Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
12851 (13)
�- ^_ �� CITY OF DIAMOND BAl� � DEPARTMENT OF COMMUNITY,&DEVELOPMENT SERVICES _W , '� 21660 E.Copley Dtive Suite 190 , (909)860-3195 Fax(909)861-3117 PRESS :A�'"' I BIIQ;DING PERMIT APPLICATION _ FIRMLY � . a DDRiESS ����'� ��..1A�d�- L�.���E DATECATION� "'��J"�`���NERMIT��"� P/C 0 ` �' I� UMBE # � w n,.� ISSUE 7YPE OCC T ADDRESS S ` RA T � �- .G'LJ - ROUP p, OWNER � �� , APN LOT bATE CONS7 G Cz�. �--^ _f��� � ZONING SETBACKS z CITY '. Y�- I. TEL�, � FRONT ', RW � , ,;,, ❑ � CONTRACTOR � TEL: S D6 ,, TREET RW ❑ SIDE/SIQE S ` O , � CDDRESS PROPOSED USE o I' ZiP TEL. w ARCHlENG/ ���,.�� ` ,^�,�� : I � , ;,` r Z DESIGNER �'6°`t . p_ ,ADpR _ UMTS , STORIES BEpROOMS � CITY ZIP TEL NO.DWEL. NO. NO. ...,0 � .. . . QWNER-BUILDEROF_CLARATION . . � ' D q/DD/REIM N SQ-.FT a'�, '`�`.F�CT�,���,��� TIQN��. � , R�'SF ADJ.AREANALUA ,Q; , I HEREBY AFFIRM UNDER FENALTY OF PEHJURV THAT I AM EXEMPT FROM THE CONTRACTORS LF � �� Gaf898/GGi{iBTC �� � � � ' ' � '. W CENSEI.AWFORTHEFOLLOWIN6REA9QN(SEQ7031.59USINESSANDPROFE9510NSCADE:ANYCIiYOR � �(n � ._. , G.7�.,COUNTYWHICHRC-0UIRESAPE MIiTQCONSTRUCT,µ7�R:iMPROVE.DEMOLISH,ORREPAIRANYSTRU6 .W p . � ^� �'� ' ' � '� I � �W �TURE,PRIOR�iOITS�ISSUANCE,ALSOi�QUIHES THE APPLiCMJT FOR SUCH PERMITTO FILE A SIGNED . W � STATEMENT"TNRT HE OR SHE I LICEIkSEd PURSUANT TO THE PflOVISIONS OF THE CANTRACTOftS LI- '� �CENSE LAW(CHAPTE99(COMM�NCIN�WITH SECTION�000)OF OIVISION 30FTH�BUSiNESSAN�PR0. �'r' POOUSp3 � . ���� fESSpN6CODE)OqTHATHEO &HEiSEXEMPTTHEREPHOMANDTHEBASISFORTHEAILEGEDE%EMP- . ,TpN.M1YVIOLATIONOF5EGT1�7031.5BYANYAPPLIGANTFORRPERMITSUBJECTSTHEAPPLICANiTO ,.Z RB-ROOf :�'. � � ACIVIL PENAL7Y OF NOTMORE AN FNE'HUNDR6D DOLLARS(SSoo�.): � ❑I,ASOWNEAOfTHEPflO�PERTV,ORMYEMPLOYEESWI7HWAQESASTHE1R501.ECDMPENSA710N, ',��'�� CQm1118fClfll ' � -' � � : ,�., � WILL DO THE WOHFC,M!D THE 9�4RUCTURE iS.NOT INTENDE�OH OPFEREO FOF SALE(SEC.7044,BUS4� J - � NESSAND PqOiESSIONS COD�THE C,aNTRACTORS LICEt.�E LAW DOES NOT APPLV TO AN OWNER OF = §,� � . PflOPER7YWHO8U11D50RIMP OVE$THEflEON,ANDWHODOESSUCHWORKHiMSELFORHEHSELFOH h)' � ��Z '.��THH017GHHISORHERONMEM,COYE�S,PHOVI�EpTHATSUCHIMPHOVEFAENTSARENO7INTEPIDEDOR m � � �� . Q OFFEREDFORSlLLEIF,HOWEVE 7}IE'BUiL01NGORIMPROVEMENTISSOLDWI7HINONEVEAROFCO!.1PlE �W,�,�,��,,jjj ��TO CO�NSTRUGT 7HE PRO.IECT SEC OW USINESS ANO PROFESSIONS CODEC7HE ECONRACTORS LF ' V8IU8Y1011 � �ADJ.AREA�� . .�.. . .. �I � . ���� �NIIIOCONTMCTSFORSUCH� �EROFAPROPEFTVWHOBUILOSORIMPROVESTHEF�ON,AN� � . � �, CENSE UW DOES NOTAPVLY AN O �,, '� f�WECTSWIh1ACANTRACTOR(SJLICENSEDPURSUqNTTOTHECONTRAG QUANTITY 'DESCRIPTION "' � "" ' �, . � FEE TORSUCENSELAW.). ' � � � ' � .. '�, . . . � 0'�. ❑I AM EXEMPT UNDER SEC. B.&P.C.FOR THIS REASON�� Q � ��� � "� ' ' � � i � � � � . .-.��:.�. ' ' � . I� '�. , � . � ': I u'� OAiE OWNER h' ' � W LICE�JSED CONTRACTORS DECLARATION W � I HEREBYAFFIRAI UNDER PEN ITY OP PEPJUHY THAT IAM LICENSED UNDEF PflOVISIONS OFCHAPTER� � � �I, . � �I�� p;, e(CAMMENCINO WITH SECT 7000�';OF DIVISION 3 OF THE BUSINESS AND PROFESSIONS CO�E,AN� k MY LICENSE IS IN FULL FOHCE D EFfECL m �^ I �� LICENSE CLAS _�LIC.NO.�.'- ��t��.�,���+.�� � � '. � � '., ���` DATE � CON?RACTOR 7�11/!� _i� - d . .. .�. . . - . , .' �I W. � WORKERS'COMPENSATION DECLARATION a 3L, I �N�� IHEREBYAFFRMUNDERPENN.NOEPER.IURYONEOFTHEFOLLOWINGDECLAFiA710NS: ' z �L"h� w � ' "' ��� _IHAYEANDWILLMAIM}I��INAyLERTIFICATEOFCONSENTTOSELF-INSUREFOflWORKERS' $ COMPENSATqN,AS PRlOVIUEO BY'SECTION 370o OF THE L46Oq CODE,FOR THE PERFORMANCE lU � � OF THE WORK FOF WHICH THIS PERMIi IS ISSUED. � � W' �I HAVE AND WILLMAINI�N WORKERS'COMPENSATIDN INSURANCE,AS REQUIHED BY SEC710N Q 37000FTHELABOR DE,FORTHEPERFORMANCEOFTHEWORKFOHWHICHTHISPERMITIS °�1�E'�'� �� ���� 159UED.MV WO S'�COM�/PEN�SFj71�N INSUflANCE CAflRiEfiAND POLICYNUMBEfl ARE: CONSTRUCTION +� C— '� 4 �yQ'��� CARRIER ��n"7lJ�� PLAN REVIEW � / _ � � � r}.��t d POLICYNUMBER �Z����' ELECTRIC G.7tJt� ..Q�,. . Ii .�, y ��Py ♦r,�y . , Q, (RiIS5ECl10;JNE�NOTiBECO�LETFDOFTHEPERMSrISFORONEHUI�DHED00LLAfiS(S1u�)ORLE55). PLUMBING 4 �7WfVV Lli(.,. '. . �g �� I CEFiTIFY THAT INTH'E'IPERFQHMANCE OF THE WORK FOR WHICHTHIS PERMIi IS ISSUED,I MECHANICAL � .71d�� � � (�. SHALL NOT EMPLOV�Y PERSON IN ANV MANNER SO AS TO BECOME SUBJECT TO THE N'�� WOflKERS'COMPENS IONLNWSOFCALIFORNIA,ANDAGREETHATIFISHOU.DBECOME INSPECTIONFEE �� SUBJECTTOTHEWOR ERS'COMPENSATIONPROVISIONSOFSEC710N37000FTHEIABOR �y �q �� COOE,i HALLFORTH ITHCOMPLYWITHTHOSEP VISIONS. ISSUANCE 6� �.(�4l 0. { e p. OATEa � � APPLICANT � � . -SMIP �� �� ENERGY P/C ! � 'JW'', WARNING:FAiLURETOSECUp�VJOR,KERS'COMPENSATIONCWERAGEISIINLAWfl1L, SHALLeE . �9pp � ' tµ'y'�, SU&IECTANEMPLOYERTOC IMINAIAENAL'fiESANDCIVILFINESUPTOONEHUNDHE�THOUSAND ENEFQYPERMIT L,id� '� DOI,URS(i1a0.0oo),IN PDDITIOPlTO,THE COSTOf COMPENSPTION,DAMAGES AS PROVIDED FOfl IN `�{/{ J���. SECTION37oeOFTHELABOR�� DE,'INTEREST,ANDATTORNEI"SFEES. RETENTIONFEE � I�' �Y v4P � �' �ON$TPUCTION LENDINC,AGENCY PRE-ALT FEE: �.i�'i, IHEREBVAFFIRMUNDERPENALTYOFPEqJUFVTHATTHEREISACONSTRUCTIONLEN0INGAGENCV - ' � �, FOR THE PERFORMANCE OFT�I E WORK FO�WHICH THIS PEflMIi IS ISSUE�(SEC.3a9],CIV.C.). � , , . . �, � � '., �. LEMOEFS NI1ME 1'�I, LENOER'SA�DRE55 ��' �;�', ICERTIFYTHATIHAVEHEA�T�iISAPPLICATIONANDSTATETHAT7HEABOVEINFOpMATIONISCApRECT. TOTAL FEES ����J�� - � ���Z,',,t���' � IAGpEETOCAMPLVW1iHALLICITYANDCOUNTVORDINANCESANDSTATELAWSRELATINGT06UILDING , . .�'�, �CONSTRUC710N,ANDHEflEBY�AUTHORIZEflEPRESENTATIVESQFTHISCOUNTYTOENTERUPONiHE � ,�,', ABOVE-MENT'ANED PHOPERT�'F6fi�.INSPECTION PLIRPOSES. COMMENTS -' ' - - �, ���A'� '���/'�� m PERMITTE�E(P�� � •"y /� /y L✓ �9 L ( �/y 61GNATUREOFPER1,91TTEE ��� DATE f � � �� � qECPT.NO. PAID BY �'��VALIDATION �a"' � ' '�. WHITE—Department Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENROD—File Gopy,GREEN—Applicarrt's C�py � ���� . . . . . .. . �� ' - ' n��.;.:«�...:.n;. , t.A�j,:... . . . .. . ���� � �� ��� � , . ��� "��� � � ;� � � � , ,. .. , . � �.,�� �`� .�," �" � � � .. � � � ,, � a � , �..� , µ, HI , ������'"ts � , , r�.���?'��`.�i�'� ' � �`'' ' ��`�.a�I�r'���€���°� _����"' � , �=[-�R�;�:�?��'� ; _�� �---p--��-^-ry^�y g�+ p-y �q �y -- _ _ _-- p�� �g g��-�p �q�q � ' ____� �k_�k.r9s59L"-,�.`+��4Jg�il�c�d . � 3 . . � 3 � 4.?V'Mvv3'l �6 V✓atllLj��tre; �'.�'-•_•,,�..�•.• $..P � t ; i p .���.. : _.v�_. .�,_�.-��.� ___�__. .^+� _ _ ---� ' �.�F°d"�Lt��?§-�t t�#t�"�"°��; ��c � E ��!'s�J �-? t"[�3�'7k�"'a�-+�.,��+,��};:" � �� � 2 '---- � , -�.-.- -� ..�_,..��_ :x.,._ ,— -----�--�-- a � ����p ���� .. � ��e�. _ � _ ������.:������3�'��`�,�1�";�� ' ' �V� _ � ���r� ����'�-� _� ; , s=',��-F�A�����1���.�;�� }._ _ � —�__. .._ - --�___ _ __.___ T __ ,_..._� � ��`J�'�€����,� '���� � LG � ( � ` ��8��a��. ��E�3`��:.�,�,9�� � �' � .__ ___- --- — r � ; -`rw , - ; _..�..-�-4 :s�'�~-~~ '-�-------_-- —�----�--- _. ,��_ �� ��;����'��+��4� ,� L � ,rt��s �tw"�s��+�Sa� _��=�^� � -�_ --- �'�i;�e�!��,�s'��,z.�i�.�;�.at�� 2� ` . �_i�at��� �'`����L�i�,�r��ra __._._.._�.w� - --� '�. _____m. __ ._._�_ .__. _..,_ � a ���F� ���� � _� .�_ _._ ---�- , � � ���� ����3��� i � .._ ;� __- ---__ — �-,- � � ���5,�'-����;1�s�ut-; �-���I € � =��y°^�?�'�� , � �, . , g � ���a�€��y����-;m� ; E i ���������,����°��� ; — _.__� g�+� Q�� g� , ___._..._..��r._g � __�____�._�.. � _.., '�4S?'axEA�O_„i �'y;.�x.d��03.�`^.� � ��'��"'.»�.� �j . �"F��7x�.2ai"a.2��.���ti� 3 . �.. � S, a d_,�� '�+/� l�,� ' '�' ,� _,�,_,,� r �� ....., "' � �,.'"_°"'-^^�,�..� � �.^^-.-- . � �`��'���T�`!�a����.���^!�`_f��l �....._ s {��C:;�" '��-�1t����� �" � ��� �_ y x � ���� ��� �� s� � _ �.___ _.. �.._ � �. F____ _.__ � � � �'�'�� ° �1���� �,l a'� -----,.-„ "� � ��",� v s���� E � ' � ( gg�, y (} �.�.��.�a.�_ �� � �.,d�s�.,.Pi � 3F�k��,d6,�g `+...�`!�`� � � brZ� ��1��¥U�@.a,T<, ,(. � � . I �� ' �. �.�' � �...�W���t g ��^{� ' ��.��w�p � ��`�*�: ;ds at�s s �r��_ � ' r € ��.��-�:����� � r k � � rv ...,..,....w.. � �4.Y i� � . � `4�x b.... ..._..as._..�.� .... ,: _....,.....,, �—:.... z g o- t�.�q�� � . ��,.s^9 �'' �Z � .. . e . ��. . .(�.' . . � �u� �. � , . ` t ) _ ?� �a � �_�' � �... . ___ �_.....___�__ ( , '� � ;�!���` �� ea^,�'s� ' �� � � ,_, { ? �.r't�`�'� `�.��",t�"�i�� � 3 � ,_.��n_.,..._�,._�..,v.�,...._....�_..��._.�_ € , :. : .__�___�.�r � g^�� g»^,g y � y »,._..._.__ _. ._._�.-��_.____,�,----� . ��,a3@;�.�P" Y"X��f�.. . .... ' '� 3 € 3 �f'V� 3 1 '�;�%f��..9.". � . '���� . . �,�..-i-.�.,,,...a Ei��� 7 g� g � ��..„.�"'.«` ��:�p� y"��� ,.. . . .. . .. t .. ' . .. �i����s-�6''F''4 .£.�,"€l��`'S� � � .,._....._,.�»�-..�..�^, _ ... ^---N ��� � � g g �^ �) e � � ��a�Y,�d.4.:r�..'�'n� �a .-,_ �.�_ �!1 �a�4..�. �..,.._.��__..�._..�.__..... 3 "Tt�,°G L i.v�� � 0.E"4f ^�__ � Y_J .. S ---.! .., -s,_ . -"""--.---'-.'"q �l'A,_v.�.,_l� t"��:a�. �'r"r�`S I"�'� ._...� �.. . � ..m.�. � € �w'l�t�i t��.l�+T."� r".�a��.....� .�..'.�.._. . ._. ._.. . : �.� � ��x*�4'�.� � ���"i�+,�'-...� .€"""� ., ....� .v..v_._.__. �( ���a� �'���w,.��'al''�._ _.., . . _....__. . .�.�.. —..�_ _ Y .�...�g .�.: �..,.. p, ,{�;,�� ,.�.��p_...__....:_.....�, .-;�--.�_"_"__..,m.._.�.�._,�......rq—�'.".-, _..�._._.._..., i-�....-.._...�_ p , ._..�...,._._,.._.__.-__.., j �'��de"�`:a� ..�t£�k"4gk,rt� € �.::�. .� ... � ; L.��'LI»3Y.A�# . � � � , .. . � 8 £ _�y............... �....,«..,.......... �+-..�.. & .�. ..�..w.�.., �_ ....,._.� .,i. ,�-�,.-..�-.:�..... .�...�....' , � ; C � � � € ! ' S ,_, _��_ .._ z } " _c� ����� �_._._.__,----.-.—!,---. ,___�� _..�.,�.. tt _,_�����..,�+��'���` ��� � � �a . . , �.._,.�.:._��._..._�.._..� _. :w.�� .��__._�_'..m._ � � � v _� �-.�� . � — _,... � � ��;`o'����� � "; � ___._,__-_.....�.,.,�.�. -w..�..-�--,-;,-. _..... _.._.,� r--- -U..`-~~~.j _.�_.. u_._____ _.�.v_._._ W.w .._ _. __ _...__..�.�.,�......, � , , ��..p..�-._.._ _..__,_. �__..__.. __,_��...__..__ __�_._.�.__.__._-.____...�.._. �_.V __; _...._._.-���._____�__m�, w._...,..:.._,�. �, _ � __-�—� _ _____ — _� j ��fi� ._ ._....�...�.... . � . . ...-._��_,.....__......................_.,..�._..�.. . � , . .,_ _ __w__..a._...»,.,_..�, ry { «._._.,...._.».�_.M.,.e....�.._�......_,,,a,.._.....�.s-.. - ....._.,..,.,..... ._._�..._�„ �, .._.��.._.,_........�,_.� ...,_.__....:� I;- ., e_........_-...e.,�..._,...._..._._, ar . - � ' . . . . . . � . , . �S . E ..�_.._. ,_.. .�._ � �.._. .e.._ . _..,_._.,,......�... _ __ _.._�......'^-.'I l, '._. . . . . . . , � �.......�_.,,..,,..�.... �..._.,.�w_.__..._._.._..�.�..ww..�._��..._-�-'- _ �. ____— ._ .� � . -„ - �� . .-..--.-� . i � ..,�.� _ . . �� , . .. . . .. � ., ; � + � .�.. , ...�..�..�_�.�,._.,.. . �"� �.L ._..._._�_—.----� . �.�..,.,._._,.�.a . . , . _ � � a . ., . ' ' � E ^�- .,...__. .__......._._..s._.�...„,.,..,...,. � .� . .,... _.._.._... . � . ��,� , , ����i� §.�E�"° �.ii°.� . � . . . . , . , �m 3 � ���.&"`�.r'��5fi`�z '�..9r,.�.-�':..�.........�... mx _. �_.. '. .. _..a»..�..__-..—..m , . . . � ..�.�.., i� � I � � � �� , � °���` " _� _._..�._.____�______ ___ __.._ _._ _ —� ___W ._____. �. �' ,�. � �.j , ;' � i��.� ��� ���� � .,.;�"�� . . . . . ,...,. ......�......_ ....�.......,... . -_._.._.... . � , ,. . .. _._.._ . � e �... � n._.,._�..,_.,.....,.,.._.�..,..�--„-._. ................... �........_...........,__.�_�..._..,..__,_�__..._._._. ��. .'�� � �f . ' � � � . , ���� . . . . ��. , ..... � °�4; :, . ?. � ,�2�� , . ; :, .. ........................_.....,._.�_�...�.�..�,--..,.,..�.....,.,.,.....�..w--,- ' �__»... � " ..�..�..�......�..-.....,M.. .,�,«�...�. � � t y s � A . . :. . . - ' � i ' S � �. '. . . ...� . _ . . � . A �;; , '.�. :. _�.._..�............._........<i____a.._�.._.�__�._......,,....._.,..........,�_. ,. � """--"---�--• g � :.. �... . -..: . . . � . , . . , . . � ,, , ,.�i � ��_ . . . I _ ' . .� � � �N � ._._....._........_........� . .. . ..��,,,,�..._ ',.�.�..,_..'. .._ , . . . � . ��, �� � �, � . . . . . . . .. � . � .. . . . �A;�&,. � _............._�...,v.o. _._._._._.,,,. .........�.. ..._.�.. .._ _... , .._.....-_i . .,�.��,.r. ,.,�,�:�..�.,..�,�.a....b,,,.�....xi�.,�......e . ,...:.� �� .�.�.,..�„..�.�.. .�:.�,.�.,.»..�,....,,w.>..���.».�..:���..«�,..�.�...�m m...,..,...,......«.