Loading...
HomeMy WebLinkAbout12978 (6) CITY OF DIAMOND BAg � ---J�- DEPARTMENT OF COMMUNTfY&DEVELOPMENT SERVICES � � 21660 E.Copley Drive Suite 190 (909)86Q3195 Fax(9D9)861-3117 PRESS "*"��� BUII.DING PERMIT APPLiCATION FIRMLY Q ADDRI SS l Sd� S 1 I✓e r Lyl h e pA�CATION�-� `- NUMB R I �-I �� � APN OT TRACT -� DATE CONST. GRO P � OWNER A1r • ' c. '_ � u' ADDRE S � ZONING SETBACKS �8 CffY ZIP TEL. � REART RW ❑ APP�ICANT TEL. SIDElSIDE STREET RW ❑ � CONTRACTOR LII 1., � SIDE p ADDRESS PpOPOSED USE � CI7Y h'I��icn V�� ZIP 92�TEL. � Pe� ARCFVENG! � DESIGNER NO.DWEL. NO. NO. ADDRESS UNITS STORIES BEDROOMS � CITY ZI _ _ TEL. y DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION Q OWNER•BUILDER DECLARATION SFR/A�WREM O I HEREBY AFFlRM UN�ER PENALTV OF PEiWRY THAT I AM E7fEMPT FI�M THE COMMCTORS LI- ' Garege�Carport CENSEUWFORhIEiOLUDWINOREA80N�3EC.7W1.6BUe1NES9ANDPPOFE5510NSCODE:AHVCITVOR (n OOUNiTYMFiCNREOUIRE9AVENMRTO00NSiRUCrKiER�MPROYE,OEMOLISN,ORREP/URANYBTHUP PB�p�DiCk IURE,PRpR TO RB 16SUANCE.AL80 REOUIRES THE APPLICAN�FOR 6UCH PENMIT TO FILE A iKiNED STATEMEHT 1HAT ME OR SHE IS LICENSED PURSUANT TO THE iqOVIS10N5 OF TNE CONTMC70RS U• CENSE UW(d111P7ER Y(CONMENCINO WITH 6ECTION 700D�OF DIYISION e OFTFIE BUSINE55 ANO PR6 POOVSRfO FESSIONSCWE)OR7MIITNEORSHEISE%EMPTTNFAEFROAIMIDiIiEB�SISWRTNEALLEOEDE%ENP- � TION.AN'/VIOUITIDNOFSECT10N7M1.68VANYMPLICANjFOARPEFNReU61ECT87HEAPPLIGWTTO � p�p�� � �CML►ENKTY OF NO7 MOfi[R1AN FNE HVNORED DOlURS(i6ao�.1: 04A40riNEROF7HEPROPERTY,ORMYEMPLOYEESWITHWACiE5A5THEIR50LECOMPENSATION, C01I11IIBfG91 riO.L DO TXE WORK Af�TME STRUCTI/RE IS NOT IMENDED ON OFFEREU FOR SAIE(SEC.7M�,BU51- . ,..1 y NE55 ANU PROFESSIWJS COOE:TME CONTMCTORS LIGENSE UW DDES NOT APPLY TO AN OWNER OF � PROPERTY WF10 BUADS OR MIPqOVES iMEREON,ANO NMO OOES 9UCH WORK HIMSELF OR HERSELF OR � TTiROUGHlRSORFIEHOWNEMPLOYEES.PROYI�EDTIUITBUCHIMPROVEMENTSARENOTINTENOE�OR m OFFERED fiDRBALE.IF.110NIEVER7HE BUILDIN�OR YAPROVEMENf IS SOLD WRFiIN ONE YEAROF COM0.E� TION,TME OWNER�BU0.DEP WILL Fi�VE iHE BURDEN OF DNOYW(3 7HAT ME OR SNE DIO NOT BUIL�OR MPROVE FOR 7NE PURP6SE OF lALE). � 04���EqOFTHEPRDPERTY.NAE%CLUSIVELYODMMCTINOWRHLICENSEDCONiRACTORS 10 OONSTRUCT 7HE PROlECT(8E0.704�.BU9INESS ANO PIqFESSIONS COUE:THE CONTHACTORS LI� V81U9110n ADJ.AREA CENSE UW DOES NOTAiPLY TO AN OMMER OF A PROFERTY YrtiO BUILDS DH d1PROVES TNEREON,MID WIIOOON�pACiBfORSUC/1PRO,lECT9WITHACONTRACfOR(3)LICBiSEDPURSUANTTOTMECONTMG QUANTITV DESCRIPTION FEE � 70R5 LICQJSE UWJ. O I AY IXEYPT UNDEN SEC. B.t P.C.FON T1iIS REASON � K..1 LL DATE ONMEH � � LICENSED CONTRACTORS DECLARAl10N '� � IXEREBYIIFFIFYUNOERPENALTYDFPERIURYTiATIAMUCEN5E0UNDERPROVISIONSOFCHAPTER � Y(G�D►IMENCNO N7Tli SECTIDN 700D)OF DNL4ION]OF THE 8LISMESS AN�GROFESSIONS CODE,/ND � Q �' a ��� MY LICENSE IS Nl FULL FORCE AND EFFECT, m 0 LICENSECI.ASS LIC.NO. �_s2_`f',_C7�I J pn� _ — coNrancroa o. WORKERS'COMPENSATION DECLARATION � � IHEREBVAFFlRMUNDERPENALTYOFPEFYURYONEOFTHEFOLLOWINODECLAFiATqNS: V � � � _IHINEANDWILLMANTNNACERfIFlCATEOFCONSENTTOBELFdNSUREFORWORKERS' CdAPENS1lTION.AS GRWIDED BY SECTION 370o OF THE LABOR CODE.FOR THE PERFORAIANCE W OFTHE WOIiK FOAMM1IICH MIS PERMIT IB 158UED. � � �1 XAVEAND YYILL M�IIfrAM YY�IY(ERS'WMPENSJRION INSURANCE.AS REOUIRED BY SECTION � 970DOFh1ElABOHCOOE.FORTiEPERFOFMMICEOFTHEWORNPoRMMICHTHISPERMITIS 0 ISSUE0.MV MAORKERS'Wr ENSAiION INSUj`�CE CARRIER AND POLICV NUTABER APE, CONSTRUCTION � CMRIEN [�dswe'�1.._���� PLANREVIEW � POLICYNUMBEH � EIECTRIC � fIFBSECION�NDTBEOO+RE7mOFT1EPERMRBFCNIONEF#JFLWED�OUJ�F151S1QOIORLFSS� PLUMBING T ` � I CERi1FY 7HAT IN 1HE PERFORMANCE OF THE VYOt1K FOR WHICH THIS PERMIT IS 16511ED,1 MECHANICAL _��l) SMALL NOT EMPLOY ANY PEFSON IN MIV MANNER 50 AS TO BECOME 8V&IECT TO THE (/) YlORKERS'COMGENSATIONlAW50FGJ1LIFORNIAANOM3REETMATIFIBHOULOEECOME INSPECTIONFEE 5 SUBJECf TO iHE WORKERS'q)MPENSATION PROVISIONS OF SECTIOp 77000F TME IABOR COOE,I SHALL F WITICWAPLY 141Ti T E PRON IONS. A ISSUANCE �- � ���°� ��r�e Il p pATE: pppLIpANT: fjj'� SMIP CCQ W ENEFGY P/C WMNINCi:FAIIUHETD SEGURE WORKEHS'COMPENSATION COVEflAOE ISUNUWFUL.AN�SMILLL 9E � BUBJECrM1EMPLOYERTOCRIMIWILVENALT1E5MlOGINLFWESUPTOONENUNOREDTNOUSMD ENERGYPER�� OOLWiS(i100,0001,�N AOD�TION TO THE COST OF COMPENSATION,DAMAGES AS PHOVIDED FOR IN J SECTIONa7oeOF7HELABOFiOODE.IN7ERE3T.ANDAiTORNEY5FEE3. RETENTION '� oCONSTRUCTION LENDINO AOENCY PRE-ALT FEE: gtHEREBYAFFIPMUNDERPENALiYOFPERJURYTHATTHEREISACONSTRUCTIONLENDINGAOENCV z FOR TME PERFORMMICE OF THE WORK FOH WHIGM THIS VERMIT I6 ISSUED ISEC.70Y7,pV.0.1. W � LENDEH'S NAME � I.ENDERSADDRE6S � I CERTIFY THAT I MAVE READ TNIS MPLICATIOfI AND 9TATE TMATTHE A80VE INFOpMA7qN IS CaRRECT. TOTAL FE ES ��� �ll 1 AOREE TO CUA/PLY WITH ALL CIiY AND COUMfY OR�INANCES ANU SUTE LAWS HEUTINO TO BU0.111NU � CONSTRUCTpN,AN�MER[BYAUTNOHIZEREPqESENTA71VE50FTHISCOLIN7YTDENTERUPONiHE PBOVE�MENTIONED PROPERTY FOR INSPECTIDN PURVOSES. COMMC-NTS � PEi1Mf1'f I • ' l I V e� 6 N ` � � BWNATUR OFPERYfTTEE DA7E RECPT.NO. PAID BY VALIDATION WHITE—Depertment Copy,YELtOW--Fnance Copy,PINK—Jlasessa Copy.GOLDENRO�FIIe Copy.OREEN—ApplicaM's Capy CITY OF DI/�►IW60ND BAR IIotSPECTION REC(?F�D � E � ! ' • � i . . � . SET BACK FLOOR JOIST ', , FTGS/FORMS/BTEEL FHA REQMTS ELECTRIC GROUND � UNDER FLOOR DUCT ' ' ' . GROUND PLUMBING UIVDER FLQOR CUMDUIT _ � . � �� SLAB GRA�E FIREpLACE-FOUf�DATION • � � - TEMP POWER FIREPLACE BOND BEAM WATER SERVICE MID HT. BOND BEAM • - • � � R(�OF SHEATHING 8 FT.iBONQ BEAM � ' � , FRAMIIVGNENTILIATION FINAL BOND BEAM � ROOF COVER PRE-GRADING • ROUGH HEATING BENCHING ROUGH ELECTRIC ROUGH GRADING ROUGH PLUMBING FINISH GRRDING SHOWER/TUB TEST POOL ELECTRlC • - EXT. LATH/SIDING P�OL FENCING WAL�INSULATION POOL FINAL CEILING INSULATION OFF SITE IMPS. DRYINALL NAf�ING DEDICATIONS SEWEFI Z$ FINAI.ENG. SEPTIC TANK LANDSCAPE/IRRlG. �^ SEEP PIT/L..L. ON SITE IMPS. GAS AIR 7EST FINAL ZONING FINAL CQNST. FIRE �EPT. FINAL FINAL HEATING �� HEALTH DEP7. FINAL - - - � __ FINAL ELECTRIC DEV. FEES PAID FINAL.PLUMBING � ENERGY � ' � ---- ------ C0�1IiMENTS � ;�;. . SEPTiC TRNK SiZE _, . , ' SEEP P!T/U S1ZE - --- `� . • S _ " -