Loading...
HomeMy WebLinkAbout12339 �� CITY OF DIAMOND BAA _ - DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES � � „ 21660 E.Copley Drive Suite 190 �� . (909)860-3195 Fax(909)861-311'! �� PRESS �"eN"�� BUII,DING PERMIT APPLICATION. FIRMLY . : .:.:. .... : : , ,. o� JOBSITE � � �''� �� " APPLICATION� C^ (�PERMIT /� a�y P/C ADDRESS--��-�-� - DATE �U__�.'- � J NUMBER �'G�� � #_ r� r ISSUE � APN__ LOT TRACT_�> i a ,.:�'' � TMPE OCC � _�- DATE__��_�CONST. GROUP p OWNER �,J -f3-'�-1.,s:a ' f-y� o ADDRESS L�• ��[6�d ZONING SETBACKS FRONT _ Z CIT`! `' ' ZIP TEL.�=i�`f(�'�,Z_ REAR RW L_ SAPPLICAf�T __ TEL.__ ��- SIDElSIDE STREET RW f-:: � CONTRACTOR _ _ SIDE _ �- ADDRESS o CI``! ZIP_ TEL. PROPOSED USE t � �'" Q ARCH/ENG/ z DESIGNER ua NO.DWEL. NO. NO. � ADDRESS u� UNITS_ STORIES BEDROOMS � ClTY ZIP TEL._ cn DESCAIPTIOR SQ.FT. FACTOR PSF A�J.AREANALUATION � OWNER-BUILOER DECLARATiON SFR/A�D/REM Gl _ 0 I 11EREBY AFFIRM UN�ER PENALTY�F PERJURY THAT'�AM 7(EMPT FROM THE CONT�ACTORS LI- G3�fl e/Ca OfS LLI CENSEUWFORTHEFOLLOWINGqEA50N(SEC 7031,5BUSINESSAND?ROFESSIO45CODE.ANYCITV09 (n 9 � _ C-7 CDUNTYWMCNREOUIRESAPERMITTOCANSTRUCT.AL'ER,INPROVE.�ENOLISN,ORREPAIRAN•/SiRIIC- W pytfU;DECk Z TURE,PRIDR TO ITS ISSIIANCE,AL50 RE�UIRES THE APPLICAM FOR SUCH PERMIT TO FILE A SIGNED W STATEMENT THAT HE OR SHE IS LICENSED PURSU0.NT TO THE PqON£IONS OF TFIE CONTRAC70FS ll- w -- — �'� CENSE LAW(CHAPiER 9�COMMENCINO WITH SECTION 7000)OF DIVISION 3 OF THF.BUSINESS ANO aRO� � POO�SQB FE3SqN3CODE�OR7MATHEORSHEISEXEMPTTHEREFAOMAN�T}1EBASISFORTHEALLEOEDEXEM17P- (� -- - U TION.AfVYVqIAT10NOFSECTION7031.5BYAMYAPPLICANTFOR0.PERMfTSU9.iE�STHEAPPLICANTTO � (�g_pppf � ACML PENAL7Y OF NOT MORE THAN FNE Hl1NORm DO::ARS(EE00).): - ^IASOVMEROFTHEPROPEqT,'.ORI�YEMP!OVGESWITHWAGESAST4iEIFSOIECOMPENSATION. � CommBrClal Z WILL DO THE WORK,ANO THE STAUCTURE IS NOT 14T'cNDED OR O�EREO FOR c&�E(SEC.7046.6USI- �J , _ � NESS MlU PROFESSIONS CADE.TNE CONTRACTORS LICEN£[LAW OOES YOT Asa�Y TO AN OWNER OF � PROPERTY WHO BUILDS OR INPqOVES THEREON,AND'Mi0 OOES SUCH WORK HIA75ELF Oq HER°ELF Oli pC iHROUGHIYSORHEROWNEMPLOYEES,PP.Ov�pE�hIATSUCH1AdPROVEMEKiSARENOTIYTEkD�DOR m � OFFEHEDFORSALEIF,HONlEVERTMEBUILDMGORIMPROVEMENT550LJWITNINONEYF:4POFCOA!PLc'- 0 TION,TNE OWNER-BUILDER WILL HNVE THE 9lIRDEN GF PROYING T�4Ai HE OFi SkE�1D NOT 6U;L�OR Z IMPROVE FORTHE PURPOSE OF SALE). = GI,ASOWNEROFTHEPROPER;Y,AMEXCLUSIVELYCON?RACT'NCWITNLICEIJSEDCONTRACTOFS W — ' [t TO CONSTRUCT THE PROJECT(SEC.7044,SUSINESS AND PROFFSSIOVS CODc TV±F COHTRACTORS ll. V01u0�iOn ADJ.AREA W CENSELAWOOESNOTAPPLVTOANOlYNEROFAPROPERTVWHOBU!Lv50RIMPROVESTHEREON.AND - '--- - --- - --�— � YONOCONTRACTSFQRSUCHPROJECTSWITI+ACONTqACTOR(Sjf'CENFEDPURFi�AN'TC1hfFCOhiFAC- Q�JANTI?Y �ESCRIPTION FEE Y TOR�E,�LICENSE LAWJ. p� /ii AM E%FMPT VNDER SEC. 8.d P,C.FOR '.IS R,qSCN Q � ✓'��"/.' I _ _-_""____ _____'______' � • - _- � � ;� �� �. �" DATE __ ONRlCF _ _ F- . � — ' '_— ..J]'..'. "___—_'— U �I. ai.�..� � ' _-- _______�� � �, � s� 1_lCENSED CONTRACTORS D-CLARAT(ON � � , E� I HEREBV AFFIRM UN�ER PENALTV OF PERJURY THAT I AM LIGcNS-D UPIDER FRCVIStiJNS O�Gi IAT.ER ��� [L 9(COMMENCINOWITNSECTION�oao)OFDMSION.lOfTHEEU5�NE55hhlDP�OFESSIONSCO�=.AV� � _ i �� �� t�� MY UCENSE IS IN FULL FORCE AND EFFEC7 � I � LICENSE GLASS_ LIC.NO,_ �j U �RTE CONTAACTOR. ""_"'.___.___'_'._— Ia — tLl � 4NORKERS'CPMPENSATIGN DECLARATION a � IHEREBYAFFIRMUNDERPF.NALTYOFDERJUP.YONEOFTHEFO.;OW7JGOFfIARATIONS: z} '1 IHAVEANDWILLMAINTAINACERT:FICATEOFCONSENTTOSc'tF-�NSURF.F(;HWOflNERS' _ % � COMPENSA710N,ASPROVIDEDBYSEC?ION37ooOFTViELAf30RCCDE,FORTNF'EPFOFlMANCF I�G —_._T_ _J Q OF THE WOFK FOR WHICH THIS PERMI'IS ISSl1E� � i � � I NA4E AND YdILL MAINTAIM WORKERS'COMPENSA'IDY!NSURANCE,AS REOL!IFED B"SEGTAN � Q 37000FiHELA90RCODE,FORTHEPEAFORMANCEOFTNEWORKFORWH:CHTHISPERMlTiS . ISSUED.MY WORKF.R�CAMPFNSA710N INSURANCE CARRIEfl.1ND PCI.ICV NUMOER ARE CONSTRUCTIO�V � '_--_' ' _—__ j caaRien _ PLAN REVIEVJ .��, '� ! O PeLIcvNUMBER_____ ___-_"""'__._—_—___"'"— ELECTFIC .._____.__. _ _ �1f,i�/ f : a __—_---'—"_'_ _.-- '_ =-.—r � �iri:5secr�wN�noreecor�t�r:oaFn-�r�w�nr�s�ot�auGr+���waE000c:�xsis�aa��oa��s). PLUMBING ---- — -- ,,� Z I CERTIFV THAT IN THE PFPFORMANCE OF T6�'E MlORK FOR WH;CeV THIS PERMIT IS�SSt:ff1,I PAECHA�ICAL �� � SNALL NOT EMPLOV ANY PF.RSON IM1 ANV MANNc9 SO AS'O BECOMF SUBJCC'Tb TI IE ,3 �} WORKEi1c•�pMPENSRTIONLAWSOFCALIFORNIA,FNDA(;REETHATIF;SHOULDP.fCOA!E IfJSPEC-CIONFEE ___ - SU�JECT TO TF?E YlORKERS'COMPENS,4TION PROV!SIONS OF SEC710:J 3�00 OF TI�IE:J�BOR � CODF,I SISALL'rO�HWITH COMPLY WITH THOSE PRC`/ISIONS. ISSUANCE ,_ � p DATE: __ APPLICANT: __.___""'__"____' SMIP _____ r. J WARNING.FAILUSYE TO SECURE WORXERS'GOMPENSATION f.OVERAGF�S UNLAWFUi,AND SNRLL BE NERGI'P/C _________________ __ � SU&IEGTANEMPLOYEftTOCRIMINALPENALTIESANOCIVILFlNESUPTOONEHUNDREOTHCl1�AN0 �oy'��'GY?F_RMIT �OLURS(5700,000�,I�AODITION'D THE COSTOF COMPCNSAT;OP:,DAfdAGF_S AS PROVIDF.D FOR IN � SECTIDN37DBOFTHLLABORCCDE.IN?EREST.ANDATTORNEY'SFEES. RETENTIOIVFEE. _______ � CONSTRUCTION LENDIN a A^ENCY PRE-HL.T FEE: _____ __ � IHERE9VqFFIRMUNDERPENALTYOFPERJURY7HAT?HF7F.�SAI:UNSTRUCTIONLENDIMGhGF.MCY _______ __ FOR 7HE PERFORMANCE DF7}1E NlORK F9R WHIf,H�HIS PERMIT!S ISSUED(SEC.3�N7,CIV C.). Z LiJ _""'_.._ -' .— � LENOER'SNAME____ F- LENDER'SADDRESS -"""'"-"--""'--' —""" ' ` _ '___"_'""__'__ '_"__ � ICEflTIFYTHATIHAVEREADTHISAPPLICATIONMJDSTATETFIATTHEA90VEINFOFl6RATICNISCOFRECT. �OTAL�EES � � 1�� � � C��% � I AGREE?O COMPLY WITH ALL CIlY AND COUNTV OHD:NAM10ES.IN�STATE�R'r15 RFU7ING TO BtiILDING ( / CONSTRUCTION,ANDHEREBYAUTHORIZEREP7E5[NT0.TIVESOFTHISCOliYTYTOENTER�oONTME 1 � Z ABOVE-MENT EO PROVERTV FOR INSPECTION PJRPOSF-S_ � n CDMMENTS � _���--d L -�-�...._--- --- ----�- -� - -..�°' � � PERMITTEE NAME(PRI j� � _ __ `f; � " _ t _"...___ . ., . (/} � SIONATURE OF PE E'c �- e ���-"-'--'—' �--�- _ ' RECPT.NO. ���,___PAID BY�_��VALIDATION ~ VdHITE-DeparimonP Copy,YE:lOL4-Fin2nce Copy,PWh; ssessor Copy GOLDENRO�-Fila Copy,GREEN-Appl�cant's Copy , , i � 4�(:S; .�.e c:=, �v u�,L�.,�.ti�=.,�, c:;f�.� �,�,•,�,�,,�.���• ;��w� ' � 3. , . .. :.. ... ., . ; . .:; . .. . ., , , , � �„ . :� <'�' ., ys`�,�=�;.{,°�:,�����; ��,.<,,-�� ' i�`:aa.'a�k=,. .` ,n����;r,�" , `':'�' .,. . -i.�. ,;; tr;e"•n:yr; #; �.�: . , , , qrz ;� e.. ", q•t„-�:,7[ s , �.r , ;,, x �q�, , e ,i':°'} e �'*. �y � a w 1�. #° ;,}x '�4�� ai' {,.¢ 4* '�.�;k�.�.,k ,Y �$y�`" at� ����„ .x;��Rib#�%.��tE s ��'��i��1a�6'S it�� ,� t,�.�`�, ��.. �5 T. =p �`�,� � '�1 *3r.S.e� .. , ...i.,>a... , � .. x.. . . . ,,,. .n..':,., .... .'3a 1#-L:'A �` , . . s.,,.. .s... �. . .,°. .� .,. �rt�'s� , t. . . Y... . . . . . .. ,.. , ,,, ( f � - . . � � . . . . .. , • �.`. . �. ....... . . ...... .... . .._.__._.... ,..._. _ .........�._.., __._ , ' . � � ..,__._.." .' ' '.._. .._ , .. -"- ' ,... ..._.. .. _.__. . <.,.. ., . , , ,�, .. .: _ V f i ( 4 .. ... ._ . . :. . , ' 1 " _ _ _'_ , � �� . u . ,+. =a � ' - I .� ; � . ..,�i a� _.. . � . • .. _ . .. . . _. . _._ __ ..'. . s ... ..... ... . -._....�..._.. ...... ....._... . . _ _ _" __ . _ .�_,...._...... .. ._. _. ._..__"'_" .__ ... _. " .. . ... .. : :... . ....�. ,. . ._ . - . r _ E. ��;� :f".F..,.'..,,�. . �.. . . :. � i ' , . 't�' ' � .,i.... .. '� • � .. ,. .. ., . ... ._. ' ___ i ... . ..1 i�Y,`... .'.�:... :. .._ ._. . .. . , ... . .'"' '"' '._.... ... . ..�... ... . _ .. ..__..."'_. .. . .._. �...._ ,. _,�___' Y '" _ • • _ _ _ .._,..,..._.._.. ._,._"' "' ' " _ . . . . , . . . . �. .-��� .. f� - . � �+ ( . , i. .._..... . ., � . .... . .. __..._. <... .. .. .._ . . . ... . . ._._ . _....... . ....._.__. ... ...."_.___ ............. .... .......�_".__ .... _.._2_.._._........... �_.._,....... i . . ' ' ^ , . . . ' ' ' nw, — ^.�• �3 . .. . ... . .. ' "_"_.._._._. -._ ._.. __ .. ""..._ ...._. __ .__. . _ . __ .. . .. . .._ "_"__ ._ ., .. .. .. .............__ ,. .,......_.. ._.. � �. . _ � i:.. � . • 1 � ..,...,,. .. a _. _ ""' ' . . . . .. .._.._ .. '.__""_"' . � � i . -. � � .�1 - .Y , . � ... .... . . . . . , . .. ,. • . . , ,.. . i_ � . . ._ . . .... .,t .... . ... . ..t. _ _ ....,...._.. ....... .._ ... ..._. ,. . .... .... ...... ... .. .._.. ........ . .. .'._..... _.._.. .. . . . . . ' , � i _A' '. . . .. � . �i � .'.. . .. .` + I � � � ' , ". �.. � . . � t .. 1. .�. .. ... .. .._.� �. ... i .. .. ... . . ... .__ ... ... ... .. .... . . ....... ..__.... ...._...'.. '..__.._ __ � ........... ..._.. ... .._. . . , , i-� _ � . , . . _ . . ,._... . �_ _ _____ . _. _._ —.. _...--•—- _. , . .__ -- — — __.. . . .. ___. _. . — —....-— — , s � ' i — . 't<- ..._._�.... _... ..... �. ::: .... ... .—--......... .. ..___.........----._........_...,._..-- —. _ .. . ----.... ... ..,.._........ .,,....... .,... .... .. .. _ .. .... ., _. ..,� --;. . - _ _. ....... ....., _ . .. . .._.. .. —-- .... . ..._ , ...——--._.._......... ..._ --— ....... -- . _ _......._ __ — -- � . . ... - , �: „ ; , . .,. .:.... .. ...---,_ ... . - ---- .._._. ..,.. ..._._...___. ——- --- .._... .... . .._........ _. .. .. ............... .,. _.. ... " ;•,.� . ..... . . _..., ; �_ ,... ; �- , .. _:�..:....� ��` ; , . _ t--..._..... . . , .... . ., . ......... .. . ................. . ..... ... _.. ..... .. — — -----——......,...,,..,. __ .,.... . . ------------- -------- _..._.. . � , . .. . , ,. — ,.. — I , , •...; _ .. . - _ .._. ... ;....,. ........ _ .._......_...... ._ .... -——--- —.._..--—---— -— ...._... -- _. ---...... . i''ti =�:'� li ri7 ; ,., ". . . . : ..-., , � _ ' , � .. . - ..�. . . . . . . - .. .. ;.._...._.._ .... '-'-. .. ...........----'�----..._......... . . ---- - ."-'-...... .......... ....... ... ..._.... . ..,.............. ......,. ._...._- "'----' ,_. . ..........__. .....'---..... . � r.,,.. .. .�.. ..... � � . � . .-..,. , . r , .. • � � .".. .... ��. .�--.._" . ... . '� _.. _ ..w" -� �--._.. ..,. . ....----.... . :_ . . .. �---. . ,. _... , ..- � - - - . � _..-- .. __---------_. . ........... ... , . . , � . ' � ' 1 �... , , ,!.. . , ' ..,:.,., . . . . ..' ' ' . . ._._.. � . . ... .. .... ... _ . ._ _..._-'._...._...__..... .. .... . .._. .... ..._.... ."'. . .._.... ..._. ': . . . ._......:.�.......:_. .. . , i .. ._.. . . , ! t ` . . . ' S � . ,,. .:-,,. �. ,.. „ "'."..... ........ . ........... ""t. . _.. . „ ....._. _.._..-".. ... . . -- -- - .___._...-"'_"'. ,... ......_..,.. . . "'........ . .�,,.... ...,. � , .. . ... . .. ... _ _ .. . _ . ... ._ . . , . ... .. ., _ . ,.._..._._... _ __.. . _.,,., . ... , ._.... .. . """" - .. I� . „ - - .. �- .,.. . . , _ . , . , . , _�,,,�, , �• .� ... .._...._ . .� .>? . ... . . . . . _ . ._ . . . . _... . . .- . . -'. . . _.. ::,�; � �• �, . . _ �� , _ �� . .. , ' , � . . ._ , . .s.. :..`..:.. `c : . . . ... . .. . . ... . � . ... . ......_ . ...'__.., ' ' ""' ' ' _ " .. ,��,s .� :r . � . . . . ' _ , ' . . . ,, .. . , .... J,.� _ , -� -,. . �. _ ,,_..' ' ' . . . . ......" _ _ "_.__. . . . •�, . .,� iw� t�..� /` w. , s 1,�.(-�9 i -j"'-�c c�.� . . . _' ._ , - , • .., . ,. . .. ,..., . .. ; ._ _ . ...._ ...... ----�-- , . . , .. . � , ,,,� a �� i �. ` i .� . ...�,".'�•,.: ........"""".._..,.,. .....,...__..._._...._ , . ,...' ' '... .. ........__.........._.......... .. . ' ....., .""'_'... _ ..._.,...._.__.......__.......�_ . . _....... ..... .........."'............_...... ..... s � y._ ,.........__-""".'___ ..._. .._.. . .____ ..... ___�_�-____..._ _.__.._... ,,,.,...„,. ' .a !x :� -�� r - . . .. . . .. . . . .. _ .. .... .,. i r'>^ } .{ Fr�. i. . ..... .............. ... . ..... ... .. ..... . .. . ._ . . .. . . _,...... . .�. . � s �,.r,. ..:'f.Y .. .. ;. ... . .................'_'...... ....... . .. .. '"'..... 9�..r. 'j"Y� .. . � . . � -. .. . ...,., �. . �� .. � � ••�, .. ... . . .. .... ..... ..... .. ... . . . . , , ,... .. . ... , .. . _"... . .........,_._..... ...... _._....... .. ....._._ .......... . . ..__._....... .. � - s,. <.-���� , a.. . . .^:r..•, e:.� . . .. , ':....i�-;'_.�.. �. .�+'��' ......_..... . ...___.................. ._.. ....,, ... . ...._. .._............._... . '_ ........ ....._..'_'... .. ... . , .___..._...__.. .... . . ._ �£k . .:,�;l, a•}••: n.�. . .}„ x,ke�y . y . :. ,..F.Ee` ��.� ,r: . : tr... <�:, . . ..... . . ""'.... ........... ...... . . ..._._... . . . _......_ , . .. ... _........... ._....... .._.. .. ._ . i{,.; : ' �z` ,��< . �. . . . ., _�� -.ny,.� + ' �"::s�- .'.:.;[� .' S:::I. . . � �; '���. , . .. $ .�.r.�� .P:: ..�. . . .. . . ..._'_....._ , _ . .,. "" '__".._._.._.........., . ... ... . .. ... ... ...__, ... . .._. . . .+.t..-,.. ,s.,, .. '• . : � w F�, .:.� ti5 � '�5 x�`�� +_ : ; ',:..� � �� . . �.,..,.�..:, %i:`=!'' ' ' ". ..... . ._ ....._. .._'.. . . . . .. ........ ..... .... . .._ ._._...._.._.. .' """'._..... . . ... .. . :.;#.,'',:t t�� `�Y� � � � : „ ', '�f..�'� r �., ,:c r.: . . ., __....... ... ..... .'"'"..._. ..... . . ._._...., .. ..... ...._...___..,..r.__. ,__."'. _ ..__.___ ... " _""_"" _ +„, - s = b � . `f x w9i '� . ry �.L �.. ' ..... ....... ..... ._ .. .._. .. . ,.._"__ _"..... _ ..... ,.. ___ . . . . ... .__ ' _-__"__""__ ... . .____ � , i. .�- . . .. . s.F.r . ,.: ' �. 'j .{fY l. „ '� + . 3,xrsw; ;, � . ...�'7, - . ....,_..___. __.,,.e...""'Y".w.........._..__......'_'__.__...._.._"..............."""""'.,�.. ""'_.__"."'_. . ....... .. ......, ._...._.... . .. . . , . .. .. , , .%l' �