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HomeMy WebLinkAbout13693 (7) _ -- - -- � '_. ...-�_1__ I—_". �� CITY OF DIAMOND BAR � DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES 21660 E.Copley Ihivo 5uiu 190 (909)860-3193 Fax(909)861-3117 PRE$S ��M�'�� BUILDING PERMIT APPLICATION FIRMLY � JOBSITE 7¢ .(� APPLICATION � PERMff /�'� P/C � o ADDRESS ` O O V� C Ct ti DATE NUMBER � 'rt-� Jt $ ISSUE TYPE OCC APN LOT TRACT DATE CONST. GROUP �j OWNER o ADDRESS �l . •� Dr. ZONING SETBACKS w CITY ZIPy06�-4 TEI� 7 'S FROhIT RW ❑ � APPLICANT S�'-�rL ��_,k TEL. 0 / REAR ' ❑ � SIDFJSIDE STREEf RW ❑ CONTRACTOR � t( �.t SIDE ❑ g ADDRESS O £ -� PROPOSED USE �X � CITY.� - { ZIP � TEL \�+ L a^ � ARCH/ENG/ �'._ V R���Cil� DESIGNER NO.DW L. NO. NO. ADDRESS b UNITS STORIES BEDROOMS � CfTY �- ZIP TEL �' O � DESCRIPTION SO.FT. FACTOR PSF ADJ.AREANALUATION � Q OWNER-BUILDER DECLARATION SFR/ADDlREM d Q 1 HEREBY AFFlRM UNDER PENALTY OF PE0.AIRY THAT I IVA IXEMPT FROA1 THE CONTMLTOHS L4 G8�800ICery0R LLI CEHSEUWFORTHEFOILOWMOHEA50N�5EC.70.71.68V5�NES51WOPROFE5510N5CODE:ANYCIiYOR (n . C� ppUHTYYN11CHqE0UWESAPEq►IRTOCONSiRUCf,ALTER�PROVE.DEMI0U5H2ORREDAIRANYSTRUG W Patlo/Deck � TURE,iR10R TO RS 65UIwCE k`.+�NEOU�R[5 TME MttICANT FOR StKN PERMR TO FILE A SiONED W STATEMENT THAT ME OR SNE IS UCENSED M10.5t1AN7 TO TME PROYISIONS OF TME CONTMCTORS L� CENSE Uw(p1APTER�(COMMENCINO MnTH SECTION 7000)OF DMSiON l OF THE BUSINESS AND PRD- u- PooUSpa FEeS10N5CO0E)IX1IHATNEORSHEISE7lEMPTT7EREFROYANOTMEBASISFOHTHEILLLEGEDE%EMP• (�] 7qN.AN'IVIOlA710NOFSECT10N7Wf.68YAN'lMPLKM(TFOqAPEW.�Ii5U9.lECTSTMEAPVUCANTTO - z qe-q�} A CMl VENALTY OF NOT MORE 71UN FIVE HUNDRED OOLlARS(i5ao).): pI,ASbMMEROFTNE7ROPERTV.OHMVEY7L�VEESMnTHWAOESASTMEIHSOLECOM0EN5AT10N, O Cpmm0fC411 ' YALL 00 71�E YlORK M10 THE STRt1CiURE IS/qT INTEHDED OR OFFERED FOR SALE(SEG)ou,BU56 J NE55 A!D PNOFESSIONS LOOE:TNE CONTRACfOit3 UCEHSE LAW DOES NOT APVLY TO AN OWNER OF � PROPEHiI'1M1O BURDS OR MPfiOVES THEREON,AND M1i0 DOES StKHNORK NIMSELF OR MERSEIF OR 1NiC710MM�5ORMEflOWNEMPLOYEE9,VROViDEDTMATSUp1MPROVEMEMSARENOTMlTENDEDOfl m OiFERm FOR SALE IF.IIOWEYE0.7ME BU4D�NdOR1uPHOVEMENT 44 SOlO VAMN OI:EYFAR OFCOMPIE• 2 ��TqN,iHE O`NNERBURDER MItLL YNVE TF1E BUROEN OF iROVINO THAT ME OR SHE DID NOT BUItD O{1 = Y7HOVE FOR TNE MIRPOSE OF SALEI � OI�OWNEf70FiMCPROVEHTY.M�E%0.USNELYCONTIUCTINONTITILMfNSEDCONTMCTOR3 70 CONSTAIICi TME iflOJECf(SEG 70N,BUSINESS ANO VROFESSIONS GGJE:T}IE CONTMLTOfl3�I- V21118t1 ADJ.AREA CQJSE UW DOES NOTAPVLY TO AN OMRIER OF A OROCERTY MM1708UILOS OH W PROyES THEREOI�AND � wMocoHrw�crsronsva+vr�ersmnucartw�cronls���NseowRsuurtron�eca+rruc pU TY DESCRIPTION FEE � TORSUCENSEUWj. O I AM IXEMPT UIiIEN SEC. 8.�P.0 FOR TNiS REAS(Nl U � ¢ � �`=' DATE OWNER V - � UCENSEDCONTRACTORSOECLARATION -� � • • - � � ' 4 W , f7C IHEREBVAFF7WUNDEHPENALTVOFiE0.A1RYtHATIAMLICENSEDUNDERVROVISIONSOFCMAPTER Ly. � •�COMMENCINOW�TI�SECTIG170oolOfOM5lON70FTHE8USWE55ANDPROFE55lONSCO�E,AND Z W UCENSE l5 N FtAL F01iCE IND EFfECT. � ucer+sE cuss C{3 C51 h uc.No. ��` �� � �- V wtE � cor+rancron /t'�•�. �yG'�1 a W � ORKERS'COMPENSATION DEC � •� �j d I R�{ 4 � ' � N INERE9YAFFliWU1JDERVENACTYOFPEfWRYONEOFTHEFOILOWiN6DECUMTqNS: Q � �IWIVEANDWILLAUIMAMACEiRIFICATEOFCONSENTTOSELF-INSUREFORNORKERS' _ CONVENSATION.AS PHOV�OE�Bv 6ECTION 710o OF TNE UBOR CODE,FOqTHE PERFORAUNCE W OF 1NE WORI(iOR YNIK7/TMIS DERMIT IS ISSVED. � � _I NAVE MID WILL Y.VMAM K'OPo(ERS'CDAIPENSATION INSl1RANCE.AS REOUIRED BY SECTIqJ � �� �./� Q 97000FiHELA80f1000E.FORTHEiERFORMINGEOFTHEWOFKPoRYAi1CHTH15PERMRIS �/ ��� _5�f • ^_ _ � ISSUED.W�ERS'CdJYtPEN-SATION INSu CE CARRIf RANO VOLICY NUMDEH ARE: CONSTRUCTION � � yy�y�-_ Q CANRIER C.C��w[1 1 PLANHEVIEW � � vaicrrnn.+ec�7-� /��' 7 SS-0 ELECTRIC � � ��,k �9 0 Q (nassecnor�r�r+oieem.s�Fr�70Fnee�rsFar+a+E�oou�as6+�1��Ess1 PLUMBING 2 ICERTIFYTUTNTMEPERFORMANCEOFTHEMIORKFORWHICHiw50ERM1715�55UED,1 MECHANICAL (� SM�LL NOT EMGLOY ANV PERSON�N ANY YANNLH SOAS i0 8E001AE SUBJECTTO THE J U'�J (1 A")(1 f, � WOPoCERSCO�.IPEN$ATpNUWSOFC/�LIFORNIA,AND�GREETMATIFISNOl1LD8ECOAIE INSPECTIONFEE SUBIECT TO THE WORKERS'Cp.�VENSATION 7ROYi5pN5 OF SECTION�70o OF T1E UBOR � � cooEistuusamrmn�couv�vvnn+nasevaohsaNs. ISSUANCE �.��r �+' r,-,._, . 0 SMIP L��T! - - •�-- � .. ' - �--��-��` � . p OATE: APPLICANT: . , . , , . . . � ENERGY P/C WAANIt14;FAILUNE TO SECURE WORKERS'COMPENSATKKI COVERAGE IS UNUWFU4 ANO SMALLBE � SU&IECTIWEMPIOYEFTOCRIMINALPENALTIESMl�CMIFWESUPTOONEMUNOPEDTMOUSANO ENERGYPERMIT } DOl1Aii5(jtoo,oDo),INAOOITIONTO7HECOSiOFCOMPENSATqN,D�AGE5A5GRON0EDFORIN � /{� � SECTION]701 OF TNE UBOH OODE,INTEREST,ANDATTOPNEYS FEES. RETENTION FEE: o �u� OCONSTRUCTION LENDING AGENCY pR�-ALT� � INEREBYAFFINAUNOERVENALT70FVERNRYTHATMENE1511CONSTRUCTONIENDINtiAGENCY ' FORTMEPEHFORMANCEOFiMEWORKiORVMICNTHi5PER1AITI51S5UED�5EC.l097.C(V.C.�. �� � � LEFIDER'S NAME � LENDEf7SA0DRESS � ICERTIFYTFUTIIUVEREMiNISMPIICATI0NAN05T1iETUTTNEABOVENFOP11ATqNISCDRRECT. TOTAL FEES � . � � 1 A6REE TO COMPL�WIM ALL LITY AND COVNTY ORDVUNCES ANO STATE U�'�5 REIATIN6 TO BUILDINO � � CONSTRUCTION,MIDNENE9YAUTIK)RIZEHE RESENTATNESOFTHISCOUN7YTOENTERUPONTNE 1�^^ (\��Q���Q��� i. ABOVE�IA ED PROPERTY FOR INSPECT N PURPOSES. ,/� COMMENTS�-^r* ` '��r"`"-- �� L O n r�� �Il�' _ •C.. 4. m PE �TT 1 � a � N SIONANHEOF RMITTEE • � RECPT.NO. PAID BY VALIOATION VJHITE—Departrnen[Copy.YELLOW—Finanee Copy.PINK—Assessa Copy. OLDENROD—File Copy.GR N ieanYs Copy / �� . . .. ,4 . , . . . . ... , „ . ` �'`---�'' CITY OF DIAM�ND Bp►R `, ,,�,, \ . �. ..,, j � :�II�SPECTION RECORG► � �1�C-�:���;:�.�'�p�i'} !�.�...^,���� II►!��,-��.��' 1►'.�`�'rts�p�.�����{���.I'.�. �.:�►�E'��-1�c,'�1��l�-�+.�j SEfi BACY. ��� � � � FLOOR J015T ; TY � �� � "� � � FTGS/FORMS,'STEEL ' ' i FHA REQMTS ' ' ' _ ELECTRIC GROUN� UNDER FLOOR DUCT ; GRQUND PLUP�IBIAJG UNDER FLOOR CUP�IDUIT " '- ' � " iSLAB GRADE FIREPLACE F�UNDATION � �� � � � �TEMP P�WER � FIREPLACE BONb BEAM - - � ' '4'VATER SERVICE MID HT. BOND BEAh1�� - '. • ' 'ROOF:St-iEATHING • � 8 FT. BOND.BEAM � 'FRAMIP�u,NENTILIATION - ' • - ' ' ! ��INALBbNDBEAM � �ROOFCOVER � � � PRE-GRADING ROUCH HEATING' BENCHtNG". • � . .,;� � �ROUGH ELECTRIC � ROUGH GRADING . ROUGH PLUMBING FINISH GRADING SHOWER�TUB TEST POOL ELECTRIC E�T.IATH.JSIDING POOL FENCING � ' .WALL tNSUtATION POOL FINAL 'CEILiNG IfdSULATION OFF SITE IMPS. DRYWALC N�ILI�JG • DEDICATIONS SE�"�ER FINAL ENG. �SEPTICTANK LANDSCAPE/IRRIG. ( SEEP PIT/L.L. , >, �•! ON SITE IMPS. ' G.AS AIR TES7 ' FINAL ZONING F1NAL CONST. FIRE DEPT. FINAL F1NAL HEATIN� HEALTH DEPT. FINAL � FiiJAL ELECTRIC �,�..r� _ DEV. FEES PAID _ _ - F �i?•!At PLU�.181N� - ENERGY 1. .. I .f.f i �tfi2 ('(�� ....1 ,� ' ' _naY'._..��W.r.—.�,+:.x._- . ..._I. -- .. _ . . . . �. , . • �. . . . COtJi�,�E7JTS --.�� ;; , : - � ' , ' � . • , • � � � • .. . , � _ _ , . SEPTiC TAN4C SlZE ^ � �SEEP PIT/U SIZE � . �V� -n.l ,: ; ' � -. " 1 ,���� =:{� _� � . �.,�! � � ' . . . . ` i . . . . , , � :�..._..'. �._,'�...v...,...:.._ �,� ,' � '�`;.. ' ' ��. . } ` - ,