE AND WRL MAIN7AIN A CERTIFICATE OF CANSENT i0 SELF-INSIIRE FOR WOHKEHS' ¢ 2 COMPENSATIDN,AS PROV!OED 9Y SECTIWd 3)�OOFTNE L ABOR CODE,FOR THE PEaFORMANCF. �U o OF THE WORK FOH WHICN THIS PFRMIT IS ISSUED. � W _1 HAVE AND WILL IAAINTAIN WORKERS'COMPENSATION INSURANCE,AS REC:/1RED BY SFCTI�?l Q 370o OF iHE LABOH CO�E.F-0R THE PERFORMANCE OF TFIE WORK FOR WNICH THIS PERMIT IS ` ISSUEO.MY W RNERS'COMPF_NSATION INSURANCECARRIER PN�PO:JCV NUMB�R ARF: CONSTRUCTION �V_�19 D � CARRIER � �/�.L._r_____,..rwli _�_._,� PLAN REVIEW __ ___„ _��'o��7 � POLICYNJMBER___�_,i����_ __ ___' ELECTRIC _ _ __ _� p. 0 (MSSECfI0Nt3EDNOT8E0CiuPETEDOFh1EPERMJ�ISFORCY.'EHUNORED�.APSI�100�ORLESS). PLUM9ING _____ _ S O W z ICEATIFYTHATINTHEPERFORMANCEOFTHEWORKFOfiWHICH7HI5PERMITISI55UED.l MECHANICAL .,_,_,_._,__ ___ ___, _ Z}' SHALLNOTEMPLOYANYPERSONINANVMANNERSOASTOBECOMESUBJF.CT'O�HE I � WORNERS'GOMPENSATIONLAWSOFCALIFORNIA,ANDAGREETHATIFISMOULDBF.COME � INSPECTIONFEE ____._ __ SI/B,lECT TO THE WORKERS'COMPFNSATION PRDVISIONS OF SECTION 37Co OF TNE LA90R � CADE.ISHALLFOflTHWfTHCOMPLYWIiHT SEPqOVIS10NS. I � ISSUANCE ____ __ ___ ,2S�DD � DATE:����/3,�;, APPLICAN7: ' _ __ I SMIP _ _1�..0 JJ- �--- ENERG`f P/C �----- �— ------ —�---- WARNINO:FAILURETOS'eCUREWORKERS'C PF.MSATIONCAVFRAGEISUNLAYlFL1L,ANDSWAL.LBE � � yL SU&lEC7ANEMPLOYERTOCRIMINALPENALTIESANDCIVILFINE5UP700NEHUt.DREDTHOUSAN� ENERGYPERMIT DOLLARS(E7 oD,000),IN ADOITION TO THE COST OF COMPFNSATIOK.DAMAGES AS FROVIDE�FOR M --------- J SECTION 37ae OF THE LA60R CODE,INTEREST,AND ATTOFlNEV'S�EFS. i FETFNTION FEE: � - - d CONSTRUCTION LFNDING f,GENCY I PRE-ALT FEE: O - - gIHEREBVAFFIRMUNDERPENALTYOFPE0.IL'i7YTHATTHEREISACONSTRUCTIOYLEN0INGAGENCY ' FOH THE PERFORMANCE OF THE WORK FOR WMICH THIS PERMIT IS ISSUED(SEC.3097.CIV.C.j. I Z i w _—_—_ _— � LENOER'S NAME _ ________--.-- � _'___"'_ __ F- LF.N�ER'S.W�RESS __'__'__'__"'_... —'__ __ � ICERTIFYTHATIHAVEREADTHISAPPLICATIONANDSTAiETHATTHEA90VEINFORMATiONISCORRECT. TVTAL rEES //''''''�� � (((��r// � I AGREE TO COMPLV W1TH AIA CITV AND COUNTY ORDINANCES AkD STATF LAWS PELATING TO BLIILDING ��( /r J " / � CONSTRUCTION,AND NEREBV AUTHORIZE REPRESENTATIVES OF T41S COUNTV TO FNTER�1PON THE � V � 1 ZA90VEMENTKN-0ED PROPERTY FOR INSPECTION PURPOSES 0 ^ COMMENTS J ��` � �.�.�. � Z�/2n�i1C -�------------ --__�' m PERMITTE E(PRI � ¢ --��-�-=9-8-- )y_-�yj- � � SIGWIT O P RMI DATE RECPT.NO._,_ ,_QL�__PAID B S 4 = VALIDATION_ r � WHITE ertmena Co YELLOW—Finenca Co PItJK—Assessar Co GOLDENROD—File Co GREEN— p py, py, py, py. ApplicanPsCopy �. ,,,..:�, r_. ., �....� F-. «.u,..� •�. �. � .r ' . ��.an s..>c;x�,�"��"s`,r'���:.,s �'�:.�: t'�a�C�:in;�:;�e."w�+r"'�;; ��s'��?'���i-i�'��� . • � .,,.. . . r�E,.. .. 'c"��,�.:;<ri;"'.�„' <-�� -,�. p.p..»» .,;fi'":Zi:w7,"� ';f:'v;- •--m,-„„M=wr77. �*�-w*sme�.�x�:�r.- «^;s,€,;, '7'•Y»."7"T.. >"��.c.,�r. e�wrp:g^;,,.s=sw:�'rs7r=,x'�^,,,'�^cr;s:.��-a>�.Y. . . .x�s� � C pe y. � Css.,au.s�..'Yx:�', w-^�^i A��as.E , - ''� r��Yi.wr { � F,rt�� ��..s�.i �§ .'� .. , .� . ._ 'E s{.'� fr F;dt-+�� ���r';43�%� �..�� r #Lr'n� . s� .;�r } ��5k3 �A� 1't�s '�,y}i""dF�'�.�x���.3.�� � � � a �. � � k.� :,� .� ..a �"; ,.� y����C�+����'� i ?,.� t� � rt� , t � ��r�� +r+ "� s �' °� {a.'.� � 7 P { I i , .. . ..F. 9 .:" Pt ; fr, . ' . � i ,.� . ..... . . i . � ..... �. . � � • ' ......�._..'_� .�__.�._............. ___ ._. . ............_._. .....'_ __ t x A • t" . ; ' (.. . . .. .__...... _ _ ......_,....._.. _ j . , _..._ ... - .,..,. _ . . � � _ x ....._ ._.«........_..f. ... ...___—"—_.__....._._�__.___ __. . _ . r ` _ ' . � 3�'. . . . ., � , � , „ , �- .... __ ...... .... .--- -....,. . . .._ ........ ... ... __ .,.. _._.._..--- _ ... ...... - - ---..... . .... ... ... .. __ .. ..._ � .. .., ,,.� _ _ M . , _ _ - . . .. , � ,..:, ,. , ,..i ,.._ . , r, t ...." .."'. ..... _._' """., r. .. .... .. . .. ... ,...... _ ' ' _' .' �_' ' .... ... ___, ..._..___ ..._.. .... + ,, . . ... _, , ., � �� t� � . � _ , < < . ._ .__..._ :." .... .. �'..' . �,_"' _..'_' . .. . .. .... .. . .. . ......._.._... . . . ..""'" ..-- . ..'" "" ' ._ .,.. ... .."_'..... _ ... .....__. � "F 1 ,�. ... .._ _ � _ . _.. ....... ' r . , ._ � � ��� '...' � . � . � . ,�... . ! ,�..: s{,�� � " � , � . .. •. ' , .• .. . ",: ,.,.. ..'....�.':. .:.'.._.. ..........,"'.............._...'t"""'.._....._'"'_._. ., .. ... .._.._....._.....__._..._...-'_'..,...,.-......... _... .. .... __" ' , ., .. .- y,� - .- . E,..:�� �' �. ' !. . _ ' ' . �_ y .. . . � � .-� . ""._...__._._...�.._..._... . �,., . .t. � F .... .. . . .. :.. _ _ . _ , _ ._._ .......'__..._.._____"__'_" , � . � � .,�.. . .. . . . � ,........ . ..� . .... . ..... .. ...I._..... . . _ . : . .... . . _.... .._.. . ....... .. .... _ �.0. . .. . ...._ .' ` , . ......... ..... „ ,�a . , •... . .._ i. _ ....._'.__..............__. . . ... . a n r � �.� . „ _ .. .,�.;..'.. _ � . . _ _ . . .. . . 's.. ...`. � g ' ' . ______'..:.._..'.5 .._ . ...,......_ " "..............._..."'...._ _ _..._..__,...""_"'_"..."'_'_..._.._. _. .. _ ' " _'_ __._'_'_____.___.. . - . . . ., ...,,.�{�.�'.A. . "' ' _ . , .. .. . •... � < ., , r „ E , .. .,�.. � _ , ' • • ' - . ,. y A - �- ,: . y = - - � --- -- . .' ._:._. � _..__.._..�.__...........� _ _ ..._. _.. ..-^---_._ . .._ ._. . . �.,._. . , ... � . � �� � -,.�.. i . ,.... ,,.. . :. . .:...... : . . 1 ; ; : , __ _ : � ' . , . t f ; � ' „" '_' ,..., .'_' "" �: . ..� r ....,.. ...... ...._..::. _'.,....... ._.. ... ...."_'""""__....."_"""""" _ -_' __ _ _'_'.." " _ __ ' "_' _ "'" ..:.. ..�.. ..... ..' 9" ,... � , ,. ,�. - - • . , . , -------c---....-----... � ' - , � � • ¢ � '- __....... ... . .. .... ...._ ' - -._... - --„-- -- .... ._ �..__ _ ._..w. _. __ .... .. , ....-----. , ..,. ..---" -- . . _ ; � � , ,�_ t:.� _ � .. _ . , ..._ .___.,_... _ , ...."' ....�....__............. �_....__....,,_...._.'.""""..._.......'__. ,... . ....._.........'__'..._..___...__b.__...,..,,.,..___ ,...._'_..._..._. ,. ..._.. _..... .""""' . _•,•..i, . ...., '_`-,e!' : ; ._., ;: ... ,,,., a>,, r ,.. ;- _...I... . "'...."'_.... .. � ._,... _ . .. . _. .,.-. _ . _ ._ .. . .. . .. .................'__ . .. ,. ... ..... ..... d �, � . , , ..t' , .' , j , . . . .._.,.. ..._.. ."' " � ..... .,,... ._. ._ ......_.,� ! _ � _ "'"._ �_ .._...... .. ....."""_ '_"' . . ,. . . . ' � 't, :.1,.� . . � • , .... .. .... ... .. _ -- -��---._ . .. .... . .. ...--` ...._.....__...._---- -------------...-- ----___.._--__�.----�-----_. ........._.. .- --' : --.—. , r , - .. i_ „��... _ . .._"-'_..---............_...... . . � .. . . . . ���R _ i . :.... ... ..,,... . . . _ ... ....., ................_"_'. ...... _ .... . . . ._,.. , .. , , . .... ._. ._...... __.... ,.,..,....... ......_ '""'"'"...._"""_' . < ,..... . .. . .� � � ?.;., . .� . . . . ..,. . , „ , . _... . ... . . _ . . J..................'"'.....__ ..__.... . � _"_..""""_'__'______.._...... _. . _..... .. _. __. .... ._._... _ ' '__.. .... . ,.._ ,�, .. ,..,, , . �, . . � �,,.�i: ' ' "....""'"....'_"""..___ � _ � _ � ; ... . . . , . , . ..,._...... - . - .,.. ._. ..... .."' . ."" � : .��_i � -, � ': i',; � , � �y4,. • - _ . . .:.......1.. ./� ' 3_,...."_'........_.._.._....... . ......_.. ...... .,...._.....,'"""'""'......_'""""".... .... . _ _ ..__................"'.....,.. . .._._.._...__. ... . . ._. �... ..._..�... � . .. ... . ....... ,... ..... _.._..._....,__.._�_..........." '_". 3 .. i . .. .. ' .. .,.. . . . �, , . � .. , .........'_.' . ., ..._. . .. . . . .. ._ .. _ ._._..__._.. , ......_. ..'" _ _ __ .....___...,__.... . .... ... ....'._." . "'_ . ._ . �� ,... . ,� . . . . . ..�. . ......................�v.__._.,_.__...,..... . _ � �. e . ..' .. . _. . . . . ... . . .... ' .. . . _..... �. ....'......... .... .........e_...:. .a... __ ..... _ .._.. ..... . � ._...,... . . ��• ___ _ _�.'.._'_...,". _._ _ < � __,.._............ ..."__"_ . .. _ _ .. " .... . , . . . . .. . . .. .....�__. ..R � Y� . .-,� � , - � .. . . . . , . . � l..._ I i .._. . . . , ' ... . _ .... . . .. .. ......... ,. _ ._ ... .. . .. . .. _..._......._.. . 1 ..., � ' � . . . . ._ ._"'._._ . i.. " . ' iF:L., d jG .....� . ........... ._'....... . ., .. .... .. . . . . ,. . ' .. '_'.'. -. „ . . .�. __. ....._..,.... ... ......._ . . .._.. .. ,.,. ....... ............_. ..__.._. �. 5_l�_0� � 1 �E. , rc r. ,�' � . �. ' . ,. s ., , . t.._. . . . .... .._ .. .,, .,.: ._.. . ...._ .._. . , . .... '_ ___ " .. ""'.....""'_. . .._ " __' . ... _ . .. "__.. ._ ... .. . .. � . . ... .... ...��......... ,- : .:. : � " ,. ,.. .....e. . , , ... . •I . . � � S . . . ''..� ' , :'�' ,r , ` ' . ' � . � � . . � .:....a... ... . ...a.. .. i ....._.._........... ..__.. � .........l.r. ._.. ,.. .._...........�...___."___............._............. .. ___ ___'__.._.. ._. ,..._....._....___'.__.__'_....... .__......_. _ , .. ..., i. .. . '� � , . . ...�.... ..........._'__"'�._...._...._..a........o-.....__....._.._........,.._...._.._ -e__�...,..........,.............__'..a......<. q - w^t: . .,.. . . . .". __ _ -... .__ . . . __.. . . .� ,. . ' . • .aY6� ,Y� <4Y�.' ;iY� . . � . . ... . , • • l , ' � � . .... ...' ..' ....... . . . ...a ..,... . . _ ....... .._ ......,. ..._._. .._.. � �$ . a...._. . .. . „ .. ._... ___'__ za;i,��� ,�, �.i, � .- '� ,� - , _......, � ,�r� .-.z-.�-, ' --- • .... .. . .. .�_ .� , � � � . - ....., . _..._.. .... ---,. ,..---.,...._... ...-- ----..........,.__..... __.. ...__...._..... ___..........._--...._...- -- • . • , - _ _--.. _ . ., ...---.._......----.._..------ ------... ' ' � ' . . . „ ., . , . .. . .. �l .'.•.. �. .. ,_ ..._.. , .. .,.. ... . ..... . .. ......"""'_."..._....._.... .......... ._. . ......,. . .. ............,.... .. ... ._ . ., . ... .. . . .___.......,....__ .. '._'...,_..._._-__-_.._-__._.i � y..,..., _. ;::......,... ._...._'""""""'.._,......,..."" '... ....................... ,.......__" ""'".:..,_.._'"'"_......_.."'""'"`_'.._.."""_""'"...""^""""'...._...""_"._,...,...:......'__.... ... ... . . ... -;at .. > _ . . � `.:. '� ,',`ei _ '�t. y, _._ ...___.._ '__-_._-____... ._ ...... __.. . ._.. ..__- ____........ .. ... ...... "' .......__ ., ...."' . ..__. ._. ..""" .. 1�;'��:�� .� � . ...... , _�__ , .,�,F�'� . ., ., a. � z � ;�t �,:<: ;�_ . ,. .. ... ....... . ... ,...,. . _.. _. . . .. _ __.. fx�.i F . . , la. .._ ..._. ......."... ..._........ . ...... , f�nt- �S*� �! r t ,.yrv. � ',.� ..�... � `:wr:.t' ..' . ...���. �; � :.,...,.�,w :.�'�.,.j. . �:,: .. .. . . .. ..... ........_.... ... ..... ... ._,....,. ... . ............ ._........... ... .... . .. . .. . _.. . ....... ._. . ....._ v t .gy��, '�'�.•�; . " k' �ai�t:�i" _ . ,�,_;r,... �� . ' �'". .1�^r,; ,r..:' .".d• ?'" ., ._ .. _..._ ..,..L::�'� ._ .,. ._ ....... ..._..... .... ___.__'__......_._.........__ ... ......_'_'........,.._ ...._.'_.._. . . ._.. _ ., . . . 4 . "' � 7 '�-1'7 ."' """.... __.__ .. . . � • r � � �� 3: � , , � . . , , _„,� - -�. t .�._.. �� � � t� _ - ------- ----. ...___.. ____.,_ .. .___ , _......,_ .- - - -...... . .. � . �� 3' . . � . x 1 �� . ' .� Vw�q.T�.'LYW�y�wr��e++v N � � #. �� s �• ��}a , . . ' ,n '. .. . , ,.... ...... ..,... "_ . __ _ _ ...... .......- ___......._'.x_.... ...... ..__...__ ., . ._ 5''�7'�S�,St��'. 15 A:`'"'�°.t :.. . �� �-� . ` . � . � ` e.�i� ia�..: [ ` - •� ' . > y..y,�. ..i'.. . �-� .�. � " . .. :P�, .. .,t.,�.-:.�� . : ..:t. . . . .'.., '. p � ( .�t,.w. - °, .. _ ... ... ..... . ...... ......."" .. .......__.�... _..._...