HomeMy WebLinkAbout12037 (14) CTTY OF DIAMOND B � � ��� ( �
AR Q�
"�- " i DEPARTMENT OF COMM[JNITY&DBVELOPMENT SERVICES �
216b0 E.Coplcy prive Suiu 190
(909)8G0-3195 Fax(909)861-3117 � PRESS
"�^'� BUII.DING PERMIT APPLICATION � FlRMLY
o D�RESS-_ I S( Q I��b�/ (..ONY'� APPLICATION1f�-�J�� PERMIT �P/C
# DATE-_ ( v NUMBE X
OCC
� APN T TRACT pATE CONST. GROUP
� OWNER - C
B ADDRESS . r- NY' ZONING SETBACKS
FRONT
� CITY S�IZt GS ZIP �.t� TEL ` d RW ❑
APPLICAMf _� tEL ��'/ SID SIQE STREET RW ❑
� CONTRACTOR '�_L�']P.rl'}r � • SIDE p
ADDRESS Q? /Fz.�.�
g CITY �r S;ior� (/ia�u ZIP,�ZT TE �'� -d�(O PROPOSED USE
� ARCFUENG/ �—
DESiGNER NO.DWEL. NO. NO.
ADDRESS UNITS STDRIES BEDROOMS
� CITY ZIP TEL.
y DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION
Q OWNER-BUILDER DECLARATION SFWADD/REM
O
1 MENEBY AFFIRU UNDEA PENALTY OF PERAIM THA7 I MA D(EMPT FROA/THE OIXJTRACTORS U- Oe�9���rt
f�NSEUWFOR7FIEFOILOWINGREA50N(SEC.7m7.68USINE88ANDPiqFE5510N3CO�E:MIYCITVOR (n
COUHNWFiIOiREGUIRESAOERMRTOCONSTiIUCT.ALTER�PROVE,DEMOlJ91i3OqREPNRANVSIAUC• W patb/Dedc
TURE.PRIOR TO ITS ISSUANCE.AL50 HEGU WES TNE APPL1CINf PDR BUCN PERWIIT TO illE A 61GNE0 W
6SATFAAEM 1NAT HE OR BME IS UCENSEO VUfiSUM17 70 TFIE PpOY1510NS OF THE CONTMCTORS tl-
CEMSE LAW�CFNPiEp i(CONMENCINO M/ITH BECTION 700D)OF�MSION 9 OF 7NE BUSINESS MYJ Pp0. � f�00U$pB
FESSIONS CODE)OR TINT ME OR SHE IS EXEIiM THEAEFROM AND THE&ISIS FOR iHEAILEOEO E%EM0.
TqN.ANYVIOLATIDNOF5ECT10N7o7t.6BYANYAPPLICANTFORIIPERMR6VBJECTBTHEAPPUCAMTiO z Re.Rooi
� ACML�ENALTYOFND7MORETNANFNFMUNDREDDOLWiSp600j.J:
OI,ABONMEROFIHEPFqPERTY,OqMYEMPLOVEE9WIhIWA(1ESASTNEIRSOLECOMFENSATION, CORIIIIBICIBI
YY11 DO TIE MIOAIC AND iHE BTRUCTURE 19 NOT INTEND60 OH PFFEREU FOR SALE(SEC.7ou,8U31- �
NE93 IIN�PROFESSIONB GODE:TME CONTRACTORS 110EN5E LAW OOES NOT APPIY TO AN OYYNEN OF
� PROPEfRYriipBULDSORYPfi0YES7/iEREON,ANUMApDOESSUqIWOqKHIMSELFORHERSELFOR �
iXA0U6111&SIXiMERONMEMPIAYEES,VR04OEDT1AT5UCHWPpOVENENTBARENOTINTENDE00R m
OFFE(iED iORSJ1LE IF,FIONIEVER7ME BUILDWOOR IMPROVEMENf 6 SOLD WITXIN ONE YFAR OFCOMPLE. �
TpN.THE OWNERBUILDER M7LL W1VE THE BURDEN OF GpOVNNi hUT ME OR 6NE OIO NOT BUILD pR
141PROVE PDRiNE iURPQSE OFlAL�.
O 1,AS OWNER OF iHE PROPENfY,AM E7(CLUSNELY COMRACTINO WITN LICENSED CONTR4�TOqS
TD CONSTRUCT 7NE PROJECT(SEC.7041,BU6INESS AND PROFE5910NS CODE:THE CaH�RAC10R3 ll• V81UBSfOf1 ADJ.AREA
CENSE UW DOES NOTMP�Y TOAN OYYNER OFA PROPERT'WHO BUMDS OW IMPROYE9 TF1EREpV.MID
� WFIOCONTRACf6PoH8UpiiRWECf8WIT1ACqRMCTOR(5)UCENS�PIlR6UANTTOTFIEGONfRAG QUANi1TY DESCRIPTION
� noas ucase uw�. FEE
O I MI EXEAI7T VI�OER 8EG B.l P.C.iOR THIS qEASON ��
U
LL DATE OYMNEH �
F� V �
[ LICENSED CONTRACTORS DECLAHATION W
LL IIIEREBYAFFFtlItINOERPEWLLTYOFPEFWRYTNATIAMUCENSEDUNDEfl7ROV6S10NSOFCHAViER Z `
� �(OOUYENCNO YAhi SECTqN 7000)OF DMSION 7 OF THE BUSINESS�NO PqOFESSIONS COOE,AND
�� IAY LICENSE IS N FULL PORCE AND EFFECT. m
� ��SE�S_�-u�.�. 6� 7�-1 �
� o�tE coriraacroa� /�/� ���/t�'�` a
WORKERS'COMPENSATION DECLARATION �'�- �
U
y IHEREBYAFFHAIUIDERPEWLLTYOFPEIWRYONEDFTHEFOLLOWINODECLMA710N5: Z
� _111AVEANDWILLMAIMAINACERfIFIGTEOFCONSENTTOSELF-INSUFEFORWORKERS' _
COMPENSATION.ASPRONDEDBYBECTION77a00FtHELABORCOOE,FORTHEPERFORMANCE W
Q OF 7/1E Y/ORK FOR NM1IICN 1NI8 P6pMlT IB I&SUEO. �
� �IHIWEANDWILLMMNf�NWOW(ERS'fAMPENSATIONMSUWWCE,ASREWIRE0BY9ECTpN
Q 7700 OF THE IABOR OOOE.FOR TFIE PERFORMANCE OF 7HE WORK FOfl WHIOi THIS PERMI719
LSSLIED.W WDRI RS'°�PENSATq7N—I_N3Uq�CE CARRIEH ANO POLICY NUMBER ME: CONSTRUCTION
� CARRIER ��Qt CK�'IG �LS• PLAN REVIEW
� PoLICYNUTABEH �1_�(� �[ C U ELECTRIC
� (nfssEcrnNr�lHoreeaO.siETmaFnfPERMR16FOaoMeMlronEnOaWwsM1�aolaFltFssl PLUMBING
z 1 CEN7IFY TNAT NITHE GERFORAIANCF OF THE WORK FOR WNICFI TNIS PERMIT IS IS6UE0,I MECHANICAL
6HALLNOT EMPLOYANY►ERSON INANY MANNER 80AS TO BECOME 9 EGTT07HE
� YYORI(ERS'COMPENSATIONUWSOFGAIJWflN10.�NDAOREETMATI BHOVIDBECqME INSPECTIONFEE
� SUBJECTTOIHE YVORKEN5 COMPENSATqN PqOVI510N50F SE 17TOD OF iHE UBOR
COOE,16 TICONPLYWI THOSEPflWI510N5. ISSUANCE
� OAT��APPLICAN: SMIP
WARNINO:FAM1UR[TOSEWREWORKERS'COMGEN90.TIONGOVER�GEISVIiAWFUL,AND5NALL9E ENERGYP/C
� 8U&1EGTANBAPLOYERTOGRIMMULYENALTIESMIOCIVILFMlE6l1PTOONEiUNDREOTHOUBMA ENERGYPERMIT�
� �0.UR5�1oo,OW),IN ADDRION TO h1E COST OF COMPENSATION.DAMAGES AS PROVIOED FOR IN �
SECTION 370!OF THE UBOR CODE,M7EREST.IWDATTORNEYB FEES. � RETENTION FEE: ���
O CONSTRUCTION LENDINOAGENCY PRE•ALT FEE:
� IHEREBYAFFlRMUNUEHPENl1L7YOFPERJURYTHATTHEREISACOHSTRUCTIONLENDINpAOENCY
FORTHE PERFOFMANCE OF THE NlORK FOR WHICH THIS PERMIT IS ISSUEO(SEC.�OY7,CIV.C.).
b
� �noEas wv+E
� LENUERSM1DORES5
� 14ER71FY1HA71H/1VEREA�THISAPPLICATIONANUSTATETHATTIEABOVENfOR1AATqNISCORRECT. TOTAL FEES (�� /J v
a, I AUREE TO COMPLY YVITN QI.Cf1Y AN�COUNTY OROINANCES ANO STATE LAWS NELATIN�70 BU&DINO J Y �
� CONSTRUCTION.IND HEREBV AURIDRIZF RFPRESENTATIVE4 OFTHIS CdMTYTO ENTER UPON THE
ABOVE•MENf10NE�PROPERIV FOR INSPEC710N PURPOSES. COMMENTS
� + � � ��,�
� PERAARTEENAME�PRI
� �J�1��''� � 7r�--F-'��
(n BqNAIUR F PEAUITTEE TE
� RECPI:NO. PAID BY VALIDATION
VYFIITE—Departrnenl Copy.YELLOW--Finence Copy,PINK—Mseaea Copy.GOIDENRO�FlIe Copy,GREEN .
—�Pd��'s CcPY
, ..,. .: , , .. .
, : . , : ,.- ,. ,.. . ..,.: _ „
. CITY OF DIrRFJIONQ BAR
' Il�ESPECTI�N RECOI�D
• i � ' 6 ' • i � � • i .
SET BACK � . FLODR JOIST '
FTGS/FORMSlSTE�L FHA REOMTS
ELECTRtC GROUND . UNDER FLOOR OUCT
GROUND PLUMBING � UNDER FLOOR COM'DUIT . �
SLAB GRADE FIREPLACE KOl1NDATIDN � � } • •
TEMP POWER FIREPLACE�ON[7.BEAM , --,,
-WATER SEFIVICE Mip HT. BOND BEAM � ' ' ' �
ROOF SHEATHING I 8 F7.BOND BEAM • � � ,r.
FRAMlNGNENTILI/�V'�ION ( FINAL BOND BEAM
ROOF COVER ' PRE-GRADING
ROUGH HEATflVG BENCHING � �
ROUGH ELECTRIC ROUGH GRADING
ROUGH Pl,iIMBING FINISH GRApING
SHOWERIfUB TEST P�OL ELECTRlC
EXT.LATH/SIDING I PQOL FENCING
WALL INSULATION j POOL FINAL
CEILiNG INSJLATlON ' � OFF SITE IMPS.
DRYWALL IVAILING DEDICATIONS '�
SEWER.�-._ � FINAI.ENG.
SEPTIC TANK ! � LANDSCAPE/IRRIG.
SEEP PIT/1..L. � i ON SITE IMPS.
GAS AIR TEST � I FINAI.ZQNING
FiNAL C�NST. ( � FIRE DEPT. FINAL �
FINAL HEATING i HEALTH DEPT. FINAL �-�
FINAL ELEC7RIC ; DEV. FEES PAID i
FINAL PLUMBING-'• ' j ': ENERGY �-�i �
' ! f �
i
� r � � -i_�..,_, �
Y--
� . .. . . . . .., .. . .. ... . . _ . .
COMM�NTS
. . .
.�.
SEPTIC TAN�SIZE
SEEP PiT/U SIZE ;?�' --. �.�;, -• -
� � .. � . __
� i ,
;; ':f��
�
- , ' •�