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HomeMy WebLinkAbout15403 (17) � _ -� CITY OF DIAMOND BA� � .� : : ,. --- " — DEPARTMENT OF COMMLINITY&DEVELOPMENT SERVICE5 � � 21660 E.Caplcy Drive Suite 190 (909}860-3195 Fax(909)861-3117 PRESS � �^�� BiJILDING PERMIT APPLICATION FIRMLY yy, JOBSITE n^,L �7.�,�f APPUCATIO - PERMIT 1� P/C o ADDRESS �n�fJ J SJ�i'I//�/OIIILA/II� DATE NUMBER � � � ISSUE TYPE OCC APN LOT T T DATE CONST. GROUP �j OWNER ADDR S ZONING SETBACKS �' CITY ZI TEL. REAR RW ❑ APPLICANT TEL. SI�E/SIDE STREET RW ❑ CONTRACT R Y � .,/' G SIDE ❑ g ADDRE S PROPOSED USE CITY ZIP _ TE � ARCFUENG! DESIGNER NO.DWEL. NO. NO. ADDRESS UNITS � STORIES BEDRDOMS �y CITY ZIP TEL. DESCRIP710N SQ.FT. FACTOR PSF AW.AREANALUATION Q OWNER-BUILDER DECLARATION SFRIADDIREM O 1 NER�Y AFFlPM UNDER VFNALTY OF PERAIRY THA7 1 AM EXEMPT FAOM TNE CON7MCTOAS LI- G8�8QB/C81p0I( CENSEUWFORTHEFOLLOWWGREA90N(SEC.70.11.6BU3NE9SAN�PROFESSIONSOODE:ANYCITlOR (n CO4R(T�'WHICNREGUIRESAPEq►1RTOCON67iYJC6KTERMPROVE.DEMOtJSM,OHNEPAIRANY57RUC- W PetIp/D6Ck 7URE,�IIqR TO rt8 IB6UANCE.AL80 REOUIRES T1E APPIICANi FOR SUCN PERMR 70 VILF A SIONED W BTAiEMENT TXAT XE OR SHE IS LICENSED PUIISl1M1Y TO TME PROVISIONS OF TNE CONTRACTOqS U• CENSE LAW(CNAPTEP Y(CdiMENCINO N7TH SECTION 7000)OF DIYISION�OF TNE BUSINESS AND PRD- � POOUSpfl iESSpNS OO�E)OR THATXE 011 SHE IS EXEMPT T/IEREFNd1 M10 TiE 8J 41S FDR THE ALLEOED E%EMP• , 7qN.M1YNOLATqNOF8ECT1ON7W1.6BYMIVAPPLIGNTFORAPERMITSUBJECTSTHEAPVLICMITTO z Re-Roof � ACML VENALTV OF NOT MOAE T/AN FNE MINOREO DOLLMS(i600).): � ❑I,ASOYMEROFTIEPROPER'fY.ORMVEMPLOYEESWITHWAGE9ASTHEIRSOLEWMPENSATION, � CORIRIB�CI81 ' WILL 00 TTE WOIi(M1D h1E STRUGTURE 1.4 NOT IMENDED OR OFFEHEO FOR BALE(SEC.7D14,6USI� � NESS AND YROFESSIONS CWE:TME CONfMCTORS LICENSE lMM DDE9 NDT APPLY TO AN 01MNER OF � PipPFATYWFiO8U1LDSORMIPHOVE87HEREON,ANOWHO00E89UCHWORKHIMSELFOqHERSELFOR � � TWi0UGH1YSD11HEHOWNEMPLOYEES.PROVIDEDTHI�TBUCHIMPROVEMENTSAIiENDTMITENDEDOR m ,OFFEREOPORBALEIF.IiDWEVERTME8l10.0WOORMIPRWEMENTISSOLDNrtTNINONEYEIIROFCO4PlE- TqN,TNE OWNER�lU0.DEF N7LL/WVE TME BURDB�I OF PROVWO THAT HE OR SNE OID NOT BURD OR YPHOVE Wq 1HE PUIiPOSE OF 8AI.E�. � O4u�NMEi1OFTHEPROPEH7Y,AMEXCLUBNELY00MMCTINOWIiliL10ENSEDCONTMCTORS . T000��5T1WCTTNE PRQIECT(BE0.70µW81NE99 AHD P1iOFE9910N9 000E:THE CONiHACTOfl9 L1• VdIUBtlOfl AOJ.AREA CENSE lAW OOEB NOTMPLY TOAN ONMER OF APROPER7Y W/qlUILDS OR YPiqVE51HEREON,AND 1YFiOCONTRACT6FOR8Uq/PRQIECTSWITH�O0NT1NC70R(S�IICENSEDPURSUMlf70T1E0OfITFUG Ol1ANTl OESCPoP'flpN FEE � lOR5l10EN5EUW.). ❑I AY EXEYPi 11NDER SEC. B.�P.C.ADR TNIS REASON � U lL � OATE OWNER U � LICENSED CONTRACTORS DECLARATION —i � W I FIEPEBY AFflNM UNDER PENALTY OF FEFLURV TV1AT I AM LICENSEU UNOER PROVI510N9 0F CHAPTER V. � ��COLIYENCq1GWITMSECTION70aD�OFDMSION90FTMEBUSINESSANDPHOFESSIDNSCODE.ANO Z W LICENSE IS W FlLl WRCEAND EFFECT. � UCENSE CLASS LIC.NO. ��`�v � J � DATE CONTRACTOR a � WORKEflS'COMPENSATION D L TION � � I HEREBY AFFIRM UNDER PENALTY OF PEIUUNY ONE OF THE FOl WINO DECI.AMT10N9: Z � _IWNEANDWLLMAINTANIACER'TIFICATEOFOONSENTTOBELFaNSUREFOFW'ORKERS' � Od1VENSATID!{ASVROVtOEDfiY3ECT10Nl70oOFTHELABORCODE,FORTNEVERWRMANCE �U Oi 1ME WORK WR WHN91 T113 PERMIT IS ISSUED. � FB _I W WE AND WILL MAIMTAIN WORKEFS'GOMPENSATpN W SIIMNCE,AS REOUIRE�BY 8ECTIDN O170a OF TNE UBOR ODDE.FOH 7}iE PERFaiMANCE OF THE WORK FOR WHICH THIS PENMR IS ���� � ISSUEO.W WONKERS'COA/PENSATION INSIRANCE CARRIER M10 POLICV NUMBERME. CONSTR N ' cuw�n•� � __ Pu � POLICY MMBEp '� ELECTRIC QQ (mssEcrpH�IDrroTaEm�E�aFnEPEwnrrs�ar+E�Um.W�sR��l��sT PLUMBING � I CE0.TGY THAT N h1E PERfOAMANCE OF TNE WORK FDR WMICH 7HI5 PERMIT IS ISSl1E0,I MECHANICAL � BHALL NOT EMPLOY ANY PERSON IN AM'MANNER SO AS TO BECOME SUBJECT TO THE � WORKERS'OOMPENSATqNUW50FCALIFORNIA,ANOAOREETHAiFISHDIILDBECAME 1 FEE _ � BUBJECT TO THE WORKERS'COMPENSATION PRONSIONS OF SECT�IXJ 0700 0F TNE l/90R 1 _1 COOE,I SMiLLI FORiY1WITFi CpARV WITi iTpSE PRONSIONS. •`���.` p DATE: APPLICANT. 5 — ! V � WARNING;FAILURE TO SEGUREMlOFiKER3'COMPEN9ATION COVEMOE IB UNLAWFUI,MI�9HALL BE ENERGY P/C BUBJECTANEMPLOYEPTOCRIMPIALPENALTIESANDCIYILFINESUPTOONENUNDREDTFpUSAND ENEFGYPERMIT � �OWRS(i100,000),W ADOITION TO TME COST DF COMPENSRTION,OMMQES A9 PfiOV10E�FOR IN J SECTqN370lOFlHELABORO00E,INTEREST,ANDATTORNEI"SFEES. RETENTIONFEE: � CONSTRUCTION LENDING AGENCY PRE-ALT FEE: 1 MERFBY AFFlRM UN�Eti PENALTY OF PERJURY THl1T THEFE IS A CONSTRUCTIOH LENDING AUENCY FOR THE PEAFOiiNANCE OF TFIE WORK FOR WHICN 7HI5 PEfiM�T IS ISSUED(SEC.30W,qV.C.�. W �a,U� � LEImER'S NM1E � LENOERSA�URE55 � ICEHTIFYTNATIMAYENEI1DT719MRIC�TqNM10STATEiHATTNE�90VE1NFORNRTqNISWRRECL TOTAL FEES � IAOREETOCAMPLYWITHILlC1TYM1OOIXINTYORDWANCE5M105UTEUN5REUTWOTOBUILDING �rrr�� CaNSTRUCTION.AND ME0.EBYAUT110HIZE REPRESENTA71VE5 OF 7HI5 CAUNTY TO ENTER UPON TNE � �904E•IAENTqNED VROPERTY PDR INSPECTION VU ES. ,^,�� COMMENTS Q PERMITiEENM1E PRI e N � � ap �� ^TE RECPT.NO. P/UD BY YALIDATION WHI7E—Department Copy,YELLOW--Finance Copy,PINK—Aeaessor Copy,GOLDENROD--File Copy,OREEN—ApplicanTs opy � K . , . - � .. .., ���r.. `r�. , r.a ., l's..r.f, Fx . _. . � .. '-. � .. . . . . . �- , ' ' . ... i . • ..r.}. . . . . � . , , • .� . . . . 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BOND BEAM ; � --------- --- ------------. ___------------------�--=----�--------�;-=--- _____.._......----.._ .._.___...-- -, ROOF SHEATHfNG �•�__ ' �____:_ 8 FT'. BOND BEAM , � �• ; ' ---•--------- --- -- ----- ----------------�-----._._. ._...-------__ ---- _( FRAMINGNENTILIATIOP!, FINAL BOl�JQ BEAM ' � ' -- ------------------------..... '..--- ----------.�...---- - --------� ----- •- -� - --- - ROOF COVFR PRE_CRA(71NG ---.� . --.-------- --_----.--------• - f �.�`._� ---�---- ROt1GH HEA7ING BENCNING I � --•— - - ---- -- ----*.._..._..------._ ...............----- 'ROUGH ELECTRIC ROUGN GRADiNG ; --- --,_�- ----------- ---------�-----�---------------�--------��_..-------------�--- --�-•-• ---- R(7UGN PLUMBING � FINISH GHADiNG � --- - -- --..— __.�.--•- -----•�---__...---.___,__.............--- SNOWERfTUB TEST � POOL ELEGTRIC � ----- - ---- � ----------- ---- - ---.i._..---------------•-----------.._._..� EXT. 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