HomeMy WebLinkAbout13-01534�_.—_ —
, �� ' �_;,���.,�. C1TY OF DIAMONll BAR ( �-' /
�_
{ ( I � DEPARTMENT OF COMMUNITY&DEVELOPMGNT SERVICES ��
�,'YJ��Ul�n. 21810 Copley Drive,Diamond 13ar,CA 91765 PRESS
r,,,� (909)839-7020 Fax:(909)861-3117 Building Inspection Hotline(909)839-7027 FIRMLY
\�y'�%B''. BUILDINGPERMITAPPLICAT[ON
� APPLICATION DATE: �^L P/C# �
wJOB SITE ADDRESS ��g ��n���A� ��' �/y
� ISSUE DATE:_�I�2��7 PERMIT# 43� ��S �i
z APN LOT TRACT
o O W N E� TYPE CONST. OCC GROUP:
w ADDRESS '2 C TAN'Go�,�� ZONING SEfBACKS
N CITY��er^O �,�ZIP��7EL.� _L,- OC� FRONT RW Q
a APPLICANT TEL. REAR �
o SIDE/SIDE STREET RW �
a CONTRACTOR �RO 5��,� 1 ��Ri L�GT��►� I N�' SIDE R
i oro ADDRESS _L,��.��{`���r ��� PROPOSED USE
o crrv�, e� wAv/.� ziP qo�rE�.���-7S"7 od_C"�
" ARCH/ENG/DESIGNER P►'1✓� Z14
a ADDRESS_��2����I�NT�1 AV� q DWEL.UNITS #STORIES #BEDROOMS
�a�. CITY ZIP C/ TEL. DESCRIPTION SO.FT. FACTOR PSF ADJ.AREANALUATION
� OWNEfl-BUIlOEA DECIARATION
� I here6y aHirm under penatty oi perjury that I am exempt hom the Contractor's State License Law fm me reasonls) SFR/ADD/REM
� intlicated below try Me checkmark�s),I have placed next to the applicable Aem(s)[Section 7031.5,Buslness antl
o Garage/Carport
w p����o�y�e:q�y�{ty��nty ihat reqWres a permit to consVuct,alter,Improv&demolish,or repalr,any
z struclure,prim to its issuance,also requires tha applicant fw ihe permit to file a signed slatertrent thal he or slre � Patio/Deck
a is Iicensed Dursuanl to Ue p�ovisions at the Co�actor's SWte Llcense Law(Chapter 9)Commencing with Section w
N 7000 ot Divlsion 3 of the 8usiness and Prolesslo�u Code]or that he w she is exemD�hom licensure and ihe basis iw LL P�VSpa
� �
� the alleged exemDhon,MY�iolation of Sec4an 7037.5 by any applicant lor a pertnit su6jects the aDPlicant to a civil penalry Z Re-Foot
� of not more than five huntlretl dollars(5500).
o (�I,as owner of Ne property,or my empioyees wlth wages as thelr sole compensation,will do(�all ol or U portio� � Commercial
0 oi the work,and ihe sWCNre is not InterWed a ottered tor sale(Secdon 7044,Business arM Pralessiwis Code:The �
w m
� Contractnrs'State License Law does not appty to an owner ot property who,ihrough employees'ar personal effort,builds d1tiV
u77 or imprwes 11re propeity,prwided that tho impmvements are not intended or ofleretl for sale.R however,the building or
� ImD��emertl Is sold wlthin one year af comp�etion,the Owner-Builder wiil have the burden of Droving that it was rot huilt
por Imprmed for tlie purpose of sale.).
� I,as nwner ot the ra Y 9 1 (
F, (� p perty,am azGuslvel canVactin with ficensed Cantracrors to construct the v�o ect on Valuation: Adj.Area:
0 7044,Business and Professlons Cafe:The CoMractors'State License Law does rrot appty to an owner of property who
z bulldsorimprovesNereon,andwhocontractstwtheprojectswilhaAcensetlCantraclapursuanttolheConhacmrs'State QUANTITY DESCRIPTION FEE
�
Y License Law.).
o (�1 am eaompt hom licensure under the ConVactor's Sfate License law lor Ihe foflowfng reason(s): �
� �
� Bq my signature below I acknowledge that.except for my personal residence in whicb I must have residetl fw at least one �
z year prior to completion oi tha fmprovements covered by Nis permit,l canrrot legally sell a swcture that I have built as an „�,
0
f.. owner-builder it it has irot been consWc�ed in its entirety by licensed contractors.l understand tha�a copy ol the appllpDle
� Ww,Section 7044 of tha Business and Professlons Code Is available upon request when this application is submittetl or at
X ihe following Web site:htlpJwvnv.leginto.ca.gov/pWw.htrni. m
w �ATE: SIGN: �
� LJCENSED CONTRACTOfl'S DECLAH/ITION �
U
w I tiareby aflirm untler penafty of pe�jury tl�al I am i�censed untler provisions oi Chapter 9(commencing willi Secfion 7000)
� ol Division 3 o1 ihe Business antl Pmlessions Code,and my license is in fuU force antl eflect �
� c�
`" uCEr+se cu�ss: �7i_e 3� G��i�00
N LIC.NO.: Z
oZ DATE���_ CONTRA OR: �
¢ WORI(EN'S COM SATION U RATION E
� I HEREBY AFFlRM UNDEfl PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS:
w
¢ I have and wifl maintain a Ceni�cale ol Consent to Self-Insure tor Waker's Canpensation,as provided by CONSTRUCTION:
� Section 3700 0l the Labor Code,for Ihe peAormance of the wwk for whkh ihis permit is issuetl.
� PLAN REVIEW:
� I have and will malntain Worker's ComD���on Insurance,as reQulretl by Secfion 3700 of ihe Labor Code,for ELECTRIC:
o the performance ol the wark tor which this pertnR Is issued.My Worker's CompensaUon In�urance Carrier and
¢ PoliqPlumeaare: r PLUMBING:
� CASIRIFA�^'��P�t�_ MECHANICAL:
Z POLICYNUMBFA� INSPECTION FEE� �O �Z
c� —
� (T}AS SCCTION NFfD NOT B COMPIFfE R 5 F-0R ONE HUNDRED DOLLARS�$100)OR LESS1. ISSUANCE: 3S� Z Z _
oI certify that in the peAortn�nce ot tice vmrk 1or which this pertnit s is.sued,I sh�ll not emplm/arry person in arry manner so as to SM IP:
o become subject to the WakerS Compertsation Laws o1 Califomia.Md agree Ihat If I sFwulU I�ccane subjecl lo ihe Waker's
�+�- C«npensaGon prwis�s ot Sectbn 3700 ot the Labor Ca1e.1 Sha11 torthwith compy with those Provisbrs. ENERGY P1C:
J oarE: nrruCnNr: ENERGY PERMIT:
�
� WARNING Fallure to secure Workers Compensalion coverage is unlawlul,antl shall subjecl an employer m criminal REfENTION FEE: �z �� -
w penatlies and civil fines uD to one hundree thousand dollars($700,000),in additim to lhe cast of the compensation,
a damages as pravided iw in section 3708 of ine IaDor code,interesi,and anomey's tees. PRE-ALT FEE:
d GQNSTRUCTION LENDING AGENGY B$AF: �t��
� I he2Dy att'um under penalry of per�ury that there ts a ConsUuction Lending Agency fw the perlormance af the work for
w
� which tnis permit is issued�Sec.3097,Civ.C.). � �
r LENDFA'S NAME
� LENDER'SADDRESS:
a I certity that I have read tliis appliplion and state tha�Ihe above Iniwmation is correct.1 agree to canpty with all city and
TOTAL FEES �
� county ordinancas and state laws relating ro building construction,antl hereby authorile representatives of this county to COMMENTS:
� enter upon Ihe above-mentioned properry fw inspecfron purposes.
m P�tiNNY w�
a PERMlT�TEE E(PRI
�
� PA1D BY: VALI�ATION:
= SIGNATUR OF PERM^� �� ��E��� r� RECEIPT H �
H
WHITE—Department Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENROD—Fle Copy,GREEN—ApplicanYs Copy
CITY OF DIAMOtVD BAR � _ ' ,
INSPECTION RECORD
. � � . • - • o � � • '
SETBACKI�LETTER�' � ���'�' v� ����` `'- = TRACTAND LEDGER
FOOTINGS FORMS `� :;, -- ' SWITCH GEAR
SLAB - ' :'� r ��. ,_ �' °�'�` :�� COMMERCIAL NOOD �
UG.PLUMBING�`- " `"�' `'�" '`' '_ T-BAR
,���
UG.ELECTRICAL ' * " ' '> INTERCEPTER
UFER GROUND��' ' ; i "' '� , -s: �> HOT MOP/SHOWERPAN
- :, � :. . .-. , . . ..
SEWER IATERAL SEPTIC/CESSPOOL
MAIN WATER L1NE HERS REPORT RECENED
SEWER CLEANOUT DEMOLITION O 2'T
ROOF SHEATHING ROOF DRAINS
FLOOR SHEATHING ROUGH CONDUIT
SHEAR WALLS EXTERIOR' ` " ROOL/SPA'� 5 - - - � i�- 4��
�"�
SHEARWALLS':_INTERIOR^o„ �; , ROUGH'PCUMBING _' ,r = F t; � �`�` �` � ��`
FRAMING/VENTING —' x '�" r�� `ROUGHELECTRICAL' r ;� - �'} ` 3 t�`'�
ROU,GH MECHANICAL .� , �^� • � {r� '�` e �� ^� � ;" ,ROUGM MECHANtCAL r z� � ''� r��' � , �� '
� �_ Y � 5 � � � � " 'GAS TEST��-��� ;'" �:� <� , ;�,� � �,:
ROUGW ELECTRICAL W(;:�)C(.) ' � - ; � i� -r �;�s k y�E � r'��;
ROUGH�PLUMBING �'" � ` _ _ .�;,'t,a P;6EGllNITE,� ti.� „ • , ' ��
� 7 r' 1 s �:
INSULATION WALL PODL,PREDECK BONDING ��-� � rc�':::i,", ' ::�r �'r��� �. .��
— � ,.:�i p"�. �: C� � -'= _� ,�,��.: ��_�
WSULATION CEILING P=�P �% '_�
DRYWALL F.ENCE'/�GATE!'ALARM � �.,a- . ,,�, , ` = � '� ` ��
Z.1:
LATH(PRE) FINAL P0,0'L ' ` .: �. :; � ,�s , ';.`
LATH EXTERIOR WALLS:
LATH INTERIOR WALL FOOTINGISTEEL
GAS TEST WALL STEEL 1sr� �Zr+o� �U�
SCRATCH COAT WALL BOND BEAM
ELECTRIC METER RELEASE . WALL DRAIN/SEAL
GAS METER RELEASE WALL FINAL
. -� 5 ;
SPECIAL INSPECT N RO FRAMING PLAIJI�NGAPPROVAL ` � �.-
FINAL BUILDING : -h ROUGH.FIREAPPRQVALi �'- _, y T�' 4�`�
' �, FINAL FIRE DEPARTMENT �' ` ''r��� r� '
FINAL MECHANI AL...', ' ' �` '; ` ;
' ' � `�' �' 'FINAL RLAPlNING � 'T N '_
�FINAL ELECTRICAL = - � �. '� `'� '
FINAL PLUMBING �" .� { ,�.r` ` ' FINAL ENGINEERING/PW `' � ` '� `�F �� � "'
T.C.of OCCUPANCY ' ,FiNAL COMMUNITY;SERVICES ' A k �=
CER,T.of OCCUPANCY'; . ,r. ;� Y , ,r,.,'� , , ,FINA'L HEALTH DEPT � °' ' a `, ��
,_ � �
_� ;. � �;� ,.
FINAL,INDUSTRIAL WASTE; `� __ _ c � '- �j -�
COMMENTS: