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Home My WebLink About17138 _�� _ ci�oF o�orro a�x EXPI RED DEPARTMENT OF COMMUNTI'Y&DEVELOPMENT SERVICES 21825 E.Copley Drive - (909)860-3195 Fax(909)861-3117 J U N 17 2002 Pff�ESS "''-��'�`` BUILDING PERMIT APPLICATION FIRMLY o� JOBSITE r , A N DATEICATION _ NUMB R I� I �`a g/�_ ADDRESS !�e�G I � � E ►7.aG►IGL]-. - � ISSUE p� I Z 0 p TYPE OCC APN LOT TRACT � DATE CONST. GROUP p OWNER Nr�1� DdLulL�s YY��AfLs�N o ADDRESS ZONING SETBACKS Z CITY�1QYY�r�l��AfL ZIP�'17/n� TEL.� -I FRONT RW ❑ o APPLICANT ��j�_y� TEL. �'� S DE/SIDE STREET RW ❑ z ¢ CONTRACTOR !1(�✓/��.(L SIDE ❑ � ADDRESS ,�,�� CITY ZIP TEL. PROPOSED USE � �� 1�"L�G� RO�d o ARCH/ENG/ � z DESIGNER w NO.DWEL. NO. NO. � a ADDRESS UNITS � STORIES �Z BEDROOMS � CITY ZIP TEL. � cn DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION p� OWNER-BUILDER DECLARATION SFR/ADD/REM O I HEREBY AFFIRM UNDER PENALTV OF PERIURV THAT 1 AM EXEMPT FROM THE CONTRACTORS LI- G8f8QBIC8fpOfl W CENSEUWFORTHEFOLLOWINGflEASON(SEC.7031.SBUSINESSANDPROFESSIONSCADE:ANVqTVOR (f� U COUNTYWHICHREDUIRESAPEHMITTOCANSTRUCT,ALTER,IMPROVE,DEMOLISH,ORREPAIRANYSTRUC- W patio/Deck w TURE,PRIOR TO ITS ISSUANCE,ALSO REOUIRES THE APPLICANT FOR SUCH PERMI7 TO FILE A SIGNED W STATEMENT THAT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE CONTRACTORS LI- � CENSE LAW(CHAPTER e(COMMENCING WITH SECTION 7000)OF DIVISION 30F THE BUSINESS AND PRO� � POOVSp2 FESSIONSCADE)ORTHATHEOFSHEISEXEMPTTHEREFROMANDTHEBASISFORTHEALLEGEDEXEMP- (� �J� � TION.ANY VIOLATION OF SECTION 7031.5 BV ANV APPLICANT FOR A PERMIT SU&IECTS THE APPLICAN770 Z RB-ROOi OV V A CIVIL P NALTV OF NOT MORE THAN FIVE HUNDRED DOILAFiS(f500).): ASOWNEROFTHEPROPER7Y,ORMYEMPLOVEESWITHWAGESASTHEIRSOIECOMPENSA710N, 0 Z Commercial - WILLbO-THE WORK,AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE(SEC.7041,BU51- J � NESS AND PROFESSIONS CODE:7HE CON7RAC70RS LICENSE lAW DOES NO7 APPLV 70 AN OWNER OF � PROPERTY WHO BUILOS OR IMPROVES THEREQN,AND WHO DOES SUCH WORK HIMSELF OR HERSELF OR � 7HROUGHHISORHEROWNEMPLOVEES,PROVIDEDTHA75UCHIMPROVEMENTSARENOTINTENDEDOR m QOFFEREDFORSALE.IF,HOWEVERTNEBUILDINGORIMPROVEMENTISSOLDWITHINONEYEAROFCOMPLE- Z TION,THE OWNER-BUILDER WILL HAVE THE BURDEN OF PROVING THAT HE OR SHE DID NOT BUILD OR � IMPROVE FOR THE PURPOSE OF SALE). w ❑I,AS OWNER OF THE PROPERTV,AM EXCLUSNELY CONTRACTING WITH LICENSED CANTRACTORS � TO CANS7RUCT THE PRQIECT(SEC.70�a,BUSINESS AND PROFESSIONS CODE:7HE CONTRACTORS LI� V31Ue�lOf1 ADJ.AREA W CENSELAWDOESNO7APPLV70ANONRJEROFAPROPERTVWHOBUILDSORIMPROVESTHEREON,AND � WHOCANTRACTSFORSUCHPRQIECTSWITHACONTRACTOR(5)LICENSEDPURSUANTTOTHECANTRAC- QUANTITY DESCRIPTION FEE Y TORS LICENSE LAW.). � ❑I AM EXEMPT UNDER SEC. B.8 P.C.FOR THIS REASON Q � U , � ^` � DATE '��/ �� OWNER � Z W � LICENSED CONT ORS DECLARATION W � I HEREBY AFFIRM UNDER PENALTV OF PERIURY THAT I AM LICENSED UNDER PROVISIONS OF CHAPTER � � 9(COMMENCING WITH SECTION 7000)OF DIVISION 3 OF THE BUSINE55 AND PROFESSIONS CODE,AND z `X MV LICENSE IS IN FULL FORCE AND EFFECT. m I � UCENSE CLASS I.IC.NO. j � H J U DATE CONTRACTOR d W � WOAKERS'COMPENSATION DECLARATION � Q = U � I HEREBV AFFIRM UNDER PENALTV OF PERIURV ONE OF THE FOLLOWING DECLARATIONS: Z � � Z _I HAVE AND WILL MAIN7AIN A CER7IFICATE OF CANSENT TO SELF�INSURE FOR WORNERS' 2 Q CAMPENSATION,AS PROVIDED BY SECTION 3700 OF THE LABOR CODE.FOR THE PERFORMANCE w OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. � � w _I HAVE AND WILLMAINTAIN WORKERS'COMPENSATION INSURANCE,AS(7EOUIRED BV SECTION /// J� Q 37000F 7HE LABOR CODE,FOR THE PEFFORMANCE OFTHE WORK FOR WHICH THIS PERMIT IS { �O, �{,/ ISSUED.MY WORKERS'COMPENSATION INSUHANCE CARRIER AND POLICV NUMBER AFE: CONSTRUCTION 1 J � CARRIER PLAN REVIEW Z POLICYNUMBER ELECTRIC , Q 0 (fHLSSECTIONNE�NOTBECI7MREfEDOFTHEPERMITISFOHONEHUrDREDDOLLARS(5100)ORLESS). PLUMBING W Z I CERTIFV THAT IN THE PERFORMANCE OF THE WOHK FOR WHICH THIS PERMIT IS ISSUED,I MECHANICAL �} SHALL NOT EMPLOV ANY PERSON IN ANY MANNER 50 AS TO BECOME SUBJECT TO THE - � WORKERS'COMPENSATIONLAWSOFCAUFORNIA,ANDAGHEETHATIFISHOULDBECOME INSPECTIONFEE = SUBJECT TO THE VlORKEHS'COMPENSATION PROVISIONS OF SECTION 3700 0F THE LABOR � CADE,I SHALL FORTHWITH COMPLV WITH THOSE PROVISIONS. ISSUANCE p� ^� � SMIP � !1�l p DATE: APPLICANT: J WA(iNINC FAILURE TO SECURE WORKERS'COMPENSA710N CAVERAGE IS UNLAWFUL,AND SHALL BE ENERGY P/C LL SU&IECTANEMPLOVERTOCRIMINALPENALTIESANDCIVILFINESUPTOONEHUNDREDTHOUSAND ENERGYPERMIT DOLLARS(5100.000�,IN ADDITION 70 7HE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN � SECTION 3708 OG THE LABOR CODE,INTEREST,AND ATfOflNEY'S FEES. RETENTION FEE: �I I a CONSTRUCTION LENDING AGENCY PRE•ALT FEE: O � I HEREBV AFFIRM UNDER PENALTV OF PERIURV THATTHERE IS ACANSTRUCTION LENDING AGENCY � FOR THE PERFORMANCE OF THE WORN FOR WHICH 7HIS FERMIT IS ISSUED(SEC.3097,CIV.C.). . Z W � LENDER'S NAME F- LENDER'S ADDRE55 � ICERTIFVTHATIHAVEREADTHISAPPLICATIONANDSTATETHATTHEABOVEINFORMATIONISCARRECT. TOTAL FEES � ��(�� w I AGREE TO COMPLV WITH ALL CITV AND COUNTV ORDINANCES AND STATE UWS REIATING TO BUILDING d � CONSTRUCTION,AND HEREBV AUTHORI2E REPRESENTATNES OFTHIS COUNTV TO ENTER UPON THE Z ABOVE�MEN710NED PROPERTV FOR INSPEC710N PURPOSES. COMMENTS . 0 � � � m PE EE NAME(PRIN7) � � �0 � SI MI DATE = RECPT.NO. PAID BY VALIDATION ~ WHITE—De artment Co YELLOW—Finance Co PINK—Assessor Co GOLDENRO�-File Co GREEN—A licant's Co P PY. PY. PY. PY, PP PY . . . .,..., . , . � . . ..�.. ._ .. . . . . .. .. .. . . . ,. .. , �6�1'� �f� ��(�i(�k�R(�' [��(� ��1��'��'06�� [�C��Cc�G�C� .�_.. --�--�- .. ,, ,, � . �me,� . , _____�� :. OG1�� QJi C.� [��3 . ,O�C� C�QU�� (1�p" .o ' .�� ---- - SET BACK � � —� , j FLOOR JOIST I � _..- --.._..._.--r___._..__ i.._--..._._ -- —� --.._ .._..____ _-1.._,_..__.__ ....._..._.__ FTGS/FORMS/STEE� ; ' FNA REQMTS --r---- —�---- - --- _ ------ ---- EL.ECTRIC GROUND ' UNDER FLOOR DUCT — - �-�-- -- - -- --- GROUND PLUMBING ; _____ _„ _ ____ � U�lQER FLOOR G��(��DUIT � ' __. ____.- --�--.. —___. _.... SLAB GRADE � FIREPLACE FOUNDATION � _ TEMP POWER _ �_ _�_�__ FiREPLAGE BOND BEAM ---....--------- ----._._.._. WATER SERVICE ' � ' MiD HT. BC3ND B�AM ____ ROOF SHEATHING ��`,t y G� �� 1�'0'"' 8 FT. BOND BEAM ------ ---- � ------ F R A M I N G N E N T I U A T I O N I � ___ __ _� FINAL BOf�lD BEAP�1 ' - -- ____ __ ___---- _.__.. _.-... ROOF COVER ' PRE-GRADING ROUGH HEATING BENGHING ROUGH ELECTRIC ROUGH GRADING ROUGH PLUMBING FINiSH GRADING - -- - --- —- ------ SHOWERIfU6 TEST � � PC?OL Et_ECTRIG �.._.. -- __�.---------- EXT. LATHISIDING POOL FENCING WALL IiVSULATION POOL FINAL ' ----- ------- --._...�. CEILING IN�ULATION OFF SITE IMPS. DRYWALL(VAILING DEQICATIONS SEWER FINAL ENG. - - - SEPTIC TAIVK • , LANDSCAPE/IRRIG. � SEEP PIT/L.L. ON SITE IMPS. GAS AIR TEST FI�IAL Z�i�ING � FINAL CONST. � . F!RE DEPT. FINA! _ FINAL HEATING ; HEALTH dEPT. FlNAL � FINAL ELECTRIC � '� DEV. FEES PAID �� FINAL PLUMBING ENERGY ! --- ---.- -- --.---.....__ ; __......_.. � � i ��'�o � COi1(iNrEN�fS SEPTIC TAiVK SIZE SEEP PIT/U SIZE — � ._- -.---._ _____ __....____._._. � � --- � . �. � . _._.—...__ �.