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HomeMy WebLinkAbout13822 (25) . .. . �� CITY OF DIAMOND BAb: ��� -- — DEPARTMENT OF COMMUNITY&DEYELQPMEN"T SBRVICES �, 2i�o�.cop�ynri��sw,�i�o � PRESS {944}86t?-3295 Faz(9�Q4}862-31I? `�.:, svu,nnvG r��trr Arr�cn�rcorr FIRMLY a DDRIESS t F if�T� � DATEICA710N�J � NUMBER �� t/C ! � 155UE TYPE OCG APN LOT T pATE CONST. GRCIUP � QWNE� $ ADD S ' 1, ZONING SETBACK5 CITY � ZIP EL. FRON7 RW ❑ APPLICANT TE REAfi D S�DE/SIDE STREET RW ❑ COFl7RAC Ft � SIDE ❑ � ADDR PR4PdSEQ USE L- CiTY ZI TEL. � ARGHIE Gt ,�� DESIGNER NO.DWEL. NQ. NC?. 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(�iOlrlflll/Ci91 Wp.L pp THE WOqN,AND TNE STR�ICTURE IS N071NTENOED Ofi OFFQRED FOR SALE(SEC.7oM,9U31• NES.Atm PppFES$tON&CODE:TNE C9NTMCTOHS LICENSE lAN DOES NbTl1PPLY TO Ni OWNER Qf � � pf10PEFITYWIiDBUMD9W7�MPROYEB'IHERGON�ANDY�T'M�DOEgSUCMWOHKMIMSELFORNEN3ELiOR �� 'fFMqWHHISORFERONAVEMPLOYEE5�PROV10E6T1AiSUUiIMPROVEMENTSARENOTINTENOEDOR � ofFEREDPORSKE�tfowEvsR�ttE 9txnudGORMtPHQVEMEPR LSSQIRw�Tti�iOtieYEAROFOa�E TpN,TI1E OWNEW9URDER N7U.HR�E TME BURDEN OF PpOVIN(i THFT N6 OR BHE Op NOT BUIID OR IXAPROVE FOR 111E PURPOSE OF&LL�. � ❑l/SONMERflFTF1EiR�PERTY,JWE.%GtUSiVElY4mN7FUCTAit'1WRNllCEN4EOC:CSN7Rl.CttsqS [� "(p CONSTpUCT 7HE PIi6JECT(ffiEC.iPu,Bl13iNE3S AND GROFESSIQNS WDE:THE CONiRACTORS LI- V8146UW1 _AQJ.AFIEA 11l CENSEUWOpESNOT+IPPLYTpi1NCNlNERQiAPPOPFATY4VFIOBU1LA50ffIMPqOVES7HEHE4N,H1D SYyNpQpNTMCT9FWi8UCHPRCUECt8Y11TiAWNTMC7�R(SI4ICENSE6PtIR9UMTTOTHECONiMG �J�7T/ DESCRtPTiON FE � 1'(N16 UCE!!3E IIHM.�. . . 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".i'ry '���'*�r�` —. � � DATE ' CON7RACTOR�J .....1h,1� -.— �� WORICERS'COMPENSATION DECLAFiATION -Iq U � I HEREBVAFFIRM UNDER PENAl7V OF PEiUURY ONE OFTME FOILOWiNG DECLANATIONS: � � �_IFiilyEJWpWILLWtIN7AtNACERTiF1CA�EOFC�HbENTTflSEIF-�NSUHEFOflWOt�CERS' COMiRISATION.A6 VRONUED BY SECTION 97�D OF THE LABOR COOE.FOR 7HE PERFORMIW CE `U � �pF 7}�w{}p�(Fpp yh�Np#TNIS PERiA1T IS IHSlJFA. � 1 HAY6 ANb WILL MAINTAIN MlqflKER3'COMPENSATKKJ INSURANCE,AS PEQIhREQ B�SECTION � 3maOF7tiEtJ�90RCWE.FORTt�VERF15i�dJ�NCE�THEW6RKFORWtqCtiMISPERMRIS ISSUED.MY WORt���I.���ENSATM?N�N9U ��0 POl1CY HUMBER ARE: CONSTRUCTION � P�1N �N .,�„ CARRIER ��"�• � pflt,tCY Muuesa � GTRIG �-� 0 (nYss[cne'sMneme+oTBEo�L�tErEaaFn+Et�f"arrSaMaJErurnREVOtxUut4�5+roloaLESSa 91NG y� �M ICER'fIF1'7NATNTHEpERFOpMANCEOFTHEWORKFpRWHICHINMSPERMITISISSUEp.1 MECHANICAL ....—_. .-1%'�_ � SHN.t MOS ELiR01 ANY PERSON W ANY MANNER SO AS M BEC9ME SUBJECT Tp THE � �pj WOpNER5COMPB1i5ATfONNW50FCALiFOHHIA,ANDAPREE'M1�1TIFi5NOULD9ECOME �N$PE IONFEE _. 6VBJECT Tq THE YMORKEAS'40Av�ENSA7IQN PRGVISiON50F 9ECTION]'70a OF TNE U60R (S� � CQpQ,!BHALC FOflTtNA7M C%M7PL7 W17H TNOSE PR4VlSII�NN9. I �^��f�,S/�.• 1�.� y� p bATE:�+�� APPIICANT:'S_7f%Y.CJ{` I'�G..-� �� � WARNINO:FAILURE To SECURE WORKQRS'COMVEHSATWN COVERMiE t5 UNLAriFUI,MJD SMALIBE ENERGY P/C - � � � �ANEMPGOYERTQCflkdWM.PENN.TtE9AN6GIVilFM1E5UPTOONENUNONED'TtKX7SM1N0 ENEfiGY�Rt�T y � pOU,Afl5��1Sp,000),INApPmONTOh1EC03TOiWMPEN5ATK7N.DMfAf�5A5PROV�pEOFON,iN � � BECTION370eOFTHELA80RO00E,WTEHEST,ANpATTdRNEY'BFEEB. Rk�ENT1O!'iFEE: CONSTRUCTION LENDMO AGENCY PR6AL7 FEE: � IHEREB`�AFFIRMUNDEflPENALTYOFpEflJURY7HATTMEREiSACONSTRUCTIONLENOIN67�C�ENCY FORTME VERFORMANGE OF TVE WOpK FOfl WM�CN 7F�N3 PERMIT IS ISSUEO(SEC.'JOW.CIV.C.). � � lENDER9 NAME �+r LENDEF511DORESS CC ��_�_��//�y �+"y t '�^ ICERTIFYiMATiMAVEREAOTHiSl�PH.IGtTMpNIWDSTAT£N/.T�NEABOVENFORMATIONISCQNHECT. T�TAL�G.GS �.QM��„' / �'" J � IAOREff TO GD1�IPlY WRHALLCT'IWp COUNTY dRDI/WiCES AND STATE lAN9 NEIATINO TO BVIL�INO ( � CONS7'FIUCTMJN.ANDFiEF�9YAt1TkiQRIZEAEPFiESENSATNE5�7H1,4G4tMttTtlENSERttPOMTNE . ABOVE�MEN710NEDPROPERTYFORINSPE RP08E3. C,OMMCNT9 0 � � SPw `r J'� /J7 � BY.yN7�, f pE11y�TTE.E OATE � RECPT.NO. PAID BY VAIIDATION WHITE^^O�sertmartf CqrY.YEtLt7W-FlnanCe CaPY.VINK-Aasesaor CcPY.GdLDENROD-Rre C,ary.t3REEN-AVP��'s�PS+ _...----..........___ -----... ............. � �. CITY OF DIAIVfOND BAR � INSPECTIE7N RECOt�C! �' s i • • - o e � - • - SET BACK \� FLOOR.J015�i . '. ;�. ;'; • � ;�., � - � FTGSIFORMS/STEEL FHA RE(�MTS . . ELECTRIC GR.OUND UNQER FL (OP DUCT �" - GRQUND PLUMBING UNDER.FCOQA£O�IDUIT �,.`, � ' � . .,; SLAB GRADE FIREPLACE-.F,O�NDATION • ` ' � � � TEMP POWER FIREPLA�E BOND BEAM WATER SERVICE - - MID HT. BOND B�AM - .' ' J 1 ... ROOF SHEATMNG � ' � • - • 8 FL BOND BEAM' � � � � � � FRAMlNGNENTILIATION FINAL BOND�BEAM• ; ; ROOF COVER PRE-GRADING ROUGN HEATING BENCHING RDUGH ELECTRIC .� � ROUGH GRADING ROUGH PLUMBING � FINISH GRADING � SHOWER/TUB TEST POOL ELECTRIC EXT.LATH/SlDIIVG POOL FENCING WAL�INSULATI�N I POOL FINAL CEIUNG INSULATION I OFF SITE IMPS. � DRYWALI.NAILING DEDICATIONS 5EWER � FINAL ENG. SEPTIC TANK LANDSCAPE/tRRIG. � �SEEP PIT/L..L. ON SITE IMPS. � � � GRS AIR TEST `•,+ - • � FINAL ZONING FlNAL EONST. � • • �- - ' -FIRE DEPT. FINAL j � FtNAL'HEATING " '';` HEALTH DEPT. FINAL I j FINAL ELECTRIC . Z . ' ! DEV. FEES PAID FINAL PLUMBING � ENERGY .� � � --�y� CUMMENTS �, � _ � . �+ � , - � t �,. . SEPTIC TRNK SIZE � SEEP PIT/U SIZE � , � '�° �'; -- 9, � ,1 � � .., . . , , . ti;—_____ -�;-�