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HomeMy WebLinkAbout15541 (656) r � CITY OF DIAMOND BAR � _. �� . - DEPARTMENT OF COMMIJI+IITY&DEVELOPMENT SERVICES 21660 E.Coplcy Drive Suiu 140 (909)860-3195 Fax(909)B61-3117 PRE$S ���^�' BUILDING PERMIT APPLICATlON FIRMLY N JOBSITE � APPLICATION�jj � PERMIT I� L�� P/C �'`�,,, � o ADORESS 9't 5 �. w,}%v�v��•v��v�� DATE �' NUMBER r � � APN LOT TRACT DA EE �� ONST. GROUP p OWNER ER/eJ/Nb� ��� "' ADDRESS s'/�f Gt/Y�/.i/L�LsilJllf'J �IL ZONING SETBACKS � CfTY��I�Jf?�JM�-ZIP TEL� REART RW p APPLICANT TEL � SIDE/SIDE STREET flW O CONTRACTO C-7l �S�� SIDE ❑ � ADDRE S / / � A�� Z�.�L �TEL. PROPOSED USE s/�.� � � DESIGNER NO.DWEL NO. NO. ADDRESS UNITS STORIES BEDROOMS ' � CfTY ZIP TEL. N DESCRIPTION S�.FT. FACTOR PSF ADJ.AREANALUATION Q OWNEA•BUILDER OECLARATION SFRIAD�/REM O eI NEREBV AFF7RM UNDER VENALiY OF GEiWRY THAi 1 AA1 EXEMVT FROA/TNE GONTMGTORS tl GarapdCarport CENSEUWFOR7MEFOLLON'V1�RGSON�SEG7Wi.6BU5WES5ANOPROFE551ON5CO0E:ANYCITYOR (n � COUNTYWHICMREOUIRESAPERMR70LONSTRUCf,AITEitMPROYE,DEMOl15FtORRCPAIRANVSTNUG W Patia/Deck � � �� � � 7URE,iRIOq TO fT3 RSUANCE.ALSO REOUIRES THE MPLICANi FOR SUCH PER1AiT TO fILE A SIGNED W ETATFMENT THAT HE OR 5HE IS UCENSE�PURSUANT TO THE PROVISIONS OF THE OONTMC70RS U• � CENSEUW�OUPTERO(COuuENCNOH'ITMSECTtlN7000)OFDNLSqN70FTMEBu5v.E55MlI)PRO- � PooVSpa � iESSIDNSCODE)OfiilU7HEOR5HE1SIXf�APTTHERCFROMAtJDTHEBASISFORiHEALLECEDEXE�IP• � TON.ANYVKA.ATIONOFSECTION70]1.68Y/NVAPPLILANfFORAPERMITSUBJECT57NEAPPLICANTiO Z Re-Roal � ACMLiENALTYOfNOT1AORETWIFIVEFR1N011EDDOlU1R5(35ao).r � O1/�50WNEROFTHEVROPERiY,OqMYEMP�OYEE5W1iHW.\GES�SMEIq50LEfAMPENSATION, O COR1rtIBfCI�I ' WILL 00 7HE WORK,!WD iHE STRUCTUNE IS NO7IHTENOED Ofi OFFEHED FOR SAtE(5EC.7oN,BUSL J N NESSAND VFiOFE5510NS OODE:TNE CONTFUCTORS LICENSE UW DOES NOTAPp�1l TO IW O'M�ER OF ? 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O I/JI EXEYPTLM�ER SEG 6.i V.G FORTH151'.e.ASON q 3 � � � wTe om+en v � UCENSED CONTRACTORS DECLMATION w J � W IHEREBYAfFlFWUNDERPENALTYOFPERIURYTUT1AMlICENSEDUN7ERPROVISiON50FLHAPTER V. s 0(COMAENCWOM/1TMSECilON7o001�FDIV15AN70FTNEBU51NES5ANOPROFESSIONSCODE,M7� Z W LICENSE l5 N FUIL FOHCE AND EffECL m — 0 u�ENSE«ass_.!� u�.N�. ��� v ` - � w� ��h—26� cornrucroa �. — -- � UI = WORKERS'COMPENSATION DECIAMTION NIHEREBVAFNiMUNDERPENALTVOFPERN�7YONEOFTXEPoLLOWIN00E TIONS: Z � �IMAVEANDWILLMAN7AP1110EFT�FICATEOFWNSENTTOSELF•INS'?EFORNORKERS a � CONPEHSATqN,A5Pi10ViDEDBV5ECT10H77a0CFTHEU00RC00. fHEPE1IFORAIANCF..� OFT/E WORIf FOR Yh/1pITMIS VEREIIT IS ISSUFD. � �I IUVE AND YnLL YA1NTAw wORKERS'COMPENS�TION IKSUMNCE,AS R�WIRED BY SECTION 11/).��� Q ]700 DF h1E L/BOR LOOE,FOfl THE VERFO WAANCE OF iF1L WOFN FOR W/I�CM 7H J Y --- -. ..� _ . ISSUED.YY WORKERS COM➢FNSATION INSUfUNCE GRRIER AND POLI 1R1MBf 4 . CONSTRUCTION (7`() �j CARPoER�J12��_���Ii.Y PLANREVIEW _�S �--�� - --- -� --- -- -. . ._ -.. � POLICYNWBER_.,�IS�Qf� � ELECTRIC � (MSSECIIONrE�NOTBE00APLFIEDOFMPEW.rt6R�RWE OOtURSK� 55) PLUMBING Z �CEFRIFY7NATINTHEPERFORMANLEOFTNEWOfiKFORWHICHTH15PEHMITI515S1,� MECHANICAL (y SHAl1NOTQAPLOVAH'fOERSONINAdYYANNER50ASTOBE _SUBlCCiTOTHE � � N'OpKERSCOMOENSATqNLAWSOCCALIFpRNItiANDAGRE i1F1 auoeEco _ INSPECTIONFEE , `- SU&lECTTOTHEWORKERS'QOI��PENSATqNPROY1510N5 CT .00OFTHE S cooc.isw�usoarxwm+ca�a�rwi s. ISSUANCE O .'L / p DATE:_�+I Z�Yl APPLICANT. SMIP W ENERGY P/C � m�AR WARNiNQ:FNLURETOSEWREN'OW(ERS' PENSAT CO HAGEISUNU`MUL.AN'J511ALLBE � SUBJEC7ANEAIPLOYERTOCWGIWLL.PE 71ESAN ViLt ESUPTOCN[NUNDRE0T/qUSAND 1 ��"'1�_ � DOLURS(3100,ODO�,INADDITIONTOTHECOSTOF ' P ..ATION,OAMAGESASPf10VIDEDFOqW ENERGYPERMIT y v� `- J SECTIDN�70eOFTHEVBORCQOE,WTEREST,AN I:NEYSFEES. 1 � Q RETEMION FEE: _�,�]�'�.��G FL- a CONSTRUCTION LENDING AGENCY PRE-ALT FEE: O � INEREBYAFFIRYUNDERPENALTYOFPERJURYTMTTHEREISACONSTRUCTIONIFNDWGACENCY 2 FOR TME PERFONMANCE OFTTIE WORK FOR WHldi TNIS►ERMIT IS ISSUED(SEC.1o9T,CIY.C.�. W � LENDER'S NAA1E � LENDER'SAOORESS �• � ICERTIfYT1ATIYUYEREADTHI3AFPLICATqNANDSTATEiF1ATTHE/�fOYENFORMATqNISGDRRECL TOTAL FEES ��� J w IAGREETOCOMPLYWITHKLCRYANOCOVNTYOROWANCESAHDSTATElAW9REUTINOTOBUILDING � Cp�STRUCTION,ANOMEREBYAUiMOR12ERCPflESEHfATIVE50FTM15COUNT'/TOENTEHUPONME � � AODVE�MENTIONEO VROPEFTY FOFIINSPECTION VUfiPO6E5. COMMENTS � � v _ m VERMI EEWWE(PN ' ��n. . ^/ - '.d0 -t � SIGNAiUR- GE E OATE � RECPT.NO. _PAID BY VALIDATION WHITE—Department Capy.YELLOW�inanca Copy,PINK�llssessa Copy,GOLDENRO�File Capy,GREEN—/�pplicaM's Copy • �• . �� • . ..,. . . , . -- , .. , _ . . ... - . , , ._ , . �, . . . � . I CITY OF DIAIU�OND BAR . . �� , . , _. • ..� ..� �.� , ._, . . ��':;:'r' :.� ��:�. If�lSPECTION RECORD ..: . . ' .; . ' . �_. ... .. . ..; . , , �4 �.(��..E-�.��,.c�;�jry►�p �.��'��E'= ������.a`'�'�r � ��►��-���.�:'R[c7�.C�+ .��!ii��'�r= (►`E-'i:��r��o��={ .-w -- --- "s-.�__ _._,�_._.....,:_.......�._„�., .........y.,.... ....v...,.�__... ,,.,... .. r _ i SET BF+CK', " ? ;',� _.� ,. .�i '� ` � � � I I FLOOR JOIST • ....I..�.. - �.= _, � �. _.. � �����. l'�h�_.t � � ',•. . � ; .. l ...� ��.� - "•: ' FTGS/FORMSISTEEL - . � - ,- : , I t � .FHA REQPATS� '" �. -�- �'-- � I ----- - .:._.._ ...i ;, ;ELECTRIC GROUNQ .__ " � _ • . �• �--'. j UNDER FLOOR DUCT � -- - - ~;� ..�,__-__-:.;..` -� ;:- GROUNDPLUPJIBING UNDERFLOORCC�,�7,.lIT--:, �=.��,`;�. ,_,,I� �>�-,..•��: ".:� ; -� ... i - -�-. `' '. -- - - -- - . :. i :� j .--� .---�.•----�-----�-.---.�---� __._..., ._... SLAB GRADE FIREPLACE FOUNDATION •�.. •� �.:�.�.r:\-:t�;; ,� ' = �-- 'TEPJIP POWER __ ,.,. � -- - - : -, . • FIREPLACE BOND BEAf�1 • " . � !WATER SERVICE - - -- -- ---- ( . ._... , . , MID HT.BOND'•BE�',D.1�•` '= ' ';`�::t•1'�:�,�.. .,� �ROOF SHEATHING •, .• ._ . _:.�i. , .. �.�:.� �,,:_� ?.,_>>• � �;. , . I fi FT.BOND BEAti1,. � ''i`. - I ; �FRAMI�:GNcNTiLiATION -, - -- - FINAL'Bb��D�BEAh'i•,�� "• -� �.-.�,':' � ' • •- ,- ROOF COVFR • . �. ' PRE-GRADING -- � - • i : !ROUGH HcATING - - � � -- �-- BENCHING ; --� ,ROUGH ELLCTRIC � '� . ' . � ' ' . ROUGH GRADING � �- - - --- --' �- � 'ROU:;I-i FLUMBING - � � � I FINISH GRADING �SHO�VERfTU6 TEST - - -. - - POOL ELECTRIC FXT.L4r H!SIDING - -- - - -� ' ' • POOL FENCING I • � • ' ;t,NA.L!IPJStJLATIaN - ; --- ------ - _ _ POOLFINAL . . . , ,C�ILIP�G 1�•:SUL.ATION � �-- - �FF SITE IMPS. ( ' • - � DRl^�^JALL NAILING - - �� - - � DEDICATIONS • . � . ��V;'cR —� FINAL ENG. � � . . i , ¢"= - � i,StPTI�TANK , ' ' . • � L'ANDSCAPE/IRRIG. . ; , �,S��F�iiiL.L � ,• '. ON SITE IP.1PS. ; ... { � •� ��(R icST ; _ � � FINALZONING � � t_---- --- - � i=� 'ONST. � FIRE DEPT. FINAL • . �C�± '�'�:.NEATING. ... _. _. _._..._ _ HEALTH DEPT. FINAL � -- � -• --.. ._ _ . -- - • DEV. FEES PAID - - - - -- ��. ;...'.:_ELECTRIL' .. ....- -- .. - • -- ".PLUP�4BING -- - � ENERGY ; ; . . - - � - � i � . � :--- —. . _ . . � - •r ��s :. tn,�__ . , �� . i� -- �a.ru....a._�_}�:s�r �. . _ __..._ ��, • i: _ . . .. . ._ . .. . ,___ .. - . !—,__ � ..._" _ ... _. . � . _. _._ '_ _ _ _ ' _ . �� �- _ —. -- . ;;C�;J�PJfENTS . _ - . .. :, ', . , ., , . , , . , .� . �- -. ,, � . . . ' . , : C .- '�� . '�__. _. • ,� � � ! . _ _. . . . . , i • , - - -• -_ .. , I .. � : . . � : . . � � 1 � t . . — • • , .c . . ,� ��'.� '� � - _ . � _ . . . � '�` �-..._� . � � , � �.'� .. . . , . . . . . .; . ' ' �\.`\� ..'V;\� , ly • •. I SEPTlCTANKS!Gc ._ I , • \ •�`. • � � SEEP P17/U S�ZE - � . - � ..,._. '!`� __��..,�� -- '� �. °� ' . I . . . � - -- , "�>_ . , , . ' . � � -- -- . . , � . . . . � I ���� . .. .��; �.. _, '. , • .. =� .!. � - . . .. .;. _ - -... . --- - . . _ � . . _ . . , . � � ,, .._ . . . . . ._ - . , , _,1 . . . _ ... ., . . . .. _ . - � - � - � � : _. ._ � '�`-,i � .��•` � ..-', � ; - ----- . ' � -