Loading...
HomeMy WebLinkAbout15434 (17) CITY OF DI.AMOND BAR � -.` s:�-.. ��— DEPARTMEIYT OF COMMUNITY 8c DEVELOPMENT SER:VICES �..�� o � 21660 E.Copley Drive Suite 190 (909)860-3195 Fax(909)861-3117 PRESS ��'��'M BUII,DING 1'ERMTT APPLICATION FIRMLY .. � _... . ..: . . , Q JOBSITE .,�. 4i � �_� APPLICATION �}� PERMIT`f��„��� P/C�. o ADDRESS I S ��.. L�C�:�,,, J�-L•��--e. DATE � �< _NUMBER�./ 6v� a T�'PE OCC � APN LOT TRACT_ DATE CONST. a� • �--. � ,•�,,- � �o — GROUP p OWNER �j I�x�.,r-�=_ f...:__>•� �`p ADDRESS J j;.�--Z :s'�-r' ,?�y l,�e,i.1�':"�• ZONING SETBACKS �W CITY/�.�1�''�lt.c!:.�i `9,�' ZIP�� T �� r' G"'`(.:r;n FRONT RW � APPUCANT ���.�.ifj;�,r�t_Ee T��� ' ""� ��^- • � REAR � z SIDFJSICE STREET RW G �¢ CONTRACTOR f,�a�'-�i.��/`d" �i�-�.fC_ SIDE C ADDRESS +�.f�r�a� f � �4"�^�-��l��' � CITY�P�t.u��',1?ti'1�Z�p a,s�'� �t ' ; PROPOSED USE '�r° � TE��/� w ARCWENG/ ��,� Z DESlGNEFi a ADDRESS NO.DWEL. NO. NO. cn UNITS STORIES BEDROOMS � CITY ZIP TEL_. � DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION Q OWNER-BUILDER DECLARATION SFR/ADD/REM O p �HEHEUY AFFIpM UN�ER PENILLN OF PERJURY THAT I AM EXEMPT FROM THE CONTRACTORS LI- Ge�age/Cafp0lt W CENSEUWFORiHEFp�IpWMGREASON�5EG7091.58U51NE53ANDPROFES510N5CODE:/WYCITVOR ((� �••� COUMYYVHN]1REWIRESAPERMITTOLONSTRUCT,AITER,IMPROYE,DEAlOLISFi,ORREPqIRAN1'STRl1C- w TURE,PRIOR TO ITS ISSUANCE,ALSO REQUIRES THE APPLICANT FOR Sllf71 pERMIT TO FILE A S:GNED W Patio/Deck � STA7EMENT THAT HE OR SHE IS LICENSEO PURSUANT TO THE PROVISIDNS OF THE CONTRACTORS ll- � - CENSE lAW(CHpP7Eq D(COMMENCING WffH SECTION 7000)OF DIVISION 3 OFTHE BUSINESS ANO PRO- POoUSpe FESSqNSCODEjOR1HATHEORSHEISE7(EMPTTHEREFROMANDhIEBASISFORTNEALLEGEDEI(EMP- (� TpN.ANVYIOLATI0NOF5ECTION7031.58VANYAPPLICANTFORAPERMITSUBJECTSTHc'APPLICANTTO Z Re-Roof � 0.CML PENALTY OF NOT MORE THAN FNE HU�DRED DOLLARS(ESoo).j: i]I,ASOWNEROFTHEPROPER'TY,ORMYEMPLOYEESWITHWAGESASTHEIRSOLECOMPENSATION. � COTRIBfCi3I � WILL 00 THE WOAK,AND THE STRUCTURE IS NOT IPI�EPDED OR OFFERED FOR SAI.E(SEC.7066,BU51- J � � NE55 AND PROFESSIONS COOE:7NE CONTflACTORS LICENSE UW DOES NOT APPLY TO AN OWNER OF = PROPER7Y VYI10 BUILOS OR IMPROVES THFREIXJ.AND WHO DOES SUCH WORK HIMSELF OR HERSELF Oq � THROUGHHISORHERONRJEMPLOYEES.PROVIDEDT}IATSUCHIMVROVE'�1ENTSARENOTINTE�DEDOR m 0 OFFEREDFOHSALEIF,HOWEVERTFIEBUILDINGORIMPROVEMEMISSOLDWITHINONEYEnqOFCOMPLE Z TION,THE OWNER-BUILDER WILL HAVE THE BUFDEN OF PROVING THAT 4E OR SHE DiD NOT BUILD OR � IMPROVE FORTHE PURPOSE OF SALE�. W CI,ASOWNEROFTHEPROPERTY,AASE%CLUSIVELYCONTRACTINGYI�THIICENSEDCONTRACTORS � TO CONSTRUCT T}7E PROJECT(SEC.7a4a,BUSINE55 AND PROFESSIONS CODE:THE CONTRACTOflS LI- Velll82iOl ADJ.AREA W CENSEUWDOESf�7APPlYTOANOWNEROFAPROPERTVWHOBUIL]SORINPROYESTHEREON,AND � NMOCONTRACTSFORSUCHPFQIECTSWIhiACONTqACTOR(S�IICENSECPURSUANTTOTHECONTRA6 QUANTITY DESCflIPTION FEE Y 70RS�ICENSE UW.�. QC I AM EXEIAPT UNDER S�C._ __B.8 P.C.FO�THIS REASON Q T„ U � � DATE OWNER F- Z U � LICENSED CONTRACTORS DECLAFtAT'ION W � I HEHEOV AFFIRM UNDEF PENALTV OF PERJl1RV THAT 1 AM LICENSED U4DF:fl PqOVISIONS CF CHAPTER � q � d 9�COMiAENCINCiWITHSECTION7000)OFDIVISION30FTHEBVSINESSANDPROFESSIONSCODE,AND Z W61' ,� � � �'j� <<� � � MY LICENSE 191N FULL FUACE AND EFFECT. m � L�CENSE CLA S � K IIC.NO.�5��_ � � �r V DATE_ CONTRACTOR_`,;.'�^_1��. f� " f�,� � Lu � WORSERS'COMPENSATION DECLARliTION a NI HEHEBY AFFIR�A UNDEfl PENALTY OF PERIURY ONE OF TME FOLLOWING OECURA710NS: Z � _I HAVE AND WILL MAINTAIN A CERTIFlCRTE OF CONSENTTO SELF-INSURE FOR WORKERS' ¢ S C'AMPENS/1TION,AS PROVIDED BY SECTION 37ao OF THE LABOR CODE,FOR THE PERFORMANCE U Q 1 OFYHEWORKFOHWHICH7HISPERMITISISSUED. g W ��I HAVE AND WILL MAINTAIN WOR%ERS'COMPENSATION INSURANCE:,AS REQUIRE�BV SECTION '~2 970oOFTHELA90RCODE.FORTHEPERFORMANCEOFTHEWORKFOFWHICHTHISPERMITIS �,�,�y95 . �,� `�-, ����� � ISSUED.MY WORKERS'CiOMPEN50.TION INSURANCE CARRIc'RAN'J POLiCY NUMBERARE' CONSTRUCTION y�"' i�• J I'' -_- j CARRIEH �.�!T•.f PLAN REVIEW 'E✓"�e'����h(Z74.r�t_7 A Ta 0 POLICYNUMBER�R.i�{.Cr�—���'�`'�' � Z ELECTRIC .�j„�,�Ij 7� *^� -r r,; ¢ �-J�- .� . _ .s�Ze � !RiS3ECIlONNE�NDTBE�MPL'cTFOOF�.iEPBi1M15FORONEHI'nYJRELDIX:ARS(5:07jORLESS� PLUMBING W Z I CERTIFY THAi INTHE PERFORMANCE OF THE PlORN FOR WHICH'fHIS PERMIT IS ISSl1ED.I MECHANICAL [S SHALL NOT EAIPLOYANY PERSON IN ANV MANNER SOAS TO BECOME SUBJECT TO'HE (A WORKERS'COMPENSATION�AWS OF CALIFOFtu.�AND ACREE TW�T IF I SHOULD BECOkE INSPEC710N FEE � SU&IECTTO?HEWORKERS'CQNFEI3SATiONPfiOV1510 O SECTION37GDOFTHELABOR � GOO ,IS ALLFORTHWITHCOMPLVWITHTN PROV 10 . — ISSUANCE _ O f a' W DATE: C� APPLICANT: _ SMIP _ J WAFNING:FAILURETOSECUREWORKERS'COMPENSAT N� ERAOFISUNLAWFVL,ANDSHALLBE ENERGYPlC LL SU&IECTANBdPLOYERTOCRIMINALPENAI.TESANDdVI�FINESUPTOCNENUNDREDTHOU5AN0 ENERGYPERMIT � DOLURS(S10o,000).IN ADDITION TO THE COS i OF COMPENSATION,OAMAfiES AS PROVIDED FOR IN SECTpN37080FTHElABORCOOE,INTEREST,ANDAT'ORNEI^SFEES. RETENTIONFEE: OCONSTRUCTION LENDING AGENC`.' PRE-ALT FEE: _ � IHEREBYAFFIRMUNDERPENALTYOFPERJUFlYTHATTHEREISACIXJSTqIJCTIONLEN0INGAGENCY FOR 7HE PERFORMANCE OF TH'c WORK FOR WHICH THIS PERMI715 ISSUED(SEC.3097,CIV.CJ. W � LENDER'SNAME __ _ — F— LENDERSAD�RESS _ w I CERTIFY THAT I HAVE REA�7HISAPPLIGlTION AND STATE 7HAT7HE ABOYE IhFORMAT6�N IS CARRECT. TOTAL FEES ��s C�� � I AGREE 70 COMPLV WITSIALL CITV ANO COUNTY ORDINANCES ANO STATE LAWS RELATING TO BUILDING V � CANSTRUCTION,PND HEREBV AUTHORIZE REPRESENTATIVES OF THIS COUNTY TO ENTER UPON hIE Z ABOVE-MENTtONED PROPEHTV FOR INSP'cCTION PVRPOSES. COMMENTS � �`�,.�I.-'�0-�--{� ..�� {�e.,�;l� S m PERMITTEE N E RI C17 � � 'r � SIGNATURE DF PE 1 � DATE — = RECPT.NO._ � PA:D BY . VALIDATION ~ WHITE--De arment Co p py,'IELLOW—Finence Copy,PINK—Assessor Copy,GOLDENROD—File Copy,GREEN—Appliran['s Copy �.�n � . `�FM:� �� . �...� ..'�{�? k�.�yi��::�. :,_,.,�. �.,,, .:�.. .4.. ���.a,s. �� .'`4 �.w . -: ,. ...,, <, ,. . ,. . . ... „ ..��'�, . ...,,�.,...,,_.; ....,..;., .,, .�,; - - r:�,�":'r, :rs; - . ,�: a 'M ,y , „� �. ��� �� r3'a 3 ..� � �y�� ��;. � �' 4 �*bf a', �l�, i � - � i ..; r � ��a r . , . , z ,7, r -�i ,si t. s r r- S , 1 5... ...r .. -i �,<. ..., ,.. �.. , .. � .. .,d ..., , . ._ ...<. , . .., , . .. . . ,w ls; _ , ., ." 2ti,j• � ,, f � � . '.. . .._.,... ..----.. .. .. __..._. --� -----.__., .,_... . ,.�..- --. .._- - .... -------. _ .._. ..... .._ _.. , t : t' f�• � ,....,. .. ,„....;�_,.:,;. _ ' � -.- ; v, ,,.,.,- � : .., ... � _, ., •,.-,.-. : - - , , .. - .... ... - , ....--- .. ._.. ............._. ., ..._.... ..._._........_................---.....-----..._.. _ _. ..._. . . _..,.......----...._ _. .. " . .. ..'f` . . ...�. .i.l\'!.}t' , 'tt % " '3_ ' .,;. _'..,._" .. ...'___"___. .__ _. . ._ _" ___'... .. ,"""_'. ._.. ."" ,__ ......._.."""""" "" . ....,._""_.._ ....'_'... . ...__'__"_"__." '. _ .. . .<r•��.: • .� - ' ' .y __ ... _ . ; . , . . , , �, ... . , - �.... . .. .......... . ... ."""" .... . . _._. .......""' ........,..... ,.,.._....... . ._.., .""" '. ..._._._.... _, .... . ...,... ........._" .. . .. ,• � �" i .,: �.. ,.,., -,r,'� � , . _r"� _ :.., . } ,_ ..,,.�: .. � _ . . . _...... . _ .�..."'"".:.. . .... . ..... .'""'..... _,... ..... ..... ..._.......'"".__.._.. -.. .. . ......... . "'... ...'__' .,._.... . ... ... .. ....'"""'"... ..... . . , ..�.,.:,-'� • . �.�.. .... � ,..,�..�.. .�.,,. ...,' _ .:.- °: �.; �="i < i�.:. " ��^ � d. . ...... .:., �, .. ...... ' "-.--...., .... .;�. , . _.. ...,._�,.�, _ .,. .�. � : ,.. �„ ' . � , . , ,.,. .,.... , i_:�'. ' _�:,:,:.:' : - __....-- . . ___.___.. .---. .. ..�:- --� ----'--- .._... .. ........--'-'_.. ... ... ........-'-'- --'...--......._.. .......-_-....._'- '........_'--...'--"'-'..... . .. :. _;„• . :< },�r. ... ........ ....... � .. - � _ ,.,_,_ . .._ •s�_' '^E,r , ,�:,... �. r.�, .. . . ,. . : - r..."'..' -"'-". .._.. .....'--. ... • .. . ..""-......... . .. .. ... . "-"".,_...._" ".. .... . "-'.. . ..,. ._.__ ....... , .. .. ' "" ,._.. . .-- .... . _ ' ; " � �� � - . .._ ..�,. ., �, . ,. 4 i"-�r��. .: .. �...,£ .. ... _ .,... ._... - _ .�f _ ,...�.- .. . . i : � .... .� n � � ' - � . ' � ' r"� '`t�'.''•'i � '. .... � .....:�. _ ..t . ' . . i_. . ... . ... .......... . . ...._"z. .... _ .. ......... ...... ........_.__._..,.... . .... .. .'_._.......... __ ... ., __..........._ ......__. .. .......__ ._"__. ....._.. ..._._ _......._ j i'., t' ` 1 5 •.p;..�::.:..:^ . __� ... . . , i.^ •?r . . {, i. 'f,a ' '" ,_ .,. ....... '"____ '"" ""__.._ ._ _... """'_ . _..... . .... ..._.. _ . ....___._......___............"""_... _... .. .., _.._ . . ..... . .. . .. _...._"""" '__..... E:.. �t '1� � � � ' - . ;_. . . ._�......_........._"_'_ . ....._........ .,. ."'_"........... .._"__" "_"_'__"".....,'_ "".. ... ........_.... ...'"_"__"...."__"'_.__..... ..___......__._..._ . .."_'_'..._v...._......... .......... r ' i r.�, � ......---_..... .�_...... . . ............,.. . ..----._............_........_._..,.---------. .. ..... ......._.__ .....---. .._... ._.... .--- ------. ... ... . _._. ...., _....... C ... ,_. , ._� ..._.,.�..� • i , - , .. .. � �) ;r'�. , . . ..w -_.. .. _`_. .. ...'.'_---�--.. .."'_"-. ._.__... ..........."-"--._,.......... ........_..._......,_...'-'.. ... ... -'---. .. .. __ . ... . .'.--'---......... ........... � .�r:�.; .`: � . -r' - .,� , � - ., � . . �..� .. :. . . .. :� . . . . ' 'r . �.. ��:.�.:. •-..; , . ...�.... ..._._...,......"' . .._ ..................._.i......._..."'_'"'"'".....__ ....... __ ...... .. ._._ ...__..,_........._.._...__....., .....,..'"'. _.. . . ...'""""""" ""'_.......... i ' F< ' _ � . . . ' _ ' I "�. , � , - ;...""'. . _ . _.._. .. __..__.. . _ .... .. . ._. ......._..._.........._...' " " '"_. .,._..."'..._.._""'. "" ......." '" ___ ,..... . ._.. ."" " '-' ._ . .. ., _ .. .�� . :. .r� ...�.t'• ' ' ,., � „ . : , ._., . _. .. .: .. _ '_ ' t.... _"._ . ...""'__ "'"'. . . „ ,. . '_"... ..._.... . ..... ....... ........_"'"' __" '"'_' .._..__...__._......."'_"""" • " ..._""......_�........... ._.....""'__._..... , ._ . i � . >.�... �..5 _y. i � S.. ; .. . .. �-� ..., ' , . �.. ..A . ..,�. '„ . ;" � � : ' �...3 . , :4 .. . . .' , , .t: i ' _ .. -- , _' '_....._........ ... .. . . .....__.._.. ."_..........._.........._.."_"..... . ' _ _ .. ........_.. .. .._........ . .... . ,.... ... _. ..... ................. . k � � . .. ' .., ..{., - .. . .. y: �....,,..�� ...-3-: . .... ._... . , . ... . ::f, ' � . .. . " •, . • , . ._ .. . . .., ... _ . . .... ..............-'"_. .... ..__._. _ ..'.�......_.._ .. _ .. . .._....... ............ "..:... . ...___'�...... ..........., .....__....._......,. .. .'_ ...... .. .. . ... ... � .. /. ... .,. , ._ "' ' _ � ..._......_. � ' . ' ':.;x': .l= yr ����'TR � ' 'ep": . .. . _t... ._� .�. . �% W .� .;.�'.�::. . ....._.._.,.,. .. . ..... .. . ....... ... ........__.'._........ ..._..........._. ........_..._...._.._........_. ., ...._. . . .. ... . .._ . ., . � � ......._..... ... .,„.. .. ._._. ...._.,..,v..'"'_""""""..........._"_' ' '"_.... . .. . . . . ... ., .'. . . .. . _._. . . .,., . , � • . .. 4''� f .__..................._...,.._..............._ ._.. _.. ...... .._ _ .......__.__'__ '.__..... ..........._...._. .. ......._._................_...__._,.,,. ._.......�..._...�__. ..._.... ....__._'._.".......,_. .. ...... _ . -- � . . . .. ' ' � .� •' y � z�._.,,._.._._ . .._" .. .� .. . ..... _. ... ..... ..__.. . ...... .. . ........ ...... . . .... "..... . . .. . ..�. . .... . . ..... a x_'_..............�.._.__..,__..._._. . ..... ... . ...._......_.._... ...... _...._..__ . ' . . _ Vya� ,. , . . .. � '; � ,:..,x . i v. $Y� . .. �',s; ,, • i•.r.,;.�. .�,.P: � . . .._'_ _. .. .. .. .. ' ' ' . '_'_' __'. .. . ._'. . ... . _. . _ . ._"_ . .. ""_.._ . .... . . ..y.. �"�:: �5' ,.9 . _ . . �..,...� .r ',r.<.��.:,"'i; � � .:;", . .. . , .,... �. ': . c. : „ .' " ." • .: .:.'.... . .� _ ...,...""_'.. ........... ......._. ._...................... .. . . . ... ..... . . ... . .... . . . . . ...._ . . "� 3 ,Y....'.y .w .:,. � .. r-..:; " . :,;..� .. ..... ... ... ......... . . ... ..... . . . .... ., ...._.. ... ... .. . . .. . .. ..... .%' :�' - ��',..u, � . . . , ;, ti � ..r,u/:.;..i.��.: -n}F., � v .. �n �...�.,i :. ...;'�"'" . : ' i. ;. : x:C � .r�. _� a, , + r � . .: ... ,.�'�3�. ." .. . . �:" , .:: �. .�. . . .,. , : � . i �f . ..... . , i . ' :'., '.,',e�.. . ... •. � . Y ' ' g ....,. i. .': . , ;�,r. . ,, . ...��'.'. . ,.. ., ; . '...+: . , '�.;':' ' . .a.T(:'.. ., ,. . '..., .