Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
13453
CITY OF DIAMOND BAI� "' C�,-!' �--�� DEPARTMENT OF COMMIJIVITY&DEVELOPMENT SERVICES _ . ,� 21660 E.Copley Drive 5uite 190 -, PRESS (909)860-3195 Fax(909)861-3117 A�°' __ _ -- _ , X , ,� BUILDING PERhIIT APPLICATION ' FIRML � r APPLICATION PERMIT � ( P/C a D R'ESS ��5� �i I�li� �FM�_ f' ��� ��`C5� DATE � �7s r ,r� NUMBER # � . ISSUE �/-�/�+ TYPE OCC p OWNER LOT', �� :�TRACT ����� DATE �'I �'�`1`! CONST. GROUP � " ADDRESS ' �c� s ZONING SETBACKS . Z ClTY �, ZIP.. b2 ..:,TEL."I)�^I� v'_,.� FRONT RW ❑ g APPiICANT,. I TEL: REAR ❑ , � SIDEJSIQE STREET RW ❑ a� CONTRACTOR ` SIDE ❑ , ADDRESS 4� . . �i 7(�� a ,CITY �ic3�l'�G� ZIP� TEL.''',�i ' '- PROPOSEDUSE �i} ��_��j 11A� �i�' � � �� w ARCH/ENGI �z DESIGNER , i UNI ADDRESS � NO.TS EL. STORIE NO. OMS � CITY � ZIP TEL. S . BEDRO ,O �WNER-BUILDER DECLARA710N �� SFR/AD�/REN1-- �� � �I HEREBY AFFIRM LINDER�ENALTY OF PERJURY THAT I AM IXEMPT�FROM THE CONTRACTORS LI- pESCRIPTION SQ. OR PSF �� AD�.AREAIVALUATI N�'�.� _ FT. FACT W� CENSELAWFORTHEFOLLOWMGFiEASON(SEC.7031.5BUSINESSANDPROFESSIONSCODE:ANYCITYOR " � Gdfd98/Cd�Ofi � '� U� COVNT`/NMICHRC-0UIRESAPERM�.ITTOCONSTRUCT.ALTER;IMPROVE,OEMOLISH,ORREPAIHANYSTRUG � �� ��W���� -.7URE,PRIOR TO ITS ISSUANCE,�/1LS0 REQUIRES THE APPLICANi FOR Sl1CH PERMIT TO FILE A SIGNED , w- P8Si0/OBCk I LICENSE�PURSUANT TO'7HE PROYISIONS OF THE CONTRACTORS LI- ��� �FESSqN5CO0E�OR7HATHEOf��INGW�THSECTION7000)OFOIVISION30FTHEBUSINESSAN�PflO- �� � POOVSP2 �� � ' CENSE LAW(CH�PTEFj 9(COMM SHE IS EXEMPTTHEREPROM ANDTHE 6A515 FOR THE ALLEGED EXEMP• �. U TION.ANYVbLATI0NOF5ECTIOr17031.SBYANYAPPLICANTFORAPERMITSUBJECTSTHEAPPLiCANTTO �. Z RE-ROOf . . I .,.I ~� ❑I,ASOWNEROFTHEpppHANFNEHl1NDREDOOLLARS'(S50oJ.): '� ' -�� � '. 'ACIVILPENALiYOFNOTMORET � I+ER7Y,OR MV EMPLOVEES WITH WAGES AS THEIR SOLE COM7ENSATION, Z � Commercial ,. WILL OO 7HE WOFSC,AND THE S�RUC7URE t5 N071NTEN�EO OP 6FFERED FOR SALE(SEC.7044,BU51- . J �, NE39 ANO PHOFES910NS CODE.THE CONTRACTOPS LICEN9E LAW DOES NOT APPLV TO AN CWNER OF '� _ � � PRbPEfliYWF108U1ID50RMP OVESTHEREON,ANDWHODOESSUCHWORKHIMSELFORHEHSELFOR � 'Q,'' THROU(YiFI15ORHEHOWNEM OYEESPRDVIOE�THATSUCHIMPHOVEtdENTSARENOiINTENDE00R "' m ' �.Q��, .OFFEREDFORSALEIF,HOWEVEq,TF�BUILDINGORIMPROVEMEMISSOLDWITHINONEYEAROFCAMFLE � �TION,THE OWNER�Bl11L�ER WILL HAVE THE BUFOEN dF�PROVING THAT HE OR SHE�I�NOT BUItD OR . IMPHWEFOfiTHEPURPOSEOFISALE). � � � 'W�'�i ❑I,ASOWNEROFTHEPRO�PEijTY,AMEXCLUSIVELYCONTRICTWGWITHLiCENSEDCONTRACTORS � . ���� _TO CONSTFiUCTTHE PROJECT(�EC.7a4t,BUSINESS AND PROFESSIONS CODE:THE CON7RACTORS LI- V2IUBllOf1 ' ADJ.AREA � � � ��� I W�' CENSELAWDOES�NOTAPPLYTQANOWNEROFAPROPERTYWFI06UILDSOftIMPROVESTHEREON,AND , ',,;�i� 'MRKICONTRAGTSFORSUCHPflQ;lEGTSWITHACONTRACTOR(S)LICENSEDPUFSUANTTOTHECONTRqG QUANTITY DESCRIPTION �� ' � ' FEE .':�.'. TOHS UCBJ5E UIW.). i'. .. . . . ... ' , . . ❑I AM E%EMPT IINDER SEC. &&P.C.FOR THIS REA50N Q � � � i W i H DATE OWNER . � .Z�., ,.„. .. . .. . , . 1U . '. ', .. � . , i �' ,UCENSEDCONTRAGTORSDEGLARATION .�W . '�� �� �.. I', � INEREBYAFFIRMUh�ERPENALTYOFPERIURVTHATIAMLICENSEDUNDERPROVISpNSOFCHAPTER - > � � �y p��� .Y(COMMENCINGWITHSECTfJN 000)OFOIVISION30FTHEBUSINESSANOFROFESSIONSCODE,AND 'Z " �I a.a`� �'� . ?{' MY LICENSE IS IN FULI FORCEA����.EFFECT. , � � � ,4�� � � �� I LLI � y� � e '� d" UCENSE CLASS � ib��. LIQ NO. '� -���� � � �� p_ r� ' lS� �� ��-� /�:� , �, I,, -���, DATE J � � CONTRACTOR �:.. � � AI�.� J� � � . � ['���:� ...�. I �. WOR}�EF15'COMPENSATION DECLARATION � � , ��' IHEREBYAFFIRMUNDERPENALTYOFPERJURYDNEOFTHEWLLOWINGUECLARATIONS: z � ' �i �, _IHAVEANDWIILMAISJT YJ'�ACERTIFICATEOFCONSENTTOSELF-1NSUREFORWORKERS' _ ' ' �� COMPEN9ATION'.ASPR VIDEDBYSECTKKJs/OOOFTMElA60FCO�E,FORTHEPEflFORMANCE � �i Q OFTME WOflK FOR WNI THIS PEqM1T IS ISSUED. � � �' _I HAVE PND WILL MAINT IN WORKERS'COMPENSATION INSUpANCE,AS RE�UIRED BY SEC710N ' Q 370a OFTHE L4BOR C0 E;�OR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS . ISSUE�.MYW05KER5'�MPENSATIONINSURANCECARRIEFANDPOLICYNUMBEHARE: CONSTRUCTION ! a . . ' . . . . _ ,, . >. CARRIER � �i �'�Ci��M�9 .� PLAN REVIEW �I � POLICY NUM9ER ' � e ��� ELECTRIC s� �, 0� f��ssEcranir��woisiEW�rmofn��wxr�srortaueHur�e000uAr,s�Siao�oA�Ess7. PLUMBING � �c�i�F ��l.f' � I CERTIFYTHAT INTHE P�HFORMANCE OFTHE WORK FOR WHICH TFHS PERMITIS ISSUED.I MECHANICAL . '+,��, _ (�' SHALLNOTEMPLOYANYPERSONINANYMANNERSOASTOBECOMESLI9JECTT�THE � � WORKERS'COMPENSATIONLAWSOFCALIFORN�A,ANDAGPEEYHATIFISY.OULDBECOME INSPECTIONFEE -. - '�' SU&IECTTOTHEWOFK RS'COMPENSATIDNPFOVISIONSOFSECTION37QOOFTHELABOR - �✓''',� �y�..'` . _� CADE,f SHALL FORTHW H COMPLY WITH THOSE PRDVI310N5. ISSUANCE � �Jt-S. �°�`� �-�- ..o �SMIP '�. . -w�"�.;�..F,� �' DATE ' ' � PPIICANT. '. J' WARNING:FAIIURE TO SECURE ORKEH3 COMPENSATION COVERAGE IS 11NLAWFUL,AND SHALL BE ENERGY P/C _ '✓ � � � �3�� ��� SU&IECTANEMPLOVERTOCRIl�11NALPENALTIESANDqVILFINE3UP700NEHUNOREDTHOUSANU ENERGYPERMIT ��� �' 1 T.�'"' ��':,Wb y„ DOLiAH5�5700r000),INADOITIOI�ITOTHEC0570FCOMPENSATION,DAMAGp'ASPROVIOEDFORIN -,;�.a J SECTION37oeOFTHElA80R DE,IN7EREST,ANpATTORNEY'SFEES. '^ �::q_5.�, � � . p�� �R RETENTION FEE: �r ��"E�� �- a �C�NSTRl1CTION LENDING AGENCY PRE-ALT FEE: ��u� ���':��µ� O � IHEREBYAFF63MUNOEftPEN OFPERJUPYTHATTHEflE15ACON5TqUCTIONLBJDINGAGENCY `��qti+'�' � - FOfl THE PERPoRMANCE OF TH WORK PoR WHICHTHIS PERMI715ISSUED(SEC.3o97,CIV.CJ. , , W' I '�.� LENDER'S NRME I�� , ' � � ' ��,F- LENDER'SADDRESS �:W�� ICERTIPYTHATIHAVEREAOTH APP�ICA7IDNANDSTA7ETHA7THEABOVEINFORMATIONISCOHRECT. TOTAL FEES � °7.+��:��" , � , � �.,� 1 AGREE TO CAMPLY WITH ALL C 7Y AND CAUNTY OR�INANCES AND STATE LAINS REUTING TO 9UILD WG �. ' . . '�,� CONSTRUCTION,ANDHEREBV TFIORIZEREPRESENTATNESOFTHISCOUNT/TOENTEAUPONTHE .. , , ' - � ABOVE•MENTIONE�PAOPERTI �RINSPECiIONPU{iPOSES. COMMENTS - ' - � l�iP�e'rsf i 8,�_ t,�"��. b-���,c„� � 'm PERMITT AME(.RI ' . .. . . Q � , �.� �/���� � �. SIGNATUREOFPERM �ATE ' � � _ � . . RECPT.NO.��f ..� PAID 8Y yALIDAiION� � �F'' ' � � '� � 1HHITE—�e artmentCo YELLOW—FinanceCo PINK—Assessor p py, py, Copy;GOLDENROD—File Copy,GREEN—ApplioanYs Gopy I ��� �� �� � � � ��� ��� � � �� � �m , , � � �_,� � � � � . � � . �, � ,: � � � � � ��� ��€��� �_��^ i ��� � ����� _:���� - i . j ; ___-. R :t��1 �",.°�,�r��t a�"`�"t � � � S 3"}'i'�,�r�I�C� ' ; -� , _ , �=�.�'Cul"�€r�" ��ifl�a�`s� i �T-=----�`----- , —�I ':M.li�,(s�.p �� V:€��8`�'-a`��IvT � ��_9 p ;f�. sq ��5 .'.�..�__�__a__ � �p p�, $ @9+�- ����� � #� '�:!��J9��t- ?,.`irP:�:I�A�� , � � j �i.,i*q4rv�'Y.."�-Y��5�5�1§�8_S�F . ' , .; ",..,....,........ �... . � � ..• . . > ............._.;m... '.«„p ,�`,a����dS�.r� E i ��r��'"��.�ti�'s�.��.°".F�.t��.�i I!C,,,�=t"� ,, ..` G � � _�_.__�_. ._,_ �.. ���—m' ---�+ _ ����� r�°��iF�mm_-__�__._.---�- 6 i �€i��"��,�.�c��sv���"�'�r� . � —�—,� ----- =-- , _... �g���-��.�c�;�l€;E� � ^�� � ����1�~'€. �a€��JC�€��:��t� - ; ��c�� ��:��=t�.;}�?��� d' , ' i: � , ' �F`1" ��:3�i��?��i�t —._ �,� � ���. _..._ � _ � ` ,.�..,.�.. � ������3�r��..N�`���.�,����:a�� , � �� ;A��P��ca�€��3��t�[��;____—�__ ( � T . . .��...�. _.. , ,�,�_._._,� q 9'���� ��d��'S' . � i�Y�r- �..��;��9�wi.-a _ _._._.._...._.. �- .�.„..-� � �n,w ��,�� � �'°' �%'"�`Y'�r' t ... ( s . . .. . .i , q � s^�.,� S`�a��.z�' .�� - 1 � � � � �6 �1a �'?Ii'ti'� � i _ � ,.._..._.,_,.a ,� ____._�_.._.—.�_._.�..��`." � ����+.'�a"�� ,..a �.. . .. . . . ��.-� --.��.` .... � °+-.g °- �.a �� �j� � j r���.:�4� .,� 1`'a�,��� � ���..�.� � �i�` ?�..�t"[F�. :�`v�E�.'a?,��..-t _��_.�.;� �i--��"'� � , ,,.____._ � . �i�7`3 i""��'d�;n�a..�b��a�-� ................�_� � .._...�.....__...__�.,.._.n._....,.-.....� �.`""-"----^ ' a �.-'�'��`��i�'� E���' ' T' �C,`�`� �L��'=d�^ v'(m_ „ : p �::iC 3�����€���R � � c � i � �'�'�?`=��C;1�3� _...�_..� � ��� �..__M �.. �.���___��� __� t ^����.�G..a� a��i,✓'�'`� . ( � � � ...�.-..... 1 � ��kY..3�..�t�'�s�'}� � . � . . 1 [ gy� *�'�+°° ,p'qg,� g �a 7 ' �../A=3'^ 66V1� ��S�a'�..dk���'k Q4n��� � �� . t ��� `G1'p �J&���k�r���,��,._....�_�- ! � �.Xi���.e'..�G Z7�t��°_.,SE.7, ..�.......�..�.............«_...�...... ;.�.........._ ..,.....�..,�.m.._. � € '�s.d bd��y�°�&s. . � ".m....._.,.`_.._....... � . .. ..�,.a.v '-•X t ! � i �'.�....v- ' « .�..�.�.« ...,.,...,..j.,...._._.�.......m...._.�....,�..............�.o.��..u....W...�......,.�...,......�. ...«..,. p r�,N. ' .m»a......w .___._.�._.. __ _...m.3� .I��'���� .€ � E TX�&'2��.9�1'!y5 _ � ..,._ .�.,�--».�--...� ' . ' , . . `'��. § p ���w �^ p^n,s�p^y�^ � �I� ��,�.����.F .��'c�@S��...,......,_..�.,.,.,......._..�� ,.,..._ 3 �T dm.J"���3.�`"$l,rd'^xz u.=.��b-1�l�e��...,,.�..,........ ), .,...,_ . _.....,.._..._ - �6 3 � '_"i . _ q � � . . C, � 6'i�`!"'°�3 ^���-F��,� . .j....,................ . . q �z7�2�� s�. ���S�i3L� � . �..�.:.w._,.,.��,. . . . � „� � t.�'":*$��;� .�,.t..�y•;" . � �j � �° � � �.a'°�� '�..1"� S'� ____W_._ ��.. �...�_.._..._ �..___.._.............. � ���_.. .�,..1..� � ._�w.. ..._.,.... _ � � �! � �"��� i� ��'1��€,_._.._ _..�i_ � . __, m._____ �rt`�` �'�`r��` r d`"'l-�� i I �i �w..�....,� �.�.,._..m�.�,� ._».�.__�_. .�. i.�.-�m_. .�. ,,._ .. j.__s __v.__m. � .�.�_.._..______ __....._.,�,,,,�����t 7H[, �tv �� F°� ��""�i S2`m6.A � � 3 tl&�.:�:�... �j �r pm4�+�@,.�e��� ............ . _t � ..�.�...a....� a �y E��§ � ._.e.�.,.`._..........„.._.,....... �9.�Ma ;.:im4*;�___��� � �=,t. �,_�ws�:�� ___� ._.__._��__ ...�_...___-��___._.y � � i �`°��.,-�.. �'����$'�-„ m _....F..7...��6��C��.. ...s...�.,..,....,.a..,_, i _ t � �"i�"'�t f�;$`'. , . . �.,....,________..Mi— . .. . . . ; � �. . � � s�..,...,.. .��-�-.:-._,.,�..�. � .�. . ,_� � ��� '" � � - .. �..�.,.. �,...�......_.....�.,..��... ....,.....�.._._. '. ?�M'. € — ' - .,.�.,�. �� � � .. - .. ,�....�_ . .� .. � ,_ ..� .._.... ..._. . - .. - . � . .� 3 � ���+� ��� ��� � ` �, � j � ,.��,�_._,...�___�_..�_ _..._.�.___._____.�..� ._.______ > �a�"��, . � • :�. � �' -- m_ ,. � ', - _ _. , , __---__--__----� , K m��'e1����:�,��'�' _ a y : };r.�, �a .� _.��_..._m_._,._a. _...�.... .,._ ...__ .... __V.�.�._....._,_w .. ����_. ___�_-� �!_:..�. � - _� ��o._.�..._.... _.ua.._.._ � � _.�._... ..� �_... � �", �� �.�.._ ._�_..,__._ _._.__.�__..�___. �. __.._._ _� �' - �_e.............��_ W..._..,.._.,..� .�.__...____ ._ -- - -_______._'_—i ;� �.....� _�,,.._..,.m._�� _ .,�_,_.W.�. __.._ ._._._._.�._..��__.�' �; . .___. �_. ____�__ ._._.._.,,____�_ _ ..v.�___.... � _ , � ._,_. .�...�.�....._._. �.�. _ _�-____. ..�.._ �.�. i S----°�--� a � .v_..� .� ._,____.._.m�. _�. �.. . - ! � � �s����1„� i���}��::°� �__.�___.____.� _._--,- __ .._._ _ _� � ����,'���.��i� ���.��" _Y._..__�� - _....�,.__ . .�,,_, ._�....._ ._�__..�_ _� I � ���� & �'� � „ �`w� �:. #„, �; __� �,�..�.__�_.�� i _ . ,_ __p � ' ..:: k ���'� Y�` � tl � P�-� � �..,� a y� : __ ��.____.�__�_�_,�..�...,w..�._. � � _ _�,_._ � k -- — ___— ____..__ �.__._.._._ __...�_.. ..� R �:'' P �,«....�..,,+......+..�.�..... . ......,.....,..................v ..».._..�._ ,�... �........m.r_�r. _�: , , . ,. �" �� 6 x . , ,: . , __._� _�_._���. . � , ._.__� _ � _.� � .; • � � _ � � °, ....r_� _..�....�:���,�_ . �._..� .. __ �..,__..�. �..� � �` A , � . � , . , � � , m__ � .._, � � .��,._._...�