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HomeMy WebLinkAbout13-123 . ,.. - _ ' C1TY OF DIAMOND BA:R '� (�.� -" "�j`^ � DEYARTMENT OF CONiMUIVITY&DEYELOPMENT'SERVICES — "} 21810 Copley�iive,Diamou��Bar,CA�91765 �� .,W . � (909)839-7020 Fax(909}861-3117 $uilding Inspection Hotline(909)839-7027 � PRESS �''"', BUILDING PERMIT APPLICATION FIRMLY � J08SlTE o ADDRESS e- DATE,CATION/.//' � NUMBERj _ ��� #/C iv m issue —T TYPE occ APN LOT TRACT DATE��I�� CONS7. GROUP p OWNER �✓l �^ " ADORESS vc �C - ZONING SEBACKS 0 z C11Y �� � TEL.[- 0 3W •� 3 FRONT qW ❑ � APPLICANT TEL. REAR p z SIDFJSIDE STREET RW p ¢ CONTRACTO %�. ri SIDE � � ADORESS-C , o CITY ZIP 9 7 S TEL� PROPOSED USE h'Q w r %1 iyla.'�i�``!� w � wo ARCH/ENG/ � � z DESIGNER a ADDRESS NO.DWEL. NO. , NO. = C�-� Z�P �L UNITS STORIES BEDROOMS � �� � DESCRIPTION SQ.FT. FACTOR PSF A�J.AAEANA�UATION p� OWNER-BUILDER DECLANATION SFR/ADDlREM O - p I HEREBY AFFIRM UNDEH PENKTY OF FERAIRY THAT 1 A/I Fj(FlIPT FROA1 THE CONTRACTORS U- Garage/Carport W CFNSEUWFOHTHEFOILOWWCf1EA50N(SEC7o]1.SBUSWESSPNDPROFE$$JpNS(',ppEANYCITYOq (n U COUH1YMTi{G1qE0UIFE5APERMIT7000N5Ti{UCT.AL7FRVdPRDyE,OEAKKJg1.OqqEPNqANYSTWJG PatidDeck w NRE.PPqq To rt5155UAHCE,AlsO R[flUIREs hIE APPI�AN�FOq 5UCli pF3iMiT TO FlLE A 51ONE0 w STATFIUENT T}UT HE OR SHE IS LICEMSED➢VRSUANT TO THE PAOV1510NS OF TY1E CONTRAC70A3 l4 � CENSE UW(qUPTEH Y�COIANENCW6 Y.�TH SECTION 7o0a)pF qVL510N]OF THE BUSW E55 AND PRO LL- PooUSpa 0 FESSqNS COO�OR THAT HE OR SHE IS IXDAPTTHEREFROM I1o0 h1E 8/SIS FOR THE AILEOED E%EAIP• � 770N.Mrv Y101A71oN Of SEC7lON 7Wt.5 8Y ANY MPUCAH�FOA A PERNIi 5U&1ECT5 THE A7PUCANT 70 z RaRaal � A CIVIL PENALTY OF NOT MOFE THIN FP/E HUNORC-0�OlLMS(S50o).} Q 04uOWNEROFTHEPRQPERTY,OHMYFJJPLOVEESYVITHW/�GESASiHEIASpLECpNGEN5AT10N, � �mmercial z YALL W THE WORK�TNE STRUCTURE 19 NOT WTQIDED Oq OFFEPED f-0q Si.LE lSEC.7a�.BUS!• _J � � NE55 PNO 7qGFE5510N5 CoOE:TNE COMRACTOfiS UCENSE LAW DOES NOT AVPLY TO AN OWNER OF j � �� � - PROPERTY Yh10 BUil0.5 O/i lMAROVES THEAEON,AND WFlO OOES NOf WORK HLUSELF OA kFA5E1F OR w 7NRWGN NIS Oq HER OMM EMFLOYEES,PFOVIOED THAT SUCN WPqOVFJ.IENTS ME NOT p(7Et(pEp pR m O OFFERmPoq301EIF,�IOWEYE{yhIE3URDW(iORWGROVEMfjf71$" )y/f7HWpHEYEAROFCANRE- Z T10N,THE OWNERAUIIDER IYILL NAVE THE&1fi0EN OF PROVINa THAT HE OH SHE Ot0 NOT 9NlD Oq � WP0.0VE FOR THE PUFlP0.SE OF SA�E} �L �l��EA�FTHE PROPEATY,AA�IXGlUSNEIY COMRACTWG WfM UCENSFU WMMCf00.5 [[ TO fANSfpUCT iNE PRWECT fSEC.7aa�,BVSINE55 ANO PROFESSIONS COOE ThE CONTiIAC�OR51} VylUHtiOn A0.1.AR"4 � CENSE LAW DOES NOTAPP�Y TO M!OWNER OFA PROPEATY WFiO BULpg OR WPROVE9 TNEAFpN,IJIp HMOCONRiACT5FOA5UCHPRQIEGTSYIfRiA�'ANTRACTORjS)UCENSEDPl1A5UANTTOTHECON7{7.1G qUANTI7Y DESCRIPT70N �E Y roas uc�Hse uw.� [C J 0 ❑I Au E%pAVT UNDEA SEc._ B.8 v.C,FOq THIS qEASpN ¢ � U _ LL ^" OATE _ OYMER � f- Z c� " �Q � LICENSED CONTRACTOFS DECLAAATION w U CL 1 HFREBv AfFiRM UNOEA PEWLTY OF PENUqY hU71AM�ICENSm LiNOFA pqOVI5fON5 OF CF�WTEq � Q�° O O�� O o e��0 O � 9(COMMENCWq WI7N SECIICN 7000)OF OM510N�pF THE BUSUIESS,WD PROFESSIONS COOE,AND z X MY LICENSE L4 W ML FORCE AND EFFECT. L1J m �C � UCENSE CtASS ���.�p �/j/�j T� �1Q O O � � O .O o V OATE �/��T�� CONTFIACTOR. �. / . fA� l� a. W � WORKEAS'COMPENSATION DECIARATION Q � � � 1 HFA�Y AFFW11 UNDEFi PEIIALTY OF PERNflY ON�OF THE FOLLpW WG DECIaRI,77CW 5: � (!) Z �Z __1 NAYE AND W!LL AWMAW A CFFTIFlGTE OF GOHSEMTO SEIF�INSUqE FOii VARNER,� ¢ Q CONPENSATION.AS PROVIO�BY SECTION 370o OF h1E LABOR COO�FOR THE PEAFORMANGE U OF THE WOPo(FOH YMldi iHIS PEAM17 13 ISSUED, �7-� � � w �INAVE.4+DWILLMNMAWWOPo(EAS'COIAPQlSATIONWSUR,WCE,ti5qE0UIFEDBYSECTION Q ]�o00F TI1E UBOR COO�,FOq THE PERFOFMINCE OF TNE WORK FOR W1Ctl1 TWS PER4IT IS �SS'�� , J ISSU�.MY WOR!(ERS OpA1PET!$A7�(k7 $IJ{y1JlCE CAflfilER At�IO POUCY 11UMBER ARE: CONS'fRUCT10N j �Po� PLAN REVIEW 0� POUCY MIMBEA o -z v� - Zd- ELECTRIC p (n-�xcr�or+N�r�ore� ocTr�a�.*Tswaor+EKa��[a.�,wSR�mlca� PLUMBING ' u.1 Z �CERTIFY THAT W THE PERFOHMANCE OF THE V10H1(�FOR WHICH THI$PER/AIT IS 65VED,1 MECHANICAL CS SHALL NOT EMiLOY fHY PERSOH Pi AHY MµNER 50 AS 70 BECOAIE SU&IECT TO 7HE (/J WORKERSCOMPENSATbNUW50FCJ�LIFpRWA,qNp,r,�qEETHATIFI5/1OUl06ECAME� INSPECT�ONFEE = SUBIECT TO THE WOHKEAS'COMPENSATION PROVISIOl�S OF SECTION�]OD OF THE UBOF co �i srvy�warHvnn�couv�v vnni niose Pa/ov�s�wr+s.p� ISSUANCE p �ATE � APPLICANi: � ((/) -7'LN SMIP � w J WIIANINfi FAIILRE 70 SECVRE YNPo(EAS COFIPENSATID VEAAGE IS UNLAWFUI_ANp$H:1LL BE ENERGY P1C � J � SUOJECf AN EMPIOYER TO CRMWFL PENALTIES/�Np qy��FW ES W TO ONE HUNORED 7}q�JS�ND DOLLARS(Stao,oao�W IDDITION 70 h1E C0.57 OF COINFNSAT7ON.OMUGES n5 PqOV10ED FOR IN EMERGY PERMIT � SEC770N 77oe pF iHE LABOR COOE WiEREST,ANO AiTOFWEYg FEES. RETENTION FEE: U W , � CONSTRUCTI�N�ENDING AGENCY pRE-ALT FEE: � � I HEREBY AfFlR1d UNDER PEN/LL1Y OF PERAIHY THA7 TNERE 1S ACONSTAUCTION IENOWO AGENCY ����' ' Z fOR TNE GEAfofiMAHCE OF 711E WOiiK FOH WMICH THig PERINT 1515SVE0(SEC 7ov�.CtV,G�. W � LENOEAS WNE F— LENQEASAODRE55 ' � I,CERfIFYTNATIHAVERFADTHISA➢PUCATIONANUSTATETIATTHEABOVEPlFORMATIONI9CORiiECT. TOTAL FEES � ��.�� � I AGAEE TO COMPIY WITH AI.L CfTY ANO WUNTy OqpWµC{5 AND STATE LAWS RELATAIG TO BUflDINO �. CONSTRUCTiON.INDHCiiEBYAUTYIOWZEREPqES^�N7ATIVESOLTHISCOUNT'/TOEMERUPONTHE Z ABOVEJ7ENT70NED OROPEATY FOR WSPECt10N FURPO5E5. o /' ,,f ' j COMMENTS � ___t ��sti� C�1 � Q vEtunnEE ww u+rl \ � ___(/��� -��/{ �.. � � i/-/1� , t/� SIaAANRE"OF MlTTEE DA7F � RECP7.NO. PAIQ BY VpLIDATION ' WHffE--0epartment Copy.YELLOW—Finance Copy,PINK—Assessor Copy.GOIDENR i e Copy,GR EEN--AppUcanYs Copy / �:n�'�` '�:.�� �?����'�a����� ��i� . L . . 9�L�J l�'��n � 7 i?'�4� l'S�a�..v�S"L P� °'�u�..'� `c.�•�j'�FyP-��.�s �x�'`�7$.�+d�."�'�`' �' -���'�, "i�mr� ;.�"' � _ . . . _ . ��d I J � � d� . I r � m''�„�--� g�� �( +s..- ��—r i� � �a � �y�+ ro�r.,'�.x�-- _ g� ;,. k.r. �A 1. � . l^'.,' [��,1.'� 1-4:. '� �i J� ti���v'}� :� �i �'C���`a `��'��`� ?��'�"''it� h`>�ia-.`� ����i3���a°�.1������ --m 1 `� ° �, », ". n_ _e.� :P c��i,-.�-...'�_ ii�'S.. .«� -�� � .���- �rd��'�a.���� 1��•��.�s:�,�'-,�i'rc'�"�,n,t. ��,�,�.._.�c...�-r�...,�. 4,,;S.��i�:j,;�'-''.'���...-'_���"'„�.v+ a.. � »' $ . . h , ':' " , •..� . �. ET B��CI' � �--- I r"100R JGIST _.- -- --- -- - —- � i_.._ — - -- - ----- -- �-- ------- ---- - - FTG`_i;FJRM_;'STEEL � FH�.P,EQ�vITS -------- ---- - --- _ - -- --- - _ ----------------- -, - ------ - -----___._..- --------� �LE�I�RIC GROUP.IQ ------ � UhdDER FLOOR DUCT ------ i �. GROUPdp FLU�_�121Nv _ -i ---- -j ---------� ,I U�•,IDER FLOOR COfJDUiT SLS6 GRr;DE 1 _ � � FIR� EPLA[E FOUP�D/�TIOP�1 � �fEtiiP PO'A/[R � � FIREFLACE 20tdD EE�.h4 V!ATER�ERVICE I I�b�UG HT.BOP�1D BeAh1 R�JOF SHEATHIf•�G �3 FT.BOND B�ANI FRAMIfJG!VEhITILA.TION FINAL 60�lD BcP,M ROOF COVER LPRE-GRADING ROUGH HEATING � _�— BENC7f-�IPJG _ _ ROUGH ELECTRIC i� � }P,OUGH GRADING P,OUGH PLUAAaIP•IG FINISH GRADI�IG SHO�YER/TUB TEST PGOL ELECTRIC EiCf.LATH/SIDING POOL FENCING �NALL INSULATION POOL FI�dAL CEILI�JG I�dSULATIO�J • CFF SITE IMFS. DRYUVALL NAILING DEDICATIONS SE4VER -------- -- ------ FINAL ENG--- ---- SEP7ICTANK i LA.NDSCAPE/IRRIG __ . SEEP PIT!L.L. ON SIT�Ii�1P5. � GAS AIR TEST FINAL ZONING FINAL CONST. � FIRE DEPT.FIP•IA.L • FINAL HEATING HEP.LTH DEPT.FINAL FIP�r\L ELECTRIC DEV.FEES P?,ID FINAL PLUN181NG EP•IERGY FINALPLANING------� --- --------- .. ` ------- ------- FINA,L ENGINEERIPIG � � � C�MMENTS _..__._ --_-------- -- - - SEPTICTANK SIZE SEEP PIT/U SIZE -- — — -- — ��' �- +� r I Attachment A Form for Non-Franchise Haulers for Construction and Demolition Requirements I Company and Project Info: Name of licensed demolition contractor hauler or self hauling coinpany T.,� „1��JKQ. ��iY.-tiJ .J Address of Cornpany f� �, �iamor�- �ovi^ �J�.,��15"�iCity �j e,,h1o>L,�( �Q„►— Zip Code q I�6,.,( Phone Number � Address and Name of Project Site z���� �d� h,��a�4� G-��� U��� 13a�►- , (',�- Y i7 6� Type of recycleable material or waste material to be transported for this project V�� V� n�S � �`�=l Report Information: Please submit this information prior to final building inspection. A report reflecting the following information: • The estimated volume or,weight of construction and demolition debris;listed for each material; • The estimated volume or weight of construction and demolition debris that can be diverted listed for each material; • The esrimated volume or weight of construction and demolition debris that will be landfilled as waste; and ' • Identification of the vendor or facility that will collect or receive the construction or demolition debris. AB 939 Fee Payment: Pay AB939 fee of$6.00 per bin and$40 per roll off for all non-francfiise hauler containers Type of Container number of container Paid date(office use only) (revenue code CD Waste) Agreement and Signature: , The property owner agrees to submit documentation to demonstrate compliance with the 50%diversion requirement for construction debris and shall indemnify and hold hannless the City for damage and liability, including any financial liability, fines and penalties, associated with using a non-City franchised hauler and failing to sarisfy diversion requirements. Property Owner Signature Print Name Date �s �. C�►��� L; �l�i/� v � � Self uler Signature Print Na e � Date Last updated March 14,2008 JAN-30-2013 09:41 FROM: T0:73967486 P.2 + .�..... �. . . ,_ >ti - '_"`_._ `. . --- -- -. '�c. -�,.� _. __ . _ . 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RECYCi�D ;YE� '�� ' . - , -�t957fl1 , Nq ..� s . - , . +y :'_ , �: ::�;" '..� -, w._ ; ., _ _ . ;w.S� ��. ' � �—� � � �E` - - �� � '- s R��C�'Cl:�{�;. :YES,.� > ,..� . .. . . . G �f � �i. :; . ntG : r. l�. _' . � . _ ;w" _ 2`01�� �O�d�n�d Q � - " `� _ � g t �l�� ��, �,� a,�,�5 . ��ecmi� � = l � � I �� � , - , ; : . . . ._ t� . . - _-� � � ��` � . � �� � . t - - � � . � , ; , . . �, . , . ' , { j' I • a , . . .�. . ' t. ` , :. ' r . ;.t. .. e., , , � � . . 4 � . .. . .. , " , ,... . . � . . .�. . . � , � — — — T0;739674B6 P.1 JRN-30-2013 09�41 FROM� ' • - , .�, . , i 4 � � � Tel: (909) 598-898$ Fax:(909) 598,B91t IE-ma�l:sunahincrfpc.9vahoo.. ro�n �SUNSHiNE T�a�F1NG �� � � ; , � L� Building SaFety F x�c 904-i3,96-7�156 , From Sun�hine Roofing DaTe• 011�O/1� �. Rc;, Disposal eccin�_ Page�(�r�Sludg cover� � � C�� . m Urgent �For Review �I Please Comment �Plcase Rcply m please reaycle Hi ' �'..: �,,�.�; ;�. � ........ Hcre are khe desposal receipts for the job site at: 2866 Wood ridge`�Ct.'Aiambnd $ar, CA �,� ., , gl'7b3.Permit#: �3-�z3,We have scheduled a flnal inspection for i�e-r'oof. '``` `- ' - Thank you! _ � . I _,"I _ . . . ._ . . _, ,. � I: E,. ,. . �;,.,� � � ... . . _.__ ----- ---�--� ------ ---._..._.... _. _ . i . . .. , . . _ .. . _.. ,'�._ _ _.........--- --... _ . _. _. _ .�'t ., ,. , _ . , __ il 'i . . ' . . .. . _... . _ .. _ . .. . ... . __. ._ ... ._ �. . . � , j I . Thi�mesaage is intrnded only fo�eh�uee oFthe�ndiv�d�al or u�dry ca which i�ia addrmeed,and may contain infortnation that ia privilegod vr confida�tial.if che rcader oFthis maeeege is.not tl�e inunded recfy�ent,m'the employec or sgent responsible for deNverit�g thr m�aage W 4ha intendcd rccipient you ars hcrcby notifled that arry disaemination,distribution or copyir�of chis eommunication;s Rt�+cdy prohiliited.lf you have reed thia � communieation in crror,plcase nodFy us immecliately by tdephone and return�he origina�meseaga w us ac ehe I � abova addreas VIA the U.S.Posca}5crvice. ` J , �i�. .. .... �_t,._ .ii:.�,.'Jb1: 1'c� .�7k;; �l'q' Li"Y.j �n;l l�C iC: 2!�Di'f����✓Di.�L:71�4!C. i_. . .,.. ... . . . '1' ' � ,. ...,, ... ..::i.�t^��.: �t[,vr. ..G,;.__.,..'....� a �..�a: :tts� ..tri;>tl �::,� �.. ;'ur..'. .. ._ i � � I i� I 4 � : � � i � ._ - -