HomeMy WebLinkAbout11038 -�� -- CITY OF DIAh10ND BAR
� COMMUNiTY DEVELOPb7ENT DEPARTMEN'f
,!�,.� 21660 E.Copley Drive Suite 190 ' PR�SS
(909)860-3I95 Fax(909)561-3117
'"'' BUILDING PERMIT APPLICATION FI R M LY
� JOBSITE r APPLICATION �� � PERMIT P/C
o ADDRESS_ Z�7Q� ��_ �_ DATE � NUMBER � p
c� ISSUE TYPE OCC
APN LOT 7RACT DATE CONST. GROUP
p OWNER � )�S P�� ZONING SETBACKS
AODRESS l�/a+i
� CITY ZIP TEL,. �! FRONT RYY O
o APPLICANT � � TE�t� flEAfl ❑
t b SIDElSIDE STREEf RW ❑
QCONTRACTOR � �, ' -{ SIDE ❑
� ADDRE$S �% �'j�_� � C
� CITY ZIP �jTEL �J(a3�; PROPOSED USE ��L� y L� i �� �
w ARCWENG/ �/���`^'�'��--�-3� 4' ��„
z DESIGNER —'T��-f�
a ADDRESS N0.DN1EL. NO. .
� CITY ZIP TEL. UNITS STORIES E3EDROOMS
�
� �ESCRIPTION SO.FT. FACTOR PSF ADJ.AREANALUATION
Q OWNER•�I;ILDEFi OECLARATION SFR/ADD�'REM
O
I HEPEBV AFFIRu UN�ER iErULTY OF PE0.AJRV THAT IM7 E%EUPT FROlA THC COI.'TMCTORS LI- Gef3gP/CaIpOR
W CENSEUWFORTNEiOLLOWiNGRE�50N(SEC.7071.6BVS:NESSAN�PROFESSiONSCODL:MlYCITYOR (J�
U COUNiYNHIp7flE0UIRESAPERMITTOCONSTRUCT,A.TEH.IMPROYE,DCMOL/SH,ORREVnIRANYSTflUG W patio/Deck
Z TUnF,PR�OR TO ITS ISSUANCE,ALSO REWIRES THE APPLICANT FOp SUCH PERIAIT TO FlLE A SiGNCD
w STATEMENT THA7 HE OR SHE IS LICENSED VURSUANT TO THE iROVI5lON5 CF THE CONTqACTORS U� W
` CENSE UW(CHAPTER Y(COMMENLII:C WITH SECTION 7000)OF OMS�ON 3 OF THE BUSINE55 AN�VRO� LL' PoolSpa
FESSiONS CODE)OR THAT HE OA SHE IS E%CMVT iHERELPOM AND THC BA515 i0�1HE ALLECCD EXEAIn�
VTqN.ANYVIOLATpNOFSECTION70J1.78YANYAPPUCAMFOR�VERMIT5V0.1CC15iHE�PP�It/�NTTO Z Fle-Rool /�
A CML PENALTY OF NOT MOfiE TMAN FIVE NUI:DAED COLLARS�f500).)• f
� ❑4ASOWNEROFTHEPROPERTV.ORMYEMGLOVEESVnTHWACESASTHEIRSOIECOMPENSATION, � Commorcia� �
L W'�L�p0 TME WOHK.�NO TM[STRUC7URE�5 NOT IMEN'JED OR OFFERED FOR SALE(SEC.7w1,BU51• J
N NESSANO PROFESS�ONS COOG THE CONTMCTOI7S UCENSE LAW DOES NOTAOP�Y 70 AN OWNER OF �
PROPERTY NT10 BURDS OR MPiiOVES THERCON,AhD WHO DOES SUCN WORK HiMSELF OR NERSELF OR
(= TNRp�JGHH150RNEflOwNEM�LOVEES,PROVIDE0T/1AT5UCHPA�ROVEMCNTSARLNOTINTEN�EDOR m
W OiFEREDiOPSALE.IF,HOWEVER7N[BNLDINCORIUDROVEIAENTI550lDWITHMONEYEAROGCOAIPLE-
� T10N,THE OWNER�BUIIDER K".LL HAVE iXE BUROEN OF VRONNO 1HAT HE ON SHE D�D NOT BU�ID OR
Z IMPRpVE fOq 7HE PURPOSE OF SALEI.
_ ❑I,ASOwYEROFTHEPRpPERTY,NAE%CLUSNELYCONTMCiRlCWRH�ICENSCDCONTMCTORS
W
[= TO CONSTFUCT T1C PR0.IECT(SE4 7W�,BUSINE55AN�PROFESSIONS CODE:TM[CONTMCTORS Lb V21U811Of1 ' ��ADJ.AREA
W CENSEUWDDESNOTAPPLYTOANONTI[ROFAPROPERTYWMOBUdDSORIMPROVES7MEREON.MID
� YYFqCONTFiACT5FOR5UCHPRO,IECTSMnTHACONTMCTOR�S�UCENSEDPURSUANTTOIMECONTMG QUANTITY DESCRIPTION . FEE
Y TOFSLICENSELAW�.
� OIAMEXCMPTUNDERSEC. B.BPC.FORTH�SP[ASON Q
O V
� �
OATE oWr<Ea U .
� W
' �Q LICENSED CONTRACTORS DECLARATION w
[L IHERCBVAFFIRMUNOERPENALTYOFPERIUfiYTHATIAMLICCNSEDUNDEAPROV15qNSOFCMAPTER �
d Y�COMMENCINGWITMSECTqN7o00�OFpIVI5lON70FME8U5INE55IWDPROFES5lON5CODE,Af:D Z
X YY�ICENSE IS N FULL FOACE Ak0 EFFECT.
� LICENSE CUSS � �LIC.NO.�yLVi' �� � j
V DATE�..�� CONTRACTOR _ � 6J.
W
� WOFKERS'COMPENSATIONDECLARATION ���� U
✓'" a
� IMEREBYAFFIRMVNDENPENALTYOFPEfiM11RYONEOFTNEfOLLOW:NGDECUMTIONS 2
z _IHAVEANOWILLMAINTAIN�CERTIFIGITEOFCONSENTTOSELF�INSUREFORWORKERS' _
d COMPENSATION,�SPROVIDE�BYSECTION]7000FTMELA80fiCODE,FORTME7ERFORMANCE �U
OF THE WORK FOR WMiLM THIS PERMiT IS ISSUED. �
O
w �IMAVEANDWRIMA:NTAINWOflKERS'COMPENSA7qNIK5URANCE,A5RE0UIqE'J9YSCCTqN
Q 97000FTHEUOORCOOE,FOATHEDFRFONAANCEOFIHEWOfiKFORNMICHiH15PERUITIS
ISSUED.MVWORNE NSATIO NSUHMCE.ARRIERIINDPO.ICYNUNBER�RE: CONSTIjUCTION ���� 4
J
j CAqRIEq�� ' L PUINREVIEW -��••
, Z POLICYNUMOER� � I Z�� � ELECTRIC
Q
0 (fHISSECf%JNNEmNOT6[OG.pIETEDOFMPEfMT6fORWEHU�DftCDDQ1/JL�R�OD1IXiLE551 PLUMBING
Z ICERTIFYTHATNTNEPERFORMANCEOFTM[WOFiKFORW111pITHI5pEF1AiTI5155UED.1 MECHANICAL
(} SWLLLNO7EA�PLOYANYV[RSONWAYYIAAF�NEHSOASTOBECO�GSUOlECTTOTHE �
(n WORKERS'CG.IPENSATIONLAWSOFCALIFORNIA,AM1D�GAEETHATIFI$HOVIDBECOMC INSPECTIONFEE
S S1161ECTTOTNEWORKERS'COMPENSATIONCROVISIONSOFSECTiON]7000FTMCLABOR
CO�E,ISNALLFOR711WI?HCOMPLYWITNT/qSECROV15ipN5. ISSUANCE Iw.� j1
o �2_4- -r��
`p DATE: � APPIICANF.�v��/ SMIP /
� WARNING FAILUflE TO SECURE MlOfiKERS'LOMPENS�110N COVFRAGE IS UNUNTUL.AN�SHALL BE EN[RGY P/C
�—y SV0.JECTAN EM7LOYEH TO CRIMINILL PENALTiES M'0 CIVIL FINES UP TO ONE NVNORED TMOUSAND ENERGY PERMIT
Dd.UAS(f I00.000�.IN AOOITION TO TH[COST OF Cq�APENSATION,D�.IAGES�S PROVIDED FOR IN
¢ SECTION]�OBOFTHEU80RCODE.INTEREST,ANDATTOFLYEYSFEES. {�ETENTIONFEE:
OCONSTRUCTION LENDING AGENCY PRE•ALT FEE:
� IHCREBYAFFIfiMUNDERPENALTYOFPCRIURYTNATTHER[ISACONSTRUCTIONLEND�NGAGENCV
�- FORTHEPERFORMMICEOFTHENK7RKFOflVh11CH7ryISFENMITI5155UE0(SEC.7JD7,GIV.CJ.
Z �
W
� IEN�ERSNAME
F– LENDER'S1IDORE55
� ICEFTIFYTNATIHnVEREADTH1511PPLICATION11YD5TATETMIITTHEl180YEWFORMATqNISCARRELT. TOTA�FEES 1
W I AGREE TO C0IAPLY WITM���CITY AND COUNTV OH'JINANCES AND SiATE U'NS PC:ATING TO BU4DII:C
� CONSTRVC110N,ANOHLRiDYAUTF10RqERE7RE5ENT�T:VC50F7H15COU>17YTOENTERUPONTME
� ABOYE�MENTIOKED Pf10PERTY FOR INSPECTION 7URPO5C5.
Z CONMENTS
0
J
�
m PEWAITTEE ME(PR', � ) �
¢ _�rG��/IIRJ Z� �Z��
�
� SIGNATU��EOFpEHMITTEE DA7E
� RECPT.NO.�PAID BY VALIDATION •
WHITE—Oepartment Copy,YELLOW—Finance Copy,PINK—Assossor Copy,GOL�ENROD—Fda Ccpy,GREEN—Applirant's Copy
".. _ .. . . .. . —. .�, . . . .... . .. .. ,.. .. . . . .,. . .... .. 0., _ ...•�y.� .. ,r, w� . � '� .. . �. . . "" n . . . .
CITY OF DIAMOh1D BAR
INSPECTION RECORD
e � , • � - ` ; t �-'i• - r ! � � . -
SET BACK ' FLOOR JOIST �
FTGSlFORMS/STEEL FHA REQMTS
ELECTRIC GROUND UNDER FLOOR DUCT � � -��
GROUND PLUMBING � UNDER FLOOR COt�DUIT
SLAB GRADE FIREPLACE FOUNDATION ' � ' � '
TEMP POWER • -- FIREPLACE BOND BEAM� • � -� ;� .
WATER SERVICE �� • . • � " - � • -� � ' MID HT.BOND BEAM ' ' ' � " � ' '_ , ,
' '• •ROOF SNEATHING � � ��• L' -%'J / c 8 FT. BOND BEAM �
FRAMINGNENTILIATION � FINAL BOPJD BEAP,A
ROOF COVER PRE-GRADING
ROUGH HEATING ' BENCHING �
ROUGN ELECTRIC ROUGH GRADING ,
ROUGH PLUMBING FINISH GRADING
SHOWERl7UB TEST ' POOL ELECTRIC
EXT.LATH/SIDING . r',�' POOL FENCING
WALL INSULATION � ` POOL FINAL
CEILING INSULATION OFF SITE IMPS.
DRYWALL NAILING DEDICATIONS �
SEWER FINAL ENG.
SEPTIC TANK � - -' •� LANDSCAPE/IRRIG.
SEEP PIT/L.L. ON SITE IMPS.
GAS AIR TEST r FINAL ZONING
FINAL CONST. ' ) 1, ,,,� FIRE DEPT.FINAL
FINAL HEATING HEALTH DEPT. FINAL
FINAL ELECTRIC DEV. FEES PAID
FINAL PLUMBING ENERGY
1 ' - - : -
� " . e) e � ', - r
_ • , . �
COMMENTS � �
f..l . :� C-:
� ;�.�:r �. ;� '?_•r � .
. �.-- -• • ..._ .
. _ . . ._.I � . �J _ . ,
SEPTIC TANK SIZE
SEEP PIT/U SIZE
i . �_ ,
_ , . ,
, , . �` _ �� � - •• _ �
� . � :