Loading...
HomeMy WebLinkAbout17332 (10) ,.�,� CITI'(yF 17If+,MOND BAR �,t — -�-- i3EPAR'd'MENT OF C�MIVI�JNITY&DEVELOPMENT SERVICES �`'i 21825 E.Copley ihive (909)860-3195 Fax(909)86i-3117 PRES$ Bu1a�D�vG�Ea�T��L�cAT1oN FIRMLY a ADDRIESS � I' � �`'� a Y^ � DAPEICATION �.�ti�� NUMBIER� A +���lC �1�� �� � — ISSUE i /�,i TYPE OCC °�° APN L07 TRACT DATE t ' CJ' CONST. GROUP °C OWNER �� ��7 � � C� O o ADDR S � ZONING SEfBACKS Z CITY f � . TEL. ,� FRONT RW � o APPLICANT TEL. . �� SIDE SIDE STREET RW ❑ z ¢ CONTRACTOR SIDE ❑ � CITY Y� IP � �TEL. � PROPOSED USE 1/ � � w ARCH/ENG/ �'a�, �,�, z DESIGNER .��, P��� 'cJ�' �' i���� �' 'ADDRE � �,.��+ ND.DWEL. NO. NO. � UNtTS STORIES BEDROOMS n 'CITY � �. ZIP ,��TEL._,� �� cn DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION �, OWNER-BUILDER DECLARATION SFR/ADD/REM O '�p I HEREBV AFfIRM UNDEFl PENALTV OF PERJURV 7HAT t AAA EXEMPT FAOM THE CONTRACTORS LI� , G8f8Q2IC8�pOf[ �.W '.CENSELAWFORTHEFOLLOWING�REASON(SEC.7031.5BUSINESSANOPflOFES510N5CO0E:ANYqTYOR (n � .U� CAUNTYWHIGHFtEQUIRESAPERMITTOCONSTRUCT,AtTER.IMPROVE,DEMOLiSH,ORREPAIRANYSTRUC- ,�w'. �TUfiE,PRIOR TO ITS ISSUANCE,AL50 REQUIRES THE APPLICANT FOR SUCH PEFMIT TO FI:E A SIGNE� W Patio/Deck � .,� ���SiATEMENT THAT HE OR SHE IS LICENSE�PURSUANT TO THE PROVISIONS OF 7HE CONTRACTORS LI- '�.',CENSE LAW(CHAPTER 9.�CAMMENCING WITH SECTION 7000y OF�IVISION 30F iHE BUSINESS AND PRO� LL POOUSP2 O ,F�SSIONS'COOE)ORTHATHEOF'SHEISEXEMPT"fHEREFROMAN�THEBAS;SFOftTHEALLEGE�EXEMP- (� �U.;'��'�TION.ANYVIOLATIONOFSECTION7�31.SBY�ANYAPPLICANTFORAPERMITSU9JECTSTHEAPPLICANiTO Z Re-Roof ,�� �ACIVIL PENALTY OF NOT MORE THAN FIVE HUNDRED DOLLARS�E500J.): :�Z , ❑I,ASOWNEROFTHEPROPERN,ORMYEMPLOYEESWITHyYAGESASTHEIRSOLECOMPEN5ATI0N, ❑ COmm0ICi21 . - � �'WILI DO THE WORK,PND THE ST)iUCTURE IS NOT IN7EN6E�OR OFFERED FOR SALE(SEC.7044,BUSI� ,J �.�'.��!�,��NESSAND�PROFESSIONSCO�E:�TyECON1'RACTORSLICENSELAWDOESNDTAPPLYTOANOWNEROF = ��.PROPERTY WHO BUIL�S OR IMPROVES THEREON,AND WHO DDES SUCH WORK HIMSEIFOR HEFSELF oR ��' 'I THHOUGH'HIS Oq HER OWN EMPLOYEES',PqOVIDED THATSUCH IMPFOVEMENTS ARE NOT INTEN�ED OR m �'W�. ,�;pFFEREDFORSALEIF,HOWEVER;THE9UILDWGORIMPROVEA�ENTIS50L�WITHINONEYEAROFCOMPLE� �'� ;TION,THE OWNER-BUILDER WILL,HAVE THE BURD[N OF PROVING THAT HE OR SHE DID NOT BUIID OR ��,; ',IMPROVEFOATHEPURPOSEOFSALE). W .. ❑I,ASOWNEROFTHEpROBERTY,AMEXCWSIVEIYWNTRACCINGWITHLICENSE�CON?flACTORS \ IQ; '.,To CANSTRUCT THE PROJECT(SEC.704,4,BUSINESS AND PROFESSIONS CODE:THE CONTRACTOflS Li� Valu8ti011 .+'S B . ADJ.AREA W�. .CENSELAWDOESNOTAPPLYTOANOWNEROFAPROPERTYWHOOUILDSOFtIMPROVESTHEflEON,AN� � _"� I'WHtlCONTRACT5FOR5UCHPRO'JECTSWITHACONTRACTOfI(S�LICENSEDPl1RSLJANTTOTHECONTRAC- �"'��'.,'�roasucENsei_aw�. � QUANTITY DESCRIPTION FEE �.,Q� ❑I AM EXEMPT UNDER SEC. B.&P.C.FOR 7HI$REASOtr' U � p �. � '�.�ATE OWNER F- �.�'..'. . .. . W .� LICENSED CONTRACTORS�ECLARATION W��� � r¢ ���. ".I HEPEBVAFFlRM UN�ER PENALTY OF PERJURY iHATIAM LICENSEO Uh�ER PROVISIONS OFCHAPTEfl � � � �. ,'9(COMMENCMGWITHSECTION7000)OFDIVIS:ON30FTHEBUSINESSAN�JPflOFE5510NSCODE,AN� z �X, �MY LICENSE IS IN FULL �flCEAND EFFECT. � �� � r-p m � 67C.i �I b'�, �IUCENS LIC.NO. _ �� �'~�',.'i��,.DATE CONTRACTOR_ d LL] . /. �, WORKERS'COMPENSATIONDECLARATION Q � ., '��,;'� I HEREBYAFFIRM UNDER PENALTV OF PERJURV ONE OF THE FOLLOWING DECLARATIONS: z ��.iZ''�,;_IHAVEANOWILLMAINTAINACERTIFICATEOFCONSENTTOSELF-INSUREFORN/DRKERS' ¢ ,¢� COMPENSAiION,AS'�RROVIDEDBYSECTION37000FTHELABORCODE,FORTHEPERWRMANCE C.� Q OF iHE WORK FOR WHICH THIS PERMIT IS ISSUED. � W I HAVEAND WILLMAIryTAIN WORKERS'COMPENSATION INSURANCE'AS fiEQUIRED BY SECTION iQ,'�, ;.�370oOFTHELABORCO�E,FORTHEPERFOqldANCEOFTHEWORRFORWHICHiHISPERMlTiS � ISSUED.MYWOFK �MP NS TIONINSUSAffCPCARRIERAN LICYNUM9ERARE: CONSTRUCTIQN ���� J � . �I.?'. cnaaiea PLAN REVIEW . u Q ',Z' POLICVNUMBER ELECTRIC e q !¢ � ',�0`, (iHI55EC710NNEmNOT�.B€COAAPLEfE�aF7HEPEW,1fiI5FORONEHUNDREDDOLLARS(5100)ORLESS). PLUMBING �3 a� � IZ�" � ICEFTIFYTHATINTHEPERFORMAM1'CEOFTHEWQftKFORWHICHTHISPERMITISISSI;ED,I MECHANICAL � g,._ ,+� ���C.�J SHALL NOT EMPLOY�ANY pER50N IN ANV NANNER SOAS TO BECOME SUBJECT TO THE �Uj; . WORKERS'COMPEN.S'ATItlNLAWSOFCAt1FORNIA,ANDAGftEETHATIFISHOULOBECOME INSPECTIONFEE � � SUBJcCTTO THE RKERS'COMPENSATION P O I51'�'�'�5 SE TI4�14 970o OF THE OR - �''^" Q COE, PH„A, O WIHCOMPLYWITHTii E �SIQ75. � p ISSUANCE ' . ) R p �DATE:6 �C^e". ',ApPLICANT: ` SMIP � g. �J� '�,J ',, WARNINGFAILURETOSEGU(lEWORKERS'COMP�NS0.TIONCOVERAGEISUNLAWFUI,ANDSHALLBE ENERGYP/C .;�"',�,,5U8JECTANEMPLOVER70CRIM�NALPENALTIESAN�CIVILFINESUPTOONEHUNORED7HOl15AND ENERGYPERMIT "� ,oOLLARS(E7oo,o00).IN AD�ITI�J SO THE COST OF COMPENSATION.DAMAGES AS PFOVI�E�FOR IN � �iSECTION37080FTHELABORCObE,iNTEREST,AN�AT70RNEY'SFEES. ""'�"► O�C� .� � RETENTION FEE: ���r � �,� CONSTRUCTIONLENDINGAGENCY PREALTFEE: �t � —� '�'�'','�,'IHEREBYAFFIRMUNDERPEMl�LTYOFPERJURYTHATTHEREISACONSiRUCTIONLENDINGAGENCV 0.:''',',FOR THE PERFORMANCE OF�THE WORK FOR WHICH THIS PERMIT IS ISSUED(SEC.309],CIV.C.J, p � I ���I �LENDER'SNAME \ �, ����'I�,',LENDER'SADDflESS ,{��`�, w',I�'�.ICERTIFYTHATIHAVEREA�THISAP7LICA710NANCSTATE�-HAT7HEABOVEINf�RMAiIONiSCORRFCT. TOTAL FEES ��/\`�J� J �V`}� _—' � d i 'I�AGREE TO CAMPLY WIiH ALl CITV AN�COUNTY OROINANCES AND STATE LAWS RELATING TO BUILOING �� ' Lp"� . �._.L.i,i�,;CONSTRUCTION,AND HEREBY AIf�HORIZE REFflESENTATNES OFTHIS COUNTV TO EMER UPON iHE �y a � ��, �",ABOVE`M�NTIONEO PROPERTY FOR�JSPc'CTION PURP,OSES. COMMENTS ���-' �' P� Y� �.�� �' i' 1 I�', ''i.'..PERM N dE P 1 ) ,,�C/h'','I . �, lil'SIG E � ER EE ' D E �, C flECPT.MO. PAID BY VALIDATION � ~ WHITE—De arlment Co YELLOW—Finance Co PINK—Assessor Co GOLDENROD—File Co GREEN—A IicanTs Co P PY� PY� PY� PX PP PY . r � .� . .. � "� � � -� ri � , _ � ': � m. � � . . ,� � � � :� � � � � .� � � � � � � ; �� � � x. � � � � � � � � � ';�t �"� '� 'S C� � ��` a �. ,y � >'� � �: s� � # '. � �€"� �' � � a � � �. � " � a� k', � � *�€� � x r, ���`��9 a ��'+ 1 � w i; � "a i �'a �'� a a w,� �,y � a�.3 a k� � ,�� � a�a g 4 a��r�i�� a w,�.=�.'��,x. �5r..��i a.:.� ., d ^. �4��..������.� ....x v_ ° , ,.� '� �. "� t.x '�a .'�.� .. � .. .. _:�,,. s.. .. .: �m.. � .. a.p .,..w.a.�",s_g.a.�. ' � a . �-.^�- ��.�. . _ � . ....r'-� ! ) � � ��„ � � � � � _ ._. ._ _.. _.�_ ...,.......... ..., l .._ . . .... ....,., .. ._._ ....._ .. ......... . .� �py / S �� �1 � �'4 3 � /�/�� � � � � 4�.� i?.., t E .... _._. .. . .._.. ..�... .. .. �. � � .._ _.• _ ...._...«f...,....... _. �. .. . . . ,.,.. .__ _� � �` � � .te''°1���/ m �- ,' � �; _ - --_ __ ____.____._. _ ._._ _ ? ' � k � v.43� t ..� A��vq y ..... �.. � .. 3 „ ._ .. ...... ....._ ..... —...__.. ��f �- ._...,.-c �� E/ �-�- -- -� '-� �1.> r.';� :, � .-� .� .; , .,: . �. _.v. ... ._.._ . . _ ...... ._......... ,...._..._._., __...,...,,,....... _ ...._.. � �-.__ _ ... _ _..._.-' -___.._ . .._.._ . --.......—.�. ...�...� � 1� ;-a �.:' � �. � {� .t- ��� : � � ._,_. � .......__... . .........__........,._... .._........ ._......,...._............._.«..__.._..�.. .... _ . _.........._....,_ ......_,._....�..._..._...._ i ....._......,........-_........_._.,_.._..........�. - � �` � �! :� `�a .: , �'� � �; : .... ���...w.. �-�;.� e� ��� � .� _�..,. -_ _..._.� . ............... ....._..�.._.,._..................... �....._..-._._, .... �. _..............._.. _, E ........... ..._,........_..�. .�........._.._..__.._...__....__........ ...�......... ._..�.� ,.� � t� ;,',"'� 4: 4_;:t p �'� , ( ,' e �,�. 4 � ,j .. id_..............._..._...m,._.....:.._..._...,..__.....' ._.�.._.._..._._ ._........._._..__,._..__.. ._.__._.._ ._.._._,_ . _ .�..._._�..._._..__.._._......................_..._.._ 1 .n , .. € - ,.• -.. . . _.._._.._..._... .i .._._,._._. .._._....... ' ..,4.:., S� .I.II C 3 p..a q� 1 ��;, f 4 ,.��.a �� .."'.C-.. .._ s.............._.._.._ __.__.. ....._........_..........__._......_,.._..�___.__.__ ..._�...� ,__ .., ...... .. .. _.,... ...._.... .. . ..... ...W . . � .;,� ..:� 1 : € � :: } „� E . � . � ..�__�_.v.......,......-.,,,.....__...,_. . ..e. __._..._.�",�........._..............r....... .4........>..._.�....._....___,.,_._,.._......,....... �..._._._.._ .._ _�.....,......_.........._..___,_.._...m-�-.._.............._,.................._.... .-.__._..__.,._...,,.,.._..............,....._.....,,.,.._.,�._..................( ! � $ r.. _ � ' p`.,'„. ,,«. . .,.:��;. '.�,a� �,:;.:..�. j � � �. � ,' : � ..,_ _._. ...�. ,.......�.................._.. f __. �..._.._........,,._....._...,..._.._..,_.___._._.._._._..�.. .w..�.........,..._.......,..... ._;-...._.._�...._._._._'__.---.._.............._.,_.,.._......,„�_...._._ ,....._..._.._._.._._.......... .. .......__...._.,._:.._._..._ ..,_.,._..�..._.... . ._. _,_ .__ . . . :»,: o- ��, p� r�",,,.; ; . ; - ���..;' ' ', �� s..x. �. �:�,., tr .;..a .� , ....7 .:, ,�! �.i.'__.__�_____.__. .� . .r,......_..............._._.,.......__.__..._.__.............._,,.,,......_......_... ..__.. ._.. _ ...._ ....._.... ......._,._......._.�......__..�___......_.............. ..... P. .tl�' �3F .�. } 3 ......_.. � '%�?,r�x.. .i�. � ..� .m w.. .i..,. . .. . ..e .. ...�.. _....�..W. .. .. .. _.._. __._.� ... � G,o t € i _.. . ... . 7 ' " I I C.y 3 �� ls �� € , ,. � . ,... , � I r f a ... i � . . ...�, .. . § .... . .... ^� . .� € fmm t ( ' µ J I ! " � � � � .., . .. . � ..�_...... ......,...., -. . ....�.... . �._ ---� 1 �� ; � . . ___.__ -���2�� : � , c ;�._ _____�.. . .___.____.._.__.._ _m__ : _ __ — — ---- __..__ � r� �.. � � �,� , �� ,� � p � j ..___.._.____ . �.. _....__.._.._ __._.._....____�._.___�._ ... ._.. :..._.__ ._ _.__.... __.__..__,__W�. ..___ _ _ ___ _ _..S . ; ,�?fi. a .,� � �.. �,. _'I'.,�? 4�..a... � A _ E _�._ d _._,_;� __._.,..__.__.._�__ ._e __._._. .. ..__.... ......_ , _..._ ._._,.._.� ..._..___ _._. ..,,.___._. ____ ..�______�.��_____.___a c��,�� . � � ; � ; ��4�� n �,;,:. �_ � ,: _,: _� - • ..__._ __._..___.__;_.__.,__ _._.,.�_.__.e .�_..� ,__...�._.._,_._.__,._____.__.____, ._._ .--;--___._ ._.._ ... _�_.. ____�___..__�__� � � .� 6 6 . � - � °i� � " �.x S`:y . C. � :.� i, i 2 .... € -." ......____'""_ __......._._..�.._._ ..... ....._..._.............�,..,, �. ..._ ._... _�..... .......,..,..�......,....._..w...._.._ .................._...__..._._._ � ,_ ...... �. � ,».�'. a�.,....,._. I . ` ` � � �...€�a , § i�. �;. � E ...._....... _ .__.._..__ . ..._ �..... ......_.............. .�....._...._.._..._-..-__......__._......_.:_.......,..._...,. _ _..,...................._..._. ,,........_,.........,..._... ,_.......,,,...__.,...._ _ .._..........._........__..._ ,.". m � � ,"'3 a.>.w.���°,,. �,.q �� � r r .�l s � r :�i. �,m. ..x � € � r � ,ti�.. $ . . _ � k ....�� .�.. ._,_._._ ._...._.M._.__._..,._ _._ .._ ._ _.. __.�__e. . ___.._„� _. _.._.V___._.�___._..... ... li _ ... � ._._._..m.. �-, m �r ;� i;, �, � ` � :,, � � i ,. � : � .._._.. ._. ..._ ._.�.__ . _ __.___ � �__.__.__ _._,�_� _ _ .._____--�..__,, ___.._ € ��., � .?� r r: '_� �i �'"a k�' - � . "= -. , �'I ,E �__..._._...�..._._..............___...._.....__._.— __ _ ._..._.__'_'.,�_ ._,�....��._._._......._.... _ ._._...,...___�..............�_��_ . .,.�,.._..,...., _-�..� '.? .„N { .,, .�,._._.._.._..._.__..._...__) � 't � -�� f.�6.7 ' � ,,• 3 '� , ...:.: ,.,v : � i �' :t��. a ",..,� - . tt ._ _.. ..... _ a_._ .._.....,....._._._I._,._.__��._._......................_._.........._...... "' ._..........,............._._._...___��.�._ _......._...._................. ........,....._......_..,...._....._.,... .. — 7 s r.� p .,q r � ��,„ ,,. .' im � i ' I m_�°��� � �_ 0 . k,vu �. . :,,..-'x.i.a, -�F I I .......,.,.. .._......_. __,.___.._..�........._._.._.............___........... � . .._. ......-._.....,........ ._.......,....__...-....__........ _...,,..�.........._......._..... ............ .__�.. i . . ........:........._.....,...................._..............,_........».,...........,...,.__.�._. . 9_._..�..._. ._.._.f_...._.___._..__..__ i � ...._._ ._...._ _ ..,..._ . ._ ..._ .._..... :� a e g:�" 'a : x < � " -� a . i 1_. � ._..W_m......_._..................._ .. .. . . . . . . , ,. . � `�'�� � ,°''"���;';,���:����..�#ax,�•",.a.=.�'.a�.�._.w.........._..._........................�........._.....,.__......__._�_.__...�..___.___� ¥ '.__ ..M§.u:'.'4 z_�,x _�d �...,...._....m..._..................«.,....,..,._..,.._...._.................«...,..'.._.,__.., _..,_...�..,......,.,.___.�_.,._•___.a,.____ .._ .'�.,..� . . __,__-�._.,.____,_ _ . __..�.—,-.�. .,-.�_r. , �- P p E�p " 5� ;�,�" I � '�tr,n�..,«°n.�,.:,a....d . a�7 .�:..._.>e,._ � g....,.w.«..,.,.....,..._�v..................>. _.,....._.....,.........,,.......,,......_....._A_.......____.._...,.._......_..__,..... ..__.....�........_.:_....,,.._._......,.,....,........:....._v........_......_.._�_ �__...._._�_.._� .,_... ..__' '____.. _._.._..__....__........,...__..... .._"....._..... ` � � . ........._................._...............___ .�_ .._....._.m._.____.__ __:.__._._.....,......._._......._._.........�.__' �_�.._........._.....__._...__._..__._.„......,« �...........................,..............._,......,,..,..__.._..._._�..... .<._.�ro_.�.,...._.._......,...,...._.._...,..,,.... -� € 8 ° . ...._._.._.__._...,,,,.._...�..:_,....._.�,.. ____._._..._.,___�_....,�_._.._._�.,._....,.__�_�._.�._..__.....,,...................<........,,.. ................._..............__........_._. . .'......................,,...,,........ ..........._,._ . B �_................_.� ' ...........,......,.................... ......... .......................,......„........_�..._�..�v.__._.._........_........ _......<...................�.__�_..._....._.,�. ; .._:..............._._.._.�..._.�._._._.___._..................._......_................«....,._.._�_ ......_..._......._.__ ......� ._.--�..._.......,..._ .�....."_'__ �..„.,_._._.�......................__........_..,._:....e...�__..,«.........,......,.......................................,_...._..�_� - . . E f ��..._............_ _..."__.`..___.___.......................v__._..............__.........,,......._���.,......._.,,_._�..........................,,.,......._..,.....,... _.._:.,..,....,.,..._.........:.�.�_..._,v.....�_.___..__._...............-�...,.......«.,,..........,..._...._.�_�_....,...._._................ . ........._.._......«.........-.,......_2 � w p.� �.� "',��,.. .. ' , � i .. - ........._.. M - � r ' ..;. � �..,<< ;. _._........................................._w_...,�..._._..:............_..................,..._....�._._..._. ,,,.....,..........._......�.._..........._...__.__�_......,....._......._._.._____.�..._..,_...._._._._.____ .._.._____—�X . . <.. ..ie.. ...£i.,s � .R..l'.�« � .._....___.�.,...,...._... ' . � ' t � ¢&'a�'�KK � ��+��"�� �t� a s'"�+i �p�'�is�.,'e _�__.......,....._..........._.____r._ _...._�_,�,._......_......_..... . _........____.._�...._..._'__'...._........._........_.___.__�.._.._..._......................._...._..�__....,,..__ � ......_ ...._....... . .___...- i '>• � #` -�, &��'" s�'� � +,:w � � � t��"�a �t�`� y ��a tr �� r������"�':��� ����� � � — � ���I�p����""xi#������� �������'�a��k�� .._._�...._.,,_..,.... _...........,.. _.�..e....»..._.. _..,..�................................... e....,_....,..,....,.. . .... .. . ... ...,........_. ..�........ � � ���:� ���. .�. ba„a��,.l�#".: ar���':,.� __............. ....................._n....m,_..._.................._..............�.......,.._...._�__.... �. �.,W'& � � � W � i k � a''s �*�`§i a� x � +& sa� . . � ._._._........� � . .---�--��----- i �k�p°�� +� ��g�������` �*�.��x �y^�+�t�a�.� .........._...._........._.,__......_..__......._._._....-._..__.m,...._......._..,......... .. ,._.__._ ._.._._..._..__..._._.............._......_"'.�__._.._..___.__ , � } � �'�"'4�'��r�i,�a.a p���"��, .�����'��e��'� - . . � ..._.. . _...__... . ... .._... . ....._...... ' ...... „a a r a aa� ,... ...�..,_ .. . ........ . . .. ....._ .... . . . . . . t �t�. ���B'� w���' ��� ���.: ._. '. C�s�a�' �� � ����'i �re�� ��. -� � �a a �^"��� a �§� �.�`�„�`�'�; �r�� ��.+, __:___�...._.�_ .__.�._...__._......M..,.._.,...._..e........�........,.....__......_...._�._ .............„„ _ �. �M���,� �`� : �,��������.��„�� ���y __ .. .. ._.___..__.__ ____.._a_... _.�__... ___. � .�i � a� �� b��aP� a x tt�t�"�a#a'�� ,a� . � . � �4 e .:� � #��:'��,� � �,� � � ., �� ; �, r ii '��`.,����a„"�w�a��.:.���:.���.���;�,'.*.��.���.:�� ..�___._......._.__�._.........,,..�..__ .��.:.....:...__._.._.............. ._.___a.__.._._.____._._.._........_,__._._...._.... _..____._.—._._._....__.........._......,,_..,_._...._.�� .�