HomeMy WebLinkAbout14483 (8) CITY OF DIAMOND BA&
- — DEPARTMENT OF COMMiTrRTY&DEVELOPMENT SERVICES
` . • : � 21660 E.Copley Drive Suite 190
�, (9()9)860-3193 Fax(909)861-3117 PRESS
' _ BUILDING PERNIIT APPLICATION FIRMI.Y
y JOBSITE -. - APPLICATION / / PERMIT L'yC/��- P/C
o A�DRESS OATE � � _NUMBER f
� APN LOT TRACT ISSUE TYPE p(;C
� OWNER '�—" OATE CONST. GROUP
ADDR S ZONING SEfBACKS
CITY � ZIP TEL. FRONT RW ❑
APPUCANT TEL. REAR ❑
SIDElSIDE STREET FiW ❑
CONTRACTOR '�J' �.' ��'IYC' SIDE ❑
ADDRES
g CI7Y IP • TEL. » PROPOSED USE �� d e�
� ARCWEN
DESIGNER NO.DWEL. NO. NO.
ADDRESS UNITS STORIES BEDROOMS
� CITY ZIP TEL.
v� DESCRIPTION S�.FT. FACTOR PSF ADJ.AREANALUATION
Q OWNER-BUILDER DECLARATION 3FRlADD/REM
O
I MEREBY AFFiW WDER PENALTY OF PEfWRV THAi I AG EXEMPT FAOM TXE OONfRACTORS LI. Qe18gBIC8ryOrt
CEIJSEUWWRTlIEFOLLOMIINGREASDN(SEC.70.77.6BUSWESSANDPROFESSIONSCODEANYpTYOR (n
COIR/TYWFIICMREOURESAPERMI7TOCOMSTNUCT,ALTERIMPROVE.UEMqJ6H2ORREP/URMIYS7RUC- IW Pelio/Deck
IURE.WIIDR 7D ITB IBBUANCE,AL90 REGtJIHES 1HE MVLICINT POR 8Wi PERMIi TO FlLE A BNiNE�
�TATOAEHT TFIAT HE OR BHE IS LICENSm PURSUAN7 M TNE PflOYl910NS OP T1E�NTMCiOHS ll�
CENSE UW(GFIAPTER Y(COtAMENqNO 1Nf7N SECTqN 7000)OF DMSION J OF TME BUSINESS M!p PRO� �" P��9
FE8910NSOODE)OFITlMTMEOR6NEISEXEMP7TNEREFf10MANOTXEBA515FOR1NEALLE�EDEXEMP• (7
iqN.ANYVIOLATI0NOF8ECT10NTW1dBYANYAPPLlCANTFOII�VERAtIT6UBIECTSTHEMPIIC�WTTO Z p9-R001
� �QVIL VENALTY OF ND'T MORE 111/N FIYE MUNOHED OOUAR31{600).):
OL��IEROFTNEPROPERTY,OR4VFMPLOYEES1MhIWAf3ESASTHEIRSOLECOMPENSATqN, Cpm�7BfC1fll
WILL 00 TME NORI(AND�F16 57RUCiURG 18 MOT INTENDED OH OFFEREC FOR SAI.E(BEC.7Ws,BU61� J
NE66 AND PpOFE6SION5 ODOE:hIE ODMMCTO0.S LICENSE LAW DOE9 HOT MPLY TO M!OWNER OF
� ►ROPERTYWFiO8U0.DSORMPqOVE6iNEREON,ANDWIWDOE55UCF1WORNWNSELFOqMERSELFOR =
� iNil0U0HM50R/1EpOWNBAPLOYEES,VROYIOEDTlIATtUp1IMVROVEMENiBARENOTNTENDEUOR m
OFFEfim FORBALE If.MOWEYER���INOOR MIPROVENENf 18801D WITXIN ONE YFAR OF CONPI.E•
110N,�ilE OWNER�UILDER WILL INVE 7NE BURDEN OF VROVPKl THAT ME OH SNE DIO NOT BUIID OR
�APqOVE FOR THE NIRPOSE OF SALEI
�l A90NMEK OF iNE PROPERfY.AY IXCLUSIVELY CONTMCTIN0INITN LICENSEO CONITUCTOq9
� TO OON5IAUCT TME VRO.IECT(SEC.7ou,BUSINESS AI�PIlOFE33lONS OODE:TNE CONfqACTOq4 LI• VBI WU011 ADJ.AREA
CENSE UNMDDES NOTAPPLY TO Ml OMMEH OF A PR0IERN YV/q BUILDS OP MPqOVE9 THEREON,AI-ID
WIWCOM11ACfSFORBUCHPRWECTBWITHACONTRACTOH(e)l1CBd8EDPURSUANTtOh1ECONTMG QUMITI7Y DESCRIPTION FEE
� fOR6LICENBEIAYV,). . . ,
❑I AN EXEMPT UNDEN OEQ 8.l P.C.FOq!Ftl5 REASON Q
C)
4' DATE OWNEfi � .. �
� LICENSED CANTRACTORS DECLARATION �
� INEREBYAPFIRMIMDERPENKTYOiPERIURYTUITIMILICENSEDUNOERVHOYISIONSOFCFNPTER �
�(OOYMENCWO YYITi SECTpN 70mJ OF GMBqN 70F TME BUSNESS ANO PRDFESSIONS WDE,AND
MY UCENSE IS M FULL FORCE AND EFFECT, m
� IK:ENSE CI.A55 �• �J� LIC.NO. - �
� DATE �"//�QO CONTRACTOR �
WORKERS'CAMPENSATION DECLARATI N �
y INEREBYAFFIRAIUNDERPENAL7YOiVERJUih'ONEOFTHEWLLOMIINOD CLAMTIONS: � Z
� _I MAVE ANC YYILL MWNTAN A CERIIFICIRE OF GONSENT TO SELFaN URE FOR MIOHK RS' �
COMPENSIRION,AS PROVIDEO 9Y 8ECf10N 37000F 7NE U90R E,FOR 7HE PEF E W
OF TMEMARK FOR WNICH 7NIS PERMR 618SUE0. �
_IH/PIEMDWILLMUIMIUNWOIIKERS'OOhIPEN3ATIONINSUAANCE,ASqEWIREDBY 'CTpN //y'�
� 9700 OF 7NE IABOR O�DE,FOR T1E PERFOFMMlCE OF TIE WORK FOR WHICH 7F1IS iERM1715 1 Vlo S O
ISSUm.W�Oql;ENSATqN INSURAyCE CARRIEH AND POLICY NUMBEN ME: CONSTAUCTION
? GHRIER ��` ���4 PLAN REVIEW
� POUCtlNUMBER a z�'.� �'1['��� �'Q EIECTRIC
(MsBECna+r�NOTeEao6itE7�aFn+EPEw.arsFataNEHUI'�nmCawas�i�ao�oriLESs). PLUMBING
B1 CERTIiYTHAT W 7XE PERFORARiWCE OF 7HE MIORN FOR WHICN THIS PEWdR IS ISSUED.I MECHANICAI
SHALL NOT EMPLOY ANY OERSON N ANY WW NER SOAS TO 9EC011E SUBJECT TXE
(q WORKEHS'COMPENSATqNUWSOFGLLIFORNIA,MlOAGREETMATIFI ECOME INSPECTIONFEE ' nnnn
� SUBJECT TO 7HE WORKERS'COMPENSA SpNS OF SECTqN 97 E tABOR ��—i
cao�,isHua.Pormm�n�oar�c�rNn sroHs. ISSUANCE
� �,�:�-t/-ov ,��,� • � a,�.�.� sM�P CIT�CI��TAMOND�+B�±A�R) a
WARNING:FMLRE TD SECUPE YYORKERS'COMPENSATION COVERAOE I6 UNUWFUL,MlO 8MA11 BE ENERGY P/C 8����r�T 1 1�Q f G�1 I
� BUBJECTIWEMPLOYERTOCqIMIW1LPENALTIESANOGVILfNJESUPTOONE/WNDREOTHOUSMW ENERGYPERMIT
�, OOl1AR5K70oAaoI.INA001TIONTOTHEC09TOFODNPEN9AT1oN.DAMA0ESA9PF0`ADEDFORIN
� BECTIDN77o00FiHElA00RCODE,NTEREST,ANDATTORNEY'SFEES. RETENTIONFEE:
CONSTRUCTION LENDING AGENCY PRE-ALT FEE:
1 FIEpEBYAFRWd UNDER PENALTY OF PERRIRY h1AT 7HEAE IB A CONSTRUCTqN LENDINO AGENCY
FOR 7HE PERFOFMANCE OF THE WORK FOR WHICFI THIS PERMIT 18 ISSUEO(SEC.MV7,dY.0.�.
� LENDEAS NNAE
C LENDEFY9ADDRES3
� ICERTIFYTFiATI11AVEqEADTHI9MPLICATqNANOSTATETiAT7HEABOVEINFOHMATpNISCORPECT. TOTAL FEES �
IACIREET04�.IPLYN7THALLCT'ANDCOUMYORDPIMICESANDST�TEUWSREIATNOTO8U0.DIN3 � O
� C01{STf1UCT10µAHD1ENE8YAUT11DRIgqEPRESENTATIVESOFTHISCWHTYTOEMERUPON7HE
�OVE.MENTqNEO PROVERT`/iOH INSPECTqN PURPOSES. COMMENTS
� f� �
� ' � ,
Q GE E EWWKT) r � - O�
y
� �10H�TU11E OF P RN6fTE CATE
3� RECPT.NO. PND 8Y VALIDATION
� WHTE--Dop�rtrnont Copy,YELLOW�inance PINK—Asseasa
Copy, [�opy,GOLDENROD—Flle Copy,GREEN--Appllcant's Copy
CITY OF DIAIIlIOND B/�tR
� II�ES�'ECTi�N RECOF��
E � • � o - o � . • - � -
SET BACK ' •., FLOOR JOIST • . � � '
FTGS/FORMS/STEEL FHA REQMTS •
ELECTRIC GROUND UNDER FLOOR DUCT , ;
GROUND PLUMBING UNDEA FLOOR CUMDUIT �.
SLAB GRADE FIREPLACE FOUNDATION ' � •
TEMP POWER FIREPLACE BOND BEAM
WATER SERVICE MID HT. BO�'B�AM ' ' �
ROOF SHEATHfNG • - �Gb � � 8 FL BQND BEAM �
FRAMINGNENI'ILEATIC7td �. ' � ' , FINAL BOND BEAM
ROOF COVER PRE-GRADING
ROUGI-t HEATiNG BElVCHING
ROUGN ELECTRIC ROUGH GRADING
ROUGH PLUMBING F{NlSH GRADING
SHOWERlTUB TEST POOL ELECTRIC
EXT. LATH/SIDiNG ' � POOL FENCING �
WA�L INSULATION POOL FINA�
CEILING INSULATION � OFF SITE IMPS.
DR`MIALL NAlLING i pEDICATIONS
SEWER : FINAL ENG.
SEPTIC TANK ! LANDSCAPE/1RRIG. .
SEEP PIT/L.L. ; ON SITE IMPS.
GAS A!R TEST ; �INAL ZONING
FtNAI CONST. .� i FIRE DEPT. FINAL
FINAL HEATING � ; HEALTH DEPT. FINAL
F1NAL E�ECTRIC i DEV. FEES PAID
FINAL PLUMBING j � ENERGY
� .
i � ` � � �"'�_
COtVi�'VIEIvTS . . ,. . �
. • y ' ,'C '
; � .
_ . . � 1 _
SEPTIC TANK SIZE
SEEP PITlU SIZE -- -----
�
;
ii
• , ti
C� ., .�7 '� . . , .
' . ' , � " ' •\ • � . .. ..-. ... • .
i