HomeMy WebLinkAbout13831 (29) J� CITY�F DIAMOND BAIt �
f��
DEPARTMENT OF GOMMUNITY&DEVELOPMENT SERVICES �z1
21660 E.Copley Dtive Suite 19D �j PRESS
� (909)8603195 Fax(909)861-3117 � FIR M LY
���MM+� BUII.DING PERMIT APPLICATION
�� JOBSI7E � , APPLICATION � � PERMI7 J ��� P/C
ADDRESS I � DATE NUMBER��,�eC1J�L_ �
� ISSUE TYPE OCC
APN_�� LOT CT DATE CONST. GROUP
� OWNER
� ADD _ ZONING 3ETBACKS
CfTY ZIP TEL FRONT RW ❑
APPLICANT T REAR ❑
� SIDE/SIDE STREET RW ❑
CONTRACT R � � SIDE ❑
g ADDR b PROPOSED USE L
o CITY ZIR�"�fEL.
� ARCHlE G/
DESIGNEA NO.DWEL. NO. NO.
ADDRESS UNITS STORIES BEDROOMS
� CITY ZIP TEL.
y DESCRIPTION SQ.FT. FACTOR PSF AW.AREANALUATION
¢ OWNER-BUILDER DECLARATION �q/qpQ/F{EM � f� �
O
I XEFiEHY AFFlRM UVDER PEW47Y OF PEf W RY THAT I AM EXEMP7 FROM 7HE CONTRACTORS LI- GAti9��T�rt
CBJ..ELAWiONiHEWLLOYYINf1REASON(SEC.7097.6BUSINESSANDPpDFESSIONS00DEANYqTVpR (n
WUNfYWHK71REQ11RE5APERMfrTOOONSTRUCT,ALTFRIMPROVE,DEMOU`.+N,OpREPAIFANYSTRUC• � W P9t10/DBdc
IURE,PFION TO 1T8 IS6UANCE.At40 REWIREg'�ME AVPUCMIT F�R SUCfI PEWAT TO FI�E A SIaNED W
8T11TELIEM TW�T ME OR SHE IS LICENSED PlAiSUANT TO TME PROV4510N5 OF THE CONiRAC70R5 LI- �
CENSE lAW(CHAPTER Y(�MENCWO YNTN SECTION 7000)OF DM510N 90F7HE BU5NE95 FNO P110- � PaoVSpa
FES5IONS CODEJ OR THATME OR SNE�8 EXEMPT 7MEREFROM ANO TF1E EA519 FORTiE�LLNlEp E%ENV-
710N.MIYVIOLATIONOF6ECTION7091.6BYANY�PPUCANTFOi1APERMIT3UBJECiSTHE�PPI�CAMTO Z Re-Raol
� ACNILPENK7YOFNOTMORE7WWFIVEMVI�OREDDOLLAR.4p5WIJ: _
OI.ABOVJNEROfhIEPROPEHTY,ORMYEMPLOVEESWITHWAC3ESASTHE1R50LECOMCENSATION, O COf11r11BfG181
NIILL OO i11E YYOFiC MID TME STRUCiURE IS NOT INTENO£D Ofl OFFEREO FOR 9ALE(SEC.70M,BU51- J
NESSAND►AOFE951ON9 OODE:THE CONTMCTORS 610ENSE LAW DOES NOi APPIY TO AN OYVNER OF� �
� iROPERf1'1MN09URUSORMPROYESTMENEqV.MAMMO00E56UCHYNORKHIMSEIFORNERSELFOR
� 1HROUOIIMShcHER04lM8Y10.0YEE3.PIqV10EDTNATSUCHIMPROVEMEMBMENOTM'6NDEDOR m
OFFENm FLRSIILE FlIOWEYER ME BUIIDIfY4OR IMPROVEIAENT 6 SOID VATNN ONE YEAR OPGOMP�E•
710N,7HE OWNER�UItDER WILL lUNE TFIE 6UHDEN OF PiIOVINO iHAT NE OR 6HE DID NOT BUILD pR
YPfiOVE FOR 1HE NHP06E OF SALE1. � '
� O4��MVNEROFIHEPROPERTY,AIAE%CLUSIVELYCDNTRACYINOW17HLICENSEDCONfRACTOpS
TO CONSTRUCf 7}E PR6IECT(8EC.TUM.BUSINESS ANO PF�OFESSIONS CODE:TiE CONSRIIC7UR54�- VeIUBt10f1 ADJ.AREA
CENSE U'M DOES NOTMPLY TO AN ONMER OF A PROPERTYYMYiO BUMS OR IMPqOVE4 TNEREON.AND
WIi000NTMLT5FOR8UC11PHOJECTSWIIHAGOHTMCTOR(S)�ICEN9EDPUH9UANTTOTMECONTMP� Q pQfj'�7Y DESCRIPTION FEE
� T00.S 110EN8E tAW.�. � .
❑1 AM�MPT UNDER SEQ 6.8 P.C.FOR THIS F#ASON U �
� � (1 a i
DATE ONMER JS
� �". V
LICENSED CONTRACTORS DECLARATION � { !
� �MEREBY 11FFMIM UNDER PENhLT'OF PERIURV TMAT IMA IICENSED UNDER PHOVISIONS OF CHMTEF � �
� •�COWIENCW6WRMSECT 7000)OFOMSION70FTNEBUSINE95ANDVROFESSIONSCODE,AND Z
!�f FIY LICENSE IS Nl F11LL M1D EFFECT. m
LLI
� UCENSE SS LIC.NO. /� _ . �
~ • � �
� DATE � CONTMCTOR
= WORKERS'COMPENSATION�ECLARATION �
� IHEREBVAFFIRMUNDERPENAL7'YOFPERRIHYONEOFTHEFOLIAWIN6DECLARATIONS: U
y Q
� _IHAVEANDWILLMAINTAMACERTIFlCATEOFCONSENT703E1F-INSVHEFORVYORNERS' S
CpAPENSATION,A4 PROVIDED BV SEC710N 870o OFTHE U60R COOE.FOH TNE PERFORMANCE - �U
OF iHE NIORK FOR WHICH THIS PERMR IS ISSUED. �
�
1 HAVE MID WILL MAINiAM WORKEHS'COMPENSATION RJSI/fUWCE,AS REOLIIREO 9Y SECTION
O970DOFTNELAUOROODE.FOFh1EGEPFORMANGEOFTHEWORKFOHYVFI1diTHISPERMRIS
� ISSUE�.MYWOflK PEN�qNINSUP�RANDPOL�CYNUMBERME CONSTNUCTION
� C�RRIEA I T P�L�A�N__�REVI�EW
0 POLICYNEIMBER -- -- ry��H��; ]
T— ���— �-�••
� (M1iSSEcnoNN�1�pTBE00�.REtmOF71EP6VATISRKiONEHl1�0aED0aLlRsKtO�OqlBS1 PLUMBING �V"�
w MECHANICAL
Z I CERTIFY TW�T W TIE PERFORMMICE OF THE N'ORK FOR YNilpl THIS PERMIT IS ISSUE�,1
(' SMALLNOiEMPlAYM/YPENSdVMANVMJWNER50A5T08ECOME5l1BJECTTUTHE
Uj WORKEqS'COrdPENSATIDNlAW90iCAL�FORNIAµDAGREETHATIFISHOUlDBE00NE INSP FEE
SUBJECTT07HEYYORKERS'CAMPEN5ATIDNPRONSIONSOF6ECTION7lfI00 TNEUBOF ' u / /� ��
E.1 SHI1LL FORTHYVITI CdAPLY WITH THOSE FF10VI910NS. ^ �I�T Cr�
� �'�. ' SMIP Y OF DIA.Ivic..itvU t��
0 pATE:�� APRICANT: �.�
W ENERGY P/C �JC1 �iT�Lh...•+���.
� WMNINO:FAILUHE TO SECUREYlORNERS'COIAPENSATION CAVERAGE IS 11M.AWFU�Ml�SH�LL BE
BU&IECTMIEMPLOYERTOCR�MINALPENALTIESANDCINLFINESUVTOONEHUNDREDTHOUSIWD ENERGYPEFMIT�
Y OOLLARS(f100.000�INADDITIONTOTHECOSTOFCOMPENSATION,DAM�GESASPHOV10EDWRIN
� SECTpN9MlOF7HELABOFiCODE,WTEREST,MID�TTORNEY'SFEES. HETENT�ON FEE:
CONSTRUCTION LEN�ING AGENCY PRE-ALT FEE:
� IHEREBYAFFIqMUN�ERPENALTYDFVE0.tt1HYTHATTHEHEISACONSTpUCT10NLFNOWCA6ENCY
FORTHE PERFORMANCE OF 711E WORIf FOR WMICH TMIS PERMIT IS ISSUEO(SEC.3097,CIV.C.�.
2
W
� LENDER'S NAME
FS– LEHDEF'SlLL7�RE�'a4 �
`� 1 CERTIF'!1NAT I HM�E REM THIS APPLIGVTIONAND STATE TiAT THE��E NfORMATION IS ODMECT. TOTAL F E ES '
d I AGREE TO CO►IPLY WITN ALL CRY ANO COUNTY ORDINANCES M1D STATE lAWS REUlT1NG TO BUILOINO
COH.STRUCTION.AND HEREBY AUfFpRIZE REPRESENTATIVES OF RIIS COUNTY TO ENTER UPON THE
� ABOYE�M ED PRJPEfiT`!FOfi INSPECTIDN PURPOSES. COMMENTS
� _���C/�_�`�t-- ��� /��
veaMmee
y /2 9 '
� rutua rtEe o�rE
� RECPT.NO. PAID BY .VALIDA
YVHITE—DepeArnent Copy,YEILOW�inence Copy,PINN—l0.ssssaa Copy.GOIDENROD--File Copy,GREEN—Applicant's Copy
� ;�_ �, CITY OF DI/�MOND BAR
" IN�PECTi(�N RECOF�D
. � � . s - • � � . . � .
SET BACK . ' FL.00R`JQ161`f__�. .�A� 1`•' , �.��, `: �� i:`�,
FfGS/FORMSISTEEL FHA RE(aMTS.... �, - � ,
ELECTRIC GROUND ! UNDER FC QR.DUCT. ;�:: .; ,. � ;. " �� • ,=r � �
UNDER FLO.pR.CpMDUlT ,, ' • ��y�Y. '
GROUND PLUMBING - � • ----
SLAB GRADE FIREPLACE FC}UN�DATION`' •=�'-' j``_` � ' �' ^
TEMP POWER � FIREPLA��B�RD$ AM
WATER SERVICE , - MID NT. BOND BE�FM : ` ` �•, r . ,`�,_`�'���� •.\ ,
ROOF SHEATHING ..• • , ,' ` � - —_ 8 FT.BOND'�EAM � _'- ._ � ,' • • , , � : '�� ;�
FRAMINGNENTILIATION FINAL BOND BEAM ' : _ �
ROOF COVER PRE-GRAC7ING
AOUGH HEATING BENCHING
ROUGH ELECTRIC �`1`i' ROUGH GRADING �
ROUGH PLUM8ING ` ! ' FINISH GRADING
SHOWERtfUB TEST � POOL ELECTRlC
EXT.WTH/51DING POOL FENCING
WALL INSULATION I POOL FlNAI�
CEILING INSULATION j OFF SITE IMPS. _
DRYWALL NAILlNG i OEDICATIONS
SEWER � FINAL ENG.
SEPTIC TANK ' LANDSCAPE/IRRIG. __ _�_
SEEP PITIL..L. , ON SITE IMPS.
GAS AIR TEST _ � � -- -.� : FINAL ZONElVG _ �
FfP1Al.�CONST:� •. ; j . , , . • 'i.,., -f FIRE DEPT. FINAL ! !
FI1�3k�t HEATING ' �"r`' ; ' ;``'� , HEALTH DEPT. FINAL � �—
FINAL'ELECTRIC ; (1-3•5�I J � ' DEV. FEES PA�D � —�— �
FINAL PLUMBING ; I ; ENERGY !_ t �
i t , ..
I j `l .\ . ': --I�j-^ -----
I � � Q 1 _
COMMENTS
�_ .� . i '. ' ,_..
. . '. __..�.'� _��:'____�- _
, . .. ....,�
�. - • �
� ... .�� . _ .. . . _._,. �
- � . . y� � . . 1, ./ - .`. "_.�� } ... ,. � . ..�.
SEPTiC TAN�G SIZE
SEEP PIT/U S(ZE
Y�� �, R,.
q;, -- —
i,
i
. �- . ., . \ r. .._: . ;.` '
_,.
; � .. . ..._..+ .�'. "'1. 1���\.1'_
� \ \ .,,-., ." _ . " . -.