Loading...
HomeMy WebLinkAbout13759 (27) CITY OF DIAMOND BAB O - � "'�� DEPARTMENT OF COMMUNITY dt DEVELOPMENT SERVICES � . 21660 E.Copley Drive Suite 190 (909)860-3193 Fax(909)861-3117 PRESS ����°�� BUII.DING PERMIT APPLICATION FlRMLY �( APPUCATIO , PERMIT CJ P/C ��� o DDRESS o C 1 DATE NUMBER 1f � ISSUE TYPE OCC APN O A T DATE CONST. GROUP g OWNEH ADDR � ZONING SETBACKS CITY � P TEL. FRONT RW ❑ APPLICA T TEL. R�R � SIDE/SIDE STREET RW ❑ CONTRACTOR SIDE g ADDRESS CfTY ZIP TEL. PROPOSED USE O � ARCHIENGI I DESIGNER NO.DWEL. NO. NO. ADDRESS UNITS STORIES BEDROOMS �� CITY ZIP TEL. DESCRIPTION S�.Ff. FACTOFi PSF AW.AREANALUATION p� OWNER-BUILDER DECLARATION SFR/ADDrAEM O I NEREBV AFFlNM UNOER PENALTY OF PEIWIIY THAT I Mt E%EE1PT FROA1 T7�E CONTMCTORS LI- G9fe0B/C81TfOR CENSEUWFORTIIEFOLIAWMOREASON(SEC.70.71.68USINESSANDPHOFESSIONSGOOE:ANYCIT(OR (n COUMYWMp1RE0UWESAPEAAIRTO00N9lAUCT.114TER.MPROYE,OEGOLI6M.ONNEPAIRANYSTRUC• W PBSIQ�DBCk � O TURE.PiUOR TO rt8IG4UANCE.KSO REUUIRES TNE MPLICMff FOR SUQI PERMITTO FILE A 614NED W STATEYENT TWIT NE OR SNE 19 LICENSE�PUIISUANT TO TME PROVISIONS OF THE CONTRAC70R3 LI• CENSE U1W�p/MTER i�COMMENCINO N7TM SECTIDN 7000)OF DIVI910N 90F TNE BUSINESS ANO PR0. � PooVSpa FESSqNS COOE�OR TWIT HE OR SHE IS EXEMMTiEREFAOMAND 7HE BAS�S FOR THE ALIEOFD EXEMP- TION.ANYVqL11TqNOF6ECTION7W1.lBYIWYAPPLICANTFOR�PEIIMITBUBJECT9THEMPLICANTTO Z fjg-F{pp� � ApVll/ENALTYDFNO7MORE7)W�FIVEMUN�REDDOLIARS�ibao).�: � OLASON'NEROFTNEPiOPEHiY.ON1AVEMPIAYEESWITHWAOESA5THE1R501EC0/dPEN5ATION, Q COmT9lClfll WILL DO THE WORK,AND THE STRUCTURE IS NOT INTENUED OR OFFEHED FOR SKE(SEC.70N,BUSI• J NESS MID PROFESSIONS OOOE:TME CONTf1ACTORS LICENSE UW DOES!qT APPLY TO Ml OIVNER OF � PNOFEFfTYWF1OBUpDSORYPNOVE97MEREON.ANONMO00ES9UdiWORKHINSELFOpNERSELFDR = ♦ � TMpOUGH H18 OR HERONM EMPLOVEE3,MbV Wm 7HAT 8UC11 MAPROVEMENTS ARE NDT INTENDED DR L� OFFEAm FOR SA.E IF.MOWEYER fME BURDINfi OR IMPROVEM@lT IS SOtD VA7HINONEYEAR OFCOMPLE- � ?qN,7FIE OWNER�l1RDER WILL FUVE THE BURDEN OF PqOVWO THA7 HE OR 8HE DID NO�911M DR MiROVE Wii TFIE PURPOSE OF MLE�. � ❑I,ASOWNEROFTNEPFIOPEHfY.AM�E%CLUSNELYCONfMCTWOMrtTHl10EN5EDG�ONTWICTOR3 ,��� 7000lSTRUCf TME PHQIECT�9EC.70M,BUSINE35 MI�PiqFESbIONS CODE:THE CONTMC70RS LI• V�IU6I1011 '�Q ADJ.AREA CENSE UW DOES NOTMPLY TO MI ONMER OF A iHOPERTY Wl10 BUNDS OR W PFqVES TNEREON,AND WFIOOON�RACT8�OR8UpIPR41ECT9WITHA00NfRACTdyS)LICENSEDPUiSUM1TTOMEOONTRAG OUANTI7Y .OESCRIPTION FEE � IORSUCENSELAW.). ❑IAMEXEAIPTUlWERSEC.� B.3P.GFORTHISREASON U � ¢ OATE OVYNER V � ll ENSEO CONTRACTOR DECLARATION � � W I MEREBY AFFUtlA IMOER VENAtTY OF VE0./Ui1V THAT I AM LICENSED UNDER VFOY15qN5 OF CMAPTER � s Y�001AMENCINGVNiMSEC710N70ao)OF�IVI610N30FTHEBUSiNESSANDPROiFSSIONSCO�E,AND Z LL� MY LICENSE IS N iW.PoRCE AND EFFECT. m 0 LICENSE ClASS LIC.NO. � �'j wh cawarancToa a W t� WORKERS'COMPENSATION DECLARATION Q � I NEREBY AFFlf1M UNOER PENIILTY OF PERJURY ONE OF 1HE FOLL0ININ�DECU1WITqNS U N a � _1 WIVEANU YNLL MAIMAN A CEHTIFlCATE OF CONSENT TO 6ELF-INSURE FOR WOHKERS' _ COM?ENSATION,AS PRONDED BV SECTION 970D OF THE LABOR COOE.FON 7HE PERFORMANCE U �� OF 7ME W0f1K fOR WHICH THIS iERM1T I$189UED. � Q _I HAVE AHD WILL NAINTAIN WOiiKERS'COMVENSATION INSUW WCE,AS REWIRED BY BECTION Q l70o OF THE L11BOR CbDE.FOR iNE iEp�OR1.tMICE OF THE WORK FOP WNICH iH15 PERMIT IS ISSU cf�.MY WOfLfERS'COMPENSATION INSURPNCE CARRIER AND POLICV NUMBER ME: CONSTRUCTION � j c�wwen PLAN REVIEW � � POLICY NUMBER ELECTRIC � � ` o m.ss�r.�r+�r,ore�mrst�cF,�aEw�r��ar+o+EKx�muu�sa,a�ioa�sss PLUMBIFICi ICERTIFYiHATIHTHEPERFORMANCEOFTHE�WRNFOHWH�CHTH15PERMITI51S5UE�,l MECHANICAL BMALL NO7 EMPLOV ANV PERSON IN ANY MANNEN SO AS TO BEC01dE SU&IECT TO THE (n YYONICERS'COAIPENSATION l,AW50F CALIFORNIA,MIDAOREE TFUU F I SIqUL�9ECOME INSPECTION FEE S SUBJECT TO THE WORKERS'COMPENSATION PHOVISIONSOF SECTqN 370o OF iHE LABON COOE,1 SXALL FORTNWITN COMPLY WI7H TNOSE PROVIS10N5. ISSUANCE � � 5MIP p DATE: APPLICANT. � WAiWINO:FNLURE TO SECURE WORKERS'COAIPENSATION COVEMOE IS UNUWFUL,ANU SXALL 6E ENEROY P/C � bUB1ECTAN ENPLOYEH TOCfUMINAL PENAUIESAND CIYII FINES UPTOONE MUNDRED THOUSAND ENERGY PERMIT DOLLANB�t700,000),N ADDITpN TO THE CA9T OF COMPENSATION,�MUQES AS PROYIDED WR IN � BECTION87o�OF1HELABORCODE.IN7E0.E5T.AN0A7TOfiNEY'SFEES. RETENTIONFEE: � CONSTRUCTIONLENDINGAGENCY p�p�T�� � � I HEREBV AFFlRAI 11N0ER PENALTY OF DERJURY TH11T TIiERE ISACONSTRUCTION LENDINQ Af1ENCY � FOqTHE VERfORMANCE OF TNE WONK FOR WHIOi 1HIS PERMIT IS ISSl1ED(SEC.80Y7,GV.C.�. �L � �ENDERSNMIE � LENDEflBADDRE39 � 1 CFRTIFV T1U71 MAVE pEM T113 APPLM�TION ANO S7A7E TUT hiE A80VE WFORM�TION IS CORRECL TOTAL FEES � I MREE TO COGIPLY WITFI�LL CRV/WD CIXINTY ORDwANCE3 AN�ST�TE UW511EU71NO TO BUIID WG /'� � CON6TRUCTION,AND HEREBV AUT110R12E HEPRESENTATIVES OF THIS COVNTY TO FNTER UPON TNE �n �(�{' � 1 �I� s �IDNE�VflOPERTYM SPECTqNPUHPOSES. COMMENTS� ti�� ��� � U �� � � � PERMIT7EE W1ME(PRINT) /� '� cq �7 �p 81ONATUREOFiEPYITTE OATE � RECPT.NO. PAID BY VALIDATION WHITE-0eperlmant C•opy,YELLOW�Ineroe Copy,PINK—,Asaessar Copy,GOLDENRO�FiIa Copy,(iREEN—ApplicanPs Copy a . „ .,. � . CITY C3F U1�,(UlQ�riD.E3�R �, �t��PECTIU!`�! t�ECORd , . , „ _n ���;���{�� �` � � �,��-� �a�� .„ � �,�,'�.�`".`� � ,►. � � � � "� ���� I ' ' � 4; � i ,.. _. �. . . ' -� ,:: �,. ,., ..� ..��..., . �� a`� �E•� ��Gk 1 _ ._.._ .___ ..____.__. i , . • � ; FLO�JR JJESl" ----� l �; _ _. ._ _ _ — -- -•-- ----- ... . .__ _:.: .Y.a-�"1� . �....` . , , , ____�_�.. �_� .�:i..._. f.. ,3, �r�stro�3rv,s;sr�r.�_ I ' � Fhit�REC�MTS � ----- --- -- - -� —�--- ----_ �--------.,�_- --- _ , ELECTr,IC:G�-'C�E.;ND j f lJN[?ER FL{7�.� GUCT � � -- t � -----,--- - __�� _ - — . . G��U�Jr) PLU�Jr`?I�VL� i � �-- � � litJDF� FLOCIR CtJ �:.��IT _ �,1' ,. ._ .= -~- � � �--� __ .. � _.-_ ._ � _.--- -------- -- - I i _ _ �} � ... .. ^'�-- -.r .1.�. . �LA�Sf�f�AdF I 4 FlftEF't4t�E��'G �V�� � �3N � �i`_ -.� t.==' 1_�--_t----.... , _..—- ---� ._.. ------------— -•-�-----�----------_--___--__ ;-----____ � � T�_MP P'JLVER � j F(flEPI.ACE BO G E7F`Ah9 i1 - _____._ --------�_�...�.----- ____ �__...._.----_._..___.— --- �.._. _..----.. WRi EF?SERVi4,E ;---- ' � �tEC Nl. E30ND BFA��" . i � .. .._. _ _— _-- ------ - � RO�'��fl�r:T1-ffi�:G � `� i � ' � r ' ' 8 F�,.F3�ND BEAM __.. .- -- ----..__ --. _.__--- .�.ry-�--p-, - � ,.. _ a x..-�--� ---- r y .--------------- �--- - ;-- - l--------. _ !"�'SAflA7�•�C.NFR�TILIAI4J�`�I , y.� 'k �� Y�'I!�"�L,B(JND BFAM ' i _.--- -- ---- ------ -...L�!--=' ---___.-------- -----------_....__ __:.___.--------�------ -------..---- _.. ,' � .. P..,..... � ' '_'__ F:s:a�)� �..C�l•r:�� " � + PR. -f3RADING � a � __�- ----------•�.--•--__--- �...._._$_— ..�--- �----._ _.. _ ___. - �-- - -____..----+ �iC);�'C'�'}{�A,�f�EG � � 6EP�iCHING � -- --- --... ._.___.—__ ..------ -------- , �-�-- _---°-•--- � �C�!_ � '_�..�__TRIC , ' � ' ROUGFi GRADiNG - ..—._-�----- -- ---- . .. _ . -- � --- i_ — � _ --- -- ------- �----------- - --- - ` Y3.. t r a t�'°�4�lIVG � i ' FINESH uI�ADING . _ --------�-----------, _.___T _.__._._ _.__ ._ -- - ---- -- ' ��: ' ,-IJEi TESz � ' F'OC7i..ELECTRIC � - -- ----, _.---..-----....._•_.+----------- � - - -- ----- ------- �" 1 afD{PdG ' .. POC?L.FENCIlvG � � ---- --------- - ----- �-- i fi.t�'.'.. 'iau,�l_�lTiC31�(�__�_— _..�-- ------------ POOL FifVAL ____---- ----- ____r_—__------------ I _ ------••-� ---.__�___�______: — ' -----�_�_____— - - -- -+-----�.____� ___ _.; � �� N � i^: LiLAT{C7+� T-�--�- i OFF 517E I�l11PS. _ ; � _ _..__ —_—_ - ---—- — --- . — ----------_ . a � •; t� '."�:<� entt� I ' ' � QEC)iCATIONS _ -- . .. _ .__________�__�,.�_�,---�----.:-� __...__----�_�_.�----__ ._.._.___— i _.--------.__._ _.. � i ; f�IN�`,L Et�G. -- ------- . _., ----- , -----.r.__ ____._____.�- -;---�-------�-----.,__----------------- ------------------- - r�r��; � i t�:�a�sca���,rir��iU. i ---- — ----._._—__ ------ ---- ; :_.f�: : _ .�...�.. i ' , i OhJ SlTC INIF'S. --{-__�.__-----}-----..._---------_ . -- �T__� _ — — � ' = �T � ! �'I'VAL�OtliNC' , _ _t _ .-- - - ------ ----�_t..__ _. __ _ _ ��7 - � -�, ! FfF'E UE F1' FfNAL ,._ _ , ' �-?� 9 �...,....__.�.��... F- -. .�...�..,�.._�._..�. ..�.....�. � i�P;��ra� : j FIE�1L�'� DEPz�i�ai-- --�-�-----_ _ ; _-----_..__---._.—,----_.._. ._____ _..._. __ _ ...__ .� : --- - __ �__ ._. 4 � EC T R! � i D E V. F�ES PF�I D �--------- � � -------.—__.....__..__...-•----___._______-------__,__ ' '_'_""_'—_"' """"'�"_4'_ -___-_;..".______'.. __....,.....S PLUMBIN::; i ; ENERGY � . _____ w._____.__._...._�._._._ � _._..--.............._._ _.._..._.........._.........---------..._....__...... -------..---->---.�_.—...._.._._..__...-----------._._.._..--�------- _ ._......... _,.. .... t ' i . .._...._. ... ..___'_3-_....___'.,_'__""'"'_'_"_'_.'_ .. .,_ . ..... . ... ._ ..... ... . . . . { ., .. .._ �. . ��� � ���f9��^t'1�Lk.,Y� . ... ..'__�.�.'�_'��...,..�.� �._.����__�_,..._����"'�___.._"__.._._ ._A t � ...Y.^�.Y3:, ,.... .. ., .....� .. '"_""'_"""_"'__"_"._"'"'...______'"'_....... ...._ . ar... i���.�{�� _l�'_k0.4��_�9"--N�-'��L---------_�_____ __..____ ' 1 __ -._._.�-- --------------•--------------- ---- -.�..-------------------------------- , �. . _ , -----�-----.__..---------.._—_._._..�_,__.�.-------------�----..---------._. ...._ --- ---------; , �..� .�.,� 3 •• � ♦ . - •. � a : ... �... � �...._..___"___._..L__._"__'"'_"__'"_".____�__ _ _'_____'"".__....___'_'____'_"__'_'""___'__�__�.�_.�__.�.._.�...._'__`____'__.__._ ' ..._............. ? ;.. : r '.,�- -�. . ;' �`'- ......_...,_..._.... _.� �'.._..,.._.__,_...._......�.......�...._..............._,..._..."_'""'1_t_.i-+�.k.....t._.,,_...._.___.�___"_.. _.�_..._._.._...___.__..____..._ . �; F _..,...."__"'.'__.'__.._'._._'__._.__..._._..._.._._."._.._.._.._..____._._..__"..... ` ........_..... ...,...._. i .. .. ... . . .... _ _. _....... �__ ..�_.�_..._._T__............-.._.._.___....__.�._T__...._,..-.-'-_"'_'_"'_""_""'-__"'_'__........�_'—___-__'_--'-�.--_-_'_�_-.__'.,_""_'—""'__"__'.-......__.........__._..........� � "'.�..._"__._____-._.-__.___.__'_".__'—' '_. ....__-__-._..... ....._._�—'___.__.'—_"....__.._._. .. ..._...... .............' "'..._...__ . ...._.....___.. ._.._'___'_ ..__..__._ _.._....._........ i i �._ _'�._-._._._..._'_..____".........._......_.._.._._.._.._..__......._...._..-.........,...._..'_'_..._..__..._..__'....__.._..._........_.__.._."__-.__'_"_.._......_..'__.._........__._..__.__._.'.—"__._._'.'.___'___.___.'._'_.-._.__.._............._.._....z �EPTiG iANK SI%'t_ .-------__ S�EF'P1T/U SIZG ..---.._,_.__._... -----------_-------- �---------------�-----..._. __.. ...------------------- --.-..------ , _ .. ... ..... ; i '. i ____._ ..r ,..r _--—--,_....------—�---------�--._ _.._.....----�-- ---..------------------- _ . .._ _... �' �'�� '� , . � . . ...� (f.� ������.r_�_y__� , ........... ..... .. .... . .. . ... . . . . _ ......... . ... ..�_ ... .. .. �' � • I •• �.. ' `._.�.._._.____.___`_�.�.._ ......_.... . . . .. . ... _..___ _...___�" _'_'...___. � . . ... .3__ _..._.._._. ' �. ' ' . . . ........ .... 4 /t .: � '.. .....___.._. _'"'_'""_...._'._. ..._....._^. .��-"".��~t.._.'_" _...."'"'� '"'_ ....._ _.. ...._. ......._.."'_'"".._.___ , `tT . .j... . ��... L Y. f � � � ` � _ _ --._._.____.._,_...____....._,.: .._.._--_, .__1--- ---. _ `