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HomeMy WebLinkAbout12039 (13) � �� 2 �f � �, CITY OF DIAMOND BAI� --�--� DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES � 21660 E.Copley Drive Suite 190 /'' (909)860-3195 Fex(909)861-31 t7 �,' PRESS �UILDING PERMIT APPLICAT[ON FIRMLY ' y JOBSITE �J� L ��) 0 .ADDRESS ��� /��vy CON r� pA�CATIOf+L/J r�� NU BER�r"'� f� r � APN LO �_ TRACT ISSUE^—� TYPE p� DATE CONST. GROUP � OWNER /'�a �i f` e ADDRESS - ZONING SEBACKS CfTY 5 Q N ZIP Z TEL ' 6 R�R RW ❑ � APPLICANT ..� TE - I � SIDE/51QE STREEf RW ❑ CONTRACTOR i �x - SIDE ❑ ADDRESS � CITY i ' ZIP �T� TEL. ;.Q Q PROPOSED USE 8 ARCFVENG/ � DESIGNER NO.OWEL. NO. NO. ADDRESS UNITS STORIES BEDROOMS CITY ZIP TEL. t/� DESCRIPTION S�.FT. FACTOR PSF ADJ.AREANALUATION p� OWNER-BUILDER DECUIRATION 6FRlADD/REM O � I NER�Y/iFFINM UNDER VENALTY OF PEiWRY TNAT I AM E%EMPT fRON THE CON'fRI�C70R5 LF a8�8gB/G•eryOK CENSEUWfORTXEPOLLOWINOREA80N(SEC.7691.68USINESSMIOPFI�FE9SIONSCODE:AM/CITYOq �(n COUNfYYYF1IGIHEOUWES/1PEfWRTO00NS7RUCT,ALTERINPAOVE,OEMOIISH,OHREMIRANY9TAUG �W P8t10/DOCk NRE PRIOR TO R8 R9VAIV�,ALSO i{EWIRES TNE APPLICANT FOR SUCM GERMIT TO F4.E A SIONED w lTA7EMENT 1►IAT NE OR 9NE IS LICQ�ISED N1q5UlWT TO TNE PRpVISIONS OF 7HE CONTRAC'f0R5 ll- � CFN9E I,AW(CFUGTER��0061YENCYNO YATN 6ECTION 7000)OF DIVISpM i OF 7FIE BUSINE65 M10 PNO� �u' POOY$p8 FESSIDNSCOOE70RTi1ATMEONSHEISEXElAPT7HFAEFROMAN07HEB0.41SFOpTHEAILE�EDEKEMP- ,(� T�ON.AWYVIOLATIONOFBECTION70]7.69YANYMPIICANTFOi1APENMIi6Uk1,lECT9TFIE1IPPL�CANTTp Z p�ROO� � AGML YEWLLTY OF NOT NDRE TIAN FNE XUNORED DOLURS(16ao).): � � ❑I,ASOINNEROFiMECitOPER7V,ORIAVENVIAYEESWI7HWAOESA3TFiEIRSOLECOMPENSATION, CW111nBfCl81 - W4L CO TFif NOFX,ANC THE 9TRUCTUqE IS NDT INTE1mE0 OH OFFEf1ED FOR BALE(SEC.70M,61131- nJ NE35 AND YROFESSIDNS COOE:iNE CONTMC70RS�JCENSE LAW DOES NOT AGPLY TO M7 pWl$R OF � ►ROPERTYNM1I�BUIDSORNdPROVESIMEREqJ,/JibYhIODOE53UCHWOpNVnNSELFOqHERSELFOq = � THf10UOV1iY5OpHENONMEMPLOYFES,VRO'VIDEDTHAT6Ud7NAPROVEMEM3ARENOTMENUEDOR m OFFERm WH B/LE IF MOWEVEFt Tl1E BUtqN00R IMPROVEMB�RIS gOID WI7NINONE YEAR OF CQARE- 710N,1NE O�MNER�BUIIDER YYILL IUVE TME WRDEN OF VROVIMO THAT HE Oq SHE DIU NO7 BUILD OR NIPROVE FOR TIE WRPOSE OF S1VLE1. �� � ❑tKsONR1EROFTHEPfIOFERfY,�MtEXCLUSIVELYODNTMCTINOWfTHIICEN5E000NfRAC70qS TO CONSTNUCT il1E P110JECT(SEC.7014,BUStNES3 AND PROFE6SIONS COOE:7HE COHfRhCTOFi6 LI- VBIUBtlOr1 ApJ,ppEp CENSE UW OOES NOTAPPLY TOl�N OriNER OF A PPOPERTYYYFp BUttD9 OR W PRDVE91T1EREON.NID MIWOODNfNACTBFORBUCNPRn1ECTSN1THACONTfUCTOR��LICENeE�M1q3UANTTOT1E00N�RAG qUANTI7Y DE3CRIPTION � npqs ucEraE yay.y FEE ❑1 AA1 IXE7APr UNOER 9EC. B.l P.C.COR THIS NEASON � U LL F OATE OWNER U � IJCENSED CONTRACTORS DECIARATION ' � . � INEqEBYAFFWJUNDERGEWLLTVOFPE0.1URViNAT1AMLICENSEDUNOERPROV1910NSOFCHAPiEq � .. � •(OpAMENCNp WITFI8ECTlIXJ 70a0)OF DMSION�OF 1NE BU61NES5 AN�PROFESSIONS COOE,AND Z ►tN LIGENSE IS IN F11LL iORCE AND EFFECT. � , 0 LICENSE CLA8S Q LIC.NO. � � DATE CONTRACTOR � WOHKERS'COMPENSATION OECLARATION � � � INEREBYAFRNMUNDERPENKTVOFPERRIRVONEOFTHEFOLLOWINGDECLAFUTqN&: z Q _�IFI�VEANDWILLLWNTAW110EqTIFIGITEOFCO1d5ENTTOBELF-INSUREFORWOPKERS' � � COMPENSATION,ASPROVIDEDBY9ECTION87ooOF1MEUIBORCO�E,WFTNEPERFOHMANCE �U ' Q OF THE WOi1N PDR NM1lldi fHl9 PERMIT IS ISSUED. ,� f '� �I HAVE MN N7LL WINfAM WORKERS'CONPENS�TpN INSl1MNCE,AS REOUIRED BV SECTION Q Y/oo OF TFIE LABOR pODE,FOR iNE PERFORMMICE OF THE WORK POR WMICH iFI15 PERMIT IS � ISSUEO.MV WOFiKERIS'OOMPEN9ATrION INSURANCE CTARRIERAND POLICY NUMBERME: CONSTRUCTION � wRweR ` !�N Ci(4�G JriS • PIANqEViEW Q,L roucY NUuaER W � � Q� ELECIAIC Q p Inase�nor+r�r�oreEoa�morn+Er+�ne.ar�sror�a+E�ooatt��siao�a+�ss� PLUMBING l Z 1 CERTIFY THAT N THE PERFORIAANCE OF THE MOFlK FOR YMICH THIS PERMrt IS ISSUEO,I MECHANICAL �7 SNALL NOT EMPIAV ANY FERSON ql MIY MANNER SO AS TO BECAME SIIBJECT 70 hIE y 1MDiiKERS'COMGENSATIONLAWSOFCALIFOqNIA,AND�OREETUTIFISHOVLOBE001AE INSPECTIONFEE � PFtOVIS10Ns OF 9ECTIDN HE IABOH . . O WOEE S�FORiMWIh1COMPLYN5ATION�SEP OYISIOHS. ��� ISSUANCE � �' ` � Y . Y � l � sMIP : ...._....._., .... .. _.__... p OATE: APPLICANT. � � ENERGY PJC � WMNIN(i:FNLURE TO SECURE WORKERS'COM7ENSATION GOVERMiE IS UNUWFUL,ANO SHALL 9E � SUBJECTANEMPLOYER7OCRIMINALPENALTESANDCIVILFNESUPTOONEXl1NOREDTF10U5AND ENERGVPERMIT ' a���` Y DOUMS(i700.0007.IN 11DOITION TO THE COST OF COMPENSATION,DAMAdESAS PROYIDEU FOR IN � BECI%1N J7oe OF 7HE IABOq OODE.INTERESL ANOATTOHNEYS FEES. RETENTION FEE: O CONSTqUCTION IENDING AGENCY pRE-ALT FEE: � INEREBYAFFlRMUNDERPENALTYOFPERR1RYiT1ATTHENEISl1CON5TRUCTIONLEl1pIN0A0ENCY 2 FOR 7ME PERF011MANCE OFTME WORK FOR NM111CN THIS VERM1715ISSUED(SEC.3oB7,qV.C.�. W � LENDER'SNNAE � LENOER'SADDRESS � I CEFTIF/7TIAT I WWE READ TIIS APPLICATION ANU STIITE 7HAT TME ABOVE INFORMATION I6 CORRECi TOTA�FE ES (,_��/e � {� � I IW REE TO COMPI,Y N7TN ALL p1Y/ND COUNTY ONDINANCE4 AND S7A7E LAWS PELATINO 7O BI1lDIN0 � Y/ (,/ � CONSTRUCTION,ANDNEREBY/LLITNOHIZEFIEPRESE(iTATIYE50FTHI5COlWTYTpENTFRUPONTHE , � /160YE•MEMIONED iROPEATY WR WSPECI'ION PURPOSES. � COMMENTS � e� es1 Q ��,� ,�E � s-��..' � y iqN11 REOFPERWTTEE p�TE � RECPT.NO. PAID BY � . �' � VALIDATON WHITE—DepettmeM Copy,YELLOW—Finence Copy,PINK—Assessor Cupy,GOLDENROD—File Copy,pREEN—Applicent's Gopy CITY OF DIAMOhtD BAR '� INSPECTICIN RECORD, , . . � � � E . . � � � . � . SET BACK �, • . ' . � FLOOR JOIST` 7 .`, FTGS/FORMS/STEEL FHA RECtMTS � ELECTRIC GROl1ND UNDER FLOOR DUCT _, '. - GROUND PLUMBING UNDER FLOOR COhIDUiT�- . � � SL46 GRADE FIREPLACE F�UNDATION - TEMP POWER - FIREPLACE BOND�BEAM � WATER 5ERVIC� MID HT. BOND BEflM ' � • � ROOF SHEATHING 8 FT.BOND BFJ�1M • � � � ! FRAMING/1lENTILIATION FINAC BOND BEAM ROOF COVER PRE-GRADtNG ROUGH HEATING BENCHING FIOUGH ELECTRIC � ROUGH GRADING ROUGH PLUMBING FINISH GRADING SHOWERlTUB TEST � POOL ELECTRlC EXT. LATHfSIDING PQOL FENCING WALL INSULATION POOL FINAL � CEI�ING INSULATION � ! OF�SITE IMPS. DRYWALL NAILIIVG DEQICATIOIVS SEWER / FINAL ENG. SEPTIC TANK � ; LANDSCAPEJIRRIG. SEEP PIT/L.L , j ; ON 51TE IMPS. � GAS AIR TEST } � FINAL ZONENG F1NAl CONST. ; j FIFiE DEPT. FINAL FINA�HEATfNG f ' HEALTH DEPT. FINAL FINAL ELECTRIC � ; j DEV. FEES PAID FINAL PLUMBING p � ' ENERGY • ; ,.. - � � • COMMENTS � �". ■' " � • _., .,,..»- . ., .P.�..,. . ' • .. . �..V•--..... . . . .� .............. � ' M1 SEPTIC TANK SIZE SEEP PIT/U SIZE - � � � .... •� � ,. ` � . . , ; . . � !: . .