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Home My WebLink About13358 (262)� - ` - • -� _�� CITY OF DIAMOND BAbt L��B�� DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES : � ai�o E.c�iey n►z�e s�c�i90 S�P 10 2002 (909)860-3195 Fax(909)861-3117 PRESS �� BUII.DING PERMIT APPLICATION FIRMLY � JOBSITE APPLICATION + G�q PERMIT P/CqG I o ADDRESS� c`7�� S� �+��LL'E,y V�l STA �� DATE �' 1 1 NUMBEd33��g ` 1� `� c� ISSUE TYPE OCC APN LOT TRACT DATE CONST. GROUP p OWNER ��,, �UP� �2�-►TRCag .)�-74L7}j p ADDRESSJ.S j� �' . V F�L��Ei� �/1"STli Q� ZONING SETBACKS W CITY�tiC.�c�ap G�AS� ZIP�Z.b.��L FRONT RW ❑ � APPLICANT TEL. REAR ❑ � SIDFJSIDE STREEf RW ❑ � CONTRACTOR � �� . r'�L • �S SIDE ❑ Q ADDRESS O N� '� � • o CITY FaA?;Al�f�.M ZIP �� TEI.�I�4��4o1—�i90 PROPOSED USE ��(�� ` C.ti�� lU\T� w ARCWENG/ � DESIGNER �`A �A�� NO.DWEL. NO. �p N . ` u � ADDRESS�l '' ' UNITS STORIES BEDROOMS � CITY �_ti�[Irvl ZIPq'�v (TE -�( � DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION Q OWNER-BUILDER DECLARATION SFRlADD/REM O � p I HEREBY AFFlRAI UNDER PENALTV OF PERNRV THAT I AM E%EMPT FROM THE CON7RACTORS LI- Gef0J6/COfPOR W CENSEUWFORTHEFOLLOWINOREASON(SEC.70.71.58USINESSANDPROFESSIONSCODE:ANYCITVOR (n U COUNTYWHIq1REWIRESAPERMITTOCONSTAUCT,ALTER,IMPROVE,DEMOLISH.OHREPAIRANVSTRUC- W Patio/Deck Z 7URE,PRIOR TO ITS ISSUANCE,ALSO RE�UIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED � STATEMEHT THAT HE OR SHE IS LJCENSE�PURSUANT TO THE PROVISIONS OF THE CONTMCTORS LI- w � CENSE UW(CHAPTER Y(COMMENCINO WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PRO- � POOVSpB FESSIONSCODE)ORTHATHEORSHEISEXEMPTTHEREFROMANDTHEBASISFORTHEALLE4EDEXEMP- (� TION.ANV VqIATION OF SECTION 7037.5 BV ANV APFLICANT FOR A PERMIT SU&IECTS THE APPLICANT TO Z Re-Roof � A CIVIL VEN�LTV OF NOT MORE THAN FNE HUNDRED DOLURS(l5a0).�: � ❑I,ASOWNEROFTHEPROPERTY,ORMVEMPLOYEESWITHWAGESASTHEIRSOLECOMPENSATION, � COrt1rtIBfCi81 ' MIILL DO THE WORK,AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE(SEC.7011,BUSI� J � NESS AND PROFESSIONS CODE:THE CANTRACTORS LICENSE LAW DOES NOT APPLY TO AN OWNEF OF � 7ROPEHTV Nh10 BURDS OR IMPROVES 7HEREON,AND MMO DOES SUCH WORK HIMSELF OR HERSELF OR � THHOUGH HIS OR HER OWN EMPLOYEES,PROVIDED 7HAT SUq1 IMPROVEMENTS ARE NOT INTENDED OR m QOFFEREDFORSALEIF,IIOWEVERTMEBUILDINGORIMPROVEMENTISSOLDWITHINONEYEAROFCOMPLE• Z �•TqN,THE OWNER-0UIIDER WILL HAVE THE BURDEN OF PROVING THAT HE OR SHE DID NOT BUILD OR � IMPROVE FOR THE PURPOSE OF SALE). W ❑I,ASONMEROFTHEPROPEHTV.AMEXCIUSIVELVCONTRACTINGWITHLICENSEDCONTRACTOqS p� � TO CONSTPUCT THE PR0.IECT(SEC.7041,BUSINESS AHD PROFESSIONS CODE:THE CONTMCTORS LI- V81U0f10� ADJ.AREA W CENSE UW DOES NOTAPPLY TOMI OWNER OFA PROPERTY NM110 BUILDS OR IMPROVES 7HEREON,AND � N'IiOCONTMCTSFORSUCHPROJECTSWIh1ACONfRAC70R(5)LICENSEDVURSUANTTOTIECONTMG pUANTI DESCRIPTION FEE - Y TORS UCENSE UWJ. . � O I AM EXEMPT UNDER SEC. B.6 P.C.FOR THIS REASON � 3 � LL DATE OVMER �' Z U W � LICENSED CONTqACTORS DECLARATION W � I HEREBV AFFIRM UNDER PENALTY OF VERIUHY THAT I AM IICEN5E0 UNDER PROVISIONS OF CHAPTER � d i(COMMENCINf3 WITH SECTION 7000)OF DIVISION 7 OF THE BUSINESS AND PROGESSIONS CADE,AND Z MY UCENSE IS PI FULL FORCE AND EFFECT. �7 m � LICENSpE CLASS l�1 U LIC.NO. 5 57 �.�� j V DATE FF��e�� CONTRACTOR��'CU�.��1 �flfQ , �w ��LY� WORKERS'COMPENSATION DECLJI ON ��/k.�U Q w / U � 1 HEREBV AFFIRM UNDER 7ENALTV OF PERIURV ONE OF THE FOLLAWING DECLARA710N5: `7 Z I N V Q � I MAVE AND WILL MAINTAIH A CERfIFICATE OF CONSENT TO SELF-INSURE FOR WORKERS' 2 � �OMPENSATION,AS PROVIDED BV SECTION 37000F 7NE LABOR CODE,FOR THE PERFORMANCE �U /OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. � � 1 HAVE AND WILL MAIHfAIN WORKERS'COMPENSATION INSURANCE,AS REOl11RE0 BY SECTION ` Q 9700 OF THE LABOR CODE,FOfi THE VERFORMANCE OF THE WORK FOR WHICH THIS PERMI7IS (/� ISSUED.MY WOFiKERS'COMPENSATION INSUNANCE CARRIER AND POLICY NUMBER ARE: CONSTRUCTION '� L v jCARRIER g^aTE. �uN+ pLAN REVIEW Z POLICY NUMBER �"7 �" � — ELECTRIC Q 0 (iH6SECf10NNE�NDT8E00A4LEfIDOF7FEPERAVfISFOR Douu�s�ttoo)oa � PLUMBING �(�p.��, Z I CERTIFV THAT IN hIE PERFORMANCE OF 7HE MIORK FOR ICH THIS PEHMI715 ISSUED,I MECHANiCAL II'F-�IJ f� �� SHALL NOT EMPIOY ANV PERSON IN ANV MANNER SO AS BECAME SU&IECT TO THE / � WORKERS'COMPENSATpN LAWS Of CALIFORN10.�b QREE THAT IF I SHOULD BECAME INSPECTION FEE �I I'�. f1�7 S SUBJECTTOTHEWORI(ERS'COMPENSATIONPROYI SOFSECTION37ooOFTH "� ISSUANCE T� WOE,ISHALLFORTHWITHCOMPLVWI7NTHOS ISIONS. 13 {� q p DATE:�_ APPLICANT: �SMIP n�.'` .... � I�Q � w l ENEFGY P/C �.ITY f�,C:r�v.,.,..,.. __ J WARNING FAILURE TO SECURE WORKERS' ION COVERAOE IS UNLAWFUL,AND SHALL BE y� yy�yb �^��,� LL SU&IECTANEMPLOVERTOCRIMINALPE AL CIVILFINESUPTOONEHUNOREDTHOUSAND ENERGYPERMIT ��-1�T T1�AT!"� n�.+� DOLLARS(t100,000),IN ADDITION TO hiE C OF COMPENSATION,DAMAGES AS PROVIDED FOR IN — � SECTION 370C OF hiE LABOR CODE.INT T,ANO ATTORNEI^S FEES. � �v� ��tl�`�'N'r�d � � RETENTION FEE: d CONS UCTION LENDING AGENCY PRE�ALT FEE� � I HEREBY AFFIRM UNDER PENAIN OF PERIURV THAT THERE IS A CONSTRUCTION LENDING AGENCY J � , FOR THE PERFORMANCE OF THE WOHK FOR WHICH THIS PERMIT IS ISSUED(SEC.3087,CIV.C.). ^ � Z "G W � LENDER'S NAME F— LENDER'SADDRE55 . � I CERTIFV THAT I HAVE READ THIS APPLICA N PND STATE THAT THE ABOVE INFORMATION IS CORREC7. TOTAL FE ES , W I AGREE TO COMPLV WI7H ALl CIT'AND UNTY ORDINMICES AND STATE UWS REUTING TO BUILDING � CONSTRUCTION,AND HEREBV AUTHO E REPRESENTATIVES OF THIS COUN7V TO ENTER UPoN THE � � ZEN710NED VPOPERTY FO� SPECTION PURPOSES. COMMENTS O � P`�� 1 m PERMIT7EE � � '�—t� °� �' � SIC R F P EE - DATE � T RECPT.NO. PAID BY . VALIDATION WHITE—DepaRment Copy,YELLOW—Finence Copy,PINK—Assessor Copy,GOLDENRO�File Copy,GREEN—Applicant's Copy . . . . . .. ' . . - . .. . . .. ., . . 1� . , .. ... . _.�Si t. . . . . . . V�� /'��,V� �1'4� . a.• ' 9�IS�(��Q43�1 (�Bf�tC�l�� .--,�.�_.,��, ..._.� . , _ , . . (�� ,]�/.�� . , , F (� �, OV`��/'�i'v"" . . , ��` .'.. ]°i ..O c� O � a`x'a. ...'7� � .� �, `•� :'�y .�� 1��' ��;�1��_ ` "� �a,5e '.. �SET BAGK FLOOR JO�ST FTGS/FORMS/STEEL _ � FHA REQMTS ELECTRIC GROUND � � UNDER FLC?OR QUCT ; - -----— GROUND PLUMBING I _ ___ __ UNDER�FLOC�R CUMDUIT ' i SLAB GRADE FIREPLACE FOUNDATION � TEMP POWER FIREPLACE BQND BEAM ---- W,4TER SERVICE MID HT. SOND BEAM ROOF SHEATHING� ' 8 FT. BOND BEAM —' FRAMINGNEI�I'CILIAT�ON ' FINAI.BOND BEAM � _____------1------ - ROOF COVFR PRE-GRADING ' � FiOL'GH HEATING BENCHING �:.� �RQUGH E�GCTRIC _ ROUGH GRADING _ ^ `ROUtaH PLUMBIPlG i FINISH GRADING SHOVVERITUB TEST ; PC?OL ELECTRIC _ EXT. LATH/SIDING POOL FENCING C ` ^ WALL IftiSULATION � POOL FINAL � ^ CEIUIVG IfJSULATIQN OFF SITE IMPS. — .—. .._— _ -__�--------- ---- . DRl'�1/AL�NAfUNG QEDICATIONS ,� SEIIVER^ FINAL ENG. --.. ____`_._.__ SERTIC TANK _ LANDSCAPElIRR;G. ____ �SEEP PITlL.L. ' ' � ON SITE IMPS. _ _ � GhS AIR TEST • • � FINAL Zt�NiNG ' �li�!i��COi�ST. , FIRE DEPT. FINAL ---- ----------- ._.._ �_____ � �1i�lI.�L HEATlNG ; HEALTH D�PT. FI�1AL _�_, � FI�ELECTRIC � � DEV. FEES !'AID _ _ 1 ._J_.___��------ � rli�!i�L PLUMBING ( ENERGY ' ; — —�--- , i ; ---- -----__ - — nz-,-. � :C��a�'.o � k _._ .�. � --- -- - - � '--. .�,a_�. ---- } � .�,lp1�l��"�J _,_._ � -.--_ i , �_..�..___ ._�. ------ - ---- � � . l� . -- _....------- F � -- -------- __--------- � . �- - --- ��____ �_._.�.� _..__.�._----- i �p .�. .._ ._�- ��._- -------- 1� i SE�'1'IG 7ANK SIZE --- -- � -- SE�P PI�/U SIZF_ _.__ -- ---- ' �r . �,� — _—__._ � _.�-- � � � _____________�__. _.._ � ��S �__.___ � __._ - --.`_._._------- � �' ,