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HomeMy WebLinkAbout13372 (138) _�� CITY OF DIAMOND BAR � � DEPARTMENT OF COMMUMTY 8r.DEVELOPMENT SERVICES �� 21660 E.Coplcy Drive Suite 190 ' ` (909)860-3195 Fax(909)861-3117 PRESS ��� � BUILDING PERMIT APPLICATION FIRMLY } JOBSITE nAD� YVt�ft'T� PL . . APPLICATION Q'�./��Q� NUMB R /_ 3 3 7a #� ��a o ADDRESS � � DATE v L c� ISSUE �, TYPE OCC APN LOT TR CT DATE 5 ' 3 � �� CONST. GROUP p OWNER �.D. . . "" ADDRESS 0 UC.� 20NING SETBACKS "`' CITY ZI TEL • FRONT RW ❑ � APPLICANT ��,(��IM�[/�.JJ � TE REAR ❑ � SIDEl51DE STREET RW ❑ CONTRACTOR SIDE p � ADDRESS PROPOSED USE �- � CfTY ZIP TEL. o ARCH/ENG/ � � DESIGNER � G ' NO.DWEL. NO. NO. ADDRESS � UNITS 3 STORIES 2' BEDROOMS � CfTY ZIP TE � DESCRIPTION SO.FT. FACTOR PSF ADJ.AREANALUATION � _ . OWNER•BUILDER DECLARATION _ ' � �. -SFRlAD�/HEM � � - � - �� O 1 NEREBY AiFlPM UNDER OENALTY OF FERAJRY THAT 1 M1 EXEMPT FROA1 THE CONTMCTORS l4 Garage/Carport . ' ' �- 8 CEHSEL►WFOi1THEFOLLOWNOREASONISEG7m1.6BUSWESSANDDROFE5510NSCO0EANYCITYOR (n � COUI�RYWNICHREOUIRESAPERMRiOCONSTiiUCT.ALTERMPFlOVE,DEMOl15H.ORREPAIRANY3TRUC- W PatiolDeck � � � TUi1E.Vp10N TO fT3 6511M10E.ILLSO NEWIRES THE AVPLIGWT FOfI SUQI YEW.IIT TO FILE A SIONED w STATEI�ENT i11AT HE O(1 6HE IS LJCENSED PURSUANT N THE PfiON510N5 OF TME CONTMRORS l/- � CENSf UW�RNPTER Y(WMMENCPIO YATM SECfION 7000�OF DIVISION�OF iHE BUSINESSANO Pq0. � PaoUSpa . FESS�DNS COO�ORT}NT HE OR SHE 14 FXFUPT 7HEREFROM M1D 711E BASIS FOH iNE ALLEOED EXEMP• TqN.M/YVqLAT70NOF5ECT10N70.11.68YANYAPPLIClWTFdiAPERMIT3UBIECTSiHEMPL1CMlTTO � Z R6-R001 F A CML PEw1TY OF NOT MORE 1HI�N iNE MMDHEO OOLLARS(l500�} � 01,1150NRIEROFiHEPROPERTY,ORMYE�PIpYEE5VAT11WAfiESASTHElqSO(ECOMPENSATqN, O (',pmmBfClfll � - MldL DO THE MIORK,AN�THE STiR1CiURE LS NOT INTElAEO OR OFFEREO FOR SALE(SEG�ON.BU51• �! NESS MD iROFES510N4 CODE TNE CONTMCTO{Y$LICENSE UlW OOES NOT A7Ply TO NJ OVMER Of � PfiOPERTYW/qBURD50RMVROVESTNEREON.MIDYNIODOESSUCFIWO(iKM�MSELFORNERSELFOR = � � � THROUGHHISORHERqMJEMPLOYEES,OqOVIDEOTUTSUCNMPROVEMENTSARElqTMTENOmOR m � ,OFFEAEDFORSIILE.IF,110VYEVER711EBULDWOORIMPROYEMFNTISSOIDWRMNpNEYEAROFCOMPLE• '�110N.7HE OWNER�BU4DER YAIl HAVE THE Bl1R�EN OF VROVINO iNAT HE OR SHE�ID NOT BUIID OR � FIPROVE fORT1E PUqPOSE OF SN.E). � . W Ol1lS0'MNEROFTHEPRDPEfTT1:M1E7(0.USNELYCONTiUC11N6WITHLICENSEDCONTMCTORS � � TO CONSTRUCt Trt PROJECT(SFC.7aa�,BUSME55 AND PROFESSIONS CODE:TNE CONTiuCiORS U� VBIUBtipn AQ1.AFjEA � � ` CEHSEUWDDE9NOTAP7L�TOMIOM�NEROFAPROPEHTVNMOBULDSORPAVROVESTHEREON,MD `L yy�q�(U�gFpqSUCHDpO.1ECTSWIT1ACp1TMCTOR(S�IICENSEDPUR5U4fTTOTHEODNTMG pUANTITY � DESCRIPTION �FEE � TORSUCEHSEUW.} . . . . . . . . , _ . . .. . . . . O IAM O(EYPTUNOER SEG B.1 P.Q fORiH15 REASON Q � . U . . � ., . � � � � . . ll.. � DAiE ' OWNER V � . F UCENSED CONTRACTORS DECLARATION � W . ,,.-�-y : � J • � IHEREHYAFFlRIJUId)ERPEWLLTYOFDEiWRYTUTIAMLICEN5E0UNDEXVROVISION50FCHAP7ER� � Vr ^'�` J � p_, �(COA41ENpH�YAT1/5ECT10N7o00)OFDMSIONIOFTMEOUSME55MlDPROFESSIONSCOOE,AND . Z �X MY LICENSE 6 N FUII fORCE IWD EFFECL � � ucENse cuss � uc.r+o. J '� U c� y� � on� corrraacTOA n. t, r � �i ���Z � WORKERS'COMPENSATIONDECLARATION U .T ♦ T A S�' �'�% y IHEREBVAiFIiWIM�ERPENALTVOF0EMIRYONEOFTHEFOLLAWINGDE0.ARJ1T10N5: - � � � - y N � � �IHAVEANDWILLWNTHNACE{iT1FICATFOFtONSENTTOSEIF•INSl1REFORWORKERS' _ COMPENSA7qN,A5PROV10ED8VSEC710Ntfo00FhIEU�BORC00E.FORTNECENPOR/AANCE W OF 7HE M/OAK FORVMIGI THIS CERAIIT IS ISSUED. � G Q �I HAVE M1D N1LL U.NfTAM VYOPKERS COMPENSATqN INSURANCE,AS REOUIRE�BY SERION /� �7000FTHEIABORCOOE,FORTMEPERFORMANCEOFTHEWOPXFORWMICHiHISPERMRIS `p,l�I/� � ISSUm.MYMORKERS'COMPENSATIONWSUPANCECARRIERANDPOUCYHU/ABERARE: CONSTRUCTION ICJ � �pqiEq PLAN REVIEW 0 POLICY MIMBER L � ELECTRIC (M">,[ci1JNNE�rqiBECd.qEfIDOFnE�Ew.frsPOFla�[HrnRE'nOnL�RSR�m1�t651 PLUMBING � I CFRTIFYTNAt IN THE CERFO�W�NCE OF TME WOPo(FOR WNiCH THIS DEFAIiT i5 BSUED,1 MECHANICAL (,�J $HALLNOTEMPLOYMiYPER50NWANYMANNER50ASiOBECOMESU&1ECTTOTNE � 1MDRKER5C047ENSATIONU�'�SOFC�LIFOf7N10.�N011CREET/UTIFI3VqULDBECOME tNSPECTIONFEE S SUBJECTT07NEN^DP10E(15COMPEN5117qNPRON510NSOFSECTqN17o00FiHEUl80R ' �� � �� CODE,1 SHAl1 FORTIM'ITH CDMPIY N1TN THOSE PROVISqNS. ISSUANCE � � SMIP I iJUb - p pATE: A7PLICANT.. . . . . � ENERGY P/C WARNiNO:iAILURE TO SECURE NORKERS COMVEN5AT10N COVERAGE IS UNUWFIA.AND SIULL BE � � SU&�ECTANEMPIOVERTOCHl471N.iEW1TIE5MIDCM�FwESUVTOONEHUNOR[DTFIOUSAN� ENERGYPERMIT - OOLURS(S10a.000).W ADDITION TO iHE COST OF COMPENSATION.DAMACES A$PROVIDEO iOR PI �^ ^ � SECTIDN�70e OF THE IABOR COOE,INTEREST,ANO ATiORNEV'S FEES. ' RETE�JTION FEE: ' .) ,/O�' pw_, CONSTRUCTION LENDING AGENCY P��ALT FEE: � O // y� � IHEREBYAFFIRMUNDERPENALNOFPERAIRYTHATTHEREISACONSTRUCTIONLENDINOA6ENCV �� �-��! ' FOR TNE CERFORNANCE OF T1E WORK iOR NTllp/THIS VERMIi IS ISSUED�SEG 70V7.pV.Gl. � � LEIIDERS NNAE . . ' IO! D � LENDER'SAODRE55 � ICERTIFY7HATIHAVEREADTNI4APPLICATqNM1D5TATETHATT1EA80VENFORWTqNISCORNECT. TOTAL FEES � � � � . � IAaREF.TOCAMPLYM7TMlU.LCRYANDCOIMTVOPDRUNCE5FND5TATEUWSREUTNOTO8U0.��N6 � � � CONSTRUCTId1/�NOMEiiE0YAl1TM0(iREREPRESENTAINESOFTHISCOUNTYTOENTEflUPON7HE . .. . . _ � � . � �eovee�Errtwr�¢pprpvcqtvwqnuoEcrar+ouavosEs. COMMENTS 9 ,(� m ocwanEE �aw L �¢ U � N 8qNATUREO E D E � RECPT.N0. PND BY �VALI�ATION WHITE—Oepartment Copy,YELLOW—Finence Copy.PINK—IUeeuw Capy,GOLDENROD—File Copy,GREEN—Appicent'a Copy �� _ ,, ... ....,, .-. , . ._. .... . ,. . . .. . . . .... . , �. , , . . . ,.. . . . "' CITY OF DIAMOND BAR � � ., ,,. . ,. • ,, '. :'.-'INSPECTION RECORD�{.' , �- ' � . . , . _ . . , � � � • � � • - • . , . � . SETBACK ` i ,r ,: <i `, ' , `' `�_�:��•<�• .. FLOORJOIST .?'1 iil; t'.-•.";� �`�.� `�,�1��., , - - • . ,.. _ FTGS/FORMS/STEEL , _ �. -,, FHA REQMTS -- - - - - - -- - - - ELECTRIC GROUND - -- "_. __ ' ` :� - '- UNDER FLOOR DUCr�.'�, �� . ; ,:;.!,.:: ; r ' - r, _ GROUND PLUMBING ' UNDER FLOOR C01�IDU1T •'+ •:�+ti�'� ��' �r?� �-� � SLAB GRADE _ ._ _ FIREP F U DA�ION `-:' � j;` -=i;..3 .� �f �:r�i, �� . . , - TEMP POWER- _ ' , -- - `� ' � ; FIREPLA� B�SND'BEAM _ ` j " '"�' ' WATER SERVICE :; :. - : - -- - �MID HL BOND BEAM - - : - . - ROdF S�A H}NG' ,�"`. , • - ' - 8 FT.BOND BEAM _ - FRAMINGNENtILIATION � � � � ` FINAL BOND EAM� ,.... ,,, - • �,, . ;, ,,, , ROOF COVER �- '� PRE-GRADI�VG' �1:+' ��.� ��' '� '� ' � ' .� ,�li_i'L. .•:t L:_ � • + .. _ : .. -_ ': ROUGH HEATING .._ ----._ . _ . - - -BENC I JC'a" ti.'S',�S;.,S ��.. •:,> .: ti_r1�r-*.tit.; ROUGH ELECTRIC - - - ROUGH GRADING ' ROUGH PLUMBING i "-- "- FINISH GRADING •. SHOWERlTUB TEST POOL ELECTRIC . EXT.LATH/SIDING i � - POOL FENCING _ WALL INSULATION ' POOL FINAL ' CEILING INSULATION OFF SITE IMPS. + : DRYWALL NAILING � DEDICATIONS , SEWER . _.__- -- - _ _ _ _ FINAL ENG. SEPTIC TANK. - ___ ,;,._ � , LANDSCAPEIIRRIG. SEEP-PITlL.L, -. . -- - - - ' ''� ',�� ` ON SITE IMPS. GAS AIR TEST -- -- - - - FINAL ZONING � FINAL CONST.- --- - � p -- L � -- FIRE DEPT. FINAL � FINAL HEATING HEALTH DEPT.FINAL F1NAL ELECTRIC -- - DEV. FEES PAID , FINAL PLUMBING ENERGY ' ' � . � • � _ _ _ _ _. . COMMENTS . . - - _ _ � ;: ''.1 1''' �, , � _ , . ,�. - � .. �:��.. .. _ SEP.TIC TANK SIZE __._ � . � SEEP_PIT/U SIZE_ , . _ , � ��� , � ` , � , , � ,-y �, ._ , _ , , , , ,__ � , - — — . .__�,, �,�� �� - , ,' � s , � �. � �,,\ . �� .` � ,,. ���.\..,,,�� ,, � �� �� , � �'\ ,