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HomeMy WebLinkAbout14572 . ..... . . _....� . . � _ � �,� — CITY OF DIAMOND BAt+t - i DEPARTMENT OF COMMLJNITY&DEVELOPMENT SERVICES � 21660&Copley Ihive Suite 190 PRESS (909)860-3195 Fa�c(909)861-3117 ''��� BUII.DING PERMIT APPLICATION FIRMLY o� JOBSITE /�,�O i� I APPLICATION n" ` m' NUMBER�_�� 1f/C ADDRESS "� DATE a f�V(/ � ISSUE TYPE OCC APN LOT TRACT DATE CONST. GROUP g OWNER C�f u" ADD S � ' ZONING SETBACKS w FRONT RW ❑ � q7Y 1GYYlaY1fl �cl✓ ZIP T . REAR ❑ APPLICANT TEL. SIDE/SIDE STREET RW ❑ � CONTAACT O�t. c rrLl SIDE ❑ g ADDR SS ' ' CITY 1 ZIP y TEL 71• 7_U� PROP05ED USE �--�---•o— � ARCWENG/ • DESIGNER NO.DWEL NO. NO. ADDRESS UNITS STORIES BEDROOMS � CfiY ZIP TEL. N DESCRIPTION SQ.FT. FACTOR PSF AW.AREANA�UATION N OOWNEF-BUILDER pECLARATION SFRlADDlREM I HEREBV AFFlRM UDER PENALTY OF DERRIRY TNAT I AM EXEIAPT FROM TME CONTAACiD0.5 Ll G21H9B/C81p0�1 8 �ElISEUWFORTHEFq.LOWMIOREASON(SEC.70.11.68U5INE55ANDPROFE55�OH5CODEANYCRYOR (n (J OOIMiYWI#O/REOUWf7AVElWRTOCONS71tt1CT,ALTER�PfiOVE.DEUOLISM.ORREVAIqANY57HUG W p8tl01DBCk � TUNE iHqq TD RS ISSUNVCE.ALSO REW WES TNE�PPLICMlT FOR S:ld1 PERAIIT TO FILE A SiGNED STATEMFNS h/AT HE OR 6ME 6 UCENSEO PU0.SUANT TO iHE DROVISIONS OF THE CONIMCTOR4 Ll• � CFNSEUw((,11AD7EROfCaMMENpNaWiiHSECTION70a010FDIV15lON70FhIE8U5iNE55ANDPRO� � PooVSpa FESSqN3 COOE)OH 71MT NE OH SNE IS EXE4VT iMEREFNOM M1D THE BAS�S FORTMEALLEGED E%EMP- T�ON.AM'VIOLAiIONOFSECTION10.71.6BYANVIIPPLMJNTFOf1APERMITSI$1EC757MEAPVLI(:1!liTO Z Ra-Roaf �„_ AGML7ENALiYOFNOTMOfiE7MANFNEHUNDREODpUR31f5oo).k � pI,A50MNEROFTHEGROOERTY,ORIAYEMVLOYEESWITNWAGESA57HE�N40LECOlAPfNSA71[JN. � (,`OmrtIBfG101 � � YALL DO iHE YfORK Ml�TME STRUCiURE IS NOT INTENOED OA OFFEAED FOR ShLE(SEC.TW�.BU51• J y NE55 AND OROFE5+70N5 CDOE TNE ODNfML70RS tIGENSE LAW DOES NOT APPLV TO AN OWNER OF ? iNOPEHIY�N�09U1D30R IYPi1DVE5 TMEREON.11M1 YVMO DOES SUQI WORK MIMSELF OR HERSELF OR (C iHq0UC�1 HIS OH HER ONRI EMPIOYEES,V110VIDED TMT SUCH MPROVEMENTSARE NOT RJiE'IDED 011 m � OFFbAEDWN4ALEIF.MOWEVER7MEBULD�NOORWCiYOVEMOJfI5501➢VrtTMNONEYEAROFCOMPIE• x 'iION.iME OwNEN-BU0.DER WILL MI�YE T7E BURDEN OF PROWKt 1HAi HE OR SNE OD NOT BURD dt = YPROVE FOq 1T1E PURP0..E OF SAIE� w OLASOwMEROFTl1EYfqPERiT.AMIXCLU5IVELYCONTfUCiNOWITHUCEHSEDGdtiMCTORS � TO tONSTRUC�iNE VRn1ECT(SEG 7oN.BUSiHE55 AtA PROFESSIONS CCDE:TNE CON7MCTORS LI- V21U0�i0(1 ADJ.AREA CENSE UW DOES NOTAPVLY TO M1 OWNER OF A iflOPEflTY NRIO BULDS OR IMPfqYES TMEREON,hYD � wwcorrtw�ersca�sua+vnaeerswmi�cartrucroA�s�i�nseorunsuu+rron�ecour�ua pUANTITY DESCRIPTION FEE � ioasutEwsEuw.�. . OIAME%ENPit7NDE0.5EG B.ZP.C.FORTNISPEASON � U � LL pAiE OWNER � � W F` LICENSED CONTRACTORS DECUIRATION W [L iMEREBYAFFYWUNDENPENALTYOFPERri1RYTW�TIAMUCENSEDUNDERPROVI3qN90FGHAPTER Ve , � • - � `� � f(COUMENCNOYIITNSECT�ON7000)OFDIVISION70FiNEBU5iNE55+wDVROFES5iON5C00f.AND Z X YYIICEN5E6PlFULLFORCEAlDEFFECT. /_1..� � ���E�s c-3� ��. . o �3 J u�vr � � w� �"2.g'a0 c a � WORKERS'GOMPENSATION DECLARATION � a � IH rAiFIRMUNDERPEWLLTYOFPEM/RYONEOF7HEFOLLOWRlGDECUMTiONS V y Z � NAVE MO wILL IM:NTM/A CEiIiIFlCATE Of GONSEHTTO SELFdNSUHE FOfi WORKERS' 2 CdIiENSAiION,A3 PitOVOED BV SECTION A0o OF iHE UBOR CODE,FOH 7HE PERFORIAANCE W OF THE WORK FOH NM1UW iMS PEHMIT 14155UfD. � d 6 _I NME/WD YALL MNNTA?7 WORKER5 COMPENSATION IHSURANCE,AS RE WIRED BY SECTION �70o OF TME IMAR COOE,fOR iHE CER�OAMANCE OF THE WOAK iOR WHICN THIS PERA1rt IS O ISSUE9.YYNOR 5' YVEN/SA�T�q�N�IN�SUMNLECAFRIERANDVOLICYNUMOERMG: CONSTRUCT�ON T�`�' T�1'� � GRHIER �� W YT � - -- - PLAN flEVIEW �`•!�'J�' . � VQIC'/NUM9ER Lqt�l 7_A 17 - ELECTRIC n � f�bCC110NNE�NOT�NFsi.ETEbOFhEPEiMT6A0�10N[HM%4'DOOLLNi56to�ORLE55} PLUMOING Fr�l !� '�_�;1f� �C � Z I CERTIFY THA7 N7HC PEHFORMANCE OF TME NR7NK FOR WNICH iMiS VEPIaIT I5155UE0,l MECHANICAL • ��u�� -----.�„�T� (� SWILNOTEMPLOYANYPERSONINANY1.WiN�RSOASTOBELCMESUBJECTtOh1E r• i�t�'�`J:'�L ✓"'� N WORKERS'LOAIPENSATIONUW50FCALIFOPNIA�AGFEETNiIFISMOUIDBECOME INSPECTIONFEE' � S 6�1BJECTTOiMEN^OpICENS'COMiENSAT PROVISqNSOFSfCT �ooOFiHEUBOR �" �u+�' coo.is�uuFonnrvnnicour�rm sEvarnnswws. ISSUANCE �U��j�'���•'�•�. p DATE: APPlIG1 . SMIP � ENERGY P!C WARNIN6 AILUIi[705ECUREWORKERS'[Du0EN5A710NCOVERAGEISUMAVYFUl,AN05 BE � SUBJECfI�NEMPLO�ERTOCiL'MINN.PENALTIESIWOCNRFNESUPi00NEHUNDREDTIWUSAND �NERGYPERMIT DOl1AR5(f 100.OW).W/�ODIiION TO THE CAST OF CpIPENSATION,DAIIAGES AS iFOVIDED FOfi Pl � SECTIONl70eOFiNEUHIXiCODE.NTEHEST,ANDATTORNE75iEE5. RETENTIONFEE: a CONSTRUCTION IENDING AGENCY PRE-ALT FEE: � INEREBVAFFlRMUIDER7ENALTYOFPERA1flYTHAT7HENE6ACON5TRUCT10NlFNDW0110ENCY Z FOH THE PERfOiWANCf Oi 7ME N�ORK LOR WHI(71 T/i5 VFNAIIT tSISSUE�(SEG 70v7,CIV.G). W � LENOEfY3 NAA1E C LENOERSADDRE55 /� � W ICERTIiYTHAT1iWVEREMTHISMPLIC�TqNMDST�TETHATTIE�BOVENFORAlAT1ONI5CORRECT. TOTAL FEES �� �V d IACREETOCOYPLYWITHALLCRYIWOCOVNTlORDINANCESANDSTATEUWSAEUTNOiOBUILDINO , � CONS7PUG7qN,M1D NEPEBY AURIORRE REPHESEN7ATNE5 OF TqS CONRV TO FNTEA UPON iME � ABOVE�YEMqNEDVROVERiYFONMSPECiIONVURPO5E5. COMMENTS - Q _ ��OYY C�i n t �1 Gi"(� m FENUAE(PW1(n a /JJ� [l� ,�w i..�d� ��� I 2��1 1� i L�'7.'�1. �� Vj 7 O�PENUTiEE �E �/ - � RECPT.NO. PAID BY VALIDATION YVF11TE—Depertment Copy,YELLOW—Finance Copy,PINK—Asaeeaa Copy,GOLDENROD—File Gopy,GREEN—Applicant's Copy . . . , . . , . ..... ,... . ...., . . .. ,. � . . ._... . .. .. . . . , . .. . t..,_ ._ ,,.. . . . ,.. . _, CITY OF DIAMOND,BAR , ��"�_� -� . ..'��. INSPECTION�RECORD .,.: �.: �. . � - �, ' � . � ,� . _. .�.::.:_:..�.�._,�,,.._ , j����i�:�'{,�`'.�'Is'.��� '.���r= '�►�..���?I,�R'�.E� • . `li'�►`�:���dl.�►���' ��'���-�0.i'=��a A ���.���°�.��� � !SET BACK , t \'• ,..{.�• ' � •FLOOR JOIST v� ,� � - .. iFTGS/FORP�15!STEEL - �-'-�� ..-.� - . -I � ' � . ,FHA REQMTS.. . . _ . _. _ . . . , :. lELECTRIC GROUPdD.__ . .. .. _._ . ... . . UNDER FLOOR DUCT - ' ; . ;GRQUND PLU�viBI�JG UtdDEf�FLOOR CUf�IdUIT ' � ' ' `� - . — . ... .. . - �SLAB GRADc - -- - ` - - • FIREPLl�CE FOUNDATION .' �_ . • , ,,. � : , : ITEPJIP�POWER�- -- � � -� - - FIREPLnCE BOND BEAb.�� !VJATER SEAVICE-- . ti11D HTi EiOND BEAM � : .'� I , � . , iROOF SHEATHINu - 8�T.BOND.BEAD�1� • � '= • � - 'FRAP.�ftd3!VENTILIATION � FINAL BOND��AP•A�' � , ' . - _ _. �— iROUF COVFR .� PRE-GRADING - - 'ROUGH HEATING �- � - BENCHING - � , � �ROUGH ELECTRIC. �'. " '.. . - .. . ROUGH GRADING - _. ._... �ROUGH PLU�.48lNG- -- - � -- --- FINISH GRADING � �SHOWER�TUB TEST--.-� - - - - � POOL�EI.ECTRIC � ;EXT:LATH!SIDlNG--- ' . --- '- POOL FENCING � 'L'lALL INSULATIO�! - �- - �- � - POO�FItJAL 'CcIU�dG It•ISU�TION -� - , OFF SITE Ih1PS. . DRYVJAL.L"-t1111LIfJG � - . ; _ .- � DEDICA710NS . � ; -. _. �5EV1ER -- - . -_ � . - FINAL'EPdG. ' .. , : 'SEPTIC TAPlK L.ANDSCAPEIIRRIG. � 'SEEP PIT/L.L. O�J SITE IMPS. iGAS AIR TEST ( • FItJAL ZONING ;FINAL CONST...' __. _. � FIRE DE�T.FINAL • _ .. _. 'F1NAL HEA71PdG.__...... . _ . . --�� , � HEALTH DEPT. FINAL :rlPJAL ELECTRIC. .. �. - . DEV. FEES Pr",Ip - - --- . ...__.. ._! �FIPJAL PLUT,ABINu - - Z,.�-�. ap ; Ei•JERGY � ; - '. _ ' . � �. ' I �. - - _ . , ; � � . . , , - - , . . ... .` . . _ .`yl�_GC�CiI�,y,^�,•"'e; ' _._ ..�sw... -,e'�.. :......--...�. . � .�_..... ... .__.._ . . _.. __.-_:_ ... ' : . . . . �.• 'COMNiENTS � � _ _ _._ .. _. _.. _ - . , ; . ,. . -- ..._.__. ; . . � � _ , , . , ; , . - - - • � �. . _ i---- . :;_:'�, ; , i . . � - i (,.; -' . _ . .` � . !SEPTICTANK SIZE . . , SEEP PiT/U StZE - _ �..-�._.._.._... .��.��..-._.• . .. . .. . . .. _. . �. . � � ' � . . . - I .... . . . . . . . '_ _ . .. .. .. . ' � - � � ... i • � .. .. . . ._:: . . _ ... . .. . . '4�� _ . , . . . . .. ; � . . . ... . . . � -- - - - -- . _ _ , , . .. � . , , . � .: , # . •. ..;, `., � ' '�` • ,. � . � - -- - - . , . .