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HomeMy WebLinkAbout11393 - -JF�—. CITY OF DIAMOND BAR � COMMUNITY DEVELOPb4ENT DEPARTMEIv'T !,..0 21660 E.Coplcy Drive Suite 190 PRESS (909)860-3195 Fax(909)861-3117 `�" BUILDING PERMIT APPLICATION FI RM LY ¢ ADDRtESS �� 'e�l. �..An DATE CATION / z� 9� NUME3 R _ ttI C�V ��� c� ISSUE TYPE OCC __ APN LOT TR CT DATE CONST. GROUP p OWNER ' J Co. � ADDRESS ZONING SETEiACKS 0 Z CITY a- IP�p(�� TEL FRONT RW ❑ g APPLICANT TEL ' � . REAR ❑ SIDEJSIDE STREET RW ❑ mCONTRACTOR SIDE p � ADDRESS PROPOSEDUSE C� of � ' � C1TY Z1P TEL. � ARCWENG/ ( z DFSIGNER � NO.DWEL. NO. r a ADDRESS (/oo .�` �2� UNITS STORIES BEDROOMS � CITY ZIP��[� T L. � � DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION � OWNER-BL'iIAER DECLARATION SFFl/ADD�'REM O q I HEFEBY AFFIRM UNOER PENALTY OF PEitNRY THAT I AM EXEMPT Fq01A TNE CONTRACTOfiS L6 � GaregelCarport � . W CENSEUWFOR7HEFOlIOWWGREASON�5EC.7o�1,58U51NE55ANDPROFE5510N5CODE:ANYqTYOR U COUNTYWHId1RECUIRESAPERMITTOCONSTRUCT,ALTER,IMPROVE,DEA�OLISH,ORREP/JpANVSTRUC� W pa!iolDeck � NHE,VRIOR TO ITc ISSUIWCE.AL50 RE�UIRES TME 11PPLICANT FOR SUCN PERMIT TO FILE A SIGNEO � 6TATEMEM THAY MG Oq SHE IS UCENSEO PURSUANT TO THE PROVISIONS Of TME fANTRACTORS U� � CENSE UW(p1APTER Y(COIAM[NCING WITH S[CTION 7000)OF DIVISION]OF THE BUSMESS�faD PR0- � POOVSp3 � FESSIONSCODE)ORTHATHEORSHEISEkEMPTTHEREFROMANDTHEBAS15FORTNEALLEGEDEXEMP� C7 VTION.ANYVIOUTIONOFSECTION70I1.SBYANY�PPLICANTFOHAVERMITSUBJECTSiHEA?PLiCAN7T0 � Z �7p-R001 ' A CNIL PENALTY OF NOT MORE TNAN iNE HUNOR�p DOLURS(f 50o�.j: Q 04�SOWNEROFTHEPROPERTY,ORIAVEMF�OYEESWITHWAGESA57HEIRSOLECOlAVENSATION, ❑ Commercial � � � Z NALL 00 THE WORK,AND THE STRUCTURE IS NOt INTEN�ED OR OFFERED FOR S�LE(SEC.loN,BUSI� J NESS AND VROFESSIONS CODE:THE CONTRACTORS LICENSE LAW DOES NOT APVLY TO AN OWNfq OF � PROVERiYN?IOBVILDSORIMPROVESTHEPEO1IANDMMOOOESSUCHWORKHIMSEIFORHERSEIFOH � Q THRWCHNISORHEROWTIEMGLOVEES.PROVIDEDTHATSUCHUAPROVEMEMSARENOTINTENOEDOR � . , 0 OFFEREDFORS�LEIF,HOWEYERTMEBUILDINCORR./PROVEMEMISSOLDYVITHINONEYEAROFCOMCLE• � Z TqN,TME OWNER�BUILDEq VJILL HAVE TNE BURDEN OF PROVIN�TH�T HE OR SHE DID NOT BUI�p OR = YAPqpVE FOR iHE GUFPOSE OF SALE). C 4 AS ONMEROF TME GROPERTV,AA�E%CLUSNELY COMRACTW G WIiH LICENSED CONTRACTORS Q TO GONSTNVCT TNE PROJECT(SEC.7014 BUSINE55 ANO PROFESS�ONS CODE:TME CONTMCTORS Lb y81U8tiOf1 �� ADJ.AREA W CENSEUWDOESNDTMPLYTOANOWNEROFAPR07ERTVWV108U0.DSORIIAPROVESTHEREON.A4D � NTiOCONTMCT5FOR5Up1VRQIECTSYATH�CONTMCTOF(S�UCENSED7URSUMfTTOTHECONTMG aunNnrr DESCRIPTION FEE , x TORS LICENSE UW.�. � OIAMEXEMPTUNOERSEC. B.BP.C.FORTNISREASON U u" DATE ONMER � � � - � z c� �.Q LICENSED CONTRACTORS DECLARATION w CL IMEREBYAFFIRMUNDERVENPLTYOFVERJURYTMATIAMUCENSEDUNOERPROVISIONSOFCHAP7(R � ' p'„ s(COMMENCINGWITHSEMIOH70001OFDMSKKJ70FT/EBUSME55ANODROFESSIONSCOOE,AN� z x M'I UCENSE IS IN FULL FORCE MJO EFFECT. W �+��1 � 0 UCENSECLA����—�`�^`-- LIC.NO. �� � . ���— '�`•-�Z 4�1 corrraacton d V DATE W � WORKERS'COMPENSATION DECLARATION Q � V � INEREBYAFFIRMUNDERPENALTYOFPERNRYONEOFTHEFOLIOWMGOECIAMTiONS: �'6 z � ' O �IHAVEANDW�LLAIAINTAINACERTIFICATEOFCONSENTTOSELF�INSUREFORN'ORNE� _ � COMPENSATqN.ASPROVIDEDBY5ECT10N77000FTHEU80RCO0E,FORTNEPERFORMANCE W OFTHE WORK LOR WHIp1 TNIS PERMIT IS ISSUED. � 0 - W �MAVEfN�WILLMAINTNNWORKERS'CAMPENSATqNINSUMNCE.ASREWIREDBYSECTION +� Q ]700 Of THE UBOR CODE.FOR THE PERFORMANCE OF THE WORK FOR WHIp1 MIS PERMIT IS /� ISSUEO.A1YNKIRK1EF—S'CO PFNS`ATION INSURANCE C RIERANO POLICYNUAIBERIAE: CONSTRUCTION � � v � CApNIER �^��L����f���—� N REVI W /• _ � Pa�crNUMoe . ' �� ��...��Q�� EL NIC 0 �nassEcm�r�muoreEaoi.w�ErEooFnfcc�rxr or+Eru�ooaYns�siroirn��a�i` LUMBING Z �CERTIFY THAT INTHE PERFORMANGE OF iHE WORK OR MICH 1MI5 VERMIT IS ISSUED,1 M[CHANICAL (,�} SHALL NOT EMPLOYANY PERSON NANY 1AANNER SO T EC01AE SUBJECTTO THE (,/) WORKERS'GOMPENSATIONUWSO 4,AN AGR �7MATIFISHOUlDB[COME INSPECTIONFEE - ' �� S SUBIECTTOTMEWORKERS'CO�.�PEN„ KKJPR 'S SOF ECTqN71p00FiHEUBOR COOE,ISHALLFOii TNCOMPLVWITN OSEP VI N5. ISSUANCE �-//1 � ���3��, S�dIP ��� ► p DA PIICAM: _ � ENERGY P/C WARN'NG:FAILUFETOSEWREWOPKERS'COMPENSATIpNCOVERAGEI3U W 4. SHALIBE �y SUBJECTANE/A7LOYERTOCR�IARULVENALT�ESANDCMLFINESUVTOONE N EDT USANO ENERGYPERMIT DOLUR$(f100,0001,INADDITIONTOTNECOSTOFCOMVENSATqN,DAMAGESA YIOEDFORIN � 6ECTION370BOFTHEUBORCOOE,INTEREST,ANDATTORNEY'SFEES. RETENTIONFEE: � a CONSTRUCTION LENDING AGENCY PR[•AL7 FEE: O ' � IHEREOVAFFIHMUNOERPENAITYOFPERIURYTHA77NEREiSACONSTRUC710NlEN�INGAGENCY ' FOR THE PERFORMANCE OF THE WOHN FOR WHip17MiS PEfiMIT IS ISSVED(SEC.7091,qV.C.). . Z W � IENOER'SNAME F— LENOERSADDRESS � W ICERTiF/iHATIHAVEREADTMIgAPPLICATIONANOSTATETHATTH[A90VEINFORMATqNISCOqRECT. TO7AL FEES . �� � ,� 1 � IAGFEETOCOM7LYWITilA:1GTVM1000UHTVORDINANLESAN�STATELAWSFELATINGTOBUR�IM1C � CONSTRUCTION,ANDNEREBYAUiHOR2EFEPRESENtAT:VE50FTHISCOUNTViOEMERL'PONTNE Z VE�IAENilO 7ERTVFORINSPECTIONWRPOSES_ COMMENTS 0 � � ¢ EIW�TTE AME(PRI , �� �, � 3 L�-�j �-- - y SicN u _oc MmEE�� . DATE yZ pAIDBY l VAUDAT�ON � - - . . � RECPT.NO. epartmeN Copy,YELLOW—Finance Copy.PINK—Assessor Copy,GO}pF�70D-File Copy.GREEN�ApOpl�nPs Copy �� (i Li�; / � i 6✓ � . .� . .. . . . ... . .. . .. . . . . . ,. , . .._ ,•c�.._.,..^t:d. :1;;�=` :'a� .��. . .xit]'.,;`i��i . . r:}.'.,i- . .._:.,..... .- , . CITY OF.DIAMOND BAR ; , � INSPECTION RECORD � . , ' "' • � ' ' � � e e ' �(�_�:�����,�l� � I SET BACK � FLOOR JOIST � - ' FTGS/FORMS/STEEL � FHA REQMTS - -- ELECTRIC GROUND UNDER FLOOR;DUCT , GROUND PLUMBING UNDER FL•OOR CU�IDUIT ; ' � � • � � � SLAB GRADE FIREP C��C3�1NbATION ' ' ' " TEMP POWER - FIREPLACE BOND BEAM WATEp SERVICE • - - �'=' � — MID HT.BOND BEAM ? ROOF SNEATHING � -��.� � �; � , �; 8 FT. BOND BEAM. -- '�,, - FRAMINGNENTItIATION FINAL BOND BEAM '' � ' ' ' - "' ' ROOFCOVER PRE-GRADING.��. �. � , ,_ , ROUGH HEATING BENCHING ' ROUGH ELECTRIC ROUGH GRADING ' ROUGH PLUMBING FINISH GRADING ` SHOWEWTUB TEST POOL ELECTRIC • EXT.LATH/SIDING POOL FENCING WALL INSULATION PO�L FINAL CEILING INSULATION OFF SITE IMPS. DRYWALL NAILING DEDICATIONS SEWER ,'„ FINAL ENG. SEPTIC TANK _ - - ' LANDSCAPEIIRRIG. . - SEEP PIT/L.L. ON SITE IMPS. GAS AIR TEST FINAL ZONING - FINAL CONST. B .�--- FIRE DEPT.FINAL ' FINAL HEATING -� HEALTH DEPT.FINAL - FINAL ELECTRIC DEV.FEES PAID FINAL PLUMBING ENERGY � n � � �/� ' ' �% !, T �� . L: _ -- ... __ `'_ ; �/ �' , COMMENTS � � . . � � . � �` �\�"� . � ' � -� J ,.�.i�.rLi � �� �i --��;-1i_ � _ __ � �r'� �_;��,.;�::r�_i ;f� - . -'—!� � ' � f � w � � . �-'�! �� . �,` �,, � � , , ��c�a; r . �M y'--�/' '�""- • �- :_ ., . .. ._-= ; . ' % � SEPTIC TANK SIZE SEEP PIT/U SIZE � �1� ;. -__l_._�..:-;�--y- /`�f;;i—;. � . , �•\. /)�_)�_..f... — � � � � V (i_ � -- ,.'\' � _� �'�f/• _ � ��_�" � � l • . � . , , � 1 � �