HomeMy WebLinkAbout12-0507' CITY OI DIAMOND BAR
1 t
DEPARTMENT OF COMMUNII Y & DEVELOPMENT SERVICES �' t
21825 Copley Drire, Diamond Bur, CA 91765
_ (909) 839-7420 Fae (909) 861.3117 Building Inspection Hotline (909) 839-7027 1 PRESS
BUILDING PERMIT APPLICATION FIRMLY
JORSITE}
ADDRESSX 219a .t I'll �Y NS�t �YL
APN 9""? LOT of h TRACT
X 0
OWNER �' 2 T ENA
ADDREfasS 2I � Z� � n rlAsh LvT
CITY ati4V'twY� (-10A11� ZIP �1 �'irS TEL 6 a
APPLICANT TEL b2b3[IDP81$
CONTRACTOR -
ADDRESS
CITY ZIP CithOl TEL 41L IVTII�M
ARCWENGl
DESItiNERX t�f>�Il>YidA.�l✓1!�'Ntii�.L�-
AODRESS Lj. A! inE'I@! ✓2 -Yp
CITY AIIHAEA 6-jr-- ZIP 91903 TEL I aA
OWNER BUILDER DECLARATION
1 HEREBY AFRROta IIA PfNAI.YOF PERPJAY THAT i AN EY£OTT FRCM ME COHMICME t6
CEW9EUW FOR ME roue oo;RMscINCBEC TIM 6OUSWE"FAc PROFESSIONS CODE FHHG CR
COUNTY WMKMRfiW WE4AFENBTTO WY9SR1(CT FLYER W PRQYE,pEM0O4i OR REPNRFMYSMUC-
TORE, PRIOR TO ITS ISSUANCE ALSO REWIRES ME APPLICAM FOR SUCH PERMIT TO FILE A SIGNED
VATEYENT MAY ME OR BHf O UC&NSEO PORSOML M ME PAONNCNS OF THE COMPACTORS U
CENSE UW EHAPTER S ICOOOENCW3 YAM SE Ml 7=1 OF CNAEOH B OF THE WWKSS MD PR,
FEffiONS CODE) ORMAT HE OR SHE IS CKENPT THEREFROM MD ME BATS FOR MEALIEOEO ESEMP
TION MYYOLAiOHOc 9ECTRHtpI1 I BY ANY APPUCAM FOR A PEW IT SIiBRCTS THE APTUCANTW
f W Ltt ND
A CML POF HOT AE MAFI A. MMORED OWARS RS ASHD
D l ASONHEROF ME PAOPERTV OR w EINLO UIVTH WALES AS THEIR EOL6COOPEN9AtON
Wry,{ W TN6YRPK At$}Mf STWFCTURE 19 NOT WIFHOED OA CffERED FOR SALE ISEG }%i ■F54
NEBBN1tl PRDFE59KKF9 CLUE ME CWIFWCIOR3LKEN9E LAW ODES 11Di AP0.Y t0 fNEAtWiAOF
PAOPERtt WHO BUIDSOPMAPIVVf9TNEREO11 AN0 WHOOGES9UCH WORRHOAFLFORHER9fiFOq
THIKNNOH149 pp NEAWM£iPitOrtFS, PACMWTHAT SUCHROYEMENtSARE I:OT YVEENpEOCA
M'FEREDPoRSAE ONOWkMERR&&M1WFOOR WPROVEN6HT990.0YAOOSONfiYEW �CCtlMI.F-
EIIX! TIE OWNfR9O0.0ER WAl HAVE THE BLpODN Oc PROYPiD iWl xE OR Oifi DID IRI 00AO �
PIWIDVEFCR ME WAPOSEU SPLE}
D{ABOYRI6POC TNEPAQPEATV y3PkYAUGVELY fONiIiMIWB4rtO{tMFftSGD C9IRMCL00.5
IO CG49RBICi ME PYWECF (SEC Fpµ BUYWESSAWJ PRDfi95KWi000E.T}i6 f-0MAACIORS W
CENSE UW 06E9NCTAPPIv roAHOWHEP�APRCPERiY W108U4DSORAYPADVEB THEAEWI,AIFD
Tofeuc TRACFBFORbOLtIPROIECfSW(OiAOdfiRU:}Gy91UCEH4WAiPSUAMTOMfi WxTFNG
rdLTucHIEEuw)
01APCV PTLHOERSEC B SPC FgiTiW PEAfRN
*ATE WITHER
LICENSED CONTRACTORS DECLARATION
i HIMEBYAFFlRIURI` A MIKE MR&TY OFPEAMUT I AN LICENSES LTHM PAMA9 OF CHAPTER
4 (LOMNENRVO WTH SECTION P400) OF DMBRN 3 O ME WSINE99 ANO PRONESOIIS WOE M0
IIY LOEN9EEWFIlk F(Oy�}ALEANO EFFECT �{f,] /"
LICEN,�SE CUSS ,—yL LIC *nb _.�j��y�
one —FACTOR WA&AA r, Cled,
WORKM COMPENSATION DEC
I NFA"e9VAPFBM ONOER PENA,TY OF PEAXEM CHF OF ME cOLUSAWC DERAMTONS
_I HAKAND VAU'JAWIAN AC5CIO'CATE OF CON"O'CF TO BELE WHIR FOR MAKERS
OPPRO MM"A9PR*IRED 9T WON, VIEW ME LABOR CODG, MA MEPEAFOAYANCE
IYl— 11iE WOAKFOR WMCNTbS PERHO L4NRUE0
1 HAVE ANO IRS, AORFfPPIwOKVERf W-APSHSACOR wSO:wiCE A9 RECOSOD BY SECTAW
]Fro OF TFTYMAX CODO PENSATP6RFOROANi6�MEYRRK PoRYMKr Mt9 PERWTW
139UE0 OYYrG0.YEA4 (WtLiIP,E�N9(A�TAW�W^4�URM�CAE GRtOERAfD PCyRTINMBfRME
CARROT, an -k I1MWl �y
FO.IC 16UER fid,2'kA — tC
ITSEMO N1RONOI BEO]AiEtfDOF1FFPO•* SPOAONE IAAIYr}aytfAip„roI ORLES4
I CERW: MFT VI ME PERFONaMCc Of Me YXiPot FOR W.uCH THIS FEAST 3 OWED
Sr 140T EM W ANAP PERSONMAm'NAigFA rA9 M BECAM TOttff
MRI CWIPEMAIWP,UWb OFC44'q$L{ FEI iIFI ECOVi
9OBJEGi TOtF#YAHRERS COOPENSAWNPAwde 4OF KRIVTWOFT USOR
0(00)8.1 SMAL FOROnAMCOUPLY MM MOPE a
LATE wPy APPUCAFR
'. wANFW¢FAAIIRET09ffAWE Y.OiCRERS t*MPfxsxtON C*YEAA*EI9ureAYJA(L AVO SIINy BE
itWUAAFAN EIIPLOYERTOCNOPW.DDIFLIESAii CRR FWES W iODHEµPAAFO T)IDU9AND M%tARS*i*Itm1 WADOIT1p1TOMECOSTOF DDUP6N9AKpNOMA*E9YPAbt10E0FtlRW
i 4[CrONVF4POFME VBORC*DE WFERESL AFO ATiORHEYSFEEA
CONSTRUCTION LENDING AGENCY
I HEREBY AFF40A IRMA PIRO&TYOF PERIURY MET THERE U ACOMPMMS1 UNWIO XOHNCY
FORME PERFCRyAN" OF ME WOR[ FOR VMSH THIS P6RHM a HouixI {SEG iw 4Y Ga
UNDERSNAMt
tEfOER'4AWAE99
1 CE RT" THTIF YE AEAD TIES AP%KATEW A SIAtfTr 1 ME ABOVE WF@WARN 3 CORRECT
I ACRES TO CNPPLY W. A MY FRO WWTY OPWO4*CES AR STATE UYA REUTMO TO SJUOMG
WHSTWKTYYI AW HEAfOV AMORIZE R FAMHtATNES OF TIRE CPIMY M SHIM UPOHME
ABOVFOfHPONEOPl�fRrYfOR W9PECMW PIRiWSEf
AFAMITiEf NAME1P
SiDW.TVAfi OFPEAMMLEE DArE ( RECPT ND �{-i PAD By ` -X3 2ta VALIDATION
�
DON YELLOW-RAMMC0py PINK-ASSISIMrOOPSGOLDENROD-FMGWY. GREEN-Applkazpa Cary
/■aG7
f
'
ION!iS„ PERMITPICTAAPEICANIMBERiEA- SgZn-�
ISSUE TYPE OCC
CONST GROUP
ZONING ••
AR
4E/SiDE STREET RW
iF 9 I
PROP• •
NO DWEL NO NO
i UNITS
r,Vl�W-iT
E_
•"
+ll..rSCli�a1
DPI'P.
�'xl�
-■
_
�P�■yu:juil
�I�s�
A_t"
n
�RI
G
�Wifl-,
o+
r
__-w
J
I.NSPECCI4N
[N
SET BACK
' `,CtATE'
INSPECTOR
, _,INSP
ECT14N`;-
DATE:` `INSPECTOR
��
ELECTRIC GROUND
IIIIIIII
i WO GRADE
! ! !
!'
HT BOND BEAM
SHEATHINGMID
'
�'a
8 FT BOND BEAM
♦
RO OF COVER
�,AFINAL
� BOND BEAM
ROUGH HEATING
_.
• i
Ii
�w+
�t�
•
ROUGH PLUMBING
•iiFENCING,
��1`
1
®t
�+�ii9l
CEILING INSULAT10N
TE IMPS
DRYWALL NAILINGFINAL
SEWER
TANK_
SEEP PITIL L
+
**"►ATIONSSEPTIC
FINAL ENG
!:
ON SITE IMPS
IIIIIIIIIIIIIIIIIIIIII�I�
IIIIIIIIII
GAS AIRTEST
FINAL ZONING
FINAL CONST'�L_
DEPT FINAL
DEV FEES PAID
�IA
=111�
�
�Lwl
CEBTOFi}CG '
�j t,} � ..J .ua. ♦
ilk
4; gin,Ilf.��ii
/Icy w
.. _ja.1 . ♦ t t
SEPTICTANKSIZE
SEEP PIT/U SIZE
W4,ma
L E'.