HomeMy WebLinkAbout17263 (17) � ci�oFnu�orrosAx EXPIRED
� DEPARTMENT OF CONIIv1UNITY&DEVELOPMENT SERVICES
��'"` (9 9�60-3 9�Fax(909)861-3117 J U N 18 2001
PRESS
����'' BUILDINGPERMITAPPLICATION FIRMLY
} JOBSITE � y /J ./f ' APPLICATIO,�1 f PERMIT /C
p ADDRESS c�?�,2� �'�� /�tcK�d�_�Z�� DATE /4/��/d I NUMBER � x
� ISSUE �--� 7YPE OCC
APN LOT T CT pATE CONST. GROUP
p OWNER
"' A�DRES ZONING SETBACKS
gCITY TEL. �,�0 �fh�N FRONT RW ❑
APPLICANT TEL.� SIDFJSIDE STREET RW D
� CONTRACTOR - SIDE ❑
� ADDRESS �
� CITY ZIP TEL. PROPOSED USE
o ARCH/ENG/
z� DESIGNER NO.DWEL O. NO.
� ADDRESS UNITS STORIES BEDROOMS
� C1TY ZIP 7EL.
uNi DESCFiIPTiON SO.FT. FACTOR PSF ADJ.AREANALUATION
p� OWNER-BUILDER DECLARATION SFR/ADD/REM
O
Q I NEREBY AFqRM UNDER PENALiY OF VE0.R7RY THAi 1 AA1 EXEMPT FAOM TME CONTMCTORS U• G9f8QB/CBryOfI
W CENSELAWFORTHEFOLLOWWQREASON(SEL.70]1.SBUSINESSANDPROFESSIONSCOOE:ANYCITYOR (n
U COUNryNR4plqEpUIRESAPERMRTOCONSTPUCT.ALTER�MPROVE,DEM0U5N.ORREPAIRANYSTRUG• W P81iypeek
� T/iiE,VN100.TO ITS ISSUANCE,AL50 REOUIRES TNE AV7LICAM FOF Slldl PERAIIT TO FILE A SIGNED W
STATEMENT T1�T ME OR SHE IS 110EN5ED PURSUANT TO TME PROVISIONS OF THE CONTFACTORS lF
� CENSEUW(GIAVTEHY(COMMENCM(iWIiHSECTION7000�OFDIVISqN]OFTMEBUSiNESSANDPHO• V"' PooVSpa
� FESSIONSCODEJORTMATHEORSHEISEI(EMPTTNEREFROIdANOTHEBAS13FORTHEhllE0EDE7(EMP-
V TION.ANVVIOLATIONOfSECTION7W1.3BYANYAFPLICANTFORAPEfiMITSU&IECTSTHEAPPLICANTTO Z pa•Roo1 DU
A CML�ENALiY OF NOT MORE TW W FIYE MINDRED DOLUPS Ii5oo1.):
zOlA50WNEROFTHEPROVERiV.ORMYEA�PLOYEESN'iTHWAGESASTNEIRSOLECOA.IPENSATbN, 0 COrtlfnBfClal �
W�LL D07ME riORK,AND THE STRUCiURE 19 N�T IMENDEO OR OFFERED FOR SALE(SEG 701�,BU51• J
� NESS AND PROFESS�ONS COOE:7HE CONTMC70R3 LICENSE UW DOES NO7APPLY TO AN OWNER OF �
PROPE�'NMO BUILDS OR IMPROVES TMEREON.M1D WHO DOES SUC//WORK HIMSELF OR HFRSELF OR
� TMROUGIiM90RHERONrt1EMPlOYEES,PAOYIDEDiH1173UCMbIPpOVEMENT9ARENOTNTENDEDOR m
� OFFEREDfOH5ALEIF,HOWEVER7NEBUILDINOOHIMPROVEMEN'ISSOLDWITHINONEYEAROFCOMPLE•
Z TqN,THE OWNEREUIIDEN VALL HAVE TNE BUPOEN OF PqOVNO TH�T HE ON SHE DID NOT BUILD OR
� MIPROVEFORTIEPURPOSEOFSALEI
O4�dWNER OFTHE VROPEHi`/,AA/E%ClUSNELYfANTMCTNO WffH IICENSED CONTMCTORS
Q TO CONSTRUCT THE PRO.IECT(SEG 70ts,BUSINESS AND PROFESSIqJS CODE:THE CONTRACTOq3 LI• VeI1121I0f1 ADJ.AREA
W GENSEUWOOESNOTMRYiOAHOWNEROFAPROVERTYW110BUILOSORIMPRWESiHERECN.ANO
� NAqCONTMCTSFOR5UOIPROAECTSNATHACONTMCTOR(5)UCENSEDPUPSUANTTOTNECONTRAP QUANTITY DESCR�PTION FEE
� TORS UGENSE UW.). ^
� OIAA16%EMPTUNOERSEC. &10.C.FORTNISREA50N U
� �
�="' DA7E OriNER V
QUCENSED CONTiUCTORS OECLARATION W
a IHEREBVAiFlRMUNOERpENAITVOfCE0.A1RYTHATINAUCENSEDUNDERPRONS10NSOFCHAPTEH V.
p� i(CpMMENCINOWITM$ECTION7000�O�OIYISION�OFTNEBUSINESSANOPNOFESSpNSCODE,ANO Z
X ►IYLIGENSEISNFULLFOflCEANUEFFECi.
� LICENSE CLASS � LIC.NO. � � �`� � j
V DATE� C � O CONTMCTO� �� � . . . .. .. .
w �7 V�6
� WORKERS'COMPENSATION�ECLARATION a
N V
� IHEREBYAFFIRMUNDERPENAITVOFPERJURVONEOFTNEiOLLOWINGDEd.ARATqNS: Z
� �IHAVEMIDWILLIAAMTAINACERTIFICAiEOFCONSENTTOSELF-INSUREFORWONNERS' _
COMVENS�TqN,ASPROVIDED8Y5ECTION�7ooOFTMELABORLODE,FORTHEPERFONAANLE W
OF TNE WORK FOR WHICH THIS VERM�i�S ISSUED. �
�
W �IHAVEANDNALLWUMAINWORKERS'CdADEN5AT10NIN5uMNCE.A4PE0UIREDBVSEC7lON �./ �(
QJ7000FTHEU�BORCOOE.FORTMEPEPFORM.WCEOFhiEWO KiORwHICHiMISPEiWIT15 X � /�
� ISSUED.IAYWOPoCERS' P �SATI�N�N� dCECARRIER +�va�crNuueEnu�e: CONSTRUCTION �� ���
� CARRIER � PLAN REVIEW
z aa�crran�eEa /r' I/ /� I ELECTRIC
¢
� (R85SEC110NNEmNOTBE00APLFTmO�'1�EFERMT6PoRONEHU'DREDOOLIAR4R�OOIOfilE55? PLUMBING
2 ICEHTIFYTHATplTHEPEPFOR6I.WCEOFTHEWORKFORWNIq17HI5PERAlIT151SSUE0,1 MECHANICAL
(7 6HALLNOTEMPLOYANI'VERSONIN�M'M�fJNERSOA3T00ECAMESV&IECTTOTHE
y WORKERS'COMPENSATION UWS OF CALIFORNIA,ANDAOREE TH F I SMOULO BECAME INSPECTION FEE
S SUBJECTTOTMEWORNERS'COMPENSATIONVROV�SiON50FSE � �7000FTHEU.BOR n
CODE,ISHALLFONTIIWITMCOMPLYWIT/T EFROVISIONS. ♦ ISSUANCE .slf�OD
� /� n SMIP s ,��U
'p DATE:o.L,�CS f—MPPLICANT:
� WARNINO:FA0.URETOSECUREWONCERS'CAMPENSATqNCOVE CEISUNUWFUL,ANOSHALLBE ENERGYP/C
� SU61ECfANEMPLOYERTOCRMWALPENALTIESM70CNILFN UPTDONEFNh9RE0TMWSAND ENER�YPERMIT !I OO
OOLLARS�itoo,00D),INADDITIONTOTIIECOSTOFCOAIPENSA ON.DA/AAGESASVROVIOEOiOqIN
J SECTqN3)oeOFTHELABORCODE,NTEREST,INDATTOiWEYSFEES. qE7ENTIONFEE:
� CONSTRUCTION LENDING AGENCY PRE•ALT FEE:
O
� INERE6YAFFIRYUNDEHiENALT'OFPEWUMTHATT/1ERE�SACONSTRUCTIONI.END�NOACENCY
FOfiTNE FERFORMANCE OF 7HE W�K FON WM�GM TMIS PERMIT IS ISSUED ISEC.]OY�,CIV.CJ.
z
W
� LENDER'S NAME �
� LENDEH'SADDRESS
W� TOTAL FEES �'
ICERTIFY7HATINAVEPEADTNISAFPLIGTpNANDSTATETNATTHEABOVEINFOR1AATqNISCOMECt /J��
� IAGREETOCOMPLYWIMALLCRYM7�COUNTYDRDINANCESANDSTATEUWSRELIITIHQTOBU401NC .
CONSTRUCTpN,AND HEREBY AUfMOPoZE REPHESEMATNES OF THIS CWMV TO EN7FR UPON THE
� ABOVE�MENTqNEDPROPERTYFORINSPECTqNVURPO5E5. COMMENTS
a VG � ��
m VERA1IiTEE NAM FlI )
N - d '
y 610NANR O ITTEE OA E
� AECPT.A'O. PAtD BY VALIDATION
W E-0epartment Copy,YELLOW—Finance CoDY.P�NK—AssessaCopy,GOLDENROO—File Copy,GFEEN—Appiicant'a Copy
r�l:�H�.cr... .. �N.. . �_, y. , . � •;r- � " �<�:.:(,4:r�r�,i. r.p,�h��Y.''J:,+,r.�r�,��r..�i,¢•y��,,�.if,n`J�..:.:,,r;.rc,...�v:.n..+r.,-. .,. . -�'-r•v+C,,.-�, •?q. -;r.-.•i:,w,�-..,.....,.,, ,.,. .,..�,.�..
CITY OF D1�MOND BAR
!tilSF�EC�'10N RECOIRD
� _.�...,. ,...�
. __ . �w ..-�----�-
i - • � '
;����:�.������ :-._. �r�p=. ���1���:��-d�"�.�*� . il���.�.�,��'�.�:►�.� ��':,�d�� � �11�.�-��� I°�
,�. __.. ..� _.___ 7.� ,..�... ��;
SET BACK , � ' �' ; � � ,. FLO�R JOIST.��w��
FTGS/FORMS/STEEL �� FHA REQMTS
ELECTRIC GpOUND � UNDER FLOOR DUCT_ � •
GROUND PLUMBING I UNDER FLOOR CU�IDUIT { I •
SLAB GRADE I FIREPLACE�FOUNDPTION I I - ' �
TEMP POWER I I I FIREPLACE BOND BEAM
WATER SERVICE � MI HTD QONO BEAP�i '
ROOF SHEATHING ( � $�• BOND BEAM
FRAMINGNENTILIATION ' FINAL BOND BEAM I
ROOF COVER � I PRE-GRADING I
ROUGH HEATING - BENCHING I •
ROUGH ELECTRIC ! ROUGH GRADING ��, ,
ROUGH PLUMBING I � FINISH uRADING
SHOWER,rI"UB TEST ; POOL ELECTFiIC
EXT.LATH/SIDING � j POOL FENCING
WALL INSULATION � POOL FINAL ' ' •
CEILING INSULATION � j OFF 51TE IMPS.
DRYWALL NAILING � DE�ICATIONS (
SEWER � ; FINAL ENG.
SEPTICTANK i LANDSCAPE/IRRIG. �
SEEP PIT/L.L. I � ON SITE I��IPS. �
GAS AIR TEST � � ; FINAL ZONING �
FINAL CONST. � � I �!RE DEPT. FINAL I
FINAL HEATING i � HEALTH DEPT. FINAL �
FINAL ELECTRIC � i , DEV. FEES PAID
FINAL PLUMBING � � j ENERGY
. � �
�_;.;� ��r'i��,„;a c•c�. —
� . .. _,..�.. �.:.r��_y _
COMMENTS
SEPTIC TANK SIZE
SEEP PITN SIZE
_ _ I��_.:
"""`"'�
'�Y'V� !'
�
,
i .
_ �
f
� , ;� � , . , ,