Loading...
HomeMy WebLinkAbout16772 (25) . �...r _.. ;,�,,��„.�...... ,.... ... CITY OF BIAMOND BAR / . � - " �` DEPARTMENT OF COI��TY&DEVELOPMENT SERVICES �� I �w . 21825 E.�opley Drive (909)860-3 L95 Fas(909)861-3117 PRESS ��'q��� BUILDING PERMIT APPLICATION FIRMLY � JOBSITE �/D /� /7v�� nJ��� APPLICATION� ,� �1 PERMIT i�lC ,,,��y� a ADDRESS R� (�C I�C r o DATE _ NUMBER � � APN LOT 3 TRA T �p ISSUE TYPE OCC � DATE � CONST. GROUP p OWNER L o ADDRESS Z. Z.- /L� ZONING SETBACKS o ��TY ZIP�F',�y-/TEL. Q, FRONT RW ❑ 0 APPLICA T TEL. REAR � z SIDE/SIDE STREET RW ❑ Q CONTRACTOR I1J� SIDE � p� ADDRESS /L � s � CITY ZIP��� TE PROPOSED USE o ARCH/ENG/ z DESIGNER a ADDRESS NO.DWEL. NO. NO. � UNITS STORIES BEDROOMS � CITY ZIP TE�. � DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION � OWNER-BUILDER DECIARATIDN p SFR/ADDIREM � I HEFEBY AFFIRM UN�ER PENALTY OF PERJURY THAT i AM EXEMPT FROM THE CONTRACTORS LI- GBf890/C81pOff W CENSELAWFORTHEFOLLOWMGREASON(SEC.�031.58USMESSANDPROFESSIONSCODE:ANYCITYOR (n U COUNTVWHICMRC-0UIRESAPERMITTOCONS7FUCT,ALTER,IMPROVE,�EMOLISH,ORREPAIRANYSTRUC- paClo/DBCk W TURE.PRIOR TO ITS ISSUANC'e,ALSO HEOUIRES THE APPUCANT FOR SUCH PERMIT TO FILE A SIGNE� W � STATEMENT THAT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OP'HE CONTRAC70RS U� CENSE LAW(CHAPTER e(COMMENCING WITH SECTION 7000)OF�IVISION 3 oF THE BUSINESS AND PRO- � POOUSpa � FESSIONSCODE)ORTHATHEORSNEISE%EMPT7HEREFROMANDTHEBASISFORTHEALLEGEDE%EMP- (� V TION.ANVVIOLATIONOFSECTION7031.58YANVA?PLICANTFORAPERMITSU&IECTSTHEAPPLICANTTO Z Re-Roof � A CIVIL GENALN OF NOT MORE THAN FIVE HUNDRED DOLIARS IE500).�: � OI,ASOVlNEROF7HEPROPERN,OFMYEMPLOYEESWITHWAGESASTHEIRSOLECOMPENSATION, � Comm0fCi81 Z WILL DO THE WORK,AND TNE STRUCTURE IS NO?INTEN�ED Ofl OFFERED FOR SALE(SEC.7044,Bl,'SI- J � NE55 AND PROFESSIqVS COOE:THE CONTflAC-0R5 LICENSE LAW DOES NOT APPLY TO AN OWNER OF � PROPEFTY WHO BUILOS oR IMPROVES THEREON,AND WHD DOES SUCH WORK HIMSELF OR HERSELF OR WTHROUGH HIS OR HEROWN EMPLOVEES,PROVIDED THAT SUCH IMPROVEMENTS APE NOT INTENOE�OR m � OFFERE�FORSPLE.IF,HOWEV'eR.THEBUILDMGORIMPiiOVEMEN7ISSOLCWI7HINONEYEAROFCOMPLE� Z TION,THE OWNER�BUILDER WILL HAVE THE BURDEN oF PROVING iHAT HE OR SHE DI�NOT BUILD OR � IMPROVEFORTHEPl1RPOSEOFSALE). W ❑I,ASONMEROFTHEPROPERTY,AME%CLUSIVELVCONTRACTINGWITHLICENSEOCONTRACTORS � TO CANSTRUCT THE PROJECT(SEC,1044,BUSINESS AND PROFESSIONS CODE:THE CONTRACTORS U� V8IU8IIOf1 ADJ.AREA = CENSELAWDOESNOTAPPLYTOANOWNEROFAPqOPERTYWHOBU'LDSORIMPROVESTHEREON.AND � WHOCONTRACTSFORSUCHPFOJECTSWITNACONTFAC70R(5)LICENSEDPURSUANTTOTHECONTMG QUANTITY DESCRIPTION FEE Y TORSLICENSEIAW.). � ❑I AM E%EMPT UN�ER SEC. B.&P.C.FOR THIS REASON Q �J � U LL DATE OWNER � Z U � LICENSED CONTRACTORS DECLAFATION W ¢ � I HEREBV AFFIRM UNDER PENALTY OF PERJURY THA?I AM LICENSEO UNDEP PROVISIONS OF CHAPTER � ,/► � 9(COMMENCING WITH SEGTION 7000)OF DNISION 3 0F'.HE BUSINESS AND PROFESSIONS CODE,AND Z !(/�' W MY LICENSE IS IN FULL/FO�RCE ANO EFFECT. A m � LICENSE CLASS .�+��� LIC.NO. ,( I I / I, � U �ATE CONTRACTOR 6J. W � WORKERS'COMPENSATION DECLARATION Q �, � IHEREBYAFFIRMUNDERPENALTYOFPERJURVONEOFTHEFOLLOWINGDECLARATIONS: Z Z _IHAVEANDWILLMAINTAINACERTIFICATEDFCONSENTTOSELF-INSUqEFORWORNERS' ¢ ¢ COMPENSATION,ASPROVIOEDBVSECTION37oGO�THELA130RCODE,FOqTHEPERFORMANCE U Q OFTHE WORK FOR WHICHTHIS PERMIT IS ISSUED. � Qw �HAVEANDWILIMAINTAINWORKERS'COMPENSATIONINSURANCE.ASREQUIREDBYSECTION .a'� � 37a0 OF THE LABOF COOE,FOR THE PERFORMANCE OF 7HE WORK FOR WHICH THIS PERMIT IS `( � ISSIJED.MY WO 5'COMPENSATION I SURANCE CARRIEfl ANO POUCY NUMBERARE: CONSTRUCTION I C,7'�-- � � CARRIER F _ PLAN REVIEW Z POUCV NUMBER O D ELECTRIC �'j Q � (fHISSECTIONNE�NOTBE00MPLETEDOFTHEPERMRISFORONEHU�URED�OLLARS(5100)ORLESS). PLUMBING ^y �_I J� Z ICERTIFVTHATINTHEPERFOPMANCEOFTHEWORKFORWHICHTHISPERMITISISSUED,I MECHANICAL '""^� .�� �} I � I�������'i �� • � (.�J SHALLNOTEMPLOVANVPERSONINANYMANNER50ASTOBECOM'cSUBJECTTOTHE `�-�� ' � ' ""'-��-�^ ' � WORKERS'COMPENSATION LAWS OF CALIFORNIA,AND AGREE THAT IF I SHOULO BECOME INSPECTION FEE SUBJECTTOTHEWOfiKERS'COMPENSATION ROVI51 S SE ION37o00FTHELABOR � CODE,I ALL FOPTMWITH COMPIV WITH E PR I^ NS ISSUANCE � / � � /� � � i � ` p �ATE: � 'v APPLICANT: � a SMIP I � �.)�'Y�Y J WARNING:FAILURETO SECURE WORKERS'COMPENSATION COVEPAGE IS 11NLAWFUL,AND SHHLLBE ENERGY P/C �•-� - LL OOLLARS($loo,Doo�,INAD0ITIONTOTHECOSTOFGOMPENSAT10N,0AMAGESASPRDVI�EOFOHIN ENERGYPERMIT �� " ""'---- SU&IECT AN EMPLOVEfl TO CFIMINAL PENALTIES AN�CNIL FINES UP TO ONE HUNDRED THOUSAND d- '_.—..2'-___ � SECTION 3708 OF T}IE LABOR CODE,INTEflEST,ANO ATfORNEY'S FEES. RETENTION FEE: � OCONSTRUCTION LENDING AGENCY PRE•ALT FEE: r � � IHEREBYAFFIqMUN�ERPENALTVOFPERIURVTHATTHEREISACONSTRJGTIONLENDINGAGENCV FOfl THE PERFORMANCEOFTHE WORK FOR WHICH THIS PERMIT IS ISSUED(SEG.308],CIV.G.�. Z W ? LENDER'S NAME 7 1— LENDER'SADDRESS � (/�� r � WICERTIFYTHATIHAVEREADTHISAPPLICATIONAN�STA7ETHATTHEADOVEINFORMATIONISCOFRECT. TOTAL FEES ' � i� 7\ , yy��� ; � � 1 AGREE TO COMPLY WITH ALL CITV ANO COUNTY ORDINANCES AND STATE LAWS RELA7ING TO BVIL�ING �"� 6 � CON3TRUCTION,ANDHEREBYAVTHORI2ER'cPRESENTATIVE50FTHI5C0'JNTYTOENTERUFONTHE ' � /'`N Z ABOVE�MENTIONED PROPERTV FOR INSPECTION PURPOSES. COMMENTS � �Ll � �� � � _ m PERMI (P T) ¢ 7�f rc� / � � GNAlURE PERM E DATE = RECPT.NO. PAID BY �` VALIDATION ~ WHITE—Department Copy,YELLOW—Finance Copy,PMK—Assessor Copy,GOLDENRO�File Copy,GREEN—ApplicanTs Copy _ _ t3�� � d Gr" . & � ,�� °��z������i;,� �`�� �k'���: �� ,� .a���� � r���a �„`� � �''',;,.a� :� m�s--�€.s� � ��'�"" � �'g���`,�"� �.a, �e x .��.���'�g.m:�3� .:, „� s� a�h .:a+?.�x� :7 :� �.�}*� �,waal.�.ti�, � ^s_�a asa,.��:;.t, , � ,"_�r �a� �,� � '� �� � � "� ,: � �� �. �,�� � � ���� � ����t �� � ���� ���`�� �'�. � � � � ��� .."� „,� � �� � � ��� � ��� �: �" � � g �� � ,� �� a � `"�.. �� �� � ,� � � �� �� �� �� �� �a.. � �� � ���a.��. -:.��._.�m��.ia �� � �:�._<.�,�:� .„�'a�., . ,m�? �.,�. s.� .�a ��.��.��,�� ��"„a��e�.�m���,�.� .�„s�-�:_'���.,, <°:�:�� �}����..?`..�.�k.,�".c�.���.:-��m'°`..,.. � �� �� � � � i s� �� � ___ _....__. , . _._ _w w � � _..�,�_ . —- .�. } �� �^ S�:.� -':,,-b. . �C �, Y"4 [' �h � ,j ... . .,. d3f .:.�'�. .._.. . .....,.. . ....3 . . ........ ....._. ___..._ _................ � � � iL. 'z 5 °Slr i -�. �� _ . . .. � � ��d�` f� -'a�3� � ! � � . .� 1... .. . ...._ .,.......,t �.. � .... ' ....... _ . . _ . _.�._ .... ..�............. .._ i ��f t i�� W ." �' ; ;v'�a t F. �f €t ti� i, �) f ___.. �...`.,_. _ . __ ___ . _.. €[ .✓4' t ��4 =. 1f _ f 'pE� S �.'"�,. I ` �d X €j�� � n g . .,. _.... .......... .._ _.,...... . .. A .. : . . .. _. _._._ ....... .............. .... .. � �T" `�5'.�° N f tF � € � '` { -;�'§ �(ti t t �" ._'.__' _ ... __..... , .__.._...___.. ..�e .. ..,_. .. ........ .. ...._...___,_. ._..__... ..............._.....,,..,._.._ .. ... ._.. ;-.. ... _.........._..,..._._.. '.:� "" r:: I 3.�� t a �_,� � „�� ,.,a....€-" .�3,�a. V i�, v`�L.���.� ....'t.. . ...� „ � ...... ._._�__ . ........... ..„,w.................. ._.............T. ... _............ ___ .. .____..._._. ___._....._... __.....__..,___..... _............_.._ ............, _ , dg.,d a .�'a��n�' � , ... . I __ P" V -...1 � I::� � ,,. � i i''u 3-.a ..... � � .__ . _ __,,. ....._..,.......,.�.......... ....a.............,...........,...._...,...,........,,,.....__... ..... ..., .... .....,.,_._.... ...... ._.......... ................,.......-.............,..,....._..,..._ .. ........ ��-�'.'.�(. „a�d� t ld `'i! ..€v, � a:�Eia� .;.t�:ai .� `';ai.'= .. �' _,.j ._ .... __ _ ..... .._ ,. ._ .. . . __ ......... . - .. ...... .... .� §�� t ',_ ., y -� _ �.� €�}. �€ - i . c , �..�,. . ...�... ..,.......__...,.... .�__ ��......_,..___!._..__.__ ______...._...._ _...�.. .__ .__..__ .._,_..___......._..,._ __ .._ ._�__._ ..,.w...............„...._._.......__ _......._.�__._..._ r .._.�.. . ...... .._,.._ �. € t °-���4 ��1' �`� , � �-r�a� ���ta� E _ _..., _..�_______. . ...,.__.._...� _.....�___.__ �.. __ _... ..._ �..__--�., .......__ _._. � _.... _____ _,,..__ ...._.._.. --- �__._ ', r'�'� . r,r< � �� � ` ��ie e��. -'i.:�'�� �?E;�i _. ... . � -�...r b .._ .._.........._ __ ._ ..__ �.._.� ......... ._..�.�..m.___.._,..-...._a_.�.._...... .___w.__._ . ......_.._... ,......._�.-� ._ ..._..........�.�......... .�...._..._...�....._.___..... _.___._.......____ 4 ,.-,r r c "'w, ; � r•'� t '� r� - . � � i � >..� e � . I ���-�n�a � .:., �. . -"i^t.�g � : §...�.....,,�.,:.. � .... ..._.............i.... ___.__.�,,,.,....................._._........____......_.,... ._. . ._...._. . .�,..._............,.... . _....._-'— . ..--'-. . ._i { ?�� ° �7 �^( � -� s �� ��x 4 ��'._..+� � . i ��i � �.��� {� (n7�..: �l.i�-l.J�.CC.��r��_ ..., . .. . . ._ .. . ._._,_. ...._,.... ... .�.. -...._ . .___ '-__ r .. � �.a:^r � ��'a _�r g'�;9n�r � - � - Y��.- �"� ���4�.- � � - � _ ._ __�_.... �..,,_...�.. ___.. ._. . ....... _. � �,��i:. � t'ti,'�.i...�t aa a��� ... ( .. .._— �.;a, .� _f°ry,�� :_ _. __..-=-__-�-��- �d ....... ... . ... ...__.. ........__ ,._�_ �._..� ....,_......... — ____. ��-�� -� _w _ ; s _;�rn � g,� � ��, rs� � �. �i ,� �n � ' - _._� ....._.__w. . _. _ __... ____._._________......___ __ __ _ .._._ _..,__�__..___1 �_,..________.._��m. ._. . ..... ; _._ ._ _�v ??=` `` �.k� �;�{ �` �� ��' ..�°�':`�-�'�'a d,M, ' � � . A ._ .. _.. g �. _ _ _.. ___ � .. . ... . . .. ��.."�2 �k ��.dd� .. .._ , ......... . ._r ...._�.._._......_...._., _ ,_.._._..__.�.....�.......»..... �.... _ ...�.�... y /� ...,.. .. . .. ...... _ ..�,._ _�_................ ... (` . z .. . � ww......... .... � �.� - _ ifd� € 'df I I..t""pb�`k���:.AF"� 1 �'� ��6Ev,. : - .. ... .... :,.,. . ....�..... ..........._�_...............�..� ..... ., .. .. ...,... . :......._,._._......_.............._ ....._...,,,__, . ___ 3. ( g . . ............. .___—_ _.,.r "t !�€ i � . "i)� �. €�b .. . . . 7 .. ;� .r� ^� ... .- ......... . ........._....n..e_.�_.��._��, _.. ...... . . �..�, � X!-e"s '"8 '[ i C'i yp�� ���dt _. __. ---� � _� ._� ..____ _ _.._._. ___ �_._.._.._. .______._. ... _..w... _. g , _. _.._ �_...._.._. . , • , „ __ . ..� ._____.____._..__ .__... __, �'��xi� ,..��.:,.',�,.��. ' . §i'�r ."`.i•s. �irax, � �. — -.._ ._T ,i_._....--- ._.__._._ - --...�_._. t ._.._. ...__ ._....... . _ _�._---�-�'-__ _ > .. .. _.�_ .. 3 t :�: <;�s 9 *:'�: ;�... � .�,�_T�. . €_ � '�.;�:�.. ----�—._.�._____,___`, ._... (^ ..m........ .�. ._... ................ j .,......,.......�......,... �............._.._.... _._...._...._... 4�� i`tt�`E. .-...-L � �, i ... . . . . .... ,.. �v €. _�� 3}.r ................. -... ._..R .... . _,..._ ...._ ... . __. __.,,,_.. ......_.... _....._.....,..._..._... ....__......._ _ _.,..,_........ _ __ .__—_.._. _ __ . t._�' __..___.__ '....�.._.._....._.....,,,.......... ...............�._.___�...... p y^', � 3.,c" i-:.I.37 e:...Y i - '�Y"{L..°.� r --- _... ._.__ ..�.. . . �}� ..__.. _ . . ...M..,. ._. .__ _ .. _ _.____.___.��.___.�.��� ..;.__W n�__.____;____._ ...� .____ ,� � i�e�t���, _� �3_�- _--� � , � �� � � � _____ ____.._ __.._ ...._..__.;.. _� ___ �...�....._W_ .. .._..e.. _. _....___,. ��s� �.��b����.���������..n� .. _,,:__ _— � ___ _ . P fi _ -- �,;� 7 ��'�,9a-a a �:� l2't�l . !r_� ����V�'.'...����r,.._.�..... ___ � . _ . ... — F W i�-.3�'.C_. ,.�Dt`r'c�--� . f���j ..._j'��a , w�_ l13b7___.�j� 1�,_ _�'lr.�??t-:... _.... ' _ _._._._..__.�__�. _ ___.ff i ......_..�n_..__._.._ _.�...__..... ......_...... _._.. _...__. ._. ........... ......_�..._ ._ ` _....._m. ..._._.._.....�____�..._....�.__�_..._....._.._.�. ..____. .�.___w._ _ ... _._.. ........__....._ .__�--� � -- . __ _. --- --- -- .____ i T_ __ _._....____. ___ .___._ .__w._ __.__._.___________.___ ___._.._._.T�._.__., �_ ; � E f < .�..................................>.�_...._..._......._.. .............._...._.. . .._..._.............._..,-..............,,...,.... ..... . .........-..�._......«�.............,�............ .................._._............. ........,.,.....,.. ._.._..................._..«......................,..................-.......................,......._...,,,...,.. .... ...............................,..._...r�,,.,,{ � � _._._".. .._,._ _... _..............__ ................_.._....____...._�,......,..,.... .................. ..._......�..................,.,.� t ; ..._.. ...... . . .... . ......... .... _...�.................-..........._........�......�.._.......�.«..............,...-._. ... ..... ...... ............_.........._.._........_._.........._'_�.___'���_._..�.....�..,.....«.......,...._ � . ........._..,.,......_.. .............._._._._____._.R ; aF.::::�'�-- -�'.. g:'��, b�. * :'"�$"" .. �@,_ .,..._..._....._._.,._._ i � .................__. ....__....__..._............... ..........________..w.......,.......w....._.....___'._�.__._......_...._.___._...........__-,..,............___.._._.__...__. ............._.. _........._...... . .._.p..,.x [.,. �t ..._r_, .. .... ........._..-..M. .. .... - ,::�:,.._, E : 3. �.,.�.��.., ¥ _._..._........ .__....._. j � �� � -.. . ... _ ..__ __ .,...... . �_ �.._._ ..._.._�.._�....._ ... ... _...� � �,. p _�.:� . � . �� ; � ..... ... g ... .. :� ��., ..................__,....__... ., � ..... _e. _._......__...._. ..__....._..__......,._.., ___.._ __...... _.._.. _.__.._.w.__�. _,..�_..._ . a ,.._......_............,.....,._�.�._.__.._ ....__� � .. . , , . ��..". ,._._..W.._._..._.,__..�...............-.....__.,......_..._........._____......__.....�...........n...___...__............._.___.__ . ............ _. .._`__.__._ � � y z ' s - . _�. ......_ . ..�__[ $ � � ._.. ._.. E �..� � ��, . ..,..,..___ _.___ .__....._._..._ .____._ . ...._.......... __..._._.,.,.... ..__.,__� .�� .r �a, �. � . �� � :�� � � ��� .. �.w_ __._....._._......_.__ _—. . __ __..._._.. . � ' ��,�5� ..� ....__..... ..............._......._..,,....,.,.,..-.. .._._�'___..... _.......... .._..,......_.__....__........_........�___. .. y . a ds . ����. ,� �� __�__ _...e.____ .__....____W__ � a �� ..s � _ a�� � � �.;.��a�� ...r�� �•�.� - , ..... ,:.: �..,.� 6 ::�.: ..__....._...._.._._._..........__.�_.,.._,.,.____... .._.__..�m. . ___ _.__._...._._........_...._.._..._,_.._..._....__ ... ..__...._....._.........____.__ . ._...__.__.�..__................. ...._.� � ��, � �x , .... �... a w� -�., � .. !. . . ._ ___. ...._Y _. ..�... _ . . _. . . .... . ..___ __..__ _,___ ___ . _..._. . . ...__ . .. �...�ab<b...F.mabw.e ........�m�.m ..._ �,,.«..�:�,.,,:.�.�.,........w-.��..,....»«.,.,«.«...,m„�__......,.M«...«.��::.�.w..�...:...w.�.�..,�..�..«�..«.:..__4 ...