Loading...
HomeMy WebLinkAbout10781 EXPIRED � . CITY OF DIAMOND SAR COMMUNITY DEVELOPMENT DEPARTMENT ` ' ..,._ ' 21660 E.Copley Drive Suite 190 NO V O 1 ZOOO PRESS (909)86a3195 Faa(909)861-3117 � "^"� BUILDING PERMITAPPLICATION FIRMLY JOBSfTE / � f� APPLICATION�j I�l PERMIT P/C a o ADDRESS�G� �'�n �t� + �� DATE���_NUMBER/O��/ M -r 7 Z- � ISSUE TYPE OCC APN LOT - T CT DATE CONST. GROUP p OWNER rJ ' ''� (,IL V I "" ADD SS + ti.- '� ' � ZONING SETBACKS • ' c — w CITY 1\� l- • ZIP� TEL - ' !' l ' FRONT RW ❑ � APPLICANT !��i �►'t�• � ' TEL S��� _ REAR O � SIDElSIDESTREET RW O CONTRACTOA • �� � K-Uk1 C�( t/1 SIDE ❑ � CITY E ' n � u ZIP� ,TEL. ' PROPOSED USE ��- 4 w ARCWENG/` �j I �z OESIGNER ���� /�'`��/� -'� NO.DWEL ' , NO. , NO. a ADDRESS UNITS STORIES BEDHOOMS � CITY ZIP TEL. N DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION � ONMEF-BI:iLDER DECLARATION SFR/A�DrAEM t O `—'i� p I NFREBY AFFlRAI UNDER PENAL7Y OF FEfLRIRY iHAi 1 AA1 ExEMVT Ff10M TME CONTMCTORS LI• GarefldC�lpOh • ' -� W CENSEUWFOHTHEFOLLOWHOREASONISEG70.tt.S8U5M1ESSANOFROFE55qNSCOOEAHYdTYOR (n U COUNiYMMItlIREOl1K1ESAVERMITTOCONSTAUCT.ALiERMGFqVE.DENOlISHORREGAIRAHYSTIAIG• � TUt�PRqR TO ITS ISSUN�CE,ALSO REOt11RE5 TME AOVLN'.ANT FOii SUU1 OERA1:i TO i1LE A SICNEO W P8fi0/D9Ck O - [j�� S1AiEMENT T11AT HE OR SNE IS UCEt�EO PURSWwT TO THE PROYtSi0N5 OF TME CONTMCTOR6 l4 � GEHSE UW(d�MTER i(CpAYENGNU Wihl SECTqN 7000)OF DIV1510N]OF 7HE BUSN1E55 N�PRO- LL' POOUSp! FESSpNS CODE)OR THAT HE OH SHE IS IXEMPT 7HEREfROM AND T11E BAStS fOR THEALLEOED EXEMP- TqN.N1YVIOLIITIONOF5ECT10N7077.S8YANYA7VLILANTfOR�PERYITSU&lECT57MEMPLICANT70 Z Re-Roof F A CML VENALTY OF NOT MORE T/UN F1VE HUNDHED DOLURS�{500�� � OIASONMEROFTHEPROPERTV.ORYYfMPLOYEESVYtTNWAGES�STNEiRSOLEC0IAPENSATI�N, 0 COmmerCi81 WILL DO THE WORK YlD THE STRUCTURE lS NOT IMEPDED OR OFFERfD FOR SALE(SEC.7W�.BU54 J NE55 AMO PROFESSIONS CODE:TIE CONTMCTORS LICENSE UW DOES NOTAPttY TO IN OWNER OF N OROPERTYYRIOBUIIDSORMPi10VESTHEREqJ.ANDNMODOESSIKHWORKHIM6ELFORHERfiEIFOR = � CC TNROl10HMi50RMEROVMEMPIOYEES,PROYlOEDTHATSUCHYPROVE�iFJiTSARENOTNRE/OE�Oq m QOFFEREOFORSALE6,NOWEVERTMEBULpN�ORMPROVEAIENTI550LDWrtMHONEYEAROFCq1P�E- Z TqN.THE OYMER BNIDER WILL MAVE iME BURDEN OF VROVN6 iMAT NE OR SNE 0�NOT BNID OR = NIPROVpFORTHEPURP0.5EOfSALE1 /`D�//S OwNER OF iHE PROPERTY.AIA EXCLUSNELY CONTMCTIN0IYITH LICFHSED CONTMCTORS � TO 06119TRUCT iHE PiIOJEC715EG 7ou,BUSINESS INO OIIOFESSIONS CODE TME CONTRACTORS U• V�It18�iIX1 ADJ.AREJ1 W CENSEUWDOE9NOiAPPLYTOIWOVMEROFAPROPERTYWMOBU1LD50HMPpOVE5i11EREON,AIA � Wr�OCOMRACTSFORSUCIIVROUECTSYnTMACONTMCTOR�S)L�CENSEDPURSUAHTTOTHECOHfRAG pUANTITY DESCRIPTION FEE � TORSLICENSEIAwj. �J �/J�y 0 OIAIAEXEYPTUNDERSEG. B 1VC THISR Q a`�' "��� • �� � � �.�Nrs . �s- Z D�7E OWNE � � d i w�iL • �a �)Ri.�«K � � LICENSED CONT ORS OECLAHAT�ON w 1 HEREBVAFFIfCM UNDER PEN►LTY OF iEiLR1RY TUT IAM LICENSED UNDER VROVISIONS OF CHAPTER � � ��COIYIENCN6WIiNSECT10N7000)OFDMSION�OFTNEBUSMESSIW7VROiE55iM15CO0E.AND Z X MY tKENSE IS W FU1 iORCE IND EiFECT. m LL1 � 0 LICENSE CUSS UC.NO. J V DATE CONTRACTOR a ��N g� �� W c� WORKERS'COMPENSATION DECLARATION � v��� � = U NIHEREBYAFFIRMUHOERVEWILTYOFGEMIRYONEOFTHEFOIIOWwODEQAMTqNS. Z � �INAVEENDWN.LMAMTAIHACERTILIGTEOFCONSENTTOSElFdNSUREFORNKIWCERS' _ tOMPEHSATqH,A9 7i10VIDE�BY SECTION S7oa OF THE LABdi CODE FOR THE PEqFOM1�NCE W OF TME NM17RN FOR wNICM THIS YERMiT IS ISSUEO. � 0 �I MAVE AND WILL YAINTAM WOPo(ER5 COYPENSATION MSURANCE,AS REOUIRED 9V SECTION 4 77000FTHELABORCODE.FOATHEPERFORMANCEOFiNEYlORRFORNM1IICHT1115CEWdrtiS �J�J .0 0 ISSUEO.IAY WOFKERS'CO4PENSATqN INSURANCE CARRIER AND POIICY NUTABER ARE. CONSTRUCTI L-` •Z jCARRIER PLAN REVIEW �y s •y 7 � vaicrwuraeEA LECT Z . !S 0 (RasSECnoNr�EIDNOTBE�.iLEiFDOFnEVEiMftsftaONEHLH7REn0ot1lli5(ftaolattFssl PLUMBI Z ICEHTIF'/THATNTHEPERFOAMANCEOFiHEWON(FORN711UITHISVERA1Ri5�S5UED,l �N�C � C7 SMALLNOTEYPLOVANVVERSONWANYY�NNERS0115TO8EOJMESUBJECTTOTHE � KOiY(E0.S'COYPENS�TIONL►WSOFC/LLIFORNI�ANOAGREETNITIF15110UIDBE[DME INSPECTIONFEE S 6UBJECTTOTMEVIDRNERS'COMVEN5A7qNPpOV15�ON50FSECipN770DOFTNEUBOR � .�• COOE,�511ALL FORTFIMn711 WMPLY WiTH THOSE FROVISICNS. SUANC O 4 ( . � V p DATE: APPLICANT. � ENERGY P/C ' WARNI�Ki�FAILURE TO SECURE WO�KERS COMPENSATION COVERAOE IS UNUwFUI.AND SNALL BE � 6UBJECTANEMPLOYERNCR�.INALPEN�LTIESMbCMlFNE4UPTOONEMUNDREOTMWSNA ENERGYPER �~ ZZ• � DOIURS IT100.000).W ADDITION i0 iHE COSTOF GOMPENS�TION.DAMAGES AS PROViDEO FOR IN - � 6ECT�ON170�OFiHEL�BORCOOE.NTERE9T,ANDAT(ORNEY'SFEE4. RETENTIONFEE: . 4 CONSTRUCTION LENDING AGENCY PRE-ALT FEE: O � IHEREBY/ilFWMUHOERVENAlTYOFGERA1RYlNA7THEREISACONSTPUCT10NlEND11HIAGENCY • Z FOq TNE iENFORMANCE OF iME WOPoC FOR NTiidl iH15 PERMIT IS ISSUED(SEC.]Oa7,pV G). W � IENDER'SNAME � LENOER'SADDRE54 � ICERTILYTN1lTINAVEREADT/15APRIGTION/WDSTATE7HATT1EAB0'lEWFOiiYAT10NI5CORRECT. TOTAL FEES ��/� �a � IACREETOCOAIPLYWR'HALLCI7YANDCOUNTYORDPIANCESANDSTATFUWSREUT0.'CTOBURDiNG � CONSTRUCTION,ANO HEREBY AUf110RIZE pEFRESENT�71VE5 OF THIS CCUNTY TO ENTER UPON THE S� ABOVE-MEMIONE07ROYENTVFORWSPECTIONFUHP06E5. COMMENTS � � � � CG � �TT�ENAYE • .� -_ . 5 � // /��I V] v/ �� � � NNEO Tf E , TE � - RECPT.NO. PAID BY WALIDATION WFi1TE—Doperlment Copy,YELLOW—Fna�oe Copy,PINK—Asasuor Copy,GOLDENROD—FIM Copy.GREEN—ApplkanCs Copy . . . , �q-r.,,. . .� ,. „ _ ..'r.;„�.. j�..�raer.. . •.i-'+'i'�- -�Y`if'�tia: ., i , . n. ' " ' • - . r ' �'• . . �. �• • • • , ` . . . , . , .. . ^��r�i t��r,.M . �� cir�r or- �i`_r�Of�� C��R � � � � � ,� . . - ; �L��,�•^ � ;'� "��;�. ,. , � �. ,� , , �'- . - , _� � . ._ . • '' _ _ . . IP�lSPECTIOI� RCC�P,� , '��;, l►�.l-_i��=c;�rl�l►�� • �.��V�'= Ji���.'?�e' l�� � "1;'k_-'fc��c;�j�l��►�I e;�����'_ '���`�'•+�c'�e:�,;��„ _ , _'� _ _. ���._____.�__........_._._..__.___ _ _.__._ _.---.------:-----�------- -- _ -.� -- -• - •---- -_�.___._._:__--- - -----, . ____ , . . -• serBaEx . _� , _. i..!.Floo��oisr- ------ -- - -- --- -- --- -- : FTGS/FOA�AS/STEEL-- O.IG �' ' - -i FHA REQUTS-. .,, - � ' - - -- ' --- - -- ELECTRIC GROUND � � -' - UNDFR . DUCT� � • � � � - -.• � —