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Home My WebLink About0850-72_Tamarind Avenue Sewer Lift Station_18.1• • Application for Building Permit CITY OF FONTANA POST OFFICE BOX 518 FONTANA, CA 92335-3598 (714) 350-7640 DESIGN REVIEW NO. PERMIT NO Use of Permit vA'1 A 1 I 2-- .1 Pe- 7 13sr tl 7 S TA T/ON ??1,n a1 p PIA/ s n/r/' J' V .04 P fv • (A, .. SskL/)r 1J Building Address ,Owner/Applicant Mailing Address City // ? 2 ? T/tit404 hi?"' .0 c •,T 4 Zip T 4'7rt. rft ti� Tel._ 'Contractor/ .p =A . Applicant f IIIS('_ iAddress ►i1 2-y A ika- State Lic. d 1c t Classif. _!11 7v'f Arch. Engr., Designer . ob70 BD?- Voo Type of Const. Occ Group Tract No. Lot No, Use Zone APN No. of Stories YARDS: Prop. faces / setbacks front left right rear Area Increase Allowed: ❑ Yes ❑ No Roof Type Fire Sprinklers: Required ❑ Yes ❑ No ❑ By Ordinance ❑ For Area 0 For Occupancy Occ Grp, Area sf, ( %) Occ. Grp. Area s.f. ( %) Occ: Grp. Area s f. ( %) Parcel Size s.f. Total Bldg. Area s.f. Valuation: 0 Computed .0 Other Source, Address Tel. Gily Zip State :r;:;: LICENSED CONTRACTORS DECLARATION 0 I hereby 'Him that l am licensed nderproviaions of Chapler9 (commencing with.Section 7000) of Division 3 of the Business and Professions Code. and my license is In full force and effect. License Class '�/`O LIcen No. Date(^ -.7`(j/ /_?• Signature1 X _ � OWNER -BUILDER DECLARATION El I hereby affirm that I am exempt from the Contractors License law for the following reason (Sec. 7031.5, Business and Professions Code): Any city or county which requires a permit to construct alter, improve. demolish or repair any structure. prlorto its issuance. also requires the applicant for such permit to ilia a signed statement that he Is licensed pursuant to the provisions of the Contractors License Law (Chapter 9 (commencing with Sec 7000) of Division 3 of the Business and Professions Code) or that he le exempt therefrom and the basis for the alleged exemption. Any violation of Sec 7031.5 by any applicant fora permit subjects the applicant to a civil penalty of not more than live hundred dollars (5500.00)El I, as owner of the property, or my employeeswith wages as their sole compensation, will do the work and the structure le not intended or offered for Bale (Sec 7044, Business and Professions Code: The Contractors License Law does not apply to an owner of propertywho builds or Improves thereon and who does such work himself or through his own employee% provided that such Improvements are not intended orofferedforsale. Il,however, the building or improvement is sold within oneyearol completion, shed ner builder will have the burden of proving that he did not build or improve for the purpose of eats.). 0 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec 7044. Business and Professions Code: The Contractors License Law does not apply to en Owner of properly who builds or Improves thereon and who contracts Iorauch projects with a contractor( s) licensed pursuant t0 the Contractors License Law.). ❑, I am exempt under Sec B a P C. for this reason Date Owner X cc t7 LD 2 QUAN. DESCRIPTION FEE Issue Fees 010-0316-5500 Issue Fees 010•0312.0700 w 2 U 2 11p'rv/L ere AAJ)V rT MIST Issue Fees /1 — 010-0312-0900 S'7- A 0 Issue Fees 010-0312-1000 2 m i 0 Issue Fees 010-0312.0800 WORKER'S COMPENSATION DECLARATION 1 hereby affirm that I have a certificate to soll.insure, or a certificate of Workers Compensation Insurance, or a candied copy 010,0ol (Sec3800. Labor Code). /r�' T ��f Company 4vi en .. /J Copy is tiled with the City. ❑ end led copy ist/hereby furnished. Date (_"" (.'y� Signature X /.l a ( tV \c cl Policy No >- t7 2 w 2 w Issue Fees 010-0316.5800 Issue Fees 010-031 ' CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE This section need not be completed it the permit is for one hundred(s100) or less I certify that in the performance of the worklor which this permit Is issued 'shall not empbyany person In any mannerso as to become subject to Workers' Compensation Laws of California Date Signature X NOTICE TO APPLICANT: 11, after making this Certificate of Exemption you should become subject to the Workers' Compensation provisions of the Labor Coda you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there la a construction lending agency for the performance of the work for which this permit is Issued (Sec 3097, Civ. C.). Lenders Name Lenders Address Grading 010-0316-0100 Building 010-0312-0700 Plumbing Mechanical Electrical -Drainage System Sewer System Other TOTAL PLAN CHECKIMANK 170tyl0-0316-0300 HAZARDOUS MATERIAL DECLARATION ' Will the applicant or future building occupant handle a hazardous material-r1��••�� or a mixture containing a hazardous material equal to or greater than the, YES �r 1 NO amounts specified on the Hazardous Materials Information Guide 7 -•,`••a Will the proposed building be within 1000 feet ❑ izj of the outer boundary of a school? YES gi NO If"YES'to any of the above you must obtain proper permits from South Coast Air Quality Management. If air permits are NOT required, provide a written statement from air quality agency. If "YES'. to any of the above, contact: San Bernardino County, Department of Environmental Health Service% 385 N. Arrowhead• First FloorPubl ounl ,San ardlno, CA 92415.0180.(714) 387.3044. Owner or Authorized Agent X NOTE: OWNER SHALL BE RESPONSIBLE FORTHE LEGAL AND ACTUAL PHYSICAL SETBACKS FROM PROPERTY LINE AS REQUIRED BY ORDINANCE OF THE CITY OF FONTANA Building Permits ere subject to expiration if work is not commenced within 180 days after date of issuance or 1 work is suspended for 180 days. I DO HEREBY AGREE that all work In connection with this Building and Safety Department Permit shall comply with all the laws and requirements of the City of Fontana. hereinafter called City, and I hereby certify Met in performance of said work I shall not violate any law of the State of California including provisions for Workman% Compensation Insurance, licenses and other regulations of the Stale. I agree to hold the City harmless from any and all liability for personal Injury and properly damage caused by any work done by me, my employees, agents or representatives on the premises. I agree that this permit snail not make the City subject to any claim for liability arising from any work done thereunder and I agree to pay the amount olsuch claim against the City. I WIN that I have read this application and that the information given is correct 1 WK. to comply with all stele laws and City ordinances relating to building construction and authorize a representative olihe Cltyol Fontana. Department of Building and Saletytoenler upon the property, orwhlch I hwe applied for this permit for the purpose of Taking II pection. /�' Date • `•�7 ?i Signature X y--t.�r. Address( (V (' •/,{r1''T!� Ll i. y Iir' C N) PNi • �• l,(&i /c -�y/L,1-1 ppecialTax- Mobile Home 010-0312-1900 Micro-Filrtl sheets @ 010-0316-5000 / , Sn Storm Drain 038-0317-2000 Sewer Expansion J�JIY uN.,.o....„1L1t123-0317-1800 SMI ia7J.'610-0226-0000 Park Development 036-0317-2400 Landscape lnsp' tfo'Tiffp x.,-...4A 312-0900 Tree Deposit 085-0220-0400 Tree Inspection 01-0-0312-2100 Landscape Plan Check 010-0316-0800 City Wide Dave!. 018-0312-3000 North Fontana 018-0312-3200 01-0311! rfrl4,Og6 / To 3 /? n — (3 r0 2 1 �SO> ZT Receipt TOTAfUE APPROVALS: Bldg. Pin. Chk. Ping. FINAL DIRECTOR OF BUILDING AND SAFETY DATE 'y ISSUED BY �93 Dale White - Customer Canary - File Pink - Accountirfo Goldenrod • Assessor Herd Coov - Inspector CONSTRUCTION PERMIT Dete Issued' `j PUBLIC WORKS DEPARTMENT Work must commence within 60 days from CITY OF FONTANA, CALIFORNIA 'a of issue - Telephone: 823-3411 Date Completed.-- Application is hereby made for permission to perform the work described below, It is expressly agreed that the work will be performed in accordance with applicable laws, regulations and specifications of the City of Fontana. This pit must be at the job site during construction. CITY LOCATION Or WORN V \ Quantity Description of Work LS. Rat. + . Unit — Amount Ln. Ft. Curb or Curb & Gutter . + e $ Sq. Ft. Sidewalk 4 • • s 100 Sq. Ft. Bituminous Paving 4 • • Each Driveway Approach ♦ • •"•s Each Cross Gutter &/or Spandel • _ Ln. Ft. Drainage Pipe or Box Culvert - Drainage Strudura Ln. Ft Sewer 2 _ Each Manhole ell/or Ceanouts • s Permiuion is the work described PUBLIC By hereby granted to the applicant to perform o. abve W DEP4t ENT_ ___ tree MOO) Inspection a"'4' ...�_ P°I." Application Fee. ! 00 —'( d �,` Total Permit Fee Received $. )1,1,7 � y na wart n+ssst a tnspeeted Nofifi► Pubt;s Warti< I�peder 24 hours lw unmet. White-ApDlicaar;. Yellow-Trasurw, P1nic-0f$q Mseiladsnpsesee.-