HomeMy WebLinkAbout11600 ---�'1— CITY OF DIAMOND BAIt
' COMMUNITY DEVELOPMENT DEPARTMENT
� �,..2 21660 G.Copley Drivc Suite 190
(909)860-3195 Fax(909)861-3117 PRE.S.S
'"'" BUILDINGPERM[TAPPLICATION FIRM Y
� JOBSITE � APPLICATION G� PERMIT /C � n
o ADDRESS� �OD��C�1 r1{��r DATE � • NUMBER � ��
� APN L T T ACT ISSUE TYPE OCC
DATE CONST, GROUP
p OWNER JZr• k' ' V
p ADDRESS ���� � �' - ZONING SETBACKS
�W CITY � Q�� T C ��Q FRONT RW `�;
APPLICAIVTRCF��-�'��t'Dh T �(�.5� REAR �-7
z SIDE(SIDE STREET RW ❑
a CONTRACTOR D 11 f SIDE �
� CITY�SCO Zlp .�Z TE . I�O ^ ,S �ROPOSED US U M � �
w ARCH/ENG/
z DESIGNER 7V •� i°M'
a ADDRESS • • d� NO.DWEL. Np. NO.
�a CITYr�I7p��] ZIP T a ._ � UNITS STORIES BEDROOMS
R�
'rn DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION
.Q , OWNER-BL'ILDER DECLARATION SFRIADDlREM
O
� p I HEREBY AFFIRM UNDER PENALTY OF DERJl1RY THAT I AM EXEMPT FROM THE CONTRACTORS U- G8f3�lC8fF70fI
�W CENSEIAWFORTHEFOLLOWINGREA50N(SEC.70315BUSINFSSANDPROFESSIONSCODE:ANVq'YOH (/�
C.) COUNTYWHICHREIXlIqESAPERMITTOCANSTFUCT.ALTER,IMPROVE,DEMOLISFi,ORREPAIRAN�STRUC-
wTURE,PRIOR TO IT�ISSUANCE,ALSO REOVIRcS THE APPLICANT FpR S�CH PERMii TO FILE A SIGNED W Patio/Deck
� 3TATEMENT THAT HE OR SHE IS UCENSED PURSUANT 70 TME PROYISIONS OF THE GONTRACTOR[�i- �
� CENSELFW�CHAPTERB(CAMMENCINGWITHSEGTION]D0o]OFO:VISION30FfHc'eU514E55ANOPR0. POoVSp2
� FESSIONSCODE�ORTFIATHEOfl5HEI5EXEMPTTHEREFFOMANCTHc'OASISFORTFIEALLE�EDE%EMP� (�
V TION.MlVVpLATIONOFSECTION7�7t.5BYANYqPPLICANTFORADERMITSUBJECTSTHEAPPLICANfTO Z Re-Roof
A CIYIL PENALTY OF NOT MORE THAN FIYE HUNORED DOL IAHS(f5V0)):
Z~ ❑I,ASONRJEROFTH[PROPERTV,ORAIYEMPLOVEESWiTNN.�AGF5A5THEIRSOLECOMVENSATIDN, Q
WILL 00 THE WORK,IWD THE STRl1CTURE 1S NOT INTENDEO OR OFFERcD fOR SALE(SEC 70u,BUSI- J Commercial
� NESS M!D PROFESSIONS COOE�.THE CONTRACTORS UCENS'c LAW DOES NOT APVLV TO AN OWNER OF ?
PROPERTY WHO BUILDS OR IMPRpVES THEREON,ANq WHO UOES 9UCH WORK HIMSELF OR HERSF.L F OR
� THROUGHHISORHEROWIJEMPLOYEES,PROVIDEDTMqTSVGMIM>ROVEMENTSARF.NOTINTEN�EOOR �
0 OFFEREDFORSPLE.IF,MOWEVER,TNEBUIL�JINGORIMPROVEMENi1550tDWITNINONEVEAFlOFCOMPLE-
Z TqN,TME OwNER�BU0.�ER WILL HAVE 7HE BUFlDEN OF PROVIhG 7HAT HF.OR SFIE D�D NOi BURD OR
� IMPROVE FOR iHE PURPOSE OF SALEI.
'.7 I.AS OWNER DF THE VROPERTV,AM E7(CLUSIVELV CONTRACTING WITH LICENSED CDNTRACTORS
� 70 CANSTRUCT THE PR0.IECT(SEG�o�q BUSINE55 AND PROFESSIONS CADE:TNE CONiRACTORS Lb alUdtiO mD ADJ.AREA
W CENSELAWDOESNOTAPPLViOANOMMEROFAPROOER7VWHOBUIL�50RIMPitOVESTHEREON,ANA
� WHOCONTRACT6FOpSUCHPpOJECTSNATHACONTRACTOR�S�LICENSEDPUN5UA4TTOTHECON7RAC� QUANT7TY DESCRIPTIDN
Y TORS LICENSE LAW.) , FEE
� C I AM E%EMP7 UNOER SEC.� __B.6 PC FOq TH!5 REASON Q
��— U
LL DATE '� OWNEq - ¢
Z -- U '
� LICENSED CONTRACTORS DECIARATIDN w
� 1 HEREBV AFFIRM UNDEfl PENALTY OF PERJURY TNAT I AM LICENSEO UNOER VROVISIONS OF CHAPTER �I
(y Y(COMMENCINGWI7HSEC7qN1000�OF�IVISION30FTHEBUSINESSANDPROFE5SqN5COD[,RND z
X MY LICENSE IS IN FULL FORCEAND EFFEC7, m
� LICENSE CLASS ���___..�... L1G.NO._� '��1 �'
7 Q T J
WDATE 3"'�?Q�O GONTRACTOR h �+�[QJ[ a I
� WORKERS'COMPENSATION DECLARATION `^ �3`.� U
l L
� I HEREBYAFFIRM UN�ER PENALTV OF Pf0.1URV ONE OF THE FOLLOWING DECLARATIqJS Z'
Z _IHAVE�NOWILLMI1iNTAINACERTIFICATEOFCON5ENT705ELF-INSUFiEFORYYOfiKERS'
Q COM.PENSATION,AS PROVIDEO BYSECTION 3700OFTHE LABOR CO�E,FORTHE PERFOFMANCE �•
Q OF THE WOfiK FOR WHICN THIS PEE7MIT IS I55UE0. �
� �I HAVE AND VAlLM41NTAIN WORKERS'COMPENSATION INSURANCE,h5 REQUIRED BV SEGTION
O 37ao OF THE UBOR COOE,FOR THE PERFORMIWCE OF THE WORK FOR WHICH THIS PERMIT IS ;
J ISSIIED.MIY RKEg�'CA ENSA710N INSURAN�¢E CARRIER 0.ND POUCv NUM�a ARE � CONSTRUCTION [
j CARq1EH �tlT��Olt���g S��!lin, .1'x�_��.e{J'(/,1�� v/�r PLAN REVIEW • �— --
Z POLICY NUMBER �2 '���+�=Q � r� ELECTRIC —i�
¢
0 (I}IISSEGI'pNNEFDNOT6EWAWtTEDOFTFIEPERhVi�sFoaan�Htl�ppEpppuany�� sl PLUMBING
w '�1
Z I CERTIFY THAT IN TME FERFORMANCE OF TNE WORN FOR WHICH THIS PERMIT IS ISSUED,I MECHANICAL
C} SHALL NOT EFAPLOY ANY PERSON IN ANY MANNER SOAS TO BECOME Sl1BJECT TO TNE
(,/) WORKERS'COMPENSA710NLAWSOFCALIFORMA,AN�AGflEETHA7IFISHOVLDBECOME � INSPECTIDNFEE
S SUBJECTTOTHEWOflKERS'CAMPENSATION OVISIONSOFS CTpN�l700f�FjHELAEIOR
CjODE.'ISH�gAUFORTHWITMCOMPLVWITMT .SEPflOY110N5 W ,��`r � � ISSUANCE
p DATE: -� APPLICANT • _�'�' /i� ��� SMIP �� �
Jw ENERGY P/C
WARNINO:FMLVRE TO SECURE VJORKERS'COMPETlSATION COVERAGE IS UNLAWFLIL,pND SH�LL BE
� SUBJECTANEMPLOYERTOCRIMINALPENA�TIESANDCIVILFINESUPTOOhENUNDRE�TNWSAND ENERGYPERMIT
DOLURS(flao.000�.M AD�ITION TO THE CDST OF COM7EN SATION,DAMAGES AS PROVIDED FOR IN �A
J SECTION370DOFTHELABORCODE.INTEREST,AN�ATTOPNEY'SFCES �y
¢ RETENTION FEE: r�� —��--�J �
OCONSTRUCTION LENDING AGENCY PRE-ALT FEE: _ �
� 1 HEqEBYAFFIFOA UNDER PENALTYOF CERJURV THAT TFiERE IS A CONSTRUCTION LEN�ING AGENCY
FOR THE PERFORMANCE OF THE WORK FOR WHICH TNIS PEqMI71515S4ED(SEC,3ae7.CIV.C.I. --
W A�� _
� LENDER'S NAME ./V .__ _ — �
�
F— LENOER'SADORESS
� '_ __
W ICEflTIFYTHpTIHAVENEA�THISAPPUCATIONANOSTATETMATTHEABOVEINFOR7MAT�ONISCORRFCi. TOTAL FEES �
� IAGREETOCOMPLYWITHALLCITYANDCOLINTYDROINANCESANOSTATEUW>REL4TINGiOBUILOWG
� CONSTRUCTKKJ,ANONEFE8VALITHORIZEREPRESENTATNESOFTHISCOUNTYTOENTERUPONTHE
Z ABOVE-MENTIONEDPROPERT'FORINSPECTI auaaoses. COMMENTS__�
o � � � —
QEENAME(7RI � �— ---- _--
(A . �URE PERMTTEE �TE � '
� RECPT.NO. _���PAID BY _ YALIDATIO
WHITE-0epartment Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENROD--File Copy,GREEN—Applicant's Copy
. CITY OF QIAMOr�iD BAR
IN�PECTION RECOF�D
• E i a ` E s e � �.�i��`�� � -
SET BACK i _ � � I FLOOFi JOIST _
� —.,�--- - -- ----_+
FTGS/FORMS/STEEL t � ; FHA REQMTS
ELECTRIC GROUNQ UNDER FLOOR DUCT � �y, , � ' -
GROUND PLUh4BiNG --�- I -- -- UNDER.FL�OR-�OJ�IDUIT ��`. ----•---�-----
SLAS GRAdE i `� FIREPL,4CE'FOUNDATION " �' " ' " �
TEMP PC7WER "� FIREPLACE BOND BERM � -i
WATER SERVlCE � • MID NT,,�BOND BEAM � • ' �
RflC7F SHEATHING 8 FT. BOND BEAM
FAAMING/VENTILIRTIQIV� FINAL BOND BEAM � � " � v�� �
- - - ------�---#
ROOF COVER PRE-GRAD}NG . . _ _ _ : j
ROUGN HEATING BENCHING ^ � l �
RqUGH ELECTRIC ROUGH GRADING ! � � _ _�
RQUGN PLUMSING FINISH GRADING j �_�
SHOWER/TUB TEST POOL ELECTRIC I
EXT.LATHlSIDING POOL FENCINC.� '
, WALL INSULATION POOL FINAL ' �
CEILING INSULATION ; OFF SITE IMPS. �
DRYWRLL NAlLING � DEDICATIONS
SE4NER I, r FENAL ENG. --y-- ,- �
SEPTIG TANK ! �`� � �� LANDSCAPE/IRRIG. _ �__ __ �__
SEEP PIT/L.L. � QN SITE IMPS. ,
GAS AIR TEST j j � FINAL ZONING . � �
FiNAL CONST. 'f $ I ' FiRE DEPT. FINAL ; ! i �
FINA�HEATING � � ! ( HEAI_TH DEPT. FINAL �
FINAL ELECTRIC '� DEV. FEES PAID i +� �
FINAL PLUM8ING � i � ENERGY �
ii ` . I .---------------
� I � .` 1h —--------
COMMENTS
' ' � t , , , �
, . , ___
` . . . .
,;��,
SEPTIC TANK SlZE ���' � �
SEEP PIT/U SIZE — --- --�-- - -----
� , -------�- ------
� . '
� , , .,
- j . � -__��___