HomeMy WebLinkAbout12745 CITY OF DIAMOND BAR EXP�RED
DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES
~.: � ' 21660 E.Copley ihive Suite 190 NO V p 1 Zppp pRESS
(909)660-3195 Fax(909)661-3117
���•�'� BUII.DING PERMIT APPI�ICATION FIRMLY
y JOBSITE
o ADDRESS,� ��z,?z If'6D � APPLICATION�h ��PERMIT f 2��S P/C
'�L/4�� OATE L�6 3- NUMBER f r
� ISSUE t/J /� O TYPE OCC
APN LOT TRACT pATE 1 L-" O J�' L �CONST. GROUP
OWNER
ADDRESS2?.�2_J .d'/>„����Cl.-A.c-'� ZONING SETBACKS
CITY � ZIP TEL. FRONT RW ❑
APPLICANT TEL. REAR ❑
SIDElSIDE STREET RW ❑
� CON7RACT0 F O SIDE ❑
� ADDRE6S '��.,YO G.A/t�r/��Cr- �
CITY 7�f�/1.f.ib� 21P�_ TEL. ,�s-T/�� PROPOSED USE�E1��4i%4 //f'I�.�'�i�� Z-- .5��
� ARCFUENCi/ F-f'7'� � 1L d c�l c.t/i4G L�
DESIGNEfi NO.DWEL. NO. NO.
ADDRESS UNITS STORIES BEDROOMS
CITY ZIP TEL
N DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION
Q OWNER-BUILDER DECLARATION S�RlADDIREM
O 1 NEI�BY AFFlRM UNDEH PFNALTV OF PERIURY THAT I AIA E%EM7T FFOM THE OONfAACTORSII- G8fl99ICBfpOA
CFNSEIAWFOR7NEFOLLOWINOREASON�SEC.703f.eBU51NE59ANDPpOFESSIONSCODE:ANYCIiVOR (n
OOUMYYANCNREOUIRESAFERMITTOG�ONSTRUCT.lLTERIMGROVE,DEMOtASH,ORREPAli1M1YSTRUC- W Pgtb/DBCk
IURE,PRIOR 70 fT8 189UAHCE,AL90 REOUIRE9 7HE 11PPLICANf FOR SUCH PERAIIT TO FILE ASKiNEO W
BTATEMENT MhT XE OFi 9HE IB LICENSED RRiSUANT TO TFIE►HOVI810NS OF TME CONTMCTORS U•
CQiSE WN(CHMTER i�COMMENCMO WITH BECTION loao�OF pIVISIqV 9 OF TiE BUSMESS AND PAO- � FooVSpa
FESSIONS CODE)OR 1HAT XE OR SXE IS EXEMPT THEREFfi�7AI ANO T1E BASIS FOHil1E ALLEGEO EKEMP-
TqN.MlVVIOLATpNOFSECT10N7091.6BYANYMPLJCANfFORAPERMRSU&IECfShIEAPPLICAMTD Z Re-Hoot
� ACMLPEW�LiYOFNOTMORE711ANFNEXUNDRED�d1M31t60D1.1:
❑4���EFOFiHEPpOVERTY,ORMVEMOLOYEEBWITHWMiESASiHEIR30LECOMPENSA710N, COmTBrCi81
WILL CO 7HE MfD{tl�MID TNE STRUCTLRE IS NOT INTEN�6U GH OFFERE�FOR SALE(SEC.70��,BUSI- Q
y NE85 AH�PipFE6610N6 COOE:T11E CONTMCTOR6 UCENSE LAW DOES NOT MPLY TO AN OWNER OF �
PiqPEHiY N1F10 BULDS OF IMPROVES h1EREON,AND NhiO DOES SUCM YVDRK W MSELF DR NER9ELF OR
� TNi10U3HMI50RlEROWNEMPLOVEES,PROYIUEDiNAT5U071MPROVEMENTSARENOTINTEN�EDOR m
OFFERFD PDR SI�LE IF FqWEVER TME BULDWOOR WPHOVEMINf IS SOLD WfTHN ONE VF/IR OF COMPLE•
TqN,TNE OWNERAURDER WILL MAVE 7ME BUHDEN OF PqOYINO TH�7 HE OH SHE DID NOT 6UILD OR
MPROVE FOR THE PURVOSE OF!ME►
� ❑I,ASONMEROfTHEG1iDVERT!/ME](qL51VELYCONTRACTNJOYYITHLICENSEDCONTMCT011S
TO CONSTRUCT THE PROJECT�6EG 7041,BUSINE55 MA PROFESSIONS OO�E ME OONTN0.CTOR5 Lb V8I1701IOf1 ���L.7.O� ADJ.AqEA
CENSE UW OOES NOTMPLY TO AN OWNER OF A PPOPERTY WFIO BURDS OR MPROVES liiEREON,IlNO
VYFIOOONTMCTSFOqBUpiPROJECf6WITHA00HTMCTOR(6)LICEN6EDPURSUANTTOTHECONTM6 QUANTITY DESCRIPTION FEE
� TORS 110EN5E IAW.).
�1 AN IXEMPT UNDEH SEC. B.i P.C.FOR 7HI5 REASON �
U
� ¢
DATE OVMER U
� LICENSED CONTRACTORS DECLARATION �
i W
Q 1MEREBYAFFIAAUNDERPENALTYOFPERJURVIlIATIAMLICENSEDUNDEHP(iOVISIONSOFCM,NTER �
2[ •�CO4NENCNO WITH SECTqN 7000)OF DIVIS�ON 70F 7HE 9USINESSAND YFqFE5510N5 CODE,MO Z
X MY UCENSE IS M FLLL FOFCE AND EFFECT.
�u �
� uceNsecuss -� ��c.No. �d S�.�f �,,,,1
~ OA7E_,�J���_ coNrRAcrO a
WORKERS'COMPENSATION DECLARATION �
i�
� I NEREBYAFFIAM WDER PENAL7V OF PERIURV ONE OFTME FOLIDWING OECLARATIONS� Z
� _IHAVEANDWILLMAINTNNACERfIFIGATEOFCONSENiT08ELF-INSl1REFORNfORKEHS' _
CqAiEN51RI0N,A9 PROVIDEO BY 6EC71DN 87000FTNE LA90R CODE,iDR iHE PEHiUHMANCE
_ OF TNE WORK FOH WHlql iXIS iERMR 16155UE0. � .'��
1 iiAVE N1D WILL MA7fTAM WORKERS'OOMPENSA7WN M�1111ANCE,�5 REOVIRED BY SECTION
Q9700 OF THE LABOR CODE,FOH TFE PEHFOflMANCE OF 1HE WORK FOR YAi1CM THIS PEflMIT IS
� ISSUEO.MY WORKERS'COMPENSATqN INSUMNCE CARPoER M!0 POLICY NUMBER ARE: ONSTRUCTION ��O O
� GRRIER '� L' PLAW REVIEW ,
� ra�cr►iuMeEn�f��i��--p n � ELEC7RIC
0 (IIi56Ec�10NNE�NOTBEOpYPIEimOinEPEw.ai�POFlOMEIU�DRmOaI � (E1a)oRlE.55} PLUM81Nd
Z ICEiRIFYTHATINTIiEPERFORMANCEOFTIIEWORNFORWHICHTHISPERMITISISSUED.I MECHANICAL
(,� SHALLNOT EM7LOYANV PERSON W ANY YANNER 50 p5 TO BECdAE SUBJECT TO THE
(q YYORKERS'COM�ENSATIONIAWSOFCALIFOqNIA,ANDAOREETHATIFISHOULOBECOME INSPE FEE ���_
SUBJECTTO THE WORKERS'COMPENSATKK/PNOVISIONSOF SECTION 87a00F TNE UBOR
s cooE i sriuu Foa�niHnn�cor�r�v wini rrase raovisioris. SUANC � �O D
O OATF/�6��APPIICAFlP. f7`�G�.�zS-�1�-��i�'�L- SMIP (� /�n(�
� WARNINO:FARVRETOSECUREWORKENS'COMPENSATIDNCOVERAGEISUNIAWFLL,AN�9HALLBE ENERGYP/C �,E� D / ��1MtS
�y SU0.IECTAN EMPLOVEH TO CRIMINAL PENILLTES AND CIVIL FINE6 UP TOONE HUNDREDTFiOUSAND ENERGY PERMiT
DOLIJViS(i10D.000).MIAD�I710N TOTHE COSTOF COMPENSATION,DAMAOES AS PROVIDEO FOR IN r��.(
� SECIK7N970DOF7HELABORCODE.MTEREST,AfiD�TTOFWEY'$FEES. (j�7ENTIONFEE: CITYOFD1C11r1
O CONSTRUCTION LENDING AGENCY PRE-ALT FEE: BUILDING AND S
g1 YIEREBYAFFlRM UNDEH PENALN OF PERJURV TTIAT THERE IS A CONSTHUCTION LENDING AGENCY
Z FOR 711E PERFORMANGE OFTHE YlORK FOR WMldi TNIS iERMIi IS ISSUED(SEC.�Oi7,CIV.C.�.
W
� LENDER'S NPME
� LENDER'SAODRESS
� �CERTIFYTHATI.NAVEREMTOSAPPLICATIONANDSTATE•hNTTiE�ABOVEINFORMAT10NI8CORHECf.'R TOTAL FEES o � D
� I�GREE TO COMPLY Wf�M ALL CIfYAND COUNTY DRDAVANCESAND STATE LAWS FEUTWO TO EU4DIN0
CONS7qUCTION,ANDHEREBYAUfFiOH1IERE7RE5EN7A71VE50F7HI5COUNttTOENTERIIPONTHE '
5�.. ABpVEMETfTqNED PpOPERTY PoR INSPECTId4 PURVOSES. _ ' � -• 'COMMENTS�• � � I
� ...1"7�/J.�
�
QPERMITTEE W1ME(PRI '
cn �- _/�..1_�z�. 5' �'
� TiEC"" - �ATE
� RECPT.NO. PAID 8Y ' VAUDATION
WHI7E-DepertmeM Copy,YELLOW-Finence Copy,PINK-Assessor Copy,OOIDENROD-flle Copy,GREEN-ApplirsnYs Capy
, - . � .�. , - �. � . , '� . . . . __ , l.. ,. . , . ' � � . •• � �� • .. ' ' ��I'�' . � � , ,
�� ��`` � ��' CITY OF DIAN60ND BAR
�:
I . ��., IIr�SPECTi01� REC�RD
:, . ,
. � ,�, � , . � . . � , � . � .
SET BACK .,-.; ' 't , - �� ! FLOOR J015T. .
FTGS/F�RMS/STEEL . � ,, � FHA RECIMTS �
ELECTRIC GROUND + ` UNDER FLOOR DUCT
GROUND PLUMBING UNDER FLOOR CUM1IDUIT
SLAB GRADE FIREPLACE FOUNDATION
TEMP POWEFi FIREPLACE BOND BEAM �
WATER SERVICE MID HT. BOND BEAM - � � •
RO�F SHERTNfNG - 8 FT. 80ND BEAM `
FRAMINGNENTlLIATION FINAL BOM11D BEAM
ROOF COVER PRE-GRADING
ROUGH HEATING BENCHING
ROUGH ELECTRIC ROUGH GRADING
R�UGH PLUMBiNG FINISH GRADING
SFlOWERITUB TEST POOL EI.ECTRIC
EXT.LATHISIDING POOL FENCING
WALL INSULATION POO�FINAL
CEILI�IG lNSULATION OFF SITE IMPS.
ORYWALL NAILING DEDICATIONS
SEWER � FINAL ENG.
SEPTIC TANK LANDSCAPE!lRRiG.
SEEP PIT/LL. � • ON SlTE IMPS. �
GAS A!R TEST FINAL ZONING ,
FINAL CONST. FIRE DEPT. FINAL
FINA�HEATING HEALTN DEPT. FINAL __�
FINAL ELECTRIC DEV. FEES PAID
FINAL PLUMBING ENERGY �
� � �
COI�IMENTS �
_
.. , ,
,`
�'�'���"' --- --
; , . .
`�!-'.�s `,'•. (i ���'��. � v
SEPTIC TANI4f.i,�H.1�'' ��4.'+r;..' a,:` �? ; ..
SEEP PiT/U S(��`=;:.� .:f�.. .', . ,,; �_..
�' ----- ------- --------------------- --�-
,,i, �
� '
,y �-L l-�/ �a�ar __.__��- a'O
� � -4l--T.l �ro rl -rr �r--b� r� , - _
�o r, i!�7 3�Y7 a� . �-�_.�
. - . , . � � Z'f�'d�iv .4� Q�!,}�1-�'�°��