HomeMy WebLinkAbout14054 (864) • •-y ��� CITYOFDIAMONDBAR ���1���
DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES
� 21660 E.Copley Drive Suite 190 S�P 10 2002 pRESS �
(909)860-3195 Fax(909)861-3117
����^� BUILDING PERMTI'APPLICATION FIRMLY
o DDR'ESS I�l7 �. ���L �� �lS T� DATE CATION NUMBER I �S� #/C � �� �
$ �SSUE TYPE OCC
APN LOT TRACT DATE CONST. GROUP
p OWNER i11D •►�� JA /�.L 5`��N/ �"'f
ADDRESS c� U�RL � ��� n . ZONING SETBACKS
z CITY -rtJL�T'C'O�✓ �ZIP�� TE . / - 6 P FRONT RW ❑
g APPLICANT TEL. REAR ❑
� SIDE/SIDE STREET RW ❑
aa CONTRACTOR F��E�-�5/O � �� r� SIDE ❑
ADDRESS ��l �.� l�C�l4N'41 s 6�� S'T� 'f' '
� CITY'FN$f?i�6.fFrJ�EACh.ZIp 97-F TEI��J rrSS5=7S�YL PROPOSED USE Ik Ni �I ,R.
w ARCH/ENG/ �-wA L�5�6� �
z DESIGNER ��dNyw�
� ADDRESS NO.DWEL. NO. NO.
UNITS STORIES BEDROOMS
�- CITY ZIP TEL.
y DESCRIPTION SQ.FT. FACTOR PSF ADJ.ARErWALUATION
Q � OWNER-BUILDER DECLARATION SFR/ADDlREM
O
� 1 HEREBY AFFIRM UNDER PEN�ITY OF PERNRY THAT I AM EXEMPT FROM 7HE CONTRACTOHS LI� GHfB J0/CefPOft
W CENSELAWFORTHEFOLLOWINGREASON(SEC.7031.SBUSINESSANDPROFESSIONSCODE:ANVCITYOR (n
� COUNTYWHItl1REWIRESAPERMR7000NSTqUCT,ALTER.IMPROVE,DEMOLISH,ORREPAIRANYSTRUG W PatiolDeck
TURE,PRIOR TO ITS ISSUANCE,AL50 RE�UIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIC,NED w
� STATEMEM THAT HE OR SHE IS IICENSED PURSUANT TO THE PROVISIONS OF THE CONTRACTORS LI�
� CENSE UW(GiAPTER G(COMMENCINO WITH SECTION 7aa0)OF DIVISION 3 OF THE BUSINESS AND PRO- � POOUSPe
FESSqNS CODE)OR THAT HE OR SHE IS EXEMPT THEREFROM AND THE BASIS FOR iHE ALLEGED EXEMP�
TION.ANYVpUTqNOFSECTION7031.5BYANVAPPLICANTFOHAPERMITSUBJECTSTHEAPPLICANTTO Z Re-Root
� A CML FENALTV OF NOT MORE hIAN FNE HUNDRED DOLURS(f5oo�.):
� ❑I,ASOWNEROFTHEPROPERTY,ORMYEMPIOVEESWITHWAGESASTHEIR50LECOMPENSATION, � COrtIRIBlCi81 �
WILL DO THE WORK AND THE STRUCTURE IS NOT INTENDED OR OFFEREO FOR SALE(SEC.70u,BUSI- J
NESS AND PROFESSIONS CODE:THE COMRACTORS LICENSE UW OOES NOT APPLY 70 AN OWNER OF
� PROPEHf'/NM1iOBU1LDSORIMPROVESTHEREON,ANDNTiODOESSUCHWOFKHIMSELFORHERSEIFOR �
Q 7HROU(iH HIS OR HER OMM EMPLOV[ES,PROVIDED THAT SUCH IMPROVEMENTS ARE NOT INTENDED OR m
Q ,OFFEREDFORSALEIF,HOWEVERTMEBUILDINGORIMPROVEMENTISSOLDWRHINONEVEAROFCOMPIE-
Z �TION,iHE ONMER-BUILDER WILL HAVE h1E BURDEN OF PROVING THAT HE OR SHE DID NOT BUILD OR
� IMPROVE FOR THE PURPOSE OF SALE�.
❑1,AS OWNEROf THE PROPEHf1',AM EXCLUSIVELY CANTRACTING WI7H LICENSED COMF7ACTORS
� TO CONSTRUCT h1E PRQIECT(SEC.7oM,BUSINESS AND PROFESSIONS CODE:THE CONTRACTORS LI- V81U0f1Of1 ADJ.AREA
W CENSE UW DOES NOTAPPLY TOAN OWNER OF A PROPERiV WHO BUILDS OR IMPROVES THEREON,AND
� NRfOCONTMCTSFORSUGIPHOJECTSWITHACONTRACTOR(S)LICENSEDPURSUAMTOTHECONTMG pUANTITY DESCRIPTION FEE
� 70HS LICENSE UW.).
� ❑I AM EXEMPT UNDER SEC. 8.6 P.C.FOR THIS REASON �
3 � � � (/ I G�
� DATE OVMER
z w �'t-�+S .Z t� �
F LICENSED CONTRACTORS DECLARATION W
� I HEREBY AFFIFUI UNDER�ENAITV OF PERIUfiV THAT 1 AM LICENSED UNDEH PROVISIONS OF CHAPTER �
d Y(COMAIENCINO WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PROFESSIONS CODE,AND Z
X MV LICENSE IS IN FULL FORCE AN�EFFECT. m
lLJ �
� LICENSE CLASS ���� LIC.NO. �� � J
V DATE C e'� CONTRACTOR d
W r
� KERS'COMPENSATION ECLARATION Q
� U
� I HEREBY AFfI NDER PENALTY OF PERIURV ONE OF THE fOLLAWING DECURA71ON5:
C/� Z
Q
� IHAVEANDWILLMAINTAINACERfIFICATEOFCQ45ENTTOSELF-INSUREFORWORKERS' 2
� COMPENSATION,AS PROVI�ED BV SECTION 3700 OF 7HE LABOR CODE,FOR THE PERFORMANCE w
OF 7HE WOFK FOR WHICH THIS FERMIT IS ISSUED. �
�
_I HAVE AND WILL MAINTAIN WORKERS'COMPENSATION INSUMNCE.AS HEQUIRED BY SECTION
Q 37000F TME LABOR CODE,FOR 7HE PERFORMANCE OF 7HE WORK FOR WHICH THIS PERMIT IS � � � 3 D
ISSUED.MY WORKERS'COMPENSATKKi INSURPNCE CARRIER M!D POLICV NUMBER ARE: . CONSTRUCTION
J
� ARRIER �SYL��E !=J AI C� PLAN REVIEW � � `"
� ICV NUM R ELECTRIC ) ,� Tr?T�
_.,,i�,
� (nus N�NOTBEOOAPLETIDOF71fPER1.TfISFORONEHIAi)FiEDDOLINiS(5100)ORLE55} PLUMBING I
w MECHANICAL
Z I CERTIFV 7HAT IN THE PERFORMANCE OF THE M/ORN FOH WHICH THIS PERMIT IS ISSUED,I
(,�} SHIU.LNOTEMPLOYANYPERSONINANYMANNFRSOAS70BECAMESUBJECT707HE J�� �' �,"''�� �/� U
N WORKERS'CAMVENSATIONLAWSOFCQIFOHNIA,AN�AGREETHATIfISHOULDBECAME INSPECTION FEE L ` '� L�- ,
SUBJECT TO THE WORNERS'COMPENSATION PROVISIO OF SEC ON 37 OF T1E UBOR
CODE SH FORTHWITH COMPLY Wlhl SE PRO IONS. ISSUANCE �T.' .'
O �n }�yD .:..�5".::"... . �..
p DATE: APPLICANT: . . . _ SMIP -[AAIdT T1TA.r� y.i�:, - ' . � —�' .
� ENERGY P/C � � ' I
J WARNING:FAILURE TO SECURE WORKERS' MPENSATION CAVERAGE IS UNUWFUI,AND SHALL BE
� SU&IECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP 70 ONE MUNDRED THOUSAND ENERGY PERMIT i
DOt.LARS(it00.00D),IN ADOITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN /s/�
J SECTION37oEOFTHEUBORCODE,INTEREST,ANDATfOHNEV'SFEES. RETENTIONFEE: � - v`�
�
d CONSTRUCTION LENDING AGENCY PRE-ALT FEE:
O
� I HEREBY�FFIRM UNDER PENALTV OF PERIURY THAT THERE IS ACONSTRUCTION LENDING AGENCV
n- FOR THE PERFORMANCE OF THE WORK FOR WHICH 7HIS PERMIT IS ISSUED(SEC.3087,CIV.C.). �
Z
W
� LENDER'S NAME
H LENDER'SADDRESS i
w I CERTIFV THAT I HAVE HEAD THIS APPLICATION AND STATE 7HAT THE ABOVE INFORMATION IS CARRECL TOTAL FE ES 7 ��� '
� 1 AGREE TO CAMPLV WITH ALL CITV AND CAUNTY ORDINANCES ANO STATE LAWS RELATING TO BUILDING �
� CONSTRUCTION,AND HEREBY AUT}IORIZE REPRESEN7A71VE5 OF THIS CAUN7V TO ENTER UPON THE
Z ABOVE-MENTIONED VROVER7Y FOH INSPEC710N PURPOSES. COMMENTS
� � .
� L��
m PERMITT NAME(PRl '
Q � �
� ��
� SIG E O MI E ATE �
= RECPT.NO. PAID BY VALIDATION
~ WHITE—Oeparlment Copy,YELLOW—Finence Copy,PINK—Aesessor Copy,GOLDENROD--File Copy,GREEN—Applicant's Copy
— -- �
_ — • , ,.
�1�'�( �I� (����if�6�1� l��aV�
��S�(��C�O�f� (���'L��t�
'�'LRJUIJ�; ,.,��`- �': l;• D..+�..i�'. � � ..0 � Q� � 4n D � �,� �.°� �..���
. , t:. . . .�,
, .,_ _ . .� > . . . � „ . ��� , , . P . +,,. «` •� , �,y ' �a , .. .:
SET BACK ! FLOOR JOIST ' . .
---._ � _..__ � � �
FTGS/FORMS/STEEL " � FHA RE�MTS �� �
I
-- ——,------- ------ -------- —__..__._._._...._......
ELECTRIC GROUND j UNDER FLOOR DUCT
— ---- --- ---.— • .................
GROUND PLUMBING UNDER FLOOR CUR4�UIT � '
_---�-- --..___.._.._
SLAB GRAQE FIREPLACE �OUNDATION ' • __ ___�
TEMP POWER ! FIREPLACE BOND BEAM
WATER SERVICE MID HT. BOND BEAM ' � • • ;
ROOF SHEATHING � ; 8 FT. BOND-BEAM '
FFiAMiNGNENTILIATION " ' � �� 'i`'FINAL BOND BEAM
ROOF COVFR � �PRE-GRADING I �
ROUGH HEATING BENCHING '
ROUGH ELECTRIC ROUGH GRADING
ROUGH PLUiV161NG i FINISH uRADING
SHOWERlTUB TEST POOL ELEGTRIC
EXT. LATH/SIDING POOL FE�VCING
VUALL INSULATION � POOL FINAL
�GEILiNG I�2SULATION OFF SITE IMPS.
DRYWALL NAILING DEDICATIONS � !
L __�� ._ _.._....�.�
SEWER FINAL ENG i
—.----T ...-----
SEPTIC TANK LANDSCAPE/IRRIG.
SEEP PfT/L.L � � ON SITE IiVIPS. � �
�GAS AI�TEST � FINAL ZONING •
�INI�L CUNST. FIRE DEPT. �INAL �
�li�h�NEATING �� HEAL.TH DEPT. FINAL �
��i��J�';�ELECTRIC �' DEV. FEES PAID
' i�' �'h�.�PLUPhBING - ENERGY . � � �
.__ ---- I ^� __-- ---__-- --
.�__ � :C3 p - � -----
� �• �` . 4� . -
` COMNIEiVTS .� _ ---. , -
SEPTIC TANK SiZE
SEEP PIT/U SIZE _ ----
� :� .��a • . — — --
�: 9 _ , �_ ----- —
�a _
�� , —� ---
.�,, -: � . . �
'• , k �
't._ � ���..:� �K3. r �� __.�_