Press Alt + R to read the document text or Alt + P to download or print.
This document contains no pages.
HomeMy WebLinkAbout12941 (13) _ - � ---.. ....._ , --��. .... . _ _.
, {
'u
�
/� �� _ CITY OFDIAMOND BAR �� •�• `'
DEPARTMENT OF.COMMUNITY&DEVELOPMENT SERVICES
/ �c . 21660 E.Copley Ihive Suiu 190 � .
j (909)860-3195 Faz(909)861-3117 PRESS
�''�^'� � BUQ.DII�'G PERMIT APPLICATION . FIRMLY
.Q AODRESS�� OQ� KjyB'LL L�Z . APPLICATION r IQ �p A PERMIT '2Gj�i ��C�_UU
p DATE a�J � � 1 � NUMBER
� APN LOT TRACT_ 7F>5� ISSUE TYPE '�, ,, OCC
4I 4 DATE CONST. GROUP
p OWNER ��NI����1�X
o ADDRESS���QA�.k_N.B`L ZONING SEBACKS
w CITY � ZIP TEL. S��7S�_5 FRONT • " qW . ❑
� � APPLICANT t.{Q- 1 C�.�,L�b��J�pL TEL.�LEGalj,-�(a D� REAR p
�+"".,, �'"" SIDFJSI�E STREET RW O
CONTRACTOR�-s��-1��sth_TDYY1 /1ffflLs' SIDE p
o ADDRESS3Z2D/L�UE.'2S.f_dE�pQ PROPOSED USE Q 'L 1� — ,;� -
o CITY G�/NO ZIPRjT/d TEL
w ARCHlENG/ ,,t'�� �
�Q DESIGNER �N • �'�G�^ NO.DWEL. NO, NO.
ADDAESS • _. `� 1�._ UNRS STORIES BEDROOMS
� CITY,�jfQfl�l M ZIP�Z�OZ TEL.
u� . DESCRIPTION' SO.F7: FACTOR PSF ApJ.AREANALUATION
p� OWNER-BUILDER�ECLAPATION ... � SFR/ADDiAEM - -
O
p 1 HEREBY AFFlRM IM�ER OENALTY OF P[NURY TNAi 1 M1 EZEMPT FROM iHE CONiRACTO/G lL .Gd290/CBtpOR
W CENSEUWF011THEfCILOWNOREASp�(SfC.707I.5BLS.NESSANDPRpFFSS10N5CODE:M'YCITYOR (n
;A V COUMYM1nCN1iE0URESAOERMR7000N57RUCT,A:,TFR,iu�ROVE,OEAblJSH,ORRED.uRANVSTRUC. LLf .
� �NPE.VPqHTO1T36511ANCE,AL50P[QUIRE5IM[l1?PLIGWTFORSUp1VERYITT�FILEA51CNE0 W Patio/pack -
�' STAiEMEM TMAT NE Ofi SME IS 110EN5FD PUH;UAN'70 7ME CfiOV1510NS OF TME CONTRACTORS L6 �� ,
�� . � CENSE UN�ICMAP7ER Y(COMUENCNO MnTH SECTiCN 70001�DN45�ON]OF iME BUSINE55 ANO iN0• � PooVSpa � �
iE53qN5000E)OR iMAT ME Q95HE IS E%EMP7 iHER[FROA1 ANO 7HE BAS�S FOR THE Al1EGED EXEMP.
TqN.AHVVIOLATIDNOFSECTION7o71.6BYA�WA�pLICANTiORAPEPUITSUBJECT5h1EA7PLILANTTO Z' RB-R001
r A CIVIL VENAL7Y OF HO7 MOFE 71UN frYE 1rt1N�REO Da1Aa5(tsoo).�. ._ . ....
� ❑4���EFOFTHEPRODERTY.ORMYEIAPLOYEESVATNWAGESASiMEIRSOLECOMPENSATIDN, O �mmerctal �- �
MALL DO TME N�OFIIC AND iME STRUC7UHE IS NO7 WTEh9C0 OR OFFEHEO FOR SA[E(SEG 7oN,BU51� J
� NE$S AND VpOFE5510NS OODE:TME COffiMCTOAS LICENSE UW ppES NOT APPLY TO AN OWNER OF ? , ,
PqOPERTY N710 BURDS OR MPi1pVE51NGREON.AND IM10 DOES SUpI W011K HIAISELF Oq HERSELF OR
� Q THRIXI0HNI50t7H[ROWNEMV�OYEES,VRDVCE07NATSUCNWPROVEIAENTSARENOTME�EOO(i ' m
OOFfEAEDFORSALE1F.i1DWEVEf�1NEBULDINGORWPROVEIAENiI550lD1YIMNONEYEAROFCOIUPLE '
Z �T10N.TME OWNER-0UItDER 1MLL H�VE TME BUiL7EN OF iROViNa THAT HE OR SHE OD NOT BUIID 0(i .
� MPFiOVE FOq 7HE PURPOSE OF SALE} -. . �I�, C�U.
� w OL�OwNEROFIHEVROPERfI:AUExCLUSM:YCON7MCTW0V/ITHIICENSEDCd7TMCTOIiS
' � TO CONSTRUCT THE iRQIECT(SES 7au.8U5ME55 AND PPOFFSSIONS CODE TNE CONTRACTORS U� V81113I1IX1 ��ADJ.AREA
CENSE UW DOES NOTAPPL�TO MI OW11Efl OF A PflOFERTY W110 BULDS OR IMViqVES iNEREON.AND
. � YMDCONiMCTSFORSUUIVROJECT5W�7HACONfRACiOf1IS1UCEN5EDPURSV�WfTOTNECONTMG QU/WT�7y-_., DESCRIPTICN j y'( ' FEE
� TqGUCENSEIAW.�. . .. . J . ' -y-r ,I V
p O IAAr EXEMPT U1DER SEC. B.l P.CI FOR 7Mi5 RGSON� � Q � � C
� V � �-.
LL Q
DATE OWNER ' � . �
� W
F UCENSED CONTRACTORS DECLARATION � W
� IHEREBYIIFFYWUNDERPENALTYOFiE0.A1AYTHATIFMLICENSEDUNDERFROVISqNSOFCHAP7ER V. �
d �(COu�ENCNOWI7H5ECT10N)oGoIOFDMSqNaCfTMEBU51Nf55M10PROFESSiON5C00L,A4D Z �
X IAYLICEHSE 6 W F11LL FORCE MA EFFfCL .
/- � �
� LICENSECGS G~� LIC.NO._(.�� O���y� �
V at� t corrrancror�T�_"f=�O� a . . . .. . .
,_ ._._ ..lyA .. � -. . .- . - � �
. � WORKERS'COMPENSATIOND[CLAFlATION a
��� � INEAEBVAFF6wl1ND[HPEIVIITYOFiERA1RYONEOFTHEFq10N7NGDECURATqN4: � Z � � 2
Q
G _IHAVEIIN�W�ILMAMNNACERTIFICA7E0FLON5EHTTOSEIFdNSUREFOAKORKERS' � S
� COYPENSATION.ASiiqV�UEDB'�SECT10N77aoOFTHELA00FiC00EFOiliHEPERFOPoAFNCE U
Q OF i11E WORK FOR WMCH TMiS►ERMI'IS ISSUE�. �
G
Q �IFI�VEM!'JYVILLMARRNNWOHKERS'COu^EN.^.AT!ONRISUMNCE,ASREW�REDBYSECTION
�7000FiHE LABOH OOOE.FOA 7HE FERFORAIANCE OF 7HE WOPJ(FOAYMip11H15 PERYITIS � n
� ISSUm.MYNORKERS'C014PENSATqNWSURM�C[C�RR�ERANDCOL�CVNUA.IOERARE: CONSTRUCTION -i �
. � CARRIEH [���Y� PUUI REVIEW �-� •J /'� .
� POLICYNUAIDER �'q 11/ 3�¢ A,E IC . � � + V
� fnessEct�r+r�w7eEm.n�ancrEr�+�sxaon�w�oaiuLSR�oo)rnt� fPL MBING -
w
Z ICERTIFYTNATWTHEPERFORMANCEOFiMEWDRNFORMA/ICHTHI5DFR4RlSISSU[0,1 MECHANICA � .
(J S/ULLNOT E�PLOYANY GERSON INANV Y0.�NER 50�5 T0 6ECOME SIRJECT TO THE y�,�� � .
, � Y/Of1KERS LOMPENS�TION lAWS OF GLLIF01iNIA AY��GREE T�T IF ISF10UL0 BECOME �1 IN P�.11� �
S SIAJEGTTOTHEWONKERS'COMPENS�TqNVFlOYI51dISOFSECTKN77ooOFTNEUEOR V
eoo�.isww.Famrnnn�ca�vivvnrr/�n�+osev�rum�/sw+��(:s►.� Avl UMICE D� O � r� j
p OATE: !/l�'' APPLICANT:�J��11 •'. � ���'�_}���]��-(.`�A � •T���{� �+ L Z _ ._ .
� WARNINQFARURETOSECUREWO/�KENS'COMP[45ATIONCOV[MGEISUMAWFULFN75HA1111E�+ �T�'i';"�!f'� � � `I -
�y SIAJEMµEMROVERTOCRIUINN.pENAlTIE5A1:�GIVI�fWESU�TOONEMMORCOM]US�r�p,`T ENERGYPERMtT 3 � � ' ���
DOUAR$(f 700,000),N AOORION T07MF C0.5TOi COMPCNSATpN,DAAIAGES�S iROVIDED f011 IrU U
aSECT�UN]10eOF7HELABORCOOE,NTCFlE$LLYDATTOP.NEY'SFEES � ,RETENTIONFEE: �,�� - � � •O _ !
d " 'CONSTRUCTIONLENdNGAGENCY ' �',1�• .• � PRE-ALTFEE:�'. ' D '�• � '
o , • _ : _. � - • — .
� IMEiiFBYAFFINAUNOEqPENILTYOFPEfU1RYT�UTiMEREtSACONSTRUCiIONLENDINCAGENGY,
FOflTH[PER�OqMlWCEOFjMEW0�7NiORNn11CHTMISVERWTISI55UED�SEG]Oa7,GV.G). ' ,
� LFNDER'SNMIE � 5 � � ` . . . .�_ '
� � LENOERS/�O�RE55 '�� � , .
��,�� ICEAT1fYTNATIHAVENEADTVP5A0VLIGTqNA1:D5TRTET1uTTHLA00VENFOW.IATqNISCORAECT. �TOTAL FEES/ �1(a �C)24a� '
w IAGREETO[XM�v�YN7TMILLLQTYAMJCOUNT�0i7:l4YANCE5�ND5UTEUWSRELATINOTOBUIlDINO _`�, "L � �
- �" LONSTRUCiION.MIDM[REBVHIT}K7RIZEREPR[SENUTIVE40FTHISCOIMTYTOEMEAUFONTHE. . . '
� � ABOYE•4EMIONEDVROPERTYFOH�N`+PECTWNPUAPOSCS. COMMENTS �
.�; � c�• IC,yY��
_..,m.
Q �ERAUTTEEI ��N Am �
[A V • � �! �
� � 6iON�TUREOF�EHYITTEE �� O�T
� . _, . RECPT.N0. ' PAID BY � VAIIDATION
�% � WHITE—popanmer.t Capy,YELLOW—Finance Copy,PINK—A�sessa Copy,GOLDENROD—File Copy.GREEN—Applicant's Copy� � �
. . .. .. . ... . . . . . , � .. . � . .. \ . . .. . � . ,.. . ..� . � � . . �.�, ..,. .. , •
/�^_ ..
/ CITY OF DIAMOND,BAR � ,
� :,_ , .. . p-� . • �
INSPECTION RECOR, .
i � � � • - • � � � -
SET BACK ' �- �� I ': (�' ,��n� ' FLOOR JOIST <,; ; „ti: �� •-� ��,�•"` �
, . _ , . .,: ., . . , ,. ._
. • - � - -
FfGS/FORMS/STEEL , - � FHA REQMTS - ` ..,;,., , ,: �
ELECTRIC'GR�UND -- � " UNDER FLOORD�ICT;•� ',.�, ±. ,� i .';' �:��„�, 1�.
GROUND PLUMBING � UNDER FLOOR COMDUIT.�: •�-1�.',+::1 :�}:' 1 ;'!""';:
SLABGRADE- - - - _ FIREPLAC�F�UNDA7lQN . :`�' ,,;.�ti;n:•.,`� '':- �
TEMP POWER - . • - _ � - � FIREPLACE$'OND��EAP,A . _ , � � ,., ^ ..'; . ,
WATEA SERVICE - ; ._ .- ..-.-__. _..-- --:_ .. ._ . ._: MID HT.BaND SEAM'�� �.., ,� �.�,► � : �,�_ ��r .� . .
,
ROOFSHEATF�ING :' ' -'�+v 1 . � �, ��ti.�t '.. ' BFT.BONDB AQA`,i, :.,'�,, - -;.;,�a�:• ,
:,
FRAMINGNENTILIATION FINAL BOND BEAM .. ��. - � . , ,., �;.. • .- ''
ROOF COVER . `PRE-GRADING- - ',.c' '1��f,'r.�;�� . •, �r�.' ',; .
ROUGHHEA7ING - -- -. . ...- �- BENCHING`-��"�'�)::•.. �:=�-::� �`1=�;-',1':'.� .' ,
'ROtJGH ELECTRiC - - - - - '� ROUGH GRADING
ROUGH PLUMBING- - - � � - "-• �: FINISH GRADING ,. , i
SHOWER/TUB TEST � � - ' -�� - � � POOL ELECTRIC � '
EXT.LATH/SIDING ���� �.= , POOL FENCING y'�J `"�j / - �
•WALL INSULATION ! POOL FINAL - .
CEILING INSULATION OFF SITE IMPS: •
DRYWALL NAII.ING DEDICATIONS' . �
SEWER.- --.. _. _.... ._ . . _. _ FINAL ENG. . . : ,
SEPTIC TANK _ _ . . ; . ._„ ; . LANDSCAPE/IRRIG.. - :-
` ' � �'�'-'-` - .. �N SITE IMPS.
SEEP PIT/L.L.. = -_._ __ .
GAS AIR T,EST• -- - • FINAL ZONING , .
FINAL CONST. �- -- - • ;2, , � FIRE;DEPT.FINAL ; �,
FlNAL H�ATING � . `-" " ' ; ' � HEALTH DEPT.FINAL ; � -�:
FINAL ELECTRIC " - �� - -" - - DEV. FEES PAID - �
;
FINAL:PLUMBING ,., ,. �1 � EPJERGY • � � '
� •.; � i ,. . `� � . ,
� '� �. � �•' ' �� ,b) 8 �. , - ; . .
`� ,
� �
. . . . . . � .
:._ _ . f , . � _. . . _ �• ._ .
, .. i .•• � . �;' --. .��l. ._..... _. ........ ' .. ... ----.... ...
' - -- . . . - . . . . . . . . . . . . . . . -_. .. ".` �
COtJIMENTS :� _ . � . : ' .
, �-• = ._ � � , . �,, , . �. . 1 .
_ � L. , . ;; � , - ,
_ . � . __...
,
r;? ..� . '`�; . '
. �e _ , �, ,�, . �
�i , .�, - - :�r; � �..� '�,� , ;' �
„
r`�) '`� •(�•i:' ���r�� ,;__ . _.. �•''
. .. •,/_.:' r' .` . � . �%�'� �'�'�'j ' � � � . •
�,
_ ._ . i . ` - -�; -, '��.:j� .f,
.";_ ,. ;,; � :'c;;. - - •�� ti - � i < , � ,
�. _ '�''?, '' 1� �/��J• `VJ'���f ``l;►' �� •�_�.�1�• ,�� 1���7 ,�` • :
SEPTIC TANK SIZE -7� ,'"'� ,f r � j� _�
SEEP PIT/U SIZE -�' -- (J� �� ���� � -�1a �� ��� .
�., � �.._��. ��L _ . �/� b.
:� ��f �3��� _ 9 -- � -�-� � �
�"v'���-�,�' � �-�___�_�v�,1� .��l�.�� . -
—t--�—'S- -_���� ' � dt� • �
� �' . �}��� _�� �,)
_ ,_ _ . � . __. _ . -_ ���I�
- + � . i :.i � ' � -,�. � � -- — � a���a �
' ., . . . .. _. _ ' ►.1 �i l i; � .._ .J� �jy. •7
� i 1+ � �