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Home My WebLink About13648 (873) j . �� • �� _��_ CITYOFDIAMONDBAR f��3Q�� DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES 21660 E.Copley Drive Suite 190 S E P 1 O ZDOZ PRESS � (909)860-3195 Faz(909)861-3117 I ��`W BUILDING PERMIT APPLICATION �IRMLY � JOBSITE � APPLICATION PERMIT / P/C o ADDRESS 15��S� �� _�� DATE NUMBER 1O # � ISSUE �TYPE OCC APN�� TRACT DATE CONST. GROUP °C OWNER t� G4'G CT� O " ADDRE L A � ZONING SEfBACKS Z CITY ZIP TEL.7/4rT�a�� REART RW p 4 APPLICANT � SIDE/SIDE STREET RW ❑ � CONTRACTOR W GS SIDE ❑ � ADDRESS � PROPOSED USE �� CF CITY - ZIP TEL� • '� o ARCH/ENG/ 3 � DESIGNER NO.DWEL. NO. NO. ADDRESS UNITS STORIES �_ BEDROOMS � CITY ZIP TEL. y DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION � Q OWNER-BUILDER DECLARATION SFR/ADD/REM O � 0 I HEREBY AFFIRM UNDER PENALTV OF PEiL1URV THAT I AM E%EMPT FROM THE CONTRACTORS LI- Ge�flJB/CBfpOR W CENSEIAWFORTHEFOILOWINOREASON(SEC.7o31.5BUSINESSANDPROFES510N5CODE:ANYCITVOR (n U COUHTYWHICHREWIRESAPERMfTTOCONSTRUCT,ALTER,IMPROVE,DEMOLISH,ORHEPAIRANYSTRUC- W Patio/Deck Z NRE,PRIOR TO ITS�SSUANCE.ALSO REOUIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED w STATEYEHT THAT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE COMRAC70RS LI- W � CENSE LAW(pUFTER Y(COMMENCINO MlITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PRO- � PooVSpa FESSqNS CODE)OR THAT HE OR SHE IS EXEMPTTHEREfROM ANO THE BASIS FOR THE ALLEGED EXEMP- TqN.M1VVI0UTIONOFSECTION7o31.58VANYAPPLICANTFORAPEPMITSU&IEC75THEAPPLICAN7T0 Z Re-Roof � ACIVIL PENALTI OF NOT MORE THAN FNE HUNDRED DOLURS(SSao).): � ❑I,ASOWNEROFTHEPROPERTY,ORMVEMPLOYEESWITHWAGESASTHEIRSOLECOM7ENSATION, 0 COrt1rtIBfClel � �� VALL DO THE WORI(AND THE STRUCiURE IS NOT INTENDED OR OFFERED FOR SALE(SEC.70N,BU51� J NESS AND PROFESSIONS CODE:THE CONTMCTORS LICENSE UW DOES NOT APPLY TO AN OWNER OF N PROPEHTYMRfOBUILDSORiMPROVESTHEREON,ANDWHODOESSUCHWORKHIMSEIFORHERSELFOR � Q 7HROU(iM HIS OR HER ONM EMPLOVEES,VROVIDED 7HAT SUCH IMPROVEMENTS AHE NOT INTENDED OR m QOFFEREDFOHSALEIF,HOWEVERTMEBUILDINGORIMPROVEMENTISSOLDWITHINONEVEAROFCOMP�E- Z �'TION,THE OWNER-BUILDER VALL HAVE THE BURDEN OF PROVIN�THAT HE OR SHE DID HOT BUILD OR � IMPROVE FOR THE PURPOSE OF SALE). W OI,ASOWNEROF7HEPROPEHfV,AME%CLUSIVELVCANTMCTINGWI7HUCENSEDCONTRAC70R5 � 70 CONSTRUCT THE PR0.IECT(SEC.7oN,BUSINE55 M1D PROFESSIONS CODE:THE CANTRACTORS LI� VHIUe�IOfl ADJ.AREA W CENSELAWDOESNOTAPPLYTOANOWNEROFAPROPERTVWHOBUILDSOHIMPROVESTHEREON,ANO � WHOCON7RACTSFORSUCHPRQIECTSWITHACONTMCTOR(SjIICEHSEDPURSUMITTOTHE00NTRAG QUANTITY DESCRIPTION FEE . � 70R5 LICENSE UW.�. 0 ❑I AM EXELIPT UNDEN SEC. B.6 P.C.FOR THIS REASON J 3 � DATE OWNER Z � LICENSED CONTRACTORS DECIARATION � 1 HEREBY AFFIRAI UNDER PENALTY OF PE0.IURY THAT I AM LICENSED UNDER PROVISIONS OF CHAPTER � Y(COMMENCINO WITM SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PROFESSIONS CODE,AND X MV UCENSE IS IN FULL FORCE AND EFFEC7. ��j� OG�r�'T�� LLJ /Jpr 2��Js 0 LICENSE CLASS UC.NO. Z/ �`'�� D A�U' . � • g27 r' w DATE �� _^ CONTRACTOq�G ��U J��I� � ,� w � � G � � WORKERS'COMPENSATION DECLARATION Q s /�(f Z �+ 2 S � I HEREBV AFFIRM UNDER PENALTY OF PEFiIURY ONE OF THE FOLLOWING DECLAMTIONS: Z �O � rj O �/: �•.. � Q ti� � _I HAVE AND WILL MAINTAIH A CERTIFICATE OF CANSEN770 SELF-INSURE FOH MIORKERS' _ � � ��S ' COMPENSA7qN,AS PROVIDED BV SECTION 3700 OF 7HE LABOR CADE,FOR THE PERFOFMANCE U � Q �E WORK FOR NMICH 7HI5 7ERMIT IS ISSUED. � `/r / � �'�/ � w _I MAVE MID WILL AUINTAIN WORKERS'COMPENSATION INSURANCE,AS REOUIRED BV SECTION Q 3100 Of hIE LA80R CODE.FOR THE VERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED.MY WORKERS'COMPENSATION INSURANCE CARRIER AND POLICY NUMBER AfiE: CONSTRUCTION jCARRIER vs �� s �a PLANREVIEW � POIICV NUMBER a22 � ELECTRIC . 0 (i}4SSECfqNNE�NOTBEOp.�LETmOFhEPEFAffSR�RONEFIULREDDOLLMS(f700)ORLESS� PLUMBING W MECHANICAL '� 9B ' z I CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED,I �} SFULL NOT EMPLOV ANV PEfl50N IN ANY MANNER SOAS TO BECAME SU&IECT TO THE .- ' -�� WORKEFS'COMPENSATIONLAWSOFCAIIFOHNIA,ANDAGREETHATIFISHOULDBECOME INSPECTIONFEE �- i S SUBJECT TO THE VlORKEHS'OOMPENSATION PROVISIONS OF CTION 3'!00 OF THE UBOR '1'"� � � COD IS ALLFOR7HWITHCOMPLVWITI ovi . ISSUANCE O DATE:� APPLICANT: SMIP o .a -.t.a� J WARNING:FA�LURE TO SECURE WORKERS'COMPEN ION CAVERAGE IS UNUWFUL,AN�SHALL BE ENERGY P/C ��.•..{ �,;��;d V LL SUBJECT AN EMPIOVER TO CRIMINAL PENALTIES CIVIL FINES UP TO ONE HUNDRED THOUSAND ENERGY PERMIT - •- �.�'�'T��'�`'' '' DOLLARS(f100,000).IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDEO FOH IN �. J SECTION 370E OF 7HE IABOR CODE,IN7EREST,M!D ATTORNEV'S FEES. l� �-�•'��-� - RETENTION FEE: ��y � a CONSTRUCTION LENDING AGENCY PRE-ALT FEE: 1Ct��J.�^:��"l�l'' �V� r� O � I HEHEBV AFFIRM UNDER PENALTY OF PERIURY THAT THERE IS A CANSTRUCTION LENDING AGENCY - n- FOR TNE PERFORMANCE OF 7HE WORK FOR N?iICH 7HI5 PERMIT IS ISSUED(SEC.�087,CIV.C.). � Z W � LENDER'S NMIE F- LENDER'SADDRESS � I CERTIFV THAT I HAVE READ THIS APPLICATION AN�STATE THAT THE ABOVE INFORMATION IS COHRECT. TOTAL FE ES ��J� � I w 1 AGREE TO CAMPLV WI7H ALL CITV AND COUNTY ORDINANCES AND STATE UWS RELA7ING TO BUILDWG � � CONS7RUCTION,AND HEHEBV AUTViORIZE REPRESENTATIVES OF THIS COUNTY TO ENTER UPON THE �� Z /�BOVE-MENTIONED VHOPER7Y F NSPECTION PURPOSES. / COMMENTS ' �'�-� � ��,�L' � - `�%Z� , � � a m PEHMI (PRI T) � p � /7 Q b � � � NATURE ERMI EE DA E = RECPT.NO. PAID BY VALIDATION ~ WHITE--0epartment Copy,YELLOW�inence Copy,PINK—Assessor Copy,G OD—File Copy,GREEN—Applicant's Copy � , . . . . . • . . . , .. , ` ,. - . _, . �� f� ��46l��(�1�3 �l�l�$ B(�Sf�'Ic�G"f��f�I (�f�� -� : ,� . . . _ s� .,U � 1� 'a f D � : Q ��-j Q � �',�o °D , n �`4 O '� .,.� .p. ... e > a� . *�e +� � . D O �o -1'� �.'<°%. JJ'1�'i � r '' ''��.�..:�.��ri,.��.. �* �' . , . ,� . �^�. . . �. �� E SET BACK .•• , ' \_� FLOOR JOIST „� � a � � � . . , . , . . . � • � �:. . > .,�., — ----- — --- ---. '___._ . _ __..._-- � FTGS/FORMS/STEEL ' ' `�;'� � ', FHA REQMTS � �' �; - ---- — — - - ._._ _.._ --.1 � . L--� .�F— ELECTRIC GROUNQ UNDER FLC}4R �3UCT � ._ • ' GR�UND PLUMBING UNDER FLO£3R�C��+�;.11T ; ' �`y'~�"•` f�"- = - - ` �'�"�` �` ----.. — :• .: SLAB GRADE FIRFRLA�E`��;ilV��T}ON'� t�.�, - ,>.:j�� i TEMP POWER - � FIREP�/��E�B(�1VD;R�AM:�`�''.�" � {..� ._ `•� `� ---- + WATER SERVIC� � MID HT. BOND B�AM ,. . �':_''" -'.� ''� '• �' - — _ — -- ---t�------- -- �.� �.,. � ROOF SHEATHING 3='� • "� �`•.�1,�:=:�:':� 8 FT. BONQ B p1��T` , , -. •��. �'� ` �; ,:=_� — ' ' _ _"_.—��_� ."_:\�� rJ�'�a\'� _._��•b°\_. .�.� FRAM!►�GNENTILIATION rINAL BONDB�AM�� ' � ROdF COVF_R PRE-GRADING ' ROI;GN HEATING ' � BENCHING RdUah �LECTRIC ROUGH GRADING ROU�� I�LUMBING FINISH GRADING , F3HC'v�'E�/�'UB TEST POOL ELECTRIC ' � ��XT. LATH/SIDING POOL FENCING � ` � __ �t^rALL{NSULATION POOL FINAL i �__ _ - ; C�iL�i�G IN�ULATION OFF SITE IMPS. � Df�Yi�l«i�.L NAILING DEdICATIONS � S�W�f; -- — FINRL ENG. � -- � �t:P;eV TANK �APJDSCAPE/IRRIG. � � � ;-------- _ �___ _._.._�. � �t:=�P *=�-/��,L. 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