Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
14313
_ ,�,` CITY OF DIAMOND�AI� DEPARTMENT OF COMMUWITY&DEVELOPMENT SERVICES � t - :`� a16bo E.coPieynrive suice i90 �'`� ` . ,: pRESS (909)860-3195 Fax(909)861-3117 �..' BYJILDING PE�tMIT APPLICATION � � FIRMLY � � � JOBSITE ����� . S � � ������ A SUEbAT10 �PEPE IT �� P/COCC � o ADDRESS ATE NUMBER �1 � AP �' q.TI T CT � - DATE ' CONST. GROUP p OWNER ., �G1'i ICz�, f�C�.!°llfCt'3 W ADDRE G7'9�} /1 ZONING FRONTCKS Rw C g AP CANT� fEa !�' IP LtrNllEptEL. "�dI REAR C�' i SIDFISIQE STREET RW ❑ _ � CONTRACTOR ��`J'�/" SIDE ❑ � CITY . .. � I ZIP TEL. PROPOSED USE _ ,"- ADDRESS � O ,ARbH/ENG/ _, ` , , � ADDRESS NO.DWEL. NO. NO. y ZIP TEL. UNITS STORIES BEDROOMS z DESIGN�ER � � � � cirv � ' " " DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION � ...O , , , QWNER-BUILDER DECLARATION .- . SFRJADD/REM � � � � � � � � �� � � � p . I HEPEBY AFFlRM UNDER PEMALN OF PERJURV THAT 1 AM E%EMPT FROM hIE CONTqACTORS LI- Gaf2ge/CBfport ' � '� W CENSELAYVWRTHEFOLLOWINGR�A$ON(SEC703j.58U$INESSAN�PROFESSIONSCAOE:ANYCITYOH � (/� . �,U Wl1NTYYdHICNpEWIRESAPER�AITTQCONSTRUCT,AITER;IMPROVE,DEMOLISH,ORREPAIRANYSTRUG 'W Patio/Deck � � " W -TLIRE,PRIOR TO�TS-ISSUANCE,jAL30'RE�l11RES'THE APP�;ICqNT FOR SUCH PERMI7 i0 FILE A SIGNED �W ' � �'� ',CENSE LAW(Qi,APTER 9(SCOMM NCIN('aSW TP SRSU QN 7�HE PROVISIONS OF THE COMRACTORS LI- . ..._-- . - .. , � g J.OFDIVISION30FTHEBUSMESSANOPRO- �'�" POOIISPB FESSqNS CODq ORTHAT HE OFI,SHE'IS IXEMP7THEREFROM AN�THE BA913 FORTHEALlE6ED E%EMP- TbN,ANYVKKATIONOFSECTIOp703i.5BVANVAPPUCANTFORAPERMITSU&IECTS'fHEAPPUCAN7T0 . Z Re-Roof �.�,,� 'ACMLPENALTVOFNOTMORETIiNJFIVEWUNDqEDOOLLARS�(55a0).J: �i�� ❑I,A50WNEROFTHEPHORERTYORMYEMPLOYEESNATHWAGESA5THEIfl50LECOMPENSATION. ' '�❑ Commerdal _ � �VYILL DO THE WONK,M1D THE STRUCT�JRE IS NpT IN7ENDED OR OFFEREO FOR SALE(SEC.7044,BU51- .J ;y �.NE6fs AND.PROF�SIONS CODE:�HE CANTRACTORS LICENSE lAW DOES NOT APPLY TO AN OWNER-OF � ;PROPERTY NhiO 6UILDS OR IMPHioVE57HEFiEON,AI4D WHCj DOES 5UCH WORK HIMSELF OFi HEflSELF OR i'��� THROUGHH150RHEHOWNEMPLOYEES,PROVitlED.THA75UCH1MPHOVEMEN73ARENO7INTENDEDOR m � � � '''�W ;OFFEAEDFOqSA4EIF,HOWEVE�THEBURUWGORIMPROVEMENTISSOLDWITHINONEYEAROFCOMPLE- ��,IZ �!710N,THE�OWNEN�BUILOER�WI�HAVE TH6 BURDEN 6F PROVMG THAT HE Oq SHE DIO NOT BUILO OR .. .. .. � IMPflOVEFORTHEPURPOSEOF$ALE} � � - . � '', ""'. � �I,A90WNER OFTHE PROPEt1N AM EXCLUSNELYCOMRACTING WITH LICENSED CONTRACTORS � � TO CONSTRUCT THE PROJECT(SEC.7ti44,&JSINESS ANb�P4YOFESSIONS COOE:THE CONTRACTORS LI- � V8IU8�IOP1 ADJ.AREA � �����,W .CENSEUWDOESNOTAPPLV7UpN OWNEROFA'PROPER"n'WHOBUILDSORIMPROYESTHEREON.lWD ".� VMO�CONTMGTSFORSUCHPHd,JECTSWITHACONiRpCTOR(5)LICENSE�PURSUAN7TOTHECONiMG - �QUANTfiY I DESCRIPTION FEE I� TGR6LICENSELAW.. .. . . „ , , . , . � ❑I AM EXEMPT UNDER SECJ ' ' B.8 P.C.FOfl THIS FEASONo � ,. �� � U . . . ,.. .. �, , .: � �. — �r ' . �'., � ' ..¢ "..,......,.. .. , . ' ' , — �ATE�.. OWlJER � C�L J.�L �U , , �� .,;�� .I,i . � � � . ' � CTORS DECLARATION � _ ': , ! L10EN�uEd CONTRA ,��:',IHEREBYAFFIRMUNpEfiPENALTNOFPERJURYTHATiAM'LICENSEOUNDEF7PROVISIONSOFCHAPTER � � -� . ' �;�, �'�,g(COMMENqNfl WITH SECTIOP7 7P00)OF OIVISION.3 OF THE BUSINE55 ANO PflOFE5510N5 CADE,AND Z '' Dt '�MY 610EN56 IS IN FULL FORCE AND�FECT. , m q.�a � ,UCENSECLASS , ' LIC_NO � ,;V�..;�DATE . . . CONTRAG'70R .'. � � � � d � IW I,'c��� , WORK�RS'COMPENSA110N DECLARATION a � �� �"IHEREBYAFFIRMUNDERPENALT'OFPEAJUPVQNEOFTHEFOLLO'MNG�ECLApATIONS: V � - � N a �O'. _IHAVEANDWILLMAINTAIY�ACERTIFICATEOf',CANSENTYOSELF-INSUREFORWOFA(ERS' _ � 'i�. �COMPENSATION,ASPRO�IOEtlBYSECqION5yD00FTHELA80RCO0E,FORTHEPERFORMANCE W ' OFTHE WORK FOR WHIGH THIS PEFWIIT S ISSUED. g ' �W'. �I HAVE ANp ViILLMAINTAIN�WOPK�S'COMPENSATION INSURANCE,AS REdUIRE�BV SECTION ' Y �� � „��S � 37000FTNELA90RCO�F�,FOR�YI-IEPERFORMANCEOFTHEWORKFORWHICHTHISPERMITIS ISSUED.MY WORKEAS'CQA9P,ENSATKKd INSUHANCE CARRIER AND P041CY NUMB5HAHE: COPISTRUCTION . S� � iL:!i ... . . . ,.� ....� . .. . , � ' . ,4Q��..' cnRaieR � PLAN REVIEW _��` . _�, ' PaicrNUMeEFl _ ' . �. . . , . .. . ELECTRiC . ?4i �;�i � (MSSECTIOYNEFDNOTBE�000.1PtETmOFT11EPEfi�MI3FOi1IXJEl-IUJDIiED�Ol1AFl.�(Stao)ORLE&S} PLUM8ING �W���' . I CEHTIFYTHAT INTHE PEFFORMANCEOFTHE WORK FOR WHICH THIS PEPMIT IS ISSUED.I � MECHANICAL - � � SHAI.LNOTEMPLOYANYPERSONINANYMAfaNER50ASTOBECOMESUBJECTTOTHE "+� � ,� ; WORKERS'COMPENSATIO�JIAW30FGALIFORNIA,ANDAGREETHATIFISHOUL�6ECOME INSPECTIONFEE : � � SU97ECTT07HEWC7RKER5'COMPENSATIONPROVISIONSOF�SECTION370DOFiHELABOR �- � �� , � � ' � CODE,1 SHALL FORTHWITH CAMPLV WITFi THOSE PROVISIaNs. ISSUANCE � �.DATE: � � ARPLICANT .... . . '. - .� .SMIP �g ��_ . � y, ENERGYP/C g��'� 9 �t _ ' .�y �:WARNIN6.FAILURETOSECUREWy RHEflSCAMPENSA7IONCOVERAGEISUNLAWFUL,ANDSHALLBE �� ,�SUBJECTAN�EMPLOVERTOCRIMINALP9JA�TIESAND�GIVILFINESU7TOONEHUNDREOTHOUSAN� . ENERGYPERI�IT�T ���^ ' .00LLARS(510a,aoo).HJ A�OITION T07HE COST OF COMPENSATION.pAMAGES q5 PROVIDEO FOR IN �} � SECTION 37oe OF YHE LABOR CA�E,INTERE9T AND ATfORNE1"9 FEES. � RETENTION 3'* �-'"� � a CO STRUCTION LENDING AGENCY PRE-ALT FEE: �� `F �'�,���� ���`'�n � � ���`W° ..� IHEREBVAFFlRM.UNDERPENALT1yI.OFPEFJURV�,ATTHERE:ISACONSTPUCTIOplIENDINGAGENCY �. .'FOR THE PERFORMANCE OF THE WORK,W R WNICH T�'�IS PERMIT IS ISSUE�(SEC.3oW,GIV,CJ. ��� '�LEN�ER'SNAME I .��......... .. - i f F— �;�I�ENUER'SAODRE55 � v `� I`., � �� I'i�IICERTIFYiHAT AYEREADTHISAPPLICATIOt1ANO5iATEiHATTHEA90VEINFORMATIONISCOqRECT. TOT/'1�FCES ' . ' I ''� i , � '�.IAGREETO� YWITHALLCITYANDWl1NTVORDINANCESANDSTATEUIWSRELATWGTOBUILOMG � ', I� GONSTAUCT ,�f1DHEREBYAUIIHORI2EHEPRES9JTpTIVE50FTHI5COUNTYTOENTERUPONTHE r �jqBOVE � ION D P PERTY FOiR INS N PURP SES. � COMMENTS ' ' h� j��g� �f 4A.'6i"'"yg-V .� ��Ir�Y'ERiN1TTE E(P INn �i � � � � �''�� Q,���'��.d�J �� l`� y �"'.SIGNANREOFPEqMITfEE ' � DATE '' - i .��., I., � '� RECPT.NO. PAID BY VALfDATION -� I � '" � ' � � - � � WHITE—De artment Co �YfLCOW—Finance Copy.PINK—Assessor Copy,GOLDENRO[S—File Co GREEN— - � � �� !� PY. PY� ApPI nYs CoPY ���`� �� ������� ��� : ����� �����'��` � ���� , $ . , , ,� _, � � .����� ����� � . ��:,. � � �;� ���`,. , A �.� � � � �. � , � � —,_' , ; _ ___ _ : _ _:.._ ___u—�.�...�__�.� � �c���,���5 ��T a��� ' a7 ,_; - _. �,�y���r�'-4.3G����' • . _ ,� .._�___ . . � . . � -. � �6 J�a..��t�~�#:k�^~��. 8-x� �;_�`� ,3 �� �t z�°`�"�,�:���a;��.��� l �i�'iL.'�� �=" � ;J�€��.4�i j ;. , ..�....�.�..�.�..__�m _��___�_�..�.. � __�_d ' � ����a€4i�:=��a����.1'�a_�_,.� _.�._. �._._,� � �;�` 1�.F� �-�.+,'�.����3'y�ta.�[�C �� ,�� . � ��L,�t������� ` E ��"R���'L����,F{:7L.�C�C'�3'��� �� ��....� �.�: �� � i � "� �xt�C.r k�fg:��."?. � .. : .,.�.._ ' . t I i�i�a�g'�.r�as����`'����s�-Y"n�ul x � �mm � �`�, �;�9d��° ����cl'3�� .�... E ---�--....._.... _ ��€�.:T,:��'��;� �����E � ___.. � �=�c�3�3a-�:��--��e��ey� O0� � � �:� ��J;� ���:��,�� � ��.. _.��_ _._f�=e�_ _ __ __�____. ���'-����1�?"�+�� ,��"���r i+E�� ___._ ` _ _ __._�s �_ ; C`�°�,��_3�'���,���������___--_ ___ _ � � _,_.______._._ , � ��`"c=�r����� a _ _ _ �_ -�-��� �� — � _ _ ----�-------: ..�_____.:_�_��..______.v__.__._..�(__ ,����a.� __ _.._�.__.._��______. ? ��>�.,�i'i}'°�a"�i€mi�z � ......�___..._ � � �."3 �`�it{��� j ; � �t ` n�"�'��,`�-�':�.���`���, �� {� F3�EJ';P-����'�&t���, �_-�-__. �_w.__,_...� g q --�^—{ �_p� 9 E_�� !�gg� .�__�,�_.____�__.a_. �'� FP ,'!'"1 aPl.s�.B���"'ed�4.,-0 . ' ��,. m...._....,..., k :"94kr`�uf�9 L.d,�P�' .l3'!"d4.mY _ � � .,.�> i ��~��'�i��f �€� cr a �� 1 ���i �"C'+ '1��L���F1�E�'� ' �_. �_ ., .� _..__.._ ���` ,.,�.i� f�`��4��;.� ���(;•,a( j-- _� , ���'' �m�:����.J� ' � ____ �_� __ ._...,___ .____, __ _. _� _, _ _ �_._� —; ._ _Y._ � " � ��� E��������� � � ;___._. � ��� �� � ar��� � �� � � �:.���,����:4 a�:s��{����� � ��I �����-~������n_ ____ ___—. � �._�._ , --� ��.3�i�a'�+�.ia���,9��a�.�_.._...����„.._..�,.. � � 3 ;:ff_��'�'�a���;��;� � .. � �� � � � ��l��%� j ; ���;C���.���� � �i� ; � .�;._.....�_�_ _.__� _.� _�.__.�., �..._..� y v�.�i�� �"t@°w'€"a _. 5 �.. � � �.m��`a���iJ<'�%�c,;°P��"��t�. � q ____, �_..�..�_..�. r _.�__ �.. _�_�__ , -�--_ ____,_t_--�_ ��..�� � �����t r i � � , ,. ,... ��s�i"`� �`�`�' ; i t � �, w� _ .,.. � __.__...... _ _._ ._____ --�--�-�-�,.�,,.___,.__ ..� �_,. � _.._.,, �.� __� - , _ . �q �!9��''`"''r�'t.*� �.s.' . � � . . °; `� �� a��"�.. d � 1 � �� � , � � #"""`:� ..,�.'��` � �{-F.� __.__�.�-......__._.__ . .�._..__ . ._... ..._._ d-... .._.._____.�_._...._._ @ �� a� ..,.L..�'� t. . �<..pC r �.._�__..�._..o_ t"�,�"�L, � a-•� rP�`i..�! � : �.��� ,_t-���;^�€:,., -�;",��. .__ � �.. """ '"i '� �r�3 i:3 ``6.�~;�`�. .��___-__- �-----.�. .___a____w.._..._ f �.�:_. �. _ --�-----. �� <.-- �.�� .�_ ..� ,._' �� a�-i� ��.��,+�'�i�.s „'•�,`�L�+. . � �' `J F i i�� =.���r �� ; j '���'_.s�:�`°�,��'"��_..�.,,� , .__..._....�,�...._� I�?W`�"�...`.�i�....�,.�� . � .� .�.._....�.__.a.v...�. � i �.�__�_� e��___�.._ m�____,____... .�...� -'-'--�-----�--6 � � I � 1 i , � �,,. �.�._.��„�_� �,�__�_______j k_._.,,...._,...._......._._.W.. _____.��...�... ....w.�.; ........._.�. �w.'" �"�; :�a-. . � � � �.���`��c��3�� '�Ei� .�'',��$:a �.-�w . 1 ;'-�--"..-"_„-"''__....._..._....._��.,�..,_.._..� ,..._�....�_..�.,._,.......� �._ �'�-`�:�.�.w.,� . ;"-:�r ���. �: .. �..,..... _..� .a.,. .� . ?. _ ._,___...__r.--� . --__.._.�.._._. � � � � ���a*S�.�� X���m�:� .- , -. _. . - � �� ..__._._.._._ ...__,_._,_w_._.___.___..,, �._.. � _ - �...... _.�.,��___., .�_.,��.. � �- 1 r ��::,...._ � .__..��...._�.,..�.m____°�.V.�..�.n,�.____w,,._�..,___�__,.�.�._ �,.___�__.-°--� -�-�____.m� a � - � . � - � �f 3 � —...�......�....s.-...�«..._�..�.,.... ..,_...., -..�...... . . � __...,....._�,. .�.....�___.._. �___m__.........._— .. _'..—� � � p�.....,..�_...-.....__...�.-......�..��..............,....r _ . ....,�r...�,..,........,..,�...—.v .,,.,..,_. ,..._�_-._....«.,__..--..._..-..,.. »...__m_,. .,,� � �......�..._._....e.,..�._..._�.......�._�,.�,.... �� . �.. «�_.....,. . . ,. ...._...._.�r.....-a.�,.... . . �, �u_�—«�-......�..«... ..<.,.a..�.,,.m.�.�.p.,�. - ..:�.�.�....,.,,,._.,,. �.... ..�._...,....,.......,.,�..„ . '".. , . . � . ... .,, .�.—..... 5. �,.,......«..,.� �.......,_.._ .....�.._ ..._. �.._.._.�_—.�.....�._�......��...�.�__�_ �_.,..�.. _..,� ��, . .. . ' � ; - � � . , . �#��'€G�M s�a��''��'a.����� � � "` . . . . .. �,.�...-. �.�.....� . �,.�._.., � `g ��, F.: ^"�"-i& ,�,`r. . -,..,.,.�......._....�,m ___.�..�-.�____—__.,.—.....��..�....._� . . q, 'S.'�. �':: t`�a .� �.,,.��a'..�.:_�.. , .. . . �. � . . . .._..___�_.__...._. ..�._.--°�,,�, i � i a:,:.�������y�-��� �� ____.�.....��...........�_....� , . ._..�.._._ . . , ,. - �"� _. , . D '�a,`�„�TM �� ,,.�, .v.....__.�-�..�..._._...m.�-_., - .-_._.,...�-_.. . . . . . �.__ �____..� g � ' e f . . � .. _. . . . . . � tt 3 �� � , � ,..�� _'_._..,.,.�._.w_...�-_ - ...,.. . _._ v..._._�.,,._._.�,._-,...-,....,.�....._____.__.........,�... .._... �i '� ' � 'e �*����'� �� ^ ����� _..� _ ____ � �. . � � � r,� _._.._._...._.,m.._, �._.�_.__.. � .,m. ____.� � u ° ,, : � _ _ �� � 3 . ���..._w.._..��.�,_....____.__ ...�....��-_�_.�. _-_�____ ��___,- � _ � � � �:�,� G x . . -: .____��,_^����._____.. �... , __.. �_�.� — �' �.������ �Y �: �� � ��....����.��.�_��.� �'