HomeMy WebLinkAbout17598 (25) - - _ . , . - ,,
_�� CITY OF DIAMOND BAB
DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES
_ w 21660 E.Copley Drive Suite 190
(909)860-3195 Faz(909)861-3117 PRES$
���^*'� BUII.DING PERMTT APPLICATION FIRMLY
� JOBSITE '/ + APPLICATION PERMfT P/C
o ADDRESS C�0 S�[`y I I�IC �� DATE � I2�I OZ NUMBER 17598 #
$ ISSUE TYPE OCC
APN LOT ��j DATE CONST. GROUP
p OWNER '"""� ��
" ADDRESS ZONING SETBACKS II
� ciTv IRVIN ziP91 61 2 TeQ49-797-44 O REART RW o
� APPLICANT TEL.
SIDE/SIDE STREET RW O
CONTRACTOR SAME SIDE ❑
� ADDRESS PROPOSED USE
� CITY ZIP TEL.
� ARCWENG/ t '
� DESIGNER l�1lM_ �4S��jM NO.DWEL. NO. NO.
ADDRESS UNITS STORIES BEDROOMS
� CITY ZIP T L. - - ,�
� DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION
p� OWNER•BUILDER DECLARATION SFR/ADD/REM '
O
p I HER�Y AFFlRM UNDER PENALTY OF PERAIRV THAT I MI E%EMPT FROM THE CONTMCTORS Ll- G8l8gB/C8f�1pf1
Lll CENSEUWFORTHEFOLLOWINOREASON(SEC.70.71.SBUSINESSANDPROFESSIONSCODEANVCI7'YOR (n
U �p�1FITYVM�pIqEpU�qESAPER1AfTTOCONSTRUCT,AL7E0.�PROVE.DEMOUSM.ORREPAIRANVSTAUG W P8�I0/DBCI( �
� 7URE,VRpfi TO ITS�SSUANCE,AL50 REW IRES THE MPLICANT FOR SUCH VERAl1T TO FILE A SIGNED w
STA7EMENT T1AT HE OR SHE IS LJCENSED PURSUANT TO THE PROVISIONS OF THE CONTRAC70RS ll-
� CENSE UW(CHAPTER Y(COMMENCINO WITH SECTION 7000)OF DMSION 3 OF THE BUSINESS AND PRO- LL POOUSpe
FESSqNS COO�OR hIAT HE OR SHE IS EXEMPT TIEREFROM AND THE BASIS f-0R THE ALLEOED EXEMP-
TION.ANV VqLAT10N OF 6ECTION 7031.6 BV ANV APPLICANT FOR A PERMIT SUBIECT3 THE MPLICANT TO Z Re-Root
� A CML PENAL7V OF NOT MORE THAN FIVE HUNDRED DOIURS(i500).�:
� ❑4ti^�NIEROFTHEPROPER7V,ORMVEMPLOVEESWI7HWAGESASTHEIRSOLECOMPENSATION, � COmm0fCl81 . � '
WILL DO THE WORIC,AND THE 9TRUCTURE IS NOT INTEND6D OR OFFERED FOH SALE(SEC.7011,BUSI- J
� NESS AND PROFESSION9 CODE:THE COHTRACTORS UCENSE UW DOES NOT APPLV TO AN OWNER oF � �
FpOPEHiY WFp BU0.D9 OR IMVROVES THEREON,AND WHO OOES SIKH NORN HIMSELF OR HERSELF Oq
Q THROUQH MIS OR HER OWN EMVLOYEES,PROVIDED THAT SUqI IMPROVEMENTS ARE NOT INTENDm ON m
QOFFEREDFORSALEIF,IIOWEVERII�EBU0.DINOORIMPROVEMBfTI550LDWI7HR10NEVEMOFCOMPLE- �
Z �'TqN,7HE OVfNER�BUIIDER WILL HAVE TME BURDEN OF PROVWO 7HA7 ME OR SHE DID NO7 BUILD OR
� PIPROVE FOR THE PURP0.5E OF SALEI.
� ❑1,AS ONMEROF THE PROPEHTY,AM E%CLUSNELY COMRACTINO WfTH LICENSED COMMCTORS
TO CONSTRUCT THE PRQIECT(SEC,7WI,BUSINE93 AHD PROFESSIONS CODE TFIE CONTRACTORS U- V9IU0fIOf1 ADJ.AREA
� CENSE UW DOES NOTMPLY TO AN OWNER OFA VROPEfl7V MMO BUILDS OR IMPROVES TIEREON,AND
WFqCON7RACTSFORSUCNPROJEC7SN7TMACONTMCTOR(5)LICENSEDPURSUANTTOTHECONTRAG qUANTITY DESCRIPTION FEE �
� TORS LICENSE UW.�.
� ❑i AM D(EMPT UNDER SEC. B.a P.C.FOR TMIS REASON Q �
3 �
� �
DATE OWNER U
W
F LICENSEO CONTRACTORS DECLARATION w
� 1 HEREBY AFFlRM UNOER PENALTY OF PERIURV THAT I AM LICENSED UNDER PROVISIONS OF CHAPTER � . - • I
� Y(OOMMENCWO WITM SEC710N 7000)OF DMSION 7 OF THE BUSINESS AND PFiOFE5SKKJ5 CODE,AND z '
X MY LICENSE 19 M FULL FORCE M!D EFFECT. m
LLI
o ����• A L�No 51 7 5 9 3 ?
V DATE CONTRACTOFl d
LII �
� WORKERS'COMPENSATION DECLARATION Q
NI HEREB AFFIRM UNDER PENALTV OF PERIURV ONE OF 7HE FOLIOW WO DECIARATIONS: Z
� ' I VEMIDWILLMAINTAINACERTIFlCATEOFCONSENTTOSELF-INSUREFOFMbRKERS' _ .
Q PENSATION,AS PROVIDED BV SEGTION 770o OF TiE LABOR CODE,FOR THE PERFORMANCE U
TME WORK FOR NM1iKx1 TMIS PERMIT IS ISSUED. W
�
INAVEAND WILLAIAIHTAIN WORKERS'COMPENSA710N INSURANCE,AS FEOUIRED BV SEC710N
QQ 37000F THE LABOR COO�FOR THE 7ERFORMANCE OF THE WORK FOR WHICH THIS PERMR IS Q��,� /t�
ISSUEO.MY WOR!(ERS'COMPENSATKKJ INSURAtJCE CARRIER AND POLICV NUMBER ARE:� CONSTRUCTION ) v'V'
� �,,,,�,�, PACIFIC EMPLOYEE INS .CO. PLANREVIEW �
Z ao��cr run�eeR WnRL 4 3�� � 8 7 4 EX P �5-QZ ELECTRIC .
sC -0
� (nassEcrqrarE�raieeoaw�7IDOFnfa�a.irswaor�r�un�oou�sg�m�oatFsS} PLUMBING I .�
Z I CERTIFY THAT IN THE PERFORMANCE OF THE M/ORK FOR WHICH THIS PERMR I$ISSUED,I MECHANICAL
(} SHNl NOT EMPLOV ANV PERSON IN ANV MANNER SO AS TO BECOME SU&1EC770 THE
� WOPoCERS'COMPENSATKKJ LAWS OF CALIFORNIA,AND AOREE THAT IF I SHOULO BECOME INSPECTION FEE
S SU&IECT TO THE WORNERS'COMPENSATKKJ PROVISIONS OF SECTION 9700 OF THE LABOR y
n+cana�rw��rgs��v�s��MES ISSUANCE ��
O r��L SMIP
p DATE: PLICANT:
� ENEFGY P/C
WARNI O:F RE WORKERS'COMPENSATION COVERAQE IS UNUWFUL,N1D SMA1L BE
�y SUaIECTANEMPLOVERTOCRIMINALPENALTIESANDCIVILFMESUPTOONEHUNDREDTMWSAND ENERGYPERMIT
DOlLAHS(floo.oao),W ADDITION TO hiE C0.5T OF COMPENSATpN,DAMAOES AS PROVIDED FOR IN
� SECTION 370E OF 7HE LABOR CODE,INTEREST,AND ATfORNEVS fEES. RETENTION FEE:
d CONSTRUCTION LENDING AGENCY PRE-ALT FEE: -
O
� I HEREBV AFFIRM UNDER VENALTV OF PERIURV THAT THERE IS A CONSTRUCTION LENOWO AOENCV
FOR THE PERFORMANCE OF 7HE WOflK FOR WHICH THIS PERMIT IS ISSUED(SEC.30D7,CIV.C.). � . .
Z NONE (PULTE)
W
� LENDERS NMIE
F= LENDER'SADDRESS
w ICERTIFYTiATIHAVEREADhIISMPLICATIONNIDSTATETHATTIEABOVEINPoRMATIONISCORRECT. TOTALFEES 1 . ���
� I A6REE TO COMPLV N7TH ALL CfTV AND COUNTY ORDINANCES AND STATE LAWS RELATttJ(i TO BUILDINO V
CONSTRUCTION,AND HEREBV AUTFIORIZE REPRESEMATNES OF THIS COUNTY 70 EMEP UPON THE�
Z /�BOVE-MENTIONED PROPERIV FOR INSPECTION PURPOSES. COMMENTS ' '
�
� JERRY AINES
m PERMfT'TEE NAME(PRIIfT)
C/) i ���
� SIONA P ITTEE ATE
RECPT.NO. � � PAID BY VALIDATION
� . WHITE—Depenment Copy,YELLOW--Finar�ce CaPY.PINK—Assessar Copy,GOLDENROD—File Copy,GREEN—ApplicanYs Copy
�
CiTV OF [�IAiVdfJi�9[3 ��6�
�. �IB�ISPECT'@�N �E�C7RCD
�.�v, b ' -:.,E d �9 ry-�ry_1
'h � ��• ' 0 �. � � � .O p i iu��n,�o �`e
w���.i
SET BACK FLOOR JUIST '
.� ',
FTGS/FORMSISTEEL FHA REQMTS �
ELECTRIC GROUND UNDER FLOOR'DUCT - L- '
GROUND PLUMBI�VG 11NDER FLOOR CU�IDUIT
SLAB GRADE FIREPLACE-F�UNDATION �
TEMP POWER FIREPLACE BOND BEAM
WATER SERVICE MID HT. BOND BEAPA
ROOF SHEATHfNG 8 Ff. BOND BEAM
FRAMIfVGNENTiLfATION F�NAL BOND BEAM
ROOF COVER • PRE-GRADING ' • ' • -•
ROUGH HEATlNG BENCHING
ROUGH ELECTRIC ROUGH GRADING
,ROUGH PLUfVISING � Z FIiViSH uRADING
SHOWERITUB TEST POOL ELECTRIC
EXT. �ATHISIDING POOL FENCING
WALL INSULATIQN P�OL FIIVAL
GEILIfVG If�iSULATIOIV OFF SITE IMPS.
�RYWAL�NAI�ING DEDICATIONS
SEWER FINAL ENG.
SF'�'TIC 7ANK LANDSCAPE/1RRtG.
SE�P P}TIL.l�. QN SiTE lMPS_ � �
�-__
� CAS,�l�s TEST FENAL�ONiP�G
FlP�AL C�7iVST. FIRE DEPT. FINRL
E=1h.RL t-iEATING t-IEALTH bEPT. FlNAL
F�I��1_ eLECl`RIC � DEV. FEES�AID �
�._._._
, ;-i`�h.t..PLUMBING Z O Z _ ENERGY
� � � m o ����;� ,
t�—� 6
E • •
' COP,��/iENTS
T�,
SEPTIC.TANK SIZE
SEEP PIT/U SIZE
� � :,_..___���
���y �� �, F r:
�v .
'"�"�s`� �;' � 9�'P�.� s��' `, �4`c �. ____
�-� s �.�� � , � ���
_R� � :� � 'a -` � �
� � �
d;
1� �,Q,; �. : �y ''��,
,I`��� c M`�'� � i .bp'N ____._.
�� � � �., y„ .,h. `� --
".'�� � �f,:^� �
.�r+ "''`9, '�'s ,�c° .
3 .ti �� ,. _ . .
f r ,S � . ,
,� {
I