HomeMy WebLinkAbout16727 (23) � CITYOFDIAMONDBAR EXPIRED
� i DEPARTMENT OF COMMUNI7Y&DEVELOPMENT SERVICES
��� 2(825E.Cop]eyDrive
- (909)860.3195 Fax(9U9)861-3117 JUtd 191D02 pRESS
" ��'<��� BUILDINGPERMITAPPLiCATION FIRMLY
:
� JOBSITE�/�,P/ ��� Qa APPLICATIO PERMIT P/C
a ADDRES�d]���� �-Q�
o DATE_ ���/ NUMBER_ �� #
� APN LOT��T�J� CT ISSUE TYPE OCC
p OWNER V �r /VJ�TY//� DATE CONST. GROUP
�` ADDRES itI ZONING SEfBACKS
0
z CITY TEL. FflONT Ryy ❑
g APPLICANT TEL. REAR ❑
z� SI�FJSIDE STREET RW O
� CON CTOR G�L /I N� SIDE ❑
� ADO �
o C i->Ct., ROPOSED USE
o <-�4�-
o ARCH/E G
z� DESIGNER NO.DWEL. NO. NO.
a ADDRESS
� CITY ZIP TEL. UNITS STORIES BEDFOOMS
�
N DESCRIPTION SO.FT. FACTOR PSF ADJ.AREANALUATION
p� OWNER-BUILDER DECLARATION SFR/ADD�AEM
O
p 1 NEiiEBV AFFIRM UNDER VENALTY OF PERAlRv THAT I M1 E%EYPT FROM hiE CANTRAC70R3 L4 Gd15g0/CBtpOf1
W CENSEUWFORTHEFOLLONlINOREASON(SEC.70]7.SBUSINESSANDVROFESSIONSCOOE:ANYGTYOH (n
C.) COVNTYNh11CHRE0UIRE5AiERMITTOCONSTRUGT,ALTER�PROVE.OEMOUSM,ORHEVAIRANYSTRUG W patiolDeck
� TURE,GRIOfl TO RS ISSUANCE,/�L50 REOUIFiES THE AGPLICANT FOR SULH PEHMIT TO FIIE A SIGNED W
� STATEMEM 7HAT HE Ofi SME IS UCENSED PURSUANT TO THE VROVISIONS Oi TNE CONTRACTORS LI• �
� CENSE UW(pUOTER Y(COMMENCWO YATH SECTION 7000)OF DIVISION�OF T11E BUSINESS M1D PRO- POOVSpB
p fE5510N5CO0E1�1TMATMEORSHEISE%EMPTTMEREFROMANDTHEBASISFORTHEALLEGEDEXEMP• C7
V TION.ANYVIOLATIONOFSECTION7a71.SBYANYA7FLICIWTFOqAPER1AiT5U61ECTSTNEAPPLICANTTO z Re-Roof
A GYtI OENALiV OF NOT AIORE THAN iNE HUNORED DOLURS�5500).�:
0 OI�OWNEROf7NEVROPERTV,ORIIVEMPIOVEESWITNWAGESASTHEIR50LECOMPENSATION, � �mmerelat �
Z VALL DOTHE WORK,IVlD THE STRUCTURE IS NOT IMENDED OR OFFERED FON SlILE(SEC.TW�,BUSI- J
� NESS AND PROFESSIONS COOE:iHE COfJTMCTOR3 ULENSE UW DOES NOT AGPLY TO AN OWNER OF �
iROPERTY Y/MO BU0.050R IMPROVES THEREDN,IW 0 WHO DOES SUp1 WORK MIMSELF OR XEfiSELF ON
WTMFOVGHMISORNEROWNEMPLOYEES,VROVIDEDTHATSUGHOAPROVEMENTSARENOTPlTENOEDOfl m
� OFFEREOFORSALEIF,110WEVERTME9ULDINGORIMPROVEMQITISSOtDWfTHINONEYEAqOFCOMPLE-
Z TION.TME OWNEREU0.0ER WILL HAVE THE BURDEN OF VROVINO THAT ME OH SHE DID NOT BUILD OH
= IMPFiOVEFORTMEPURPOSEOFSALE4
W OI.ASOWNEROFTMEVROPERTY,AMEXCLLISNELYCAMMCTIN�WRHLICENSEOCONTMCTOtiS
� TO CONSTRUCT THE PROJECT(SEG 7W�,BUSINESS AND DROFESSIONS CODE:THE CONTRACTORS LI- VdIU8Ii0t1 ADJ.AFE11
W CENSELAWDOESNOTMPL�TOMIOWNEROFAPROPERTYW1108UILDSORIMPqWESTMEREON,AND
T�— KMOCON7MCTSFORSUCHPR0.IECTSWIhIACOMMCTOfyS)LICENSEDPURSUANTTOiHEW17TRAC• QUANTITY DESCRIPTION FEE
TORSLICENSEIAW.).
� OIAME7(EMPTUNDERSEC. B.6P.C.FOHTHISREASON Q
?� U
� �
o�re owr+Ea 1-
O W
F LICENSEO CONTRACTORS DECLARATION W
� IHEREBYAFFlRMUNDERPENA�TVOFPERIUMTMATIAMLICENSEDUNDERPROYISIONSOFCHAVTER � d77� /�J7n)i�-�/)
p� i(COMMENCINOWfTHSECTKKi)000)OFDIVISION]OFTMEBUSINESSANDPflOFE5510N5CODE,AND Z �T/= F%GIVG���
�L MY LIGENSE 6 W iULL F CEAyD EFFECL m
0 LICENSE CUSS � LIC.NO. �
V DAT COMRACTO(i 6J.
W
� WORKERS'COMPENSATION D C ATION a
� IMEREBVAFFlRMUNOERPENALTYOFPERIURYONEOF7HEi0UOWIN6DE IONS: Z
0 _I/UVEANDWIILlUR1TAINACERTIFICATEOFCONSENTTOSELF-INSUREiO ERS' _
Q COMPENSATION,ASPROViDEDBYSECTION�7ooOFTHEU80RCO0E,FORTHEPERFORMANCE W
Q OFTHEWORKPoHWHICHTHISVERMiTISI55UED. �
� _IIUVEANDWILlW11NTlUNWORKERS'COMPENSATIONINSURANCE.ASflEWIREDBVSECiqN
OJ)OOOFTHELABORCOOE,iORTXE�ERFOHMANCEOFTNEWORKFORWHIp/THISOERAlIT15
� ISSUED.M'/WORKERS'COMPENSATIONINSURANCECMRIERANDPOLICYNUMBERME: CONSTRUCTION
� CMRIER PU4(J REVIEW
� POLICY NUMBER
Z ELECTRIC
¢ c
p frwssEcrcNr�mrprBEca.�ErmoFnErErr,+rtswna��oouu�s �aoloatFssl PLUMBING v
Z ICERTIFYTHATINTHEPERFORMMICEOFTHEWORKF IICH RMtt SUED,1 �ECHANICAL
C} SHAILNOTEMPLOYANYVER50NNANYM�VlNERS ST BE 'SV 07HE
(n WORKERS'COMPENSATqNUW50FCKIFORN� DA EE ULDBECOME INSPECTIONFEE -
S SUBJEGTTOTMEWORKEFS'COMPENSATpNP VI510 >OF 177000FTMELABOR ISSUANCE ���� � ! "�l �
OD� iQqR�VITH COMP�V WITH _P ISIDN. �
� pq _V I APPLICANT: SMIP
W ENEHGY P/C
� WARNINO:FAIIURETOSECUREWORKERS'COMVENSATIONODVEHADEISUN F 4�NDSHALLBE
� SUBJECTANEMPLOYERTOCPIMINALPENALTIESANDCMLFINESUPTOONE JN REOTMOUSAND ENERGYPERMIT
OOLURS(f100.000).WADDITIONiOTHELOSTOFCAMPENSATpN,DM1ACE 115P VIDEDFORIN
¢ SECTIONJ7olOFTHELABORCOOE,INTEREST,ANDATTONNEY'SfEES. RETENTIONFEE:
OCONSTRUCTION LENDING AGENCY PRE•ALT FEE: ~��
� IHEREBYAFFIRMUNDERFENALTYOFPEM1flYTHRTTHEREIS�CONSTPUCTIONLENDIN6AGENCY
FORiHE PERFORMANCE OF 7nE WORK FOR WHlpl iMIS VERMIT IS ISSVED(SEF�ov7,CIV.CJ.
Z
W
� LENDERS NAA1E
� LENDER'SI�DORESS
� TOTALFEES �
� I CERTIFY iHAi I HAVE REA�TMIS�VVLICATION AND STATE T1iAT THE ABOYE W FORMATION IS CORRECT.
w IAGREETOCOMPLYWITNALLCITYANDCOUNTYORDINMICESANDSTATEUWSPELA7WGTOBU0.DING
�
� GONSTRUCTI .MlDMEREBYAUT/qRIZEREPflESENTATIVE50FTN15C�ri1N7YTOENTERUPONTHE
Z A90VE-M D PEHT'F INSVECTIONPUR .
o �v COMMENTS
_
m VERMITTEE N Rl
¢ �-D
�
(A S�GNATUR F E DATE
� RECPT.NO. _PAID BY VALIDATION
ITE- epaAment Capy.YELLOW-Finance Copy,PINK-Assessw Copy,GOLDENROD-File Copy,GREEN-ApplicaM's Copy
i .y.� -.-.��.,,.�.��l,a�n. . .�t;,..y.. :. .;..... , .:.,_ ._; .1+...5 . .3-. :nr .,�i��+'j� ..�5471:C..� .iKr,: .� .. . +. ,... � -. ... . .. ....... .:v. r ' ., . -� _ ., .... ,, a:.
ci-r�� nr� a��Yr��r�� ��,�
���s�=Ec�oor�,� ��cc�rD .�
.�,.�.__.._....___�__.�.._..____..�._-�_._
____._._____.__.__ _.__�
�1`1f 1„c7�'�c�ar� c��t�- _�,v�`I.I ti���l�i_._.....__. _._ 11'k�•`f.��+c:..�.`�}�1k._--- __. _._��ij'rLN.-�; ,►�I�'��..��c1'�C�'� I
[�`�r -: -- ------ ._.___...M__--= A --'
SET BACK---��---�_�__._ . �__ _.I ___ FLOOR JOIST � -- -
FTGS/FORMS,'STEEL � FHA REQMTS
ELECTRIC GROUND j UNDER FLaOR DUCT �
GROUND PLUMBING I I UNDER FLOOR CUMDUIT _
SLAB GRADE FIREPLACE FOUiJDATION
TEMP PO4VER i l FIREPLACE BOND BEAM
WATER SERVICE I � MID HT. BOND BEAP�1
ROOF SHEATHING I� 8 Fi�. BOND BEAM I
FRAMINGNENTILIATION I I I FINAL�OND BEAM I
ROOF COVER PRE-GRADING
ROUGH HEATING BENCHING
ROUGH ELECTRIC ROUGH GRADING
ROUGH PLUMBING I FINISH GRADING
SHOWERlfU6 TEST POOL ELECTRIC
EXT. LATHlSIDING POOL FENCING
WALL INSULATION POOL FINAL
CEILING INSULATION OFF SITE IMPS.
QRYWALL NAILING DEDICATIONS
SEWER FINAL ENG.
SEPTIC TANK LANDSCAPE/IRRIG.
SEEP PIT/L.L. ON SITE IMPS.
GAS AIR TEST FINAL ZONING
FINAL CONST. FIRE DEPT. FINAL
FINAL HEATING HEALTH DEPT. FINAL
FINAL ELECTRIC DEV. FEES PAID
FINAL PLUMBING • ENERGY
c�cy:rt:�i- c:(c�a. _.___—.__--
COMMENTS
SEPTIC TANK SIZE
SEEP PIT/U 51ZE
;R?I
,;r�r� _
.`y � .�