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Home My WebLink About17199 (25) � ----��---- crrY oF n�orm s� EXPIRED � DEPARTIvIENT OF CONA�fiJNITY&DEVELOPMENT SERVICES � 21825 E.Copley Drive '�w (909)860-3195 Fax(909)861-3117 J U N 19 2002 PRESS •�-��" BUYILHDYIVG�E&�IT�'PY.ICATION FIRMLY r �h APPLICATION rl� �ll PERMIT � P/C Q D RIESS�' 7 reS o dr• `L��O� ��"l� DATE I v � v 1 NUMBER �' # � ISSUE TYPE OCC °r APN�� LOT TRACT DATE CONST. GROUP °C OWNER O O p ADDRESS � ZONING SETBACKS Z CITY ZIP�� TEL d Tj FRONT R�/y ❑ � APPLICANT TEL. REAR ❑ Z SIDE/SIDE STREET RW ❑ a CONTRACTO C �S L O� (�' SIDE ❑ � ADDRESS O � CITY ZIP TEL� � - 'LI PROPOSED USE ��E.l►/ DG�- � CQ10I!�i�Q� w ARCH/ENG/ z DESIGNER -�`�� '�n' w NO.DWEL. NO. NO. a ADDRESS � CITY ZIP TEL. UNITS STORIES BEDROOMS � cn DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION p� OWNER•BUILDER DECLARATION SFR/ADD/REM O p I HEREBY AFFIRM UNDEFi PENALT/OF PERIURY THAT I AM EXEMPT FF10M 7HE CANTRACTOqS LI- G2fe9B/CefPOR W CENSELAWFORTHEFOLLOWINGREASON(SEC.7o31.58U51NE55ANOPROFESSIONSCA�E:ANVCITYOR (n U CAUNttWHICHREOUIRESAPERMITTOCANSTRUCT,ALTER,IMPROVE,DEMOLISH,ORREPAIRANYS7RUC� w NRE,PRIOR TO ITS ISSUANCE,ALSO REOUIRES THE APPLICANT FOR SUCH PERMI7 TO FILE A SIGNED w Patio/Deck STATEMENT THAT HE OR SHE IS LICENSED PURSUAN7 TO THE PROVISIONS OF THE CANTRACTORS LI- � CENSE LAW(CHAPTER B(CAMMENCING WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PRO� � POOVSpB � FESSIONS CADE)OR THAT HE OR SHE IS EXEMP7 THEREFROM AND THE BASIS FOR 7HE ALLEGED EXEMP- (� V TION.ANY VIOLATION OF SECTION 7031.5 BYANV APPLICANT FOR A PERMI7 SUBJECTS TNE APPLICAN7 T0 Z Re-Roo( A CIVIL PENALTV OF NOT MORE THAN FIVE HUNDRED DOLLARS(f5o0).): � OI,ASOWNEROFTHEPROPER7Y,ORMYEMPLOVEESWI7HWAGESASTHEIPSOLECOMPENSATION, � COrtIrtIBfClel � Z WILL DO THE WORK,AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE(SEC.70I4,BU51� J � NESS AND PROFESSIONS CODE:THE CONTRACTORS LICENSE LAW DOES NOT APPLY TO AN OWNER OF � PROPERTV NM1iO BUILOS OR IMPROVES THEREON,AND WHO DOES SUCH WORK HIMSELF OR HERSELF OR Q THROUGH HIS OR HER OWN EMPLOYEES,PROVIDED THAT SUCH IMPROVEMENTS ARE NOT IN7ENDED OR m w OFFEREDFORSALEIf,HOWEVER,7HE8UILDINGORIMPROVEMENTISSOLDWITHINONEVEAROFCOMPLE- � TION,THE OWNER-BUILDER WILL HAVE THE BURDEN OF PROVING 7HA7 HE OR SHE DID NOT BUILD OR Z IMPROVE FOR THE PURPOSE OF SALE). _ ❑I,AS ONRJER OF THE PROPERTV,AA/EXCLUSIVELY CON7RACTING WITH LICENSED CANTRAC70RS W Q TO CANS7RUCT T1E PRQIECT(SEC.7o�a,BUSINE55 AND PROFESSIONS CODE:THE CONTRACTORS LI- V81t181iOf1 ADJ.AREA W CENSE LAW OOES NOTAPPLY TOAN OWNER OF A PROPERTV WHO BUILDS OR IMPROVES THEREON,AND � WHOCANTRACTSFOPSUCHPROJEC75WITHACANTRACTOR(S)I.ICENSEDPURSUAN7TO7HECANTRAC- QUANTITY DESCRIPTION FEE Y TORS LICENSE LAW.). � ❑I AM EJ(EMPT UNDER SEC. B.6 P.C.FOR THIS REASON J o a � U LL � DATE OWNER � Z W � LICENSED CONTRACTORS DECLARATION w � I HEREBV AFFIRM UNDER PENAL7V OF PERIURY THAT 1 AM LICENSED UNDER PROVISIONS OF CHAPTER � � o(COMMENCING WITH SECTION 7000)OF DIVISION 3 OF 7HE BUSINESS AND PROFESSIONS CODE,AND Z X MY L�CENSE IS IN FULL FORCE AND EFFECT. � LICENSECLASS�L�i3l�jq N I`�LIC.NO. �O�2� j �7 J V DATE_ � CONTRACTOR G� y O. C d W � WORKERS'COMPENSATION DECLARATION �nG' Q � I HEREBV AFFIRM UNDER PENALTV OF PE0.IURY ONE OF THE FOLLOWING DECURA710N5: Z Z _I HAVE AND WILL MAMTAIN A CERTIFICATE OF CONSENT TO SELF-INSURE FOR WORKERS' _ ¢ CAMPENSATION,AS PROVIDED BY SECTION 3700 OF THE LABOR CODE.FOR THE PERFORMANCE w Q OF THE WORN FOR WHICH THIS PERMIT IS ISSUED. � QW I HAVE AND WIIL MAINTAIN WORKERS'COMPENSATION INSURANCE,AS REOUIRED BY SECTION /� 37ooOF7HE LABOR CODE,FOR THE PERFORMAN OFTHE WORK FOR WHICH THIS PERMIT IS ' Q�+ �� J ISSUED.MY�R6 5'CqMPENSA��C:CARRIER AND POLICV NUMBER ARE: CONSTRUCTION �� 1/��J.. � CAFiRIER ; �� Q PI.AN REVIEW ZPOLICV NUMBER ELECTRIC Q' � (fHISSECIIONNE�N0TBE0Cf.1RETmOFhiEPEWMISFORONEHUI�DRED (f100�ORLESS) PLUMBING Z 1 CERTIFY THAT W THE PERFORMANCE OF THE WORK FOR WHIC PERMI IS ISSUED,I MECHANICAL �.-_�--------- LJ SHALL NOT EMPLOY ANY P IN AN ER SO A TO B M S BJEC TO THE ��f�., � Uj WORKERS'COMPENSATIONLAWSOFCALIFOR ,AND GR THATIFISHOUDBECOME INS°ECTIONFEE�� / \ I I "--�-�� SU&IECTTO THE WORNERS'COMPE SATION PR VISI S SECT N 3700 7HE LABO � CODE,1 SHALL FORTHWITM COMPLV ITH THOS PRO 51 Ns. ISSUANCE /. � p DATE:��D I APPLICANT: � SM1P („ I I �� J WAFNING FAILURE TO SECUHE WORKERS'COMPENSATION COVERAG LAWFUL,AN HALL BE ENERGY P/C I ' � SUBJECTANEMPLOYERTOCRIMINALPENALTIESANDCIVILFINESUP700NEHUNDRED USAND ENERGYPERMIT•�—��r DOILARS(5100,0OO�,INADDITIONTOTHECOSTOFCOMPENSATION,DAMAGESASPHOVID FOFIN � � SECTION 3708 OF THE LABOR CODE,INTEREST,AND ATTORNEV'S FEES. RETENTION FEE."""��""""'--v ' "�—�` a CONSTRUCTION LENDING AGENCY PRE-ALT FEE: O � I HEREBYAFFIRM UNDER PENALTV OF PERJURY 7HAT7HERE IS ACONSTRUCTION LENDING AGENCY FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PEPMIT IS ISSUED(SEC.3087,CIV.C.). Z W � LENDER'S NAME F— LENDER'SADDRESS � TOTAL FEES l � a.� � I CERTIFV THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CORRECT. w I AGREE TO COMPLY WITH ALl CITY AND CAUNTV ORDINANCES AND STATE UWS RELATING TO BUILDING � CANSTRUCTION,AND HEREBV AUTHOHIZE REPRESENTATIVES OF THIS COUNTV TO ENTER UPON THE � OVE�MEN710NED PROPEF FOR INSPECTION PURPOSES. Z COMMENTS � J � PER TTEE NA E(P N7) I � (p -�-U � SIGN UR P M EE DA7E I = RECPT.NO. PAID BY VALIDATION � ~ WHITE e artment Co YELLOW—Finance Co PINK—Assessor Co GOLDENROD—File Co GREEN—A licant's Co P PY. PY. PY� PY. PP PY . . .. . . .. . ' . , . . . , , .. .. . •.I..r � ., . �.a . "�v � . . . .. . i.. . . . , , . , . . . . . . �SA� U U �11 ��ll"3UQY�U V� �WII LL ' � o��c��o�� c�c�� 0�° �rt OO�l oDQ51� 0� v � � � ° �G Q DD Q� 0 ° = o � - ---- � ' SET BACK ' i FLOOR JOIST , j __}------------- ---- ---- --___.. FTGS/FORMS/STEEL ; ; FHA REC�2MT5 � � __ __ ,_.---- -.....-- ------....�..._..._..---- -�--:- ELECTRIC GROUND ' UNDER FLUOR DU�T - � __ _— ------ __ _,_ _-- — ----�—�—, —:—� --- .___. GROUND PLUMBING j UNDER FLOOR CC'��DUfT . °, .� ' , .: I -- -- FIREPLACE F'OUNDATION •�� ' 4 � l SLAB GRADE ' ' «_.._ TEMP POWER FIREPLACE F.iONQ gEAM �� . W,4TER SERVICE � MID HT. BC]Rfl BEAM ' � ,, __ ROOF SHEATHIfVG � o�j yo� ,�_�c,�e� 8 Ff. BO�ID,�BEA�I . _ ' FRAMIRlGNENTILIATION� � FINAL BOND BEAM � _ ROOF COVER PRE-GRADING ROUGH HEATING BENCHING _ __ ROUGH ELECTRIC __ ROUGH GRADING __ __ ROUGH PLUMBING ! FINISH GRADIN� _---- -- ---_____� _._..........._...__.-- SHOWERrfUB TEST r POOL ELECTRIG EXT. 1�4TH/SIDIIVG POOL FENCING WALL II�SULATION POOL FINAI CEILIMG INSULATION OFF SITE IMPS. DRYWALL NAILIiVG DEDICATIONS SEWER FIIVAL ENG. SEPTIC TANK LANDSCAPE/IRRIG. SEEP PIT/L.L. ON SITE IMPS. GAS AIR TEST FINAL Z�NING FINAL COiVST. FIRE DEPT. FINAL � FINAL HEATING j HEALTH DEPT. FINAL __ FINA�ELECTRIC DEV. FEES PAID FIfVAL PLUMBING ENERGY , � �� f•��o ' ' • , . --- -- , . , --.---5-- — CU�iiNiENTS � � � SEPTIC TANK SIZE SEEP PIT/U SIZE ---- �— � ,� � � , � . . — --------