HomeMy WebLinkAbout17509 (35) � CITYOFDIAMONDBAR EXPlRED
� DEPARTMENT OF COMMUNTI'Y&DEVELOPMENT SERVICES
21825 E.Copley Drive
(909)860-3195Fax(909)661-3117 JUN 19 2002 PRESS
' '%•�'` BUILDINGPERMITAPPLICATION FIRMLY
o� JOBSITE J�/� �AYL� �II �Q� APPUCATION I h� �11-(J PERMIT �/� ��� P/C
ADDRESS_( DATE o� �� NUMBER.1-tv� x
$ ISSUE TYPE OCC
APN LOT��—�-rn TRACT DATE CONST. GROUP
p OWNER� U !7W/7N(s
� ADDRES ZONING SETBACKS
gCITY ZIP TEL�Ip � 9 REAR Rw ❑
APPLICANT TEL. SIDFJSIDE STREET FW ❑
� CONTRACTO / • � SIDE ❑
ADDRES
� CITY ZIP TE PROPOSED USE
o ARCH/ENG/
z� DESIGNER NO.DWEL NO. N0.
n. ADDRESS UNITS STORIES BEDROOMS
� CITY ZIP TEL.
�
�n DESCRIPTION SO.FT. FACTOR PSF ADJ.AREANALUATION
Q OWNER•BUILDER DECLARATIpN SFR/ADDlREM
O
p 1 HEREBV AFFlRN UNDER PENAL7V OF PEFWRv THAT 1 M1 E%EMPT FROM ME COfRMCTORS l4 Garage/Carpon
W CENSEUWFORiHEFOLLOWWORE/�SON(SEC.70J1.68US�NESSMIOP�FESSIONSCODE:ANYqTYOR (n
U CpUMYWHIpIREWIRESAVEFutTTOCONSTRUCi.ALTERIAIPROVE,0ElA0LISN,OHREPAIpFNYSTRl1G W pd110IDfiCk
� TURE,GRiOq TO I75 ISSUANCE,AL50 REIXlIRES THE APPLICANT FOR SUqI PEIiMIi TO FILE A SIONED w
� STATEMENT THAT HE OR SHE IS IICEN5E0 PUfiSUANi TO TNE VRONSIONS OF THE CANTMCTORS LI•
CENSE UW(pUPTER i�CdAMENCINU WITH SECTION 7000)OF DIVISION f OF THE BUSINESSAND PRO- V" PooUSpa
� FESSIONS CODE)OR TIUT HE OR SME IS E%EMPT iMEREFROM FND TNE BA515 FOfl TME ALLEGEO EXEMP•
710N.�1M'VIOUTIONOFSECTIdJ7o71.68vANYAPPLICAMFORADERM1iStlalECiSTHEAPPLIGNTTO z Re•Roof
ACNL PENALTY OF NOT MORE TH�UI FIVE MUNDAED DOlLMS ry5oo).�:
ZDI,ASOWNEROFTMEPROPERTY.ORIAYEMPLOYEESWii}1WAGESASiMEIq50LECOMPENSATION, 0 Commerclal -
VALL 00 THE WORK,AND THE STRUCiUHE IS IJOT IMENDED OR OFFERED iON S.LLE(SEC.7W�,BVSI� J
� NE55 FND PROFESSIONS CODE:THE CONTRACTORS UCENSE UW DOES NOT AVPLY TO AN OWNER OF j
ViiD7EHTY WIiO BU0.A5OR IMPRpyES TMEREON.M1D WM0 DOES SUq1 WOqK HIMSELF OR HERSEIF OR
L� THRIXICHHISORHEROWNEMGLOVEES,iROVIDEDTHAT5�ICMMCROVEMEMSAAENOTMENDE�OR m
w OfFERE0FOR3ALEIF,NOWEVER7f1EBUL0INGORIMPROVEMENTI330lDWITHINONEVEAROFCOMVIE
� TqN.THE O'M�ER�BUIL�ER WILL HAYE THE BURDEN OF VFlOVIN�7HAT HE OF SNE DID NOT BUILD OR
� IMVROVEFOHTMEPURPOSEOFSALE�
(L O1�01NNEROFTNE►ROPERTY.AME%ClUSNELYCANTMCTWOYATHLICEN5EDO0HTMCTORS
W roN�SENUWDOESNOTMPLVTOANO�"MEROFAPqOPERTYWHOBUM1D50RDA1PPAVE�STiE EON,ANO V0IU8IIq1 A0.1.AHEA
� YM1IOCOMMCTSiORSUCHCR0.tEGT5YATIAWMMCTOR�S�IICENSEDPURSUAMTO7HECONTRAG pUANTITY DESCflIPT10N FEE
� TORSLICENSEIAW�.
� O IAM EXEMPT UNOEH SEC. 8.8 P.C.FOR TH�S REASON U
�S ¢
LL DATE OWNER �
Z W
�Q LICENSED COrJTRACTORS DECLARATION W
CL IMEREBYAFFIRMUNDERGENALTYOFFE1UURVTHATIAMUCENSEDUNDERGROYi510NSOFCHAPTEq � � 1 1
p. Y(COYIAENCWOWI7MSECTION7000lOFDIVI510N30FiHEBUSINE55ANOPNOFE55lON5CODE.MID I/
� MYLICENSEISNFULLFORCE/WDEFFECT.
9�l�8� m
� UCENSE CUSS LIC.NO. J
V DATE COMRACTOR d
W
� WOfiKERS'COMPENSATION DECLARATION a
= U
� INEREBVAFFIRMUNDERPENALTYOFVEit1URVONEOFTHEFOLLOWINGDE0.I�W�TqNS: Z
� ^IHAVEAN�WILLFWNTAWIICERTIFlCATEOFCONSENITOSELFdNSUREFOHWORKEflS' _
r COMPENSATION,AS PROVIDfD Bv SECTION 770o OF TME LABOP CODE,FOR i11E PERFORM.wCE U
d OF iME WORK FOR WMlpl iNIS VERMIiI5155UE0. �
�
�I H�VEµ0 WILL MAINTAIN WORKERS'CA�PENSATIDN INSUW W CE,AS REOUIRED BY SECTION
0 77ooOFTHELABORCOOE.FORTHEPEHiORMANCEOFTHEWORKFORWNICHTNISiER1AITIS
� ISSUED.MYWO K R'COMrP�ENSAI INSURANCEWRHIERANDPoIILVMIMOERANE: CONSTRUCTION
� uwAieA -TCv� PLlW REVIEW
0 DOLICYNUMaEa ELECTRIC
� (f165ECfqNNEmNOTBE00M1PLFTEDOFT/EPEW.TrSFqiONEFIIR�Uf�DDLLAiL561W1�N1E531 PLUMBING .�
Z ICERT�FYTHA7NTHEPERFORMANCEOFiHEY'ORNFORWHIq1THISPERMITI5�S5UED,l MECHANICAL
C7 SWLLLNOTEMPLOYANVVERSONWANYMANNERSOASTOBECO/AESUBJECTTOTNE
� WORKERS'COMPENSATqNUN50FCALIFOHNIAANOAGREETHATIFI51i0UlDBECOME INSPECTIONFEE
S SI1fl1ECTTOiHEWORKERS'COAIPENSA7qNVR SOFSECTqN770aOFTHEUeOR
coo�,i ww.v R7NMATHCAMPLYWIT!{ �s s. ISSUANCE , i
� SMIP
p DATE: APPLICANi:
� ENERGY P/C
WARNINO:FIIILURE TO SE WPE WORNERS'COMPENSATqN COVERAGE�UNUWFIA.AND SHALL BE
� SUBlECTANEMPLDYERTOLRiMINA1.PENALTIESMlDpVIL�INESUPTOONEHUNDREDTIOUSAND ENERGYPERMIT
DOLLARS(f Io0.0o0�,IN/�DDIiION TO THE COST OF COMPENS�TqN.DAM�GES AS PFOViOED FOR IN
¢ SECTqNJ70eOFTHEUB�RCOOE,INTEREST,ANDATTORNEYSFEES. RE7ENTIONFEE:
aW., CONSTRUCTION LENDING AGENCY PREALT FEE:
0
� I HEREBV AFFIRM UNDEF PEN/�LTYOF PERJURY TMAT TMERE�S A CONSTRUCTION LENDING AGENCV
n- FORTHECERiORMANCEOFTHEWORKFORWMId7TNISFERMITI5�55UE0(SEC.709T,GV.C.). �
Z
W
� LENOER5 NMAE
� LENOERSADDRESS
w ICERTFYTNA7IMAVEAEADTNISAPPUCATqNANDSTATETNATh1EA90VEINFOR4ATqNISCORRECT. TOTAL FEES ��� � � �
p IAGFEETOCOMPIYWITHIILLCITYMlOCOUNTVORDINANCESANDSTATEUWSREUTWGTOBU0.DIN0
� CONSTPl1CT10N,ANDMEFlEBVAlR110RIZEREPRESEMATNE50FTHI5LOUNTYTOENTERUPONiHE
Z �BOVE-MEN mPiiOPENTYfORINSPECTqNPUqPOSES. COMMENTS
� �l/
� y�
¢ PERMITTEEN ( �KT7 I�^/I IV/
N
(n SIGf'NiURE F VERMITTEE DATE
� FECPT.NO. PAID BY VALIOAT�ON
WHITE-0epartment Copy,YELLOW—finance CoDY.PINK—Assessor Copy,GOLDENROD—FileCopy.GREEN—ApplicanYs Copy
•�. � ..�..� .... .�.._' ._••�: � � ry, -� .�. . _ .._._.__._�.. . ! � ".. . �
.. ... ., �N .„1" ���. f�. 1 -�. . . . .. i�.y'�.M1��.,�., .:1+.' :�" i�.v+ , '�' a i • .. . . �. .. ... . .,
�ITI' QF �3l�,fJiOj�3C? t3�R
!P�!Si'�G i IU6'� F.L"CCi�'t7
.__.____..____.._.. _____._�__..__ _�_�____�_.. _.._ ...__..__ .�.._
l►�k-�I:��c.cCG,��v� r�;w�'c . �►�F-`i 1=1c,` t'cl:i f►'�=f.�.;c;i[ie'a►`E r��`�r.:: �1���-'i�#�c�'e�.�
,
_�__... __.__ _.__._..__�-----.... .
_ .�_.__._..__ __ _ .,_....___ ..._______. __ _.- ----..--.
� .� �_�._Y��.:._..___
. _ . . _ ___.
SET BACK ; I � FLOOR JOIST , , ;
FTGS/FORMS/STEEL � I I �HA REQMTS �
ELECTRIC GROUND I I UNDER FLDOR DUCT �} . � . �
GROUND PLUMBING U��1DER FLOOR CU�IDUIT I I
SLAB GRADE I FIREPLACE FOUNDATION !
TEMP POWER FIREPLACE BOND E3EAM (
WATER SERVICE I i MID HT. �OPdD BEA��1
ROQF SHEATHRdG ! f3 FL BOND BEAM '
FRAMING,NENTILIATIOP� I FINAL E30ND BEAM I
RO�F COVER I ~ PRE-GRF,DR�G
ROUGH HEAi ING BENCHING
ROUGH ELECTRIC ROUGH GRADING �
ROUGN PLUMaING � FINISH GRADING
SHOWER/TUB TEST POOL ELECTRIC
EXT. LATH/SIDING I POOL FENCING �
WALL INSULATION POOL FINAL
CEILING INSU�ATION OFF SITE IMPS.
DRYWALL NAILING DEDICATI�PJS �
SEWER FINAL ENG.
SEPTIC TANK L.APJDSCAPE/IRRIG. �
SEEP PIT/L.L. i CN SITE IMPS.
GAS AIR TEST � FINAL ZONING
FINAL CONST. �IRE DEPT. FINAL
FINAL HEATING � HEA�TH DEPT. FINAI
FiNAL ELECTRIC � � DEV. FEES PAIG
FINAL PLUMBING ENEflGY �
r-; ���;����=.r�,lf.���M T '��.
1,,;
0 ' ' •
COMMENTS
SEPTIC TANK SIZE '
SEEP PIT/U SIZE
R��
���� =.'I
��
f
i . -.1, �• � • . , .
_., ,
v . ,
� .
_.__.�_ .__�_..___...__...... � ',