HomeMy WebLinkAbout11780 �i� i
CTTY OF DIAMOND BAB =
--- — DEPARTMENT OF COMMUNTTY 8t DEVELOPMENT SERVICES .-
� . 21660 E.Copley Drive Suite 190 .PR�.�'$
(909)860-3195 Fsa(909j 661-3117 . � � : �: . .
� . BUII.DING PERMIT APPLICATION FIRMLY
oqppq�g Jsa Fs /�(f�J� CTi'U� DATECATION;. "� _NUMBER ./ I7 B� �� •�O
�, 15SUE � �" TYPE OCC
APN LOT_� . TRACT Z DATE • CONST. GROUP
� OWNER ST ��C19�/`�
ADDRESS rs W MI�! D ZONING SETBACKS'
B CI7Y ZIP �+ TELT/�f�oFfl' � � FRONT RW ❑
� APPtICANT TEL. REAR � . ❑
SIDFJSIDE STREET RW ❑
a� CONTRACTOR S E�'�� SIDE ❑
g ADDRESS PROPOSED USE �'B R
CITY ZIP TEL. , ,
B ARCWENG/
� DESIGNER NO.DWEL. NO. �j NO.
n ADDRESS UNITS � STORIES ` BEDROOMS
yCITY ZIP TEL.
DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION
q� ONMER-BUILDER DF_CLARATION SFRlADD/REM 3� q
O
1 HEREBY AFFIRM UNDER PEN4LTY OF PERRIRY TNAT I AM E%E1AP7 FRJM 7HE OONTRACTORS U- G8f9QB/G8IpD1I • OZ �
CENSEUWFORTHEFOLLOWINOREAflON(SEC.7031.68USMESSANDPROF�SIONSOODE:ANYqTYOR (f�
COlAJ7YMRi1G1RE0UIRESAPERMRTOCONSTRUGT.ALTERWPROVE,DEMOUSM.ORflEP4URANYBTRUG W P8110/D6CI( $S
TIRiE.PRq1110 1T8 185UANCE,AL80 flEQUIRES TME APPIIGMfT PoR BUCM PERMIT TO FILE A BION W
SiATEMENi THAT HE Oil SHE IS LICENSED PURSUAN7 TO TNE PAWISIONS OF iME 00�(�MCTORS U• . .
CENSE UW(QihP1ER Y(COMMENCWO WITH SECTION 7000)OF DN610N a pF TNE BUSINESS AND PRO• � LL PoOVSpB � � �
FESSIONS CO�E)OR IiUT NE OR SNE IS EXE►IPT TMEAEFqOM M10 fllE 811415 FOR T11E ALLEQEO EXEIIP•
TION.ANYVpUTpHOF8ECT10N7Wt.6BYANYAGPLICANTFORAPERA11T8UBJECT9THEAPPUCANTTO � Z Re-Roof ..
-� � A C7VIL PENALTY OF NOT MORE TIMN FNE NUNDRED DOLLARS(t600).l: � .,
04��N1EROFTHEPROPERTY,DIIMYEMPLAVEESWI7HWAOESAShIElA90LECOMPENSATqN, O Commerclal
WYL DD TiE WOi1K MID TIIE STRl1GiURE�S NOT IMENDED OR OFFERED FOR&LLE(9EC.T714,BI7SI- J
NESS A!m PROfES510NG COOE:TNE COMfRAC70RS LICENSE IAW OOES NOT MPLY TO AN qNNER OF ?
� PROPERfYW1106U0.DSORIMPROVESTIEREON,ANDNh10�0E55UC11WOfiKNMASELFORNERSELFOR
TNRWOFi1NSOiiHEROYVNBdPLOYEES,PROVmE07MATSUCHMPHOVEMENTSARENOTMTENDEDOR m
OFFERFD FORSALEF,lpYVEYERTME BUIDINCiORMIPRDVEMENT 19 SOLD WITHIN ONEYEAROf COlJPLE- •
liON,TNE ONMEi48ULDER WILL NAVE TiE BUROEN OF PRONNO TNAT ME OR SFIE DI�NOT BUIIO.OR ��
MPi1WE FORTHE PURPOSE OF fALE�. P
O 4��1ERGF iHE PROPERTV,AM EXCLU9NELV O�lfiRACTINOIMiTi LICEHSED ODNTRACfORS
TO OONS7RUCT THE PAQIECT(SEC.Tws,BU81NE59 AND PROFESSIONS CODE:tHE CONfRAC70R3 LI- VflIU9tfOn ADJ.AREA
CENSE U1W DOES NO7APPLYTO AN OMrtJEX OF A PNOPEHfYVNW BURD9 OR IMPROVEB THEHEON.AND
YVFpOOMAA(.`TBPDRBUCNFROJECfeWIT/AWNiR�CTOR(5)LICENSmPURSUANTTOTHE00N7RAG pUANTITY DESCRIPTION FEE
� IOAS 110ENSE IAW.�.
O I ALI E%�JPT IMDER BEG &8 P.G FOR THIS REASON � �
U
� �
W�TE OWNER U
� UCENSED CANTRACTORS DECLARATION W
� INEREBYAFFlRIAUN�ERPENALTYOFPEiWRYI}UTIlJAUCENSEDUNUERVROVISqN90FCHAPTEF Vr . _
lPC06WENCWClMIRMSECTION7o�0)OFOMSId190FTNEBUBINESSMIOPROFESS10NSCO0E,AND Z
MY UCEN9E IS NI FULL FORCE AND EFFECL
� 1.{�G� m
0 LICENSE ClA UC.NO. . J
o�� O (� corrtFucroR 5�'1"D�P r a
WORKERS'COMPENSATION DECLARATION �
� 1 HEREBYKFIRY UNDER PEHALTY OF PERIUR'!ONEOFTHE FOLLOWINO DECUMTIONS: Z �
� _I NAYE A!A WIi1 MAINTAN A CEiRIFICIITE OF CONSENT TO SELF•INSURE FOR NqRKENS' _
Cd1PENSATION,AS VRDVIDED 6Y BECTION BMOOF THE LABOR OODE,FON THE PERi'OHMANCE w
OF TIEMlDRK FOR NMlpl TMIS PERMIT W ISSUED. �
� y�IMIIVEAlOYY1LLMA1MT111NWOiiKERB'OOMPENSA710NINSUflMlGE,ASREWIREDBYBECIqN
Q 9700 OF 7NE LABOH OODE.FOR THE PERFORMIWCE OF h1E WORK FOR WHICH THIS VERMIT IS !'f��S"'o
ni 159UFD.YY WOFIKERS'OOMPEN TION INSl1RANCE CAHNIER AND POl1CV NUMB£H ARE CONSTRUCTION +� �-
� CARRIER �—�� PLAN REVIEW /�
� Pd.ICYNUMBER Z5 ELECTHIC
0 (nassEcnoN�IDNo7eEoou�t�moFnEvewersraraar�furo�noatutsR�awoAtFss} PLUMBING
Z 1 CERTIFY 7HA71N lHE PERFORMANCE Of THE WORK FOH WHICH TMS PERMIT IS ISSUEO,I MECHANICAL
�� SFIFLLNOTEMPLOYANVPERSONINANY4ANNER50ASTOBECOMESISJECTTOTHE
YWRKERS'COMPEN9ATIONLAYYSOFCALIFORNI/�ANDAGREETIMTIFISIKKriDBECOME INSPECTIONFEE
8U&IECfTOh1EN�OFiKEHS'COMPENSATIONPROVISIONSOFSE/C�TqN]'1000FiHEkABOR f �h
GOOE.1 IiTHWI7MCOGPLYMniT7 EPR 5�� ."-� ISSUANCE I � .
� DI17E: APPLICAM: T ) SMIP 3� r
� WA(iNINO: AIIUR,��E WORKER3'COMPENSATKKJ COYEHAOE IS UNUwFUL,IW�3HAt1 BE ENERGY P/C /'�
� BUBJECTN7EMPLDYERTOCRIMIN�L7ENALiIESANOCIY1Li1NE5UPTDONENUNDREUTfK7USM10 �ERGVPERMIT ZSI v
.r DOlURS�{100,000),NMDI710NT07HECOSTOFCAMPENSATpN,UAMME9A8►ROYWEUFORIN
� SECTIONa7atOFTHELABORCODE.INTEREST,ANDATTOFWEYSFEES. FiE7'ENTIONFEE: �Sf�O
CONSTFiUCTION LENDING AGENCY pRE-ALT FEE:
�
1 HEREBVAfFIRM UNOER PENALTY OF PERIUiY THAT THERE IS A CONS7RUC710N LEN�INO WENCY
fOR THE VERFORMAIJCE OF h1E WORK PoR WMICH I$PERMI713ISSUW(SEC.9aY7,GIK C.).
� IENDEWSNAME In_
� LENDEII'S PDDRE55
� ICERTIFYTiATIW1VEREADTHISMPLICATIONANDBTATETHA771iEABOVEWFORMATpNIBCORRECT. TOTALFEES ����� � � � � •��, S
� 1 ACiREE TO COMPLY WRH ALL CT'AND COUNTY ORDMIANCES AND STATE UWS REUTMIG TO BUILOINO
� lri1STRUCf1ON.MI�HEREBVAUT10RIlENFPHESENUTIVESOFTHISCOUNTVTOEMERUPON7HE
ABOVEilEHT10NEO iROVER7Y fOR INSPECTION CURPOSE9.
9 � COMMEN75
� �rc-�A�
Q PERMIT7EE E�ItlT) /�— )
N ,'� � . . (� ,�� / � �� 1
� &GNA7UR F VERMITTEE ' ' ' ..: •.: OATE •• • • - � . �� �
F FECPT.NQ PAID BY YALIDATION
WHITE—�Departrn�ft Capy,YELLOVJ--Flne�e Ccpy,PINK—Assessor Copy,GOLDENROD--File Capy,GREEN�—Applicanl's Copy
. , CITY OF DI1�N6�ND BAR � -
. INsF�ECTiOfV I�ECdRD
� d � �� � �
6 � � ' E . • 0 � � . � .
' FLOOR JOIST �� , ' ` � � .;� � -
s BACK�. ,: _. j i 7�'� �ir+wt^_� �ti...� `'.1. �. . ; : i. �1
FTGS/FORMS/STEEL ' �' - �:) FHA REQMTS. : ,.1�
ELECTRtC GROUND - UNDER FLOOF#'DUCT ' `
GROUND PLUMBING , �O � UNpER FLOOR CU�lDUIT + � • � �
SLAB GRADE L e�- FIREPLACE'FOUNDATION ' • ' •
TEMP POWER FIREPLACE BOND BEAM
•WATER SERVICE MID HT. BOND BEAM • • ��`e ,
ROOF SHEATHfNG- � 1 � � � 8 FT. 60ND BEAM
FRAMINGNENTILlATION c3 j� '' FINAL BOND BEAM
Fi00F COVER . � PRE-GRADING '
ROUGH HEATING c3 BENCHING ; .
ROUGH ELECTRIC : . ROUGH GRADING
' ROUGN PLUMBING ' �.. FINISH GRAD{NG �
SHOWEFtfi`UB TEST : L� POtJL ELECTRIC
EXT. LATH/51DING c z- �j POOI.FENCING
WAL�INSULATlON POOL FINAL
CEILlNG INSULATION C3FF SITE IMPS.
DR`(WALL NAILING z a DEDICATIONS
SEWER � ¢ FIfVAL ENG. �
SEPTtC TANK _ LANDSCAPElIRRIG. �
SEEP PITIL.L. ' ' �N SITE IMPS. '
GAS AIR TEST 9' FENAL ZONlNG
FfNAL CONS�f. FlRE DEPT. FINAL
FINAL HEATlNG MERLTH DEPT. FINAL
FINAL ELECTRIC DEV. FEES PAID
F1NAL PLUMBING z. ENERGY
Z_ /� 7
� � � , .
� , . . � . , . T�----•-•-
. . .,. ;.... . , . ^.. ...... . .... .. . . . .. . .. ... .. . _._..._._
' �COti1M�NTS� �
�.. . .f:� • . �` . , , , ��. `
� .. : ,
± . , � � ,
'' 'J `... _ .;�� .
-'�1
SEP.TIC TANK SIZE �'�"� �� „'��
SEEP PIT/U SIZE �-- -- --- —
a, --------._._..------ —
" li ! �.-__
� . -.
"
. . ,, . , .. . . . ,
,'� -
:� _ �`, . , � .. :,��!'r'L7i"."� �'U�