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HomeMy WebLinkAbout11482 - - - � CITY OF DIAM�ND BAR ,./ � COMMUNTCY DEVELOPMENT DEPARTMENT � . ,..� 21660 E.Copley Drive Suite 190 . (909)66(�3195 Fax(909)861•3117 , PRESS '""° BUILDING PERMITAPPLICATION FIRMLY � JOBSITE /� APPLICATION i � PERMIT /G o ADDFESS �7 5S C✓��.�/�� �1 K D 2 OATE � � NUMBER ' # ' ISSUE TYPE OCC � APN LOT TRACT �ATE CONST. GROUP, `�„ p WNER GO �` ADDRESS Ii ZONING SETBACKS ' z CITY C� ZIP_� TE - FRONT RW ❑ o PLICA T ' TEL: ' 0 ' REAq ❑ z SIPElSIDE STREET RW ❑ � .CONTRACTOR StDE ❑ ADDRESS � CITY ZIP TEL. � PROPOSED USE w ARCWENG/ � � W DESIGNER NO.DWEL. NO. NO. . � ADDRESS � CITY ZIP TEL. UNITS STOFiIES BEDROOMS u� ------- cn DESCRIPTION S�.FT: FACTOR PSF ADJ.AREANALUATION p� OWNER-BUILOER DEGI:AfiA770N � SFR/AD�/REM - O � p I HEREBY AFFIRM UN�ER PENALTY OF PER.NRY THAT lAM E%EMPT fqOM THE CONTRACtOR3 LI- GafBgBlCelpoll W CENSEIAWFORTHEFOLLOWINGREASON(9EC.7071.SBUSINESSANDPROFESSIONSCOpE:ANY�ITYOR �. �(f� GJ COUNT/WHICFIREIXIIRESAPERMITTOCONSTRUCT,ALTER,IMPROVE,DEMOUSFI,ORREPIJRpNY3TRIC- . W w TURE,PRIOR TO IT:ISSUANCF,AL50 REDUINES 7HE APPLICANT FOR SUd1 PERM17 TO FILE II SIGNED � PBtIDID9ck , � STATEMENT 7HA7 ME OR SME IS UCENSED PURSUANT TO THE PROYISIONS OF THE CONTMCTORS Lh` � . � CENSE lAW(CHAPTER Y(COMMENCIN�WITH SECTION 7000)OF DIVtSpN 30F h1E BlJ51NESS AN�OqD-� P001(Spe O FESSIONSCODE)ORTHATHEOR5HEISIXEMPTTIEfiEFRON/NDTHEBASISFORTHEALLEGEDEXEMP• � (1� V TION.ANYVIOLRTIONOFSECTION7031.SBVANYAPPLICANTFOqAVERMITSU&IECTSTHEAPPLICANTTp Z Re•Roo1 A CIVIL PENALTY OF NOT MORE iHAN FIVE HUNDREO GOlJ.AF6(f500)J: ZC71,AS014NEROfTHEPROPERTV,ORMVEMPLOYEESWITHWA0E5A9TNEIR90LECOMPENSATIDN. � COf111T1BfCI8I WILL DO THE 1YORK,AND THE STNUG7URE IS NO7 IN7ENDE0 OR OFFERED FOR 6ALE(SEC 701�,BU51� J � NE55 AND PROFESSIONS CADE:TNE CONTMCTORS IICENSE LAW DOES NOT RPPLY TO AN W✓NER OF = VROPERTv WHOBURDSpR IMPROVESiHEREON,ANO WHOODES 511CH WORKHIMSELFORHERSELFOR � THROUGHHISDRHEROWNEMPLOVFES,PROVIDEDhIA7SUCNIMPFOVEMENTSARENOTWTENOEDOR � , LO � OFFEREDFORSALE.IF.HOWEVERTHEBUIL�INGORIMPHOVEMENTISSOLDWITHINaNEYEApOFODMPIE. Z TION,TNE OWNER-6UILDER WILL MAVE TNE BUROEN OF PqONNO TMAT NE OR 9ME DID N07 BUIID OR � IMPROVEFORTHEPURPQSEOFSALE�. ' `i w ❑I.ASOWNERDFhiEPflOPERTV,AME%CLUSIVEIYCONTRACSINGWITHLICENSEDODNTMCTOR3 , Q TO CONSTRUCT THE PRQIECT(SEC.70{0.BUSINE93 AND PqOFESSIONS CODE:T1fE COMW\CTORS LI• • VBIUB�lOf1 ADJ.AREA W CENSELAWDOESNOTAPPLYTOANONMEROFAPROPERTIWM09UILDSORIMPFqVE5R1EREON.AN� � WHOCONTRRCf5FOR5UCHPRQIECTSWITHACAMFl1CTORIS�UCENSEDPURSUANTTOTHECONTMF ; QUAMTITY DESCRIPTION FEE Y iORSLICENSELl1W.). � � CJ 14M E%EAIPT UJOER SEC. B.{P,C.FOR TiIS AEASON Q • ' U � DA7E OWNER � � F- Z W � LICENSED CONTRAGTORS DECLARATION W ¢ � IHEREBYAFFIRMUNOERPENALTYOFPERJURYTHATIAMLICENSEDUN�ERVROYISIONSOFCHMTE0. -� d B(COMMENCINGWITNSEGTIONTOOO�OFDIVISION]OFTHEBUSINESSANDPROFES570NSOOD[,AND' Z 'X MV UCENSE IS M FULL FORCEANO EFFECT. m � IICENSE CUSS LIC.NO. � V �ATE CONTHACTOP� � ' � d W � WORKERS'COMPENSATION DECLARATION Q � I HEREBY AFFIRM UNDER VENALTY OF PERJURY ONE OF THE fOLLOWING OEGLAMTpNS: Z � _IHAVEAN�WILLMAIN7AINACERTIFICATEOFCONSENTTOSELF•INSUREFORWORNERS' a � 2 CAMPENSATION,ASVROVIDEDBVSECTION37000FTHEUBORMOE,FOHTHEPERFORMANCE tU Q OFTHEWORKFORWHICHTNISPERMIT�9ISSUED. � QW _IHAVEMlOWILLMAINTAINWORKERS'WMPENSA710NINSURANCE.ASNEOUIREOBYBECTIDN 37ao OF THE LABOR CODE,FOR iHE PERFORMANCE OFTHE WORK FOR WHIC11 TXIS PERM1715 . I ' ,1�� ISSUED.MVWONKERS'COMPENSATIOHINSURANCECARRIERANDPOLICYNUMBEHME: CONSTRUCTION !� V �/ J j CARRIER PLAN REVIEW Z POLICV NUM9ER ELECTRIC Q 0 (fHISSECfCNREmNOTBE00MPlEfmOFThECERnYTtSFaqONEHIX�DFim00LLpAS(f1ao�Of3�E55} PLUMBING W Z 1 CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICM THIS PERMIT R ISSUE�,1 MECHANICAL C`} SFIALL NOT EMPLOY ANY PEfl50N W ANY MANNEfl SOI1S TO BECOME SUBJECT 70 TME q] WORKERS'COMPENSATION LAWS OF CAIIFORNIA,AND AGREE THAT IF I SHOULU BECOME INSPECTION FEE ���� � = SU&IECTTOTHEWORKERS'CAMPENSATIONPROVISIONSOFSECTION97oaOFTHEUBOR CADE.I SHALL FORTHWITi COMPLY WITH THOSE PROVISIONS ISSIJANCE � � p DATE: APPLICANT. SMIP W LLWARNINO:FAILURE TO SECURE WORKERS'COMPENSAYION COVERAOE IS UNLAWFUL AN�SHALLBE ENEROY P/C ����� SU&IECTAN EMPLOYER TO CRIM WAL PENALTIES AND CIVIL FINES L1P TOONE Nl1NORE�T1i0USAN0 ENERGY PEflMIT DOLLARS(S��.Doa�.IN AD�ITION TO THE COST OF ODMPENSAi1DN,DAMAGES AS CROVIDE�FOR IN � SECTION]7aeOFTHEU80RCOD£,WTEAEST.lNDA7TORNEY'SiEES. pETENTIONFEE: � � CONSTRUC710N�ENDING AGENCY PRE-ALT FEE: � IHEREBVAFFIRMUJDERPENALTYOFPERIURVTHATTMEREISACONSTqUCTIONLEN�INOA6ENCY � FOR 7HE PERFOHAIANCE OF T11E WORK FOR WHICH TMIS PERMIT IS 165UED(SEC.9087.CIV,CJ. Z W � LENDER'SNAME _ H LENDER'SPDORE55 �� � � I CERTIFY TMAT I XAVE REAO TNIS APPLICATKKJ ANO STATE TIATTHE ABOYE INF01iMATION IS CORRECT. TOTAL FEES • � � 1 AGREE TO CAMPLY WITH AL�CITYAND COUNTY ORDINANCES AND STATE LAWS RElA71NC TO BUILDING ' � � CONSTHUCiION,hN0 HEREBV AUTHOFIZE REPHESENTAiIVE50F 7HI5 CAUN7Y TO ENTEH UPON hIE � z ABOVE�MENTIONE�PROPERTY FOq INSPECTION PURPOSES. COMMENTS � � � Q 'PERMITT qME RINn / � (n ��"'�,� —� SIGNATUREOFVE MI E �AT � RECPT.NO. PqID BY ' VAL�DATION ~ WHITE—Depertment Copy,YELLOW—Finance Copy,PINK--Assessor Copy,GOLDENROD—File Copy,GREEN—ApplicanYs Copy � � CITY OF DIAM4ND BAR INSPECTtON RECORD ' • � • ` � ' • i � � . � . SET BACK . FLOOR JUIST FTGS/FORMS/STEEL FHA REQMTS , ,. ELECTRIC GROUND UNDER FLOOR Dt1CT � � . GROUND PLUMBING t1NDEp FLOOR CO�Il�U1T • . ' SLAB GRADE FIREPLA'CE FOUNDATIQN ' ' TEMP POWER FIREPLACE BOND BEAM WATER SERVICE MID HT.BOND BEAM ROOF SHEATHING � 8 FT. BOND BEAM FRAMINGNENTILIATION FINAL BOND BEAM ROOF COVER PRE-GRADING ROUGH HEATING BENCHItUG ROUGH ELECTRIC ROUt'.,H GRADING ROLJGH PLUMl31NG FINfSH GRADING SHOWERlfUB TEST POQL ELECTRIC EXT.LATHlSIDING POOL FENCING WALL INSUTATION POOL FINAL CEILING INSULATION OFF SITE IMPS. DRYWALL NAILING DEpICATIONS SEWER FINAL ENG. SEPTIC TANK LANDSCaPElIRRIG. SEEP PITIL.L. ON SITE IMPS. GAS AIR TEST FINAL Z�NINCs FINAL C�NST. - FIRE DEPT FINA� �. FINAL HEATING HEALTH DEPT. FINAt FiNAL ELECTRIC DEV. FEES PAID FINAL PLUMBING ENERGY ' o e COMMENTS t��, ��� � r . . 'y . SEPTlC TANK SIZE SEEP PIT/U SIZE I � � � ,� � , � , r