HomeMy WebLinkAbout13890 CITY OF DIAMOND BAx �--,
����----- DEPARTMENT OF COMMUNTTY 8z DEVELOPMENT SERVICES
� 21660 8.Copley Ihive Suite 190
(909)860-3195 Faz(909)861-3117 S$
"�����+' BUQ.DING PERMIT APPLICATION FlRMLY
y JOBSITE d APPLICATION PERMIT �p/C
o ADDRESS (3u'�S ROLLII�I(x K�Jei_(_ �R oaTs � NUMBER_3�iV�1
� ISSUE TYPE OCC
APN LOT TRACT DATE CONST. GROUP
p OWNER LL /.P
"" ADDRESS l. O D ZONING SETBACKS
8 CITY �D ( �S ZIP TEL. �i � FRONT RW �
APPLICANT JAt� !GI F-� TEL - REAR ❑
SIDFJSIDE STREET RW ❑
CONTAACTOH�_AMDN t � �l N�,_ SIDE ❑
ADDHESS x DI *
� CITY f.'Z/ 7� � ZIP TEL. �^7/ PROPOSEDUSE 0 O Ak. 1 AI.L � Gf1vD
aARCHlENG! _ . �o
DESIGNER NO.DWEL. NO. NO.
ADDRESS UNITS SI�RIES BEDROOMS
� CITY ZIP TEL.
� DESCRtPTION S0.FT. FACTOR PSF ADJ.AREANALUATION
Q OWNEFi•BUILOERDECLARATION ' SFR/ADD/REM
O
� 1 HEREBY AFFIRY UNDER PENALTY OF PERA1flY THA7 1 AM E%EMPT FROM iHE(SINTRAC7Dfl5 LI• G8f8A8/C81POR
f�T6ELAWFORTHEFOILOWP10RE0.50N(SEC.70.i1.68U51NE95MlOFROFESSIONSODDE:ANYC(7VOR (n
COUMYNh#CHpE0U1RE5APEPM�TTOCON5IAUCT,ILTERIMPROVE.DEMOLISM.OflREPAIRANY6TRUP W pg��aCk
TUqE,PNIOR 70I78 165UANCE,ALSO REOUIRES THE APPIICANT FOR SUCN VERMI7 TO FllE A SIONED
.� BTATEMENT iHAT HE OR BHE IS IICENSED PUi1SUM1T TO THE PROVISIONS OF THE CONTRACTORS LI-
c CENSE lAW(CNAPfER i(COAAMENCINO WI7H BECTION 7aoo)OF DIVISION 30F iHE BUSINE65 AIA PRO- � POOUSpi
lG FESSpNS GODE)OR?HAT ME OR SHE IS EXEMPT 7HEREiHOM AND h1E BA915 FON 1HE A/LE4E0 EXEMP-
V TqN,ANYV10lATIDNOF6ECT10N7W1.EBYMIYMPLICM7�FORAPEHMITSUBJECTSTHEAPPLIGNITTO Z Re•Roof �.Z.-
F ACMLiENALTYOFNDTMOHETWWFIVENUNDREDUOLLARS�{5o0).):
� OLASOYfNEROFTHEPROPERTY,ORMVEMPIAYEESWITXWAfiE5A5THEIRSOLECOMPENSAiION, � (;pmry�BMl81 -
YALL OO 7HE WOirC M1D THE STRUCfI1RE IS NOT INiEN0E0 OH OFFEHEO FOR 9ILL.E(SEC.f0��.BUSI-
NE65 AND PFqFFS51ON9 COOE:T1E CONTMCTORS LICENSE lAV!ODES NDT APPLY TO AN pNlNEH OF
y PROPERTVWFIOCUIDBORMIPROVEBTHEREON,ANDWHODOESSUCHWORKNIMSELFORHERSFiFOR �
� THROUGH HIS OR NER ONIIJ EMPLOYEE9,PIqNDED TMT SUCH 111PROVEMENTS AHE NOT IMENOED Oq m
OFFEAED PORSKE IFlIOWEVER MEBUA-OING OH IMPROVEMENi I9 SOID WRNINONEYFJ�R OFCOMRE
TIW,iNE ONNEfFBU1LUER WILL MAVE TNE BURDBi OF PNOVIN(3 THAT NE OR BHE DIO NDT BUIID Oq
YPROVE FOR iTIE PURP0.4E OF&LLE�. ' . �
y� ❑I,A401VNEROFTNEPROPERfY.AUEXq.U81V0.VCONTRACTINaWRMLICENSEDCONTMCTONS i
� TO CONSTRUCT T11E YROIECT(SEC.7ou,BUSINESS MID PROFESSIONS CODE:7HE CONTAACIORS IJ- V81UYtlOf1 ADJ.AHEA
� CBISEUWDOESNDTAPVLVTOANO4MIEROFAPNOPERNWHOBUIlD50RINPp�VESTHEREON.AND
WFIOCONTMCT8FOR8Ud1PRQ1ECTSWITk11CONTRACTOR(S�LICENSEDPURSVANTTOTHEOONTMG OUANTITY DESCRIPTION � FEE
� TOPLS LICENSE lA1W.�. .
OIAMEXEMPrUN�ERSEG B.BP.C.WNTMI6REASON a
U
u' DATE ONMER �
W
� LICENSED CONTRACTORS DECLARATION �
� 1lfEREBTAFFIRiI UNDER VENALTY OF PElUUITY TIMT I AM LICENSED VNOER PROVISIONS OF CMAPTER �
� �(OOMMENCINGWITHSECIpN)OW)OFOMSIONJOFTHEBUSINESSANOPfiOFES510NSCADE,AND � Z
�� YY UCENSE IS N FVLL FORCE M1D EFFECT. m
0F� UCENSE CU5S .�2_���.No._feq 3 v�z � �
r' DATE CONTMCTOR�� �
LTJ
� WORKERS'COMPENSATION DECLARATION Q
N �I NEREBY KFIRM UNDER PEWILTY OF PERIURY ONE OF h1E FOLLAV/iNG DECLAPATIDNS: V
(�/ Z
� �IHAVEIWDWILlMA1NTAM1ICER'fIFICATEOFCONSENTTOBELFMSUFEFORWORKERS' _
CdIPENbAT10N.AS PROVIDED BV 9ECTION 97000F7HE L�1BON CODE,FOR THE PERFORMANCE W
OF 111E WORN FOq NM1IICN THIS VERM�T 19 ISSUED. �
0
_I NAVE AND WILLMIIIMAIN WORKERS'COMPENSATIDN INSUMNCE,AS REOUIRED BY 3ECTION
Qd 9700 OFTNE LA90R CODE.FOR7HE PERWRMANCE OF THE WOHK FOR WNICH 7HI5 PERM�T IS
ISSUED.MY WORNERS'COMPENSATION INSURANCE CMPIEH AND POIICY NUMBER ARE: CANSTRUCTION
� CAqqIER STA Ti Gt.L/lll� PLAN pEVIEW
� iOLICv NUMBER ICSt��'O�� ELECTRIC
0 (TM55ECfqNNE�PqrBEmbFLEfEo0F7FEpERMiSwRONet1JloREODa.Wisry�ao)atl6s} PLUMBING
Z I CERTIFY THAT IN THE PERFORMANCE OF THE NIORK FOR WFiICH TIi15 PERMIT IS ISSUE�,1 MECHANICAL
(� SHILLNOTEMPLOYANVPERSONINANYMMINERSOASTOBECOMESUBJECiTOTHE
� YYORKERS'COMPENSATqNLAW50FCALIfOHNI�ANOAaflEETHATIFI6HOUlDBECOME INSPECTION FEE
� SU&IEGTTOTMEN�ORI(EAS'COMVENSpiIONPROW510N90fSEClIONS7000Fh1EUBOR •
CUOE.ISHALLFORTHWI7HCAMPLYWIT}7THOSEPROV�SIONS. �SSUANCE _��Ip,�=„j 'I�If1A �
o w�:— aPa��c,wr. ,�t� �6h'1 SMIP CI�.��, �—T79J i_S(")
'�r� g �.flMO'VD RAR
� WARNINO:FAILURE TO SECUflE WORKERS'COMPENSATqN COVERAGE IS UNLAWFUL,AND 61MLLBE ENERGY P/C T]7r .�_ A
� 6U&IECTANEMPLOYERTOCRIMINALPENALTIESNVOCIVILFINESUP�OONEXUNOREDTHOUSMID ENERGYPERNlIT v A•�����.:�FE;TY
OOLLANS Ii100.000).IN ADDI71qiTOhIE COSTOF COMPEN5�7qN,UAMA�E5115 PROVIDE�FOR IN
J� SECTIDN�7oeOFTHEIABORCODE.WTEREST,AN�ATTORNEYSFEE3. RETENTIONFEE:
nW,. CONSTRUCTION LENDING AGENCY pRE-ALT FEE:
O
� I MEREBV AFFIRM UNDER PENhLTY OF PERJUqY TIMT THERE 19 ACONSTRUCTION LENOWG MiENCY
Z WR THE VERFOMIqNCE OF THE WORK FOR WHICH TMS PERMI715ISSUEO(SEC.7aW,CN.C.).
W
� LENDER'SNNIE
� LENDER'SADDRE85
� ICERTIFYTNATIHAVEREMT119APPl1CATIONAND5T11TETHATTHEABOVEINFORM�7qNISCORpECT. TOTAL FEES � ��� /�/I /
1 AOREE TO COMPLY WITH ALL CRYAND COUNTV ORDIW WCE9IND STATE UWS RELATING TO BULDINp ���J
CqISTRUCTIOH,MICI MEREBY AUT4WRIZE REVRESENTATNES OF THIS[bUNTY TO ENfER UPON THE �
S� ABOVEl�IENTIONEO PROCERTV FON INSPECTqN PURPOSES. COMMENTS
� l.4�1
�)V
� PERMITTEENMIE(PFI �
C/7
y BN3NA7UNEOFP TTEE � DATE
r� RECPT.NO. PAID BY VALIDAl70N
� WHITE—Department Copy,YELLOW—Finenee Copy.PINK—Assessar Copy,GOLDENROD—File Copy.GREEN--AppiicanPs Copy
CITY OF DIAI°�ffOfrlD B�4R
IIVSPECTiON RECOf�D
. � � , . � . . a � , . � .
SET BACK �;;'•'-'''�` � \� '� � � FLOOR JOIST,• '
�.1C , — `-- \.;,,...; i �.� '/,, `-. I .i
FfGS/FORP�ISlSTEEL y� FHA REQMTS '
ELECTRIC GROUND UNDER F�OOR DUCT '.
GROUND PLUMBING UNDER FLQOFi C(�l�ID�IT � �-!-,;I .� -.:r
Sl.A6 GRADE FIREPLAGE�OUNb7�TiON `1 '• `�
TEMP POWER FIREPLA�E BbN�B'�AM ' '
WATER S.ERViCE MID HT. BOND BEANi. ' • ' ' '�` ` �
' ROOF'SNE�tTH1N� '_' � 8-�t,'=.� ' � 8 FT. B• ND �AM ,.. . .. , , �=-T'-
FRA7v1.ir1Gl1yB1yT11ilATION � , ': � � FINAL BOND BEAM
ROOF COVER ` `!.2-� • PRE-GRADING
ROUGH HEA7ING BENCHING
ROUGH ELECTRIC RQUGH GAADING
ROUGH PLUMBING FINISH GRADING
SHOWER/TUB TEST POOL ELECTRIC
EXl". LATFi/SfDING POOL FENC�NG
WALL INSULATION POOL FINAL
CEILING INSULATION OFF SITE IMPS.
DRYWA�L NAILING i DEDICATIONS
SEWER ;`i7;�';�;i 1 FINAL ENG.
SEPTIC TANK LANDSCAPFJIRRIG.
SEEP PIT/L.L, � ' •� ON SITE IMPS. �
GAS AIR TEST { FINAL ZONENG
FtNAL CONST. ��1�•`�'a ; : FIRE DEPT. FINAL �
FINAL HEATING ' HEALTH DEPT. FINAL �
FINAL ELECTRiC � DEV. FEES PAID '• �
FlNAL PLUMBING : ENERGY
-�—..- —
�. � �. � __
� , . . � � . .. . ,
COMMENTS
°,l\; . \'
.._i__ �
� r
y .
, ., �. ,�- .
SEPTIC Tl'al�lK S1ZE
SEEP PIT/U SIZE -
{ .
., . �,���.
:. ,�,...., - 1~. � _ . . . -__ _ :: —
y `�`._. ��'�f. 1��.