HomeMy WebLinkAboutPR-3443CITY OP'DIAMOND SAR l G.— I`t'
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i ' DEPAR''MENT OF CC?MMUNITY Sc 1?EVEL{7PMLN'I'SERVICES
j;,,, 21870 Copley Drive,Diumond 13ar,CA 91755 PRESS
909)839-7020 P'ax:(9f)9)861-3T17 F3uilding Inspection Hotline(909)839-7027 F R LY
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BUILDING I'ERM2'I'APPLICt1TION
i APPLICATION DATE: P C
JOB SITE ADDRESS R
w ISSUE DATE:PERMIT# /--`
z APN OT TRACT
0 1YPE CONST. F-- OCC GROUP:
o OWNER
ADDRESS /// , ZONING S ACKS
y CtTY.I/u r i"L'i=- IP TE. ¢ 7+ FRONT RW
APPLIGANT TEL. flEAR
o SIDFJSIDE STREET RW
4 Ct?NTRRGTOR G A BtDE
o AQ[aRESS
G PR4POSED USE
cc GITY ZIP 7EL. ZZ -I
0
a ARCH/ENG/DESIG R
o ADDRESS tt DWE.UNITS STORIES BEDROOMS i
Q CITY ZiP TEL
DESGRIPTION SQ.FL FACTOR PSF ADJ.AREANALUATION
QWNEti-BUSLDEN DECtARATtON
I hereby aflirm urMer penatly ot F'lury ihal 1 am exempt hom the Cuntractor's State License Law Mr lhe reason(s)
8FR/ADD/REM
intlitaied beiow the checkmark(s},i have taced nr t to the appflqbie item s Seetian 037.5,Busirtess andttypi)[ Garage/Carport
Protessione Code:My city ur county lhat reqWres a permlt to consUuct,alter,imprdve,demoliSh,or repair,any
z structnre,prior ta its issuance,aisa requires the appticant for the permit to fiie a signed statement that he m she tA PatiolDeck
Is licensed pur5uant to the pravisions ot the Contractor's State Licensa Law(Chapter 9)Comme ing wilh Section W
7000 of Division 3 of ihe Bus3ness and Professians CodeJ or that he cu she is ezemDt hom#ice csure and the basis for PO°'Pa
Ne alleged eaemptbn.Ang violatbn of Section 1037.5 dy any applicaM tor a permft subjecLs Ihe applicant to a civil Denairy Z Re-Roof
ot rtot rtrore than('rve hundred aatiars i$l O
o (}t,as owner of the property,a my emplayees wtSh wages as UieU sole compensatlon,wil3 do(...}aA of w}portiorts mmarcia
0 01[he work,aM the structure is no lniended w ottered lor sale(SeC[ion 7p44,Business and Professloris Cada:The
antractors'Siate iice se L w dces ot apply to an owner of property wtm,ihrough employees'or Rersona!effurt,butlds
m
w imprmes the property,pmvided that ihe imprpvements arn not intended or olfered lor saie.B however,Ne builtling or
improveme t ks soltl withio one year of completion,ihe Ovmer-Builder wiA have the burden ot proving that ii was rmt bWri
p m improved for ihe purpose of sale.).
t,as awner ot the property,am ea dusiveSy conVacting with licensed Contraciors ta construct he pro}eci(Section
0 76q4,Business and Prolessions Code:The CoMractas'Sfale tJcer se Law does not eppty to an rnmer ol properry wfro
Valuatiqn: Adj.Area:
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buiidsorimprovestnereon,andwnocontracistortheproiectswi#t}alicensedGontractorparsuantiotheContrxtors'Sdte 4URNTfTY DESCRIPTION FEE
Y LICCIISC Li1W.).
J
p (I am exempt from itcansure under the Contractw's Staie Gcense iaw fw the toliowing reason(sy:
By my signaNre beiow i acknowiedge that,excepi for my personai residence in whfch I must have resided for at ieasf one W
Z year prior to completiun of the imprrnements covered 6y this permit,l cannot legalty sell a strucWre ihat I have built as an W
owner-builtler if it has nnt 6een crosW cted in its entirety by iicensed contractors.i understami tltat a copy oF fha appiiq ie
law,Section 7644 of the Business and Professlons Code Is available upon request whGn Uiis appliCation fs submitted or al
tho toitawing Web sHe:httplwx w.teginfo.sa.govtcataw.htrni. z A_J '
J X
DATE: SIGN:
4
LICENSED CONTRACTOH'$pEG.ARATION a
UW 1 hereby affirm under penatty of perjury that i am iicensed untler prwisfons of t apter 8 t mmsncing with Sectian 7600}
of Division 9 of the Business and Professions Cade,antl my licer se is in fuU force and eflect
C.No.:9,ro Z
o OATE: CONTNl1CTQR:
d WORKEFi'S GOMPENSATION DEGtARATiON g
I HFAEB AFFIRM UNDER PENALTY OF PERJURY ONE QF 7HE FOLLOWING DEq.lVRATIONS:
a i have arM wiii maintain a Ceni(ip e ot Conseni tn Sett-tnsure Ipr Waker's Compensalion,as pmvtdetl 6y CC7NSTRUCTION:
SecUon 3700 0!Ihe Laba Code,tor I e pertormance ot thfl wark for whicb this permit Is issued.PIAN REViEW:
j I have and will maintain Wwker's Compensation liuuranCe,as required by Sectipn 370Q of fhe Labor Code,tw ELECTRIC:
o the pertamance ol tMe wark for which this peRnit is fssued.My Worker's Compensation t uurance Carriet an0
a PolicyNumberare: PLUMBING:
w CAF2ftiER MECHANtCAI:
v LICV NUMBER INSPEG7lON FEE:
fH5 SECIION NEEO NOT BE CQMPLEI'ED IF TFff PEAMIT IS FOR ONE MINDRED DOI..I.ARS($100j OR LESS. ISSUANCE:
oI certiN iha!tn the pertarrnance oi ihe wnrk(or which ihis permi[is issued.i steii rot emPbY Y D in arty manner so io
becane suhJect to the Worker5 Compe uaUon Laws ol Calltomia.Md agree ihat it I stmultl Ik cane suqect m fhe Worker's
SMiP:
CAmpensa6on provisions of Ser.tion 37oD nt Ne t iba Code.I shaA fathwith compiy witti ftrose prouislarrs. E[dERGY PIC:
DATE: N'PUCANNT: ENERGY PERMIT:
WARNING:Faiiure to secure Workers Compensation cmerage is unlawlui,a shail subjeci an empbyer to criminal REfENTION FEE:
penaftles and clvil fines up to one h ndrCd ihatsand doHars{$700,000},in addition to the cost ot thc compensatlon,
d damages as prauided for in section 3706 al the labor code,interest,and attomay's fees. PRE-ALT FEE:
a CONSTRUCfl4N tENDiNG AGENCY BSAF:
Z I hereDy a rm under penalty of perjury thal there is e CorrstrucGon Lending Ageiuy for the peAorn ance of the work forwwhichthispermitisissuedtSec.3097,Civ.C.).
F LENDER'S NAME:
LENDER'SADORESS:
a 1 certify fhat have read this appiication and state that the above informabon is correct I ag ea tn compty with ai aty and
TpTAL FEES j
county ordinances an0 state laws relatlng to Duilding cunstruction,and bereay autherize representativas of this county to QMMENTS:
Z eNer upon the above-menfioned properry fa inspec(an purposes.
m
d PEftM HAME{ i
i ftE OF PERM OATE - RECEtPT#_ „.""'PAID$Y:V V.4tlDATlON:
H
W HITE—DepaRment Copy.YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENROD—File Copy,GREEN—ApplicanYs Copy
CITY OF DIAMOND AR
INSPECTION RECORD
o o s ,
SETBACK/LETtER ' TRACTAND LEDGER
FOOTINGSfORMS . i ::SWITCH GEAR
S B = F COMMERCIAL HOOD
llG.PLUMBING `'` ,
ti , ; ,_t° '` `: T-BAR
UG:ELECTRICAL_
t .r.INTERCEPTER
UFER GROUND " - '-c ` HOT MOP/SHOWERPAN
SEWER LATERAI SEPTIC/CESSPOOL
MAIN WATER LINE HERS REPORT RECENED
SEWER CLEANOUT DEMOLITION
ROOF SHEATHING ROOF DRAINS
FLOOR SNEATHING ROUGH CONDUIT
SHEAR WALLS EXTERIOR"i BOOUSPA r -
4
Y_' t
SHEARWALLS INTERIOR r ' ' ROUGH PLUMBING '
FRAMINGN NTING ^'r''" '' flOUGH ELEGTRICA p ', ` 4
ROUGH MECHANiCAL ROUGH MECHANICAL' ' `',
v x
j f 1,.u
ROUGH ELECTRfGAL'W( )CO _ f:- GAS,TEST-- r. s _
y i ;
ROUGH PLUMBING..- PRE GUNITE J
INSULATION WALL POOL FRE DEGK BONDIIVG ` +# ! , i" ' ` "
INSULATION GEIUNG P P ` ''° `
DRYWALL FENCE(GATE/AIARM :`
Y''' ` 4 "-
LATH(PR F1NAL POOL, _
LATH EXTERIOR WALLS:
LATH INTERIOR WALL FOOTING/STEEL
GAS TEST WALL STEEL 1 sT( )2"0( )LIFT
SCRATCH COAT WALL BOND BEAM
ELECTRIC METER RELEASE WALL DRAIN/SEAL
GAS METER RELEASE WALL FINAL
SPECIAL INSPECTION RO`FRAMING PUWNINGAPPROVAL f= '
FINAL'BUILDING . z - ': _ ' ROUGH FIRE APPRQVAL 4
FINAG MECHANICAL '
t FINAL FIRE DEPARTMENT ' : ` ;
1 '
FINAL ELECTRICEIL FINAL PLANNING r
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r ' FINAL:ENGINEERtNGIPW ; f
FINAL PLUMBING _
T,C.of OCCUFANCY= ` FlNAL COMMUNITY_SERVICES
CERT.of OCCUPANCY" 1,> . F ':' FINAL HEALTH UEPxT`
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EINAGINDUSTRIAL';NIASTE ;.' ,' t_.Y': } '. .. ->
COMMENTS:
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