HomeMy WebLinkAbout12408 (14) �,� CITY OF DIAMOND BAx � �. '7
DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES '
21660 E.Copley Drive Suite 190
(909)860-3195 Fax(909)851-3117 PRESS
"�'� - BUILDING PERMTP APpLICATION FIRMLY
y J08SITE APPLICATIOtv �y ,��f�� PERMIT p/C
o ADDRESS 1��]��� n f'7taP�"'1'� DATE i� / NUMBER � #
� APN LOT TRACT � � ISSUE TyPE pCC
¢ DATE CONST. GROUP
� OWNER
ADDR S ZONING SETBACKS
CITY ZIP 42L7.4 TEL. FROIYT RW ❑
APPLICANT TEL. !r� SIDE/SIQESTREET RW ❑
CONTRACTOR � SIDE p
ADDR r
g CRY ZIP TEL - ,, PROPOSED USE
� ARCH/ENG/
DESIGNER NO.DWEL NO. Np,
ADDRESS UNITS STORIES . BEDROOMS
� CITY ZIP TEL
� DESCRIPTION SQ.'FT. �FACTORPSF AW.AflEANALUATION
q� OWNER-BUILDER DECIARATION SFR/ADD/REM
O
I MEREBY AFFlFqA UiDER PENKTV OF PEiW RY TF1AT I AM EXEMPT FNOM THE OONTRAC7OqR LI• G8feg9/Cery01(
CENSELAWWR7MEFOLLOWINOREA.9dJ(SEC.7037.lBUSINESSANDVNOFESSqNSCODE:ANVp7VOH (n
CaUMYWHICi1REd11RESA7ERMfTTOCON57qUCf,A�TER.IMPROVE,pEMOIJSV�pqqEpAIRµYBTRUG W PetlolDeck
TIIRE,PRIOH TD RB KSUANCE,AleO REW IRES THE APPLICANT fOH SUCH VERMIT TO iFLE A BIaNEO
STAEMENT TfAT HE OR 6HE IS UCENSED PURSUAN7 TO TME PROVI81ON8 OF TNE COMMCTpFtS LI-
CENSE LAW(q41PTER��COIAMENGNf3 MATTISEGTION 7000)OF DMSION e OF 7NE B1131NESS AND IRO� � POOVSPR
FEbSqNSCODE)DRiFM7MEOR8HE15EXEMP7T/1EREFHOMAND7HEBASI5FOR7HEALLEOEDEXEAIP• ('
TION.MIYWOLI1T10NOFSEC71DN/W7.6BYANYMPLICAAITFOHAPERMRBUBJECTSTHEAPPLICAMTO � (�p.pppf
� 11CMLPEWLLTYOFNOTMORE7NANfNEFNNDREDDOLWISp5a01.1: � y
011SONMEROFIHEPROPER'TY,Oi1YYEMPLOVEE8W�7MW�aESil51NE�RSOLECAL1oENSATION, (;Omme/del
MI1L 00 h1E WOHIf,AND THE STRUCTUHE 18 NOT INTEN�ED OR OFFERE�FOR SALE(SEC.70u,BU61- �
� NESfiAND PROFESSIONS CODE:TME CON7MCTOi19 LICENSE LAW OOES NOTAPPLY TO AN OWNER OF =
PIqPE1RY WFiO BUIL,DS OR\IPqOVEB iHEREON,M!�WFIOOOEe SUCFI WORK 111MSELF OR MERSELF OR
iHROV6HHISORIEROWNEMPLOYEES,PRCNDED7lIAT8Up1MPqOVEMENTSARENOTIHTENOWOR m
OFFERE�FORSKE li lpMfEVER 7ME BULUINOOR MIPROVEMEN7690LD WfTXIN ONEYFAR OFCOMPLE
TqN,T11E OWNER�UIL�ER MALL MINE 7NE 6UfDEN OF PROVIIKi iF1AT NE OR SHE OW NO7 BUMD OR
MVfWYE FRt TNE PURPOSE OF SALE�
O L�SOYNIER OF7XE PROPER�Y,AM EXCLU8IYELY GONTMCTINO YN7M LICEN6E�O�NipqCTOqS
TD CONSTRUCT 7NE PIb.IECT(SEC.7W,BUSINESS AND GROFESSIONS CODE:THE CONTMCTORS LI- I Valuatlon ADJ.AREA
CENSE UW�OES NOTAPPLY TOIW OVMER OF A PROPEpTY YVFq BUILOS OR IMPIqVEB THEREON.AND
WFIOWMRACTBPDRBUCHPqO,JECT8M11TiACOMMCTDR(8)LICENSEDPURSUMITMTHECONiMb Q(JA�.(�'�TM DESCRIPTION FEE
� lONS UCENSE WN.�. �
p I AM p(EYPT UNpER BEC. 6.d P.C.FOR THIS REASON �
��1
� DATE ONMEA F-
7r V
F UCENSED CONTRACTORS DECLAFL4TON W
� 1 HEREBY AFFIR4 UNDER PENAITY OF PERJURV lY1�T I AM LICENSED UNDEA PRDV15lON5 OF CHMTEN �
� ��COMNENCIN6 Wli}i BECTqN 7GOp)pF DMSION a OF TME BIISPlE35 ANO PROiES5lON5 CW E,ANO z
�� MY llCENSE IS Ni FUl PoRCE M1D EFFECL m
0 ,�LICE(/NSE CUSS !''�/�J LIC.NO.�,�f� (2�� �
� �,S__��?�GY,r7 CAMRACTOR f�Y'//V> � � �$'�
= WORKEHS'COMPENSATION DECLARATION Q �,v .,
� IMEREBYIIFFIRYl1NDERPENALTYOFPERIUiWONEOFhIEWLLOWINODECLARATqNS: � +'J _1
N O f fw% ��
� _IHMEANDYVILLIAAINTAINACERTIFlCATEOFCANSENTMSELF-0NSUREf-0HWORNERS' _ — � ^
OOMPENSATqN.AS PHOVIDm BY SECTION T7aa OF THE LABDA COOE,FOR THE VER WNMANCE U v
O OF 1HE NlORK FOR N711CH THIB PERMIT IS ISSUED. � J �E ^ �.Q
�W1VE MID WILL MNMAIN WORI�RS'Cq1PEN6ATION MSUAANCE,/S REOUIRED BY 9ECTqN
Q 970o OF 7HE LABOR COOE.FOR 7HE PERFORMANCE OF 7ME WOpK FOH MMICH iM15 PERMIT IS
� IS5UED.MY NfORKERS'COMVENSATqN INSURANCE CARRIER AND POLICY NUMBER ARE: CONSTRUCTION
] CARRIER�, PLAN pEVIEW
� POLICV NUTABER � � —
ELECTRIC
8 (Mse�r�wTeEaowaETFnoFn�v��ar�era+or+EMna+Euoaliw9M1�m)ar+�ss} PLUMBING
� I CEHTIFY 7H11T W TNE PERFORMANCE OF iHE YYORN FOR WHICH TNIS PERMIT IS ISSUE0,1 MECHANICAL �
6YIILLNOTEMPIAYANYVEfl60NINANYAUWNERSOA3 MESU&IECTTOTHE
(q NfORKER3'COMVENSATIDNI,AW9 iwarua ATffISNDULOBECOME �NSPECTIONFEE
S fiUBJECTTO7HEYYORNE ' P 5I .CTIONa70DOFh1E4180R �
CODE,16H+ILL FORT COMPLV p E P ,a�/F LQ(�7"� ISSUANCE
� - �V
� W17E:_�,ll�� PPL SMIP
WARNINCi:iWLUR[TO SECURE WOfUCER AT COVERAOE IS UNLAVYFVL,ANO SNALL BE ENERGY P/C
�y &18JECTANEAPIOYER70CRIMINALPE IES ILFWESUPTOONEMUNDREDTFKK/SMq ENERGYPERMIT
JGOLI.N6(it0U.00G).IN A�DITqN TO THE COST OF PENSATIGV,DAMUGE9 A9 PROVIDED FOR IN
O8ECTqN97000FTNELA80RCODE,MTEREST,ANDATTORNEY'$FEES. RETENTIONFEE:
CONSTRUCTION LENDING AGENCY PFEALT FEE: �'�+ 1 I 'i�'
� I HERFBY AFFlRM UN�EH PENALTY OF PERJUNY THAT THEHE 19 A CONSTRUGTION IENDINO AOENGY ��^4
FOR iHE OEqFORMANCE OF iHE MfORK FOq WHId1 THIS PEfiM1T IS ISSUED(SEC.�oi'/,CIV.G).
�
� LENDER'S NMIE_ __ " '" ''` ""`
C LENDER'SAODRE55
� ICERTIfYTMTIHAVERF,�1�h11SMPLICATpNANDSTATEiHATT1E�BOVENFORMAT10NI5GORRECL TOTAL FEES 'S���
p� IAOREETOCqJPLYYATNALLC17YlW�WlM7YOflDINANCE5�NO8TATEUWSRELATINOTOBUp,pPlp
� CONSTRUGTION.ANDXEREBYAUlIqRIZEREPRESENTATIVE50FTMI5COUN77TOENTEHUPONTHE
I�BOVE•MEMIONED Yf WPEHTY WR INSPEGTION PURPOSES. CQMMENTS
� _ �
� P RTEE M'�
N
Vj t10NAlU G E
� RECPT.NO. � PAID BY VALIDATION
1NFIITE—Oepertment Copy,YELLOW�Inence Copy,PINK—Auesaor Copy,GOl.�ENROD—�Fiie Copy,GRE icenPs Copy
. ,... . . . , , .
, .. . . :.... , . . .
. ., , .
,. � .. , :.:.... ... ... .
� .. . , , .. . .. , •;,, ,. .
"- CITY tJF DU�II�IOND E3AR
� t1�SPECTl01`! f�ECORD
. - � � . e - • d e , . � .
SET BACK ' FLOOR JOIST• , .
FTGSlFORMS/STEEL FHA REQMTS.
ELECTRIC GROUND UNDER FLOOR-DUCT" " �
GROUND PLUMBlNG UNDER FLO�R.CUMDUIT., . � �, ,
SLAB GRADE FIREPLACE FC�!lNDATION - • , ' � -
TEMP POWER FIREPLACE BOND BEAM �- -� " '-
WATER BERViCE - Mip HT,BOND B�AM -' ' - • • - •
RODF SNEATHING 8 FF.�BONp:BEAM � � ' ' ' '
FRAMING.NENTILIATION FINAL BOND BEAM
ROQF COVER PRE-GRADING
ROUGH HEATING (� - BENCHING �
ROUGH ELECTRIC ROUGH GRADING
ROUGH PLUMBING FINISH GRADING
SHOWERITUB TEST � POOL ELECTR[C
EXT.LATH/SIDING ; POOL FENCING ,
WALL INSULATION POOL FINAL
CEILING INSULATION � OFF SITE IMPS.
DRYWALL NAILING I ; OEDICATIDNS
SEWER `--�- ; FINAL ENG.
SEPTIC TANK. i LANDSCAPE/IRRIG.
SEEP PITI�.L � ON 51TE IMPS. {
GA8 AIR TEST � FlNAL ZONING
FiNAL CQNST. 4 F{RE DEPT. F(NAL
FINAL HEATtNG j � _ I HEALTH DEPT. FINAL � �
FINAL ELECTRIC ; DEV. FEES PAID ,
FINAL PLUMBING � ' ENERGY ,
• q� � � -- ' �
- .. _
COMMEN�'S .. . . .
. �
� � �� �
. ; - .:; _.._ . .. .
. ti
,
SEFTIC TANK SIZE
SEEP PIT/U SIZE
�I
i
. �. •
� � " _" . .. _ . . ' " . �:�'\.
"� '
i
� � . . . . ��4,' . .