Loading...
HomeMy WebLinkAbout14041 (1077) f ' � .....__,..._. . .._.............. ..�*q�M \ � CITY OF DIAMOND BAbt ,�i� DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES ` � . 21660 E.Copley Drive S�rite 190 (909)860-3195 Fax(909)661-3117 PRESS M�'J BUII.DING PERMTC APPLICATION FIRMLY � JOBSITE ' 2 APPLICATIO G' �"'• PERMIT [f P/C o ADDRESS �GJ� C CtI��GO PI DA7E �,� NUMBER� �t•� i � ISSUE TYpE p� APN OT TRACT DATE CONST. GROUP � OWNER S r � t� ADDRE� 2 s� cco + •-�. ZONING SETBACKS RW ❑ CfTY a ZIP TEL. FRONT APPIICANT a �� TEL �:St��"13�,� REAR ❑ SIDFISIQE STREET RW ❑ CONTRACT R �^^+ � /b_.�+��s� SIOE ❑ g ADDRE^�S - v ' /•.� _.r�r t 1�� CITY 1�1 ` '� ZIP __a TEL.fvtL."�.SW-`17 PROPOSED USE ARCWENG/ DESIGNER NO.DWEL. NO. NO. ADDRESS UNITS STaRIES BEDROOMS CfTY ZIP TEL. � OwNER•BUiLDER DECLARnTION DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION 0 SFWADD/REM 1 NEAEBY/FFlRY UNDER PFNALTY OF PEqA1RY THAT I AM EXEMPT FAOM iNE CONTMCTOqS LI- GH�fiQ8IC91Rl0A CEMSEUWFORTMEFOLLOWWOREA60N�8EG7091.6BUSWESSANOPROFESSIONSCOOE:ANyCT'OR (n OOIMTYNMKJ111EGU1RESA7ERMfTTOCONSTRUCT,ALTER,IMPROVE.OEMOLJShlORqEPA�RANYS7RUG W P81idDBCk 7URE.IRIOR TO RS ISSUANGE,ALSO REGUIqES THE APPLICAM FOR 6UCM PENNIT TO FILE A SIONED W 87ATEMENf iT1AT ME OR SME IS LICENSEU PUNSUANT TO TNE PHOYISIOfB OF TME CONTRACTOp9 L4 CENSE LI1W(CFIAPTER f(COMMENqNO N7TH SECTION 7000)OF DIVISION 9 QF TNE BUSINESS AND PRO- V' POOVSpB FESSIONSOOOEIOR7MATHEORiXE18EXEMPTTIEREFROMANUTNEBA3ISFORTHEALLEOEOEf(EYP. (ry TION.ANYVIDLATIONOFSECTIONT0.71.68VANYADPLICMlTFORAPEMIITEUBJEC'fSTHEAVPLICMfTTO Z Re-Roo1 � � A CML OENALT!OF NOT AAONE TiMI FIYE NUNDRED OOLLARS�l500).1: OI,IlS01MJEROFTHEPROPFRTV,ORIAYEMPLOYEESWITHNMCiESJSTIEIRSOLECOMPENSi1TqN, CpmRgfCl81 W�LL DO?NE NWiYC AHD THE 9TRUCTURE IS NOT INTENOEO OA OFFERE�FOR 9ALE(SEC.7qM,9U51- � NE65 AIA CROFf�591pN5 COGE:7HE CONTMCT0R4 LICENSE 1AW DOES NOT MPLY TO MI pWNER OF � ►ROPERiYYlF10WLDSORIYPFqVES1NEREON,ANDYMODOESSUCFIWORNWM6ELFORHER5ElFOq = � TMAOUfiHMISORNEHOMR�EIA%AYEES,VHWIDm1/NT6UCHIMPROVEMEMSARENOTINTENDEDOR m OFFEAm WH BALE IF IIOWEVEit TIEBULDINOOq MPROVEYENTIS SOID WITHIN ONE VEAR OFCOMPLE iION.7NE OYVNERBUILDER N7LL HAVE THE BURDEN OF PROVWO 7HAT ME 01t 8HE DID NOT Bl1RD OR YPROVE POR 7ME PIIRPOSE OF 9ALE�. � ❑4�OMMEROFTHEPAOPERTV,IUAE%CLUSNELYOOMMCTINOWRNUCEHSEDCONTRACfORB MODNSTRUCT TMF PHD.IECT(BEC.7ow,W81NE55AND PROFESaIONS CODE THE CONTMCTORS ll- V81u8tlOn ADJ.AREA CENSE I.IIW D065 NOT MPLY TO AN OVYNER OFAPROOEH7Y MM1q BULL,DS OR IMPipVE9 TMEREO!!,MID WFi000HTMC78FOR841CHPFpJECTSVATHACONTHACTOR�3)LICENBEDPUFSUMI7TOTHEGONiMG pUANTIIY OESCRIPTION FEE � TORS UCENSE LAW.} ❑1 AG EIfpIPT UJDER BEC. B.�P.C.FON THIS REASON � Md, ' s� U I u' WVE OMMER � / ^ � � � � � ,J =•L( / LICENSED CONTRACTORS OECIARATION W (�j f Z � 1 NERE6YAFFIIW UNDER FENALTY OF PERlUiIY iHAT I AM UCENSED UNDER VROVISIONS OF CHAVTER � � �(COAIMENpNON7TNSECTI0N700D)OFDMSION90FTHEBUSINESSMDPROFES510NSCdOE.AND Z ' W UCENSE IS N FUl WRCEAND EFFECT. Gzc���3 � � u��s�cuss C ��c.No. � unh conr�ucroa ��yc a � RKER$'COMPENSATION DECLARATION./ �� 4 NINEREBY F�E NALNOFPERIUMONEOFiHEFOUAWINGDECL�MTqN& Z � _I ANDMALLMUNT/UNACENTIFIC�TEOFCONSEI7r706ELFM5UREFORWORKERS' a COMP SA7pN,AS PROVIDW BY SECTION 370D OF THE LABOR CODE,FOR THE PERf-0RAIANCE U OF OHK FOR WHICH TH6 PERAIR IS ISSl1E�. � 8F- _IHAVEANDWILLWIMNNWORKER3'COMFENSATIONINSURANCE,ASREGUIRE09YSECTqN � � O � 37o00F Tl1E UBOR CODE,FOR T/IE PERFORMANCE OF iNE WORK FOR MMICH i}IIS PERMR 19 t6911E0.W KE�O-OMPENSATION I CE CARRI RMA POLICY NUMBERARE: CONSTRUCTION �j CMRIEP J r�`I� J J PUW REVIEW � vaucv txn�BER ELECTRIC 8 (M6 PIDTB[OORPLEfIDOF'IFEPERMIT6FORaYEM�O�oRUARSIi�aa)ontEss} PLUMBING � � IC T EVERFORMANCEOF7HEMlOPo(FORMMI(5i7W5PERM1719155UED,1 MECHANICAL S Y PERSON IN ANY MANNEF 90A3 70 BECOME SUBJECT TO 7HE y WORK NSATqNUW50FCALIFORNIA,MIDA6REETINlIFISHWLClECOME INSPECTIONFEE SU6IECT THEWOW(EFS'COMPENSATqNPf10VI510NSOFSECTWN77000FTHEIABOR � CQOE,1 FORTHWIl11COMPLVWITHT`y!19EY 3. ISSUANCE J• '"�� � p DATE:��/l�./4 ti APPLICANT: J� ��J,��- SMIP Cs_i_1_zJ�:1'�: ^ s R � 0 � :,:��-;�-r3:�t. ENERGYPlC BITT►.n1 " R*��n .- WARNINfi:FARURE TO SECUqE WOAKERS'COAIPENSATION COVEl1AOE I&UNLAWFUL,M!D SNALL BE j i' }{'s• -�, ^ � SUBJECTANELIPLOVERTOCRIMiNH.PENAI.TIESANDCIVILFINESUPTOONEHUNDRE0Ti0U8AN� ` a'�+i-'=+ � OOLLMS({f00,000),NAODIiqNTOTiECOSTOFCOMPENSATION,DAMAOESA3GROYIDEOFORIN ENERGYPERMIT Y 8ECTpN 9TW OF TME LABOH CODE,INTEflEST,MID ATTORNEYS FEES. �L RETENTION FEE: 4 CONSTRUCTION LENDINGAGENCY 0 PRE-ALT FEE: � 1 HEREBYAFFIRM UNDER PENALTY OF PERIUHV THATTHERE IB�GONSTRUC71qJ LENDINO A3ENCY Z WRTHE PENFORMANCE OFTiE WORK FOR WMlq1 TFIIS FENMIT IS ISSUED(SEC.JOD7,CIY.G), W � LENDERS NAME �S lEN0ER5ADURE35 w IGERTIFYTlIATINlNEREADTHISMPLIGTqNANDSTATEiW1TT1EABqYEINFORMATqNIS00RRECT. TOTAL FEES d I A9REE TO COMiLY Al�CITY AND CDUNT'ORDIW W CES ANO STATE UWS qELATINO TO BURDINO � CONSiqUCTION,AND EREBVAUiFqRIZEREPRESENTATNESOF7NISCOUNTVNENTERUPON7HE ABOVE-YEMIONED ER7Y WH WSPECi��J0rrn��lll PURPOSES. � S � �- �v��. CAMMENT5 � � m iERMRTEE NAYE iU ) G � __�" �����7 % � � BIONATURE 1'fT E DATE f RECPT.NO. - PAID BY VALIDATION F YVHITE-Dapanment Copy,YELLOW-Flnence Cop�r,PINK-llsaessor Copy,GOtDENROD--File Copy,pREEN-JlppicanCe Copy w. C!�'"�' C�t� C�9�4.P,�Qt�9[� ��6� 1��"5��=�a"I��°� ������ .,,. .:����;..�;. � t.�•�.• , . : s�.;.:�,; __ ., �" ��ta r+;. � t`c.���. �rr�:� . ...._�{��"�q�,'�'� ���qo.,, M�4��,t«�� `�. '�]�(,�,�l� ��;�'�f: . .afis�'�i1"i�!.`S. �`r����R4.�. �. ...» . .. .a., _._:.,.,._.,.e��.......�:.�� �,,. .�_� ,.< . ._., �. , ._ .. . ,. ., .. -� �, .. � ,�_ . ; ,..,..._ � . . ,..;, i r.,�,: i: � f-i..C)C)F�.I:7I�� � . , � ,. . - - - - •- --------.. �. .._.. - - - - �- -- - _ . .._ - -. . .-- -- --- - - -- . . . .. - -._ ._ . _. . .... : ; � .,,_„_,} r�t,-:'` ':';'F i ' FH?t H�.Ci'vl i S - - . . , ; .; , , , ; ,. ... . . . .. .. ._ ..... . _.. , ----- - - --. _ . . ----- . .. ...--- - _...,... ._ ... .._ __._ � I ,_.�; • -• � - ..�_...... .,,. .±m.-:..;��it; ,._. ,. .. . . _ _ . ._...._---- . .. _' Gi ._._�'........., _ __Cli�.'_._.. __. . _ _ . - - . . .......... . .., _ _.,. ... . �: ac- , . � � � .. . ., •::•-. _ , -. - , , . , ; : �,,..:,, .� '�r,,ar�;;,,;�: t ifrC"R F+_C�C7R GUhl�;i14T l � • ; � ,_ _ . . - . _ . . - --.. ...._ . : _ . . _.. .. ---- -._... _._.._ . ._: . .... ... - , -- - -- ------ --- Ch /'�1 nE/� /�' - --- ( : ��: :.,=.11 1't�'^f-.i): ' ; F"l��i�.��.f1�f�. �'1J4���✓STIl�1�' � ._ . ... . . _ "_ __"_' " _. . .... __. . ___'""' ' '_"'_._.. ..._. . " '_"__'" _. ....._' " ' "" " . : : � . . , '" ' . � _... �.• ..' "" "' _' '` _ _'��ts�'...Z::' ' i E-i��i-�,�_��_/�Z:�: ��i`�:rJ�'a�e��.� . , � . � � ..'� '.'. , ... .. .. ... _ . ........... ... ...... ._ --..,. . . ... . _ . •_.._......._ ..----- --`----_..,-:.-----`^—'---"--`----__. ..... .. � ,�,;�,tt',�'�Lj �;�:.:;�.tli,r' ' ' "' _' . 1 �_f�t;3i14_.i��. E3')t�1Q��:'�i," "' ' "'_. ! � . . . -� - - - - - . �.�_, i , ._ i 'tt( ��� �. � Fi £-;^ht''?f3E h,� ' - . .. . ___-_--,�__-•---•- - - , : ..Ffi . A T , :.. . ... ... .. _�_4���� '- .. _.....' ' _ « " __ __ . "�.'_'. _ .,.._ . _.. , i, ._'. 1 < � ; i=f�er,�',�lr.�': .P!1i:_#n,(E:�,. ti . �-- : F1�1P.E_ !3C�.^�7 �C�',i�', i . . _ .._.. ---- .. _ _.... _...... _. _..-- ---- -.... -- '-- .. •--. _ ..... . . - - --.._ .._... ........ . _, s_.._.._... . _. .... .. - ----. : .__I . . .- .�. .. . _ � i«.;;r t.;C>'vr. �' 1 I Fr=:�-:'�!�Ai�ING � ,. . _ .._ .._ ..__.._ .... ._-- - _..._........__ _�____._---- -______..—.__...._ _..__.-------- -. ....---------------- ---.._...----....--....... .......... .._.._..__...._._.......__ € �-�,..�C.Ea!-E".r-E;,ar;. • � �E�tuCf'IfJCi ; ----...._--- -------------- - '-- ---._._ ._..._....-�-....................---------------j _ _ - - _-- ---.. - -- - - • - - ----------------�-- ' F�„�`:�i!�:ii '�1.L'�:���!: i C;'il(iFi GRADlIVG I ' � . _.._ ._ --..._.... ---. . ---- -- -.._._ .. . .- -�- --� -- - ._..__........ . ..._ ..-------- --..._..----.. _......_..._........--...----.....__... --- -----.._ - - -., ....---.. ._ i � F;:�.`�i,l-: i': t.i:.r[,'.i��t i � Fi(�IIS�•!:a�AC)II�IG , . . . _ . ...--�----•---- -........-----------....---........._ _.__... .. ---__ _ --___ _ -.--__—.-------�--•--_.._--.__................__...------�-----_------_----- - � �>; i°,�,� ,;i'i..1k::-i'[:.`;�- ' • PCi:��. E�ECTF3iC , ti,'-. � � , ...�----- --�— --�------ --..__._.....,....----.,..._...__. ._..._. _ .... :.. ....._.....__.. ..---- ,.... ......,._._._.._..---...__...- ------ ------..:__.._.....- - �----� - . +1'ti,�:�_ . F'(:;+)i.FENCIN.''a '---------- . ... ...-- -- --._ ..._......_..-------------------..._.__...... _.._..._�-C��---/-��!--------._...------- ------------.._.....___.--- -----.,__.....-----_...,_ ... 1.i.:R���..e�:f:!.��..3:���f��;'4 ' � . ' ���`..�1..�1 ��f\'i_ "'"_"""'"'. ...._""""' "__'"'.,.."._._.._....-.'"""._""' """""""'_.._......."'._....._..'_'._...'"_.� ___."'._ .......„�......_"""""""...""'_" ""_" . ... ... . . ." ' '""""".. . ... .._ . _ .. . �-^�; r�u." !;,':�t;!.adi 1C'u. , �;"C:Si;;.-.iP�7F'S. , r __-- - - -- --.._.._.._---- -- - -- -----.._......_.._. .. . __. ._ � . ......... .............._..... ...... ... . .. ; .� ____.._--- ------�-- -.. .--- - - - ' C,�:'�r.,�: s.:,'�1• ft-t;� j i ��;.11(;t;:lC)t•1S .. . ..u... ...-- - ------•-----•-------�---...._...._ _. , ._.._......_.-- ----------------------�----.....---- - � __..-------�-------�-- ' �'__i"' _ ,. . ' ' ' ' ' � .^.1:1��yk ' 7^ . _ _�•---w, C..b:��? � _ .I'.I�..L'�'i'.'n. � i � _._.....'' "''..... _..... ......'_'' "".._ .......... .. ."_"'""'" '..._..,...._........... ,.' " '_.._._.. _.._'_'_""'..._ . ..' _'7..... . � � ✓..4� / }�pp ,�pqr [�/+ i�^e-� . .. .. . ..."__ """'_"""'___"'___I t � ..���t.. lFtl'tY\ ' �� � �_f•i�YiJ�7la4.�':T'i€!'f���j r. i' � �_.,.�___�____�_ �.:_"— ______._.�_..,__.�_—__'_"'__- _-_ "_- _'"________"_'"__._.....}�!'____.__—..___""__._._......".__�...__'..._._.."_"_. "�E��;�' ��fl;�_`_. . C��; SlT'�= InA�,�. - -.. ... ..._. i � ,`,__. .... .... ...._`_....._._.....__.....-- - - ----- --------._....... ____.. ... ._..._._ i :. . ---._..__... _ ---•--�— --.._...� , "�n.f ni€.;-,._.. -._,. ,.r--"-" `.�...�! C . -'_'..__.._._. ..'-.-'—'--_�__.,_,..."'..�.' ..... .. . .. �s; .F r .. 3[.La E ' r'I!`:�`,1..i, P� P�1 � _. - --...�,..._ ........ .___----.......'--- ---_. ...__.. - - - ..__ .__. . _. . ----- ._ ... .,_.,.. . _ ...... - --- - ----- � i [',� 9 •.r y �.�•. �^� -y� p j. �.{_ .�.4:::,. ' . � . . z-1�"1f�.�JE'"i�l. �"�N11�_ t � E�".'I..R1_ " , .. ___.... .......... ..._....,""— ---"---'--.. . ._. _. .. r� . ;..- � .. —. ... .. . . . .-' - --"--... .__.. .�.f�. - --�.� _.. � ' '_� _... ..,. i �'�i�:��.�Y:��:��',�s:x. i • ,.. _C'!cr',���.C?-� '.):,F��--�II`Jfi.,�_ , ...._ .. .._ __�.^........ ----_. _._ ...._„_. _..____..� ...._..__.�.. ----- •� � _..._....._..----[-,--{ -- - -- ..,._....... _._..---..,.. . _.. _... . . _ .. _. .. . I i:��o,�t, i=i #'.1..�1"f�i. . . �'1.--4� ��`+��i f"11f� ^ ' .. ._. _ .. . ......... .""_'""_ �. ......,...._.�..._._ _.._.."_.�.._.. ..."'_'_"". .. .. ."__.,_ . .. .. . ......"'_""'_'""" ""'_"""'"'""".___"'"""._ . ... . ._ _ _..... . , 'e'! ..).��'�f?Sh�{:� � ' t"i�:F'.('i`F � .... . ....__._.,. ..... _-' - -- . ....... ---.. .....,... _....._... . . _� _ .... . . . . ........ . .. . .. . . . . . � _ . , °j" �. .. .;�X�•i,.. �ry,�� . . .. . . . ..... ._ , ....- --_ �..... �. w:,..,' , _ .. _. . ... -- - - - .. -., _., ... ,.;,�'e;� : -. , ---- �--- "---._. ..._ - ..>!p�..'«a <., , ..... - ---,.. .: . . i �,*..,t�./�C-:.!S.'"�•�e"I C • � , � ' . � '. ' � .7 . _ . _ _... ." '_ _ ' ' " ' . . � i �.. .. . . .. .""'.. .. . � �' . � .. ., ' . . .. . . . .. . . ... . . _ . : . .�.ro ' ' "'. . .. _ . . . ..,._..._"'"_" ' ,... . . ' ' � . ,fi,.. .i�.' �h�, i _'°A . ... . . - . , ... . _ . . . . ...... .. .. . . ... . r • . �' � , ." �'. ' ' " . _ . � � . g .M1 . . . .. _ . ......."' . .. ...._ ... . .. . , . . ... .._ . . , , , '�f . � ' .;' R e �, ',; . � . , .. .,._. .. .. . .. ._. _ . , ..._ . . . .... . � .. �y4 . . ' ... .:V �. � ' . ��� ,._ . ... ...... .. ....... . . . . ."' . . ... _.. . .... . , . . . . .,ly °,�^ � • � , f � � i ... , .. � ' .. . _.. .. ...__..... ...._.._...__ _ - -�- --• -- - _ . ._ . . ' . .._. . .. , . a . � ' . . . \ ' ' ' ,� " � ' �, �r. . � ..., . , � 1 . �. - . ,.. . ... _...� ' .